An electrolarynx, akin to a megaphone or Mr.
Microphone, only it is held to a blowhole in the throat after the larynx has been removed due to diseases like Cancer. The resulting "voice" is very buzzy, throaty, and monotone - but
it's all you got at that point. What's sadder is that a lot of the people in this situation smoked a truckload of
cigarettes along the way, and they usually look somewhat "weathered", "leathery", or "rugged" to add a visual scare with the auditory one.