How the brain transforms thought into speech: Dr. Eddie Chang reveals neural circuits controlling the larynx, vocal folds, and articulators, plus breakthrough brain-machine interfaces that decode paralyzed patients' speech directly from brain activity—including the BRAVO trial's first patient who spoke again after 15 years of locked-in silence. Speech and language are distinct: speech is the motor production of sound via the larynx and vocal tract, while language encompasses meaning, grammar, and pragmatics processed by different brain regions.