How Living With CF Has Made Me a Better Opera Singer

I have always been a singer. I have also always had cystic fibrosis. Together, these two distinct aspects of my life have led me down a unique path and allowed me to grow in ways I never could have anticipated.

| 6 min read
Elaine K. Malik

I've always been a singer. In fact, many of my earliest childhood memories involve singing, being backstage at the theatre, or holding someone's hand while following the flash of glow tape on the floor.

But, I've also always had CF. My other earliest childhood memories involve doctor's offices or watching my mom stir my enzymes into a tiny bowl of yogurt. I was diagnosed in 1982 at the age of 2 and a half after a two-year search for the cause of my “failure to thrive.”

These two aspects of my life have intertwined and led me down a path that nobody could have foreseen.

Today, I'm in my tenth season singing with a professional opera company in Tacoma, Wash. I made my solo debut with the company in 2013 and am currently singing the role of Olga Kromov in Franz Lehár's comic operetta, The Merry Widow (plus, I'm working behind the scenes as the choreographer). When all's said and done, I've sung in about two dozen operas, soloed at churches in Europe and Asia, and performed in too many concerts to count.

Although many of my professional colleagues still don't know about my CF diagnosis, it is public enough to the point that I'm increasingly being asked, “How are you able to sing opera when you have CF?”

At first, I wasn't quite sure how to answer that question. I've never known life without CF, so I have no frame of reference for what singing would be like otherwise. Asking me how I'm able to sing with CF is like asking a sea turtle how they're able to swim so far with that huge shell on their back … they would probably look at you cockeyed and say, “Why would it stop me? I was made to swim, and this is part of who I am.”

So, I had to flip the question on its head in order for it to really make sense to me: “How has living with CF made me a better opera singer?"

  1. Breath awareness
    Classical singers work constantly on their breathing technique. Common vocal exercises focus on establishing a solid base of breath support to ensure a steady stream of air, learning to sing progressively longer phrases without interruption. This foundation is what every other aspect of singing depends on -- pitch accuracy, agility, and dynamic flexibility (the ability to fluidly move between soft and loud sounds).
    I started taking voice lessons in eighth grade and, as a freshman in high school, won our district solo voice competition and went on to compete at the state level. I was flummoxed by the win and thought it was a fluke. How could I possibly have measured up to all those other people who seemed to sing long phrases so effortlessly?
    But, what I didn't realize at the time was that my focus on that one fundamental thing -- breath support -- was giving me a solid base of body awareness and knowledge, allowing me to improve those other parts of my vocal technique.
    Backstage getting ready for my first operetta, HMS Pinafore for the Seattle Gilbert and Sullivan Society’s 50th anniversary season, 2004.
    My lung function is now only 60 percent of what it was back then. Yet, precisely because of the fundamental work I've done on my breath support over the years, I'm still able to sing on an operatic stage. Plus, as my lung function has gradually fallen over time, singing has become an “early warning system” that keeps me aware of changes in my lungs so I can catch exacerbations before they really take hold.
  2. Mental toughness
    With never-ending auditions, ceaseless rejections, and demanding rehearsal and performance schedules, the life of a singer is not for the faint of heart. Singing professionally can be demoralizing at times, and you have to learn from mistakes and then let them go -- acknowledging that you are valuable as an artist, even when it feels like the world around you doesn't see it.
    It takes a level of persistence and tenacity I've experienced in only a few other areas of my life … like managing CF.
    Even when you're healthy, living successfully with this disease takes organizing your life to the hilt so that you have enough time for treatments and doctor's appointments, calling insurance companies, exercising, cooking healthy meals, and then doing more treatments. When you get sick in spite of all that hard work, it can make you want to throw up your hands and say, “Why try?”
    Whether you are managing CF or singing opera, it takes tenacity and determination to simply keep going.

    There's a time to curl up in a ball and let yourself cry over your frustrations … a time to give yourself the space to heal and maybe even reassess your strategy and priorities. But, at the end of the day, you have to stick with it and keep going. It's the only option, really, because what's the alternative?

  3. The human connection
    When I was born, the average life expectancy for those with CF was the mid-to-late teens. Nobody back then would have expected me to live this long, much less be singing opera.
    This success is due in no small part to my CF care team who eagerly and creatively works with me to find ways to tailor my treatment regimen to my unique lifestyle, and to the countless people who have supported me in my lifetime -- who I lovingly dub the “cast of thousands” in the big picture epic of my life.
    With this sense of gratitude always in the back of my mind, making music becomes a joyful celebration of these gifts I have been given. And an audience can pick up on that, even if they don't know why.
    When I put all of that together, I can't help but wonder if my successes thus far have come not in spite of CF, but because of it. What would you decide to do with each day, each breath, if you weren't sure how many you had? Because that's not just true for me; it's true for everyone.

This site contains general information about cystic fibrosis, as well as personal insight from the CF community. Opinions and experiences shared by members of our community, including but not limited to people with CF and their families, belong solely to the blog post author and do not represent those of the Cystic Fibrosis Foundation, unless explicitly stated. In addition, the site is not intended as a substitute for treatment advice from a medical professional. Consult your doctor before making any changes to your treatment.

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An opera singer, choreographer, voice actor, and freelance writer based in Seattle, Katie's travels have taken her around the country and the globe. She has been on solo tours in Europe and Asia, and on multiple trips to Sweden -- where her inspirational story captured the country's heart on the top-rated, international, Emmy-winning TV series, Allt för Sverige. Also a registered yoga teacher, Katie created a video series for in collaboration with the Cystic Fibrosis Trust, “Yoga for Cystic Fibrosis.” She holds a BA in vocal performance and music theory from Seattle Pacific University, where she received the Philip J. Mack music scholarship and graduated magna cum laude. You can connect with Katie on FacebookInstagramTwitter, and LinkedIn, or visit her website,

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