Laryngitis, forgetting words to the music and maintaining stage sizzle throughout multiple services are some of the worries that precede the High Holy Days for cantors.

The holidays, they say, are like a debut performance — every year.

No amount of preparation can assuage pre-performance jitters. Even the most prepared, like Broadway actors, wait for the other shoe to fall in the countdown before showtime.

After weeks of rehearsing last year and a Rosh Hashanah appearance, the final curtain call for cantorial soloist Todd Silverstein never came. The singer for Tiburon's Congregation Kol Shofar was rushed into surgery just two days before Yom Kippur with acute apendicitis.

Silverstein called Kol Shofar's Rabbi Lavey Derby after his surgery to break the news — he wouldn't be coming for Yom Kippur.

"I truly felt this enormous sense of panic," said Derby. "So much of our [holiday] service depends on the spiritual and aesthetic beauty that our cantor brings.

"As the initial panic subsided, I realized we had to do something. We turned to the congregation," whose members help lead services during the rest of the year, the Conservative rabbi said.

Kol Shofar's ordeal is the stuff of nightmares for many Bay Area cantors now finessing their repertoire for holiday services.

"As much preparation as you can do, you never really feel fully prepared," said Cantor Ilene Keyes of the Reform Temple Sinai in Oakland.

"You can have the whole year and it's not enough," she said. "That's because you always feel humble standing [on the bimah]. You feel small next to the awesomeness of the moment."

Keyes begins to prepare for the High Holy Days in the spring, when hiring a professional choir and contracting a cellist. During the summer, she plans her repertoire as well as those of the professional and volunteer choirs.

Much of High Holy Days music is unique to the service and thus remains the same year after year. But Keyes selects fresh pieces for what she calls sermon anthems.

Those pieces can be pre-service prayers that prepare people for more intensive davening, or tie in with the theme of the rabbi's sermon.

This year, she posted her rabbi's sermon ideas on the Internet and got back 30 recommendations from cantors all over the country for complimentary music.

Cantor Roslyn Barak of the Reform Congregation Emanu-El in San Francisco also prepares early in the year. She contracts musicians and a choir, meets with rabbis, selects old musical favorites and hires composers to draft new pieces.

This year, she spent the months preceding the holidays on a spiritual sabbatical in Israel.

With the logistical preparation for the High Holy Days completed before she left, Barak focused her time in Israel on fueling her spiritual reserves.

"Praying in Israel's traditional synagogues makes me pay attention to things that I don't pay attention to [while singing]. Parts of the liturgy come alive," Barak said.

The work of cantoring is very spiritual for her personally, even during the stressful High Holy Days. "This year, more things will catch my eye and touch my heart," she said.

Barak says her role is to be a shaliach tzibor (messenger for prayer) and to pray for those who for whatever reason cannot, and to help congregants feel a connection to God.

"It's a very powerful thing, music. To convey the words of prayer through melody is another channel to God. But it's quicker. It has wings."

Because High Holy Day music was written with a special liturgy in mind, it is especially majestic. With its motifs of repeating notes, it reminds the congregant that this is the time for serious introspection and repentance.

"The words are powerful and the composers have gone to extra trouble. It's not just have-a-nice-day-God music. We shouldn't be listening to tunes from the campfire," Barak said.

Cantor Martin Feldman of the Reform Congregation Sherith Israel in San Francisco doesn't have to gear up for the holidays. "I'm spiritually charged all the time," he said.

Nevertheless, Feldman gets a thrill from greeting some congregants who he hasn't seen for a year. He looks out over the sea of faces on Rosh Hashanah and Yom Kippur to recognize new parents, former b'nai mitzvah students and recent widows and widowers, and says he feels blessed to have been a part of their life passages.

"We're here to be inscribed for another year of life when so many have passed away. Life is a mixed bag," he said. "We try to lean on something and hope there is light at the end."

The cantor, who's spent the last 39 years at Sherith Israel, said the music of the High Holy Days has the power to evoke memories from childhood, of parents and grandparents. "That's one of the reasons people come. When you hear the Kol Nidre, it links you to your roots. It bridges the gap of generations in a unifying force."

Cantor Stephen Richards of the Conservative Congregation B'nai Tikvah in Walnut Creek alternates his preparation time between choir rehearsals and composing new music.

"I also like to take traditional music and put it in a new setting, kind of like old wine in new bottles," said Richards, who is a classically trained composer and conductor.

"I give [musical stand-bys] a fresh sound with a slightly different rhythm, harmony or instrumental," which, he said, delights those who recognize the squeeze-play on old favorites.

After nearly 30 years in the field, Richards said he doesn't fret as much about the High Holy Days as he used to. But he does worry that his voice will give out during the lengthy services.

"Every cantor worries about it. Two weeks ago, I was in the middle of a wedding and laryngitis set in…You wonder whether the voice is ever going to come back again."

The Walnut Creek cantor preserves his yodel by eating lightly before services and keeping himself healthy.

Of course, no health supplements could have helped Kol Shofar's Silverstein, when he faced emergency surgery. The appendectomy survivor will make a comeback this year at both Rosh Hashanah and Yom Kippur services in Tiburon.

True to his grass-roots style, Silverstein, whose full-time job is teaching college chemistry, keeps his preparation simple. For a month, he listens repeatedly to three albums of High Holy Day music, reads a machzor (a High Holy Days prayerbook) and thinks back on the performances of his childhood cantor from New York.

"He was a little Orthodox man with a tall yarmulke, but he really swung and moved around. He had really powerful melodies," many of which Silverstein has been singing at Kol Shofar's holiday services since the early 1980s.

For his own performance, he keeps to a fast-paced clip for most prayers until reaching the more soulful pieces that elicit the congregation to sing along.

"I am not dragging the kahal [congregation] with me. It's an equal thing. We get energy from each other, back and forth."

Though he never attended cantorial school, Silverstein said as long as the congregation keeps asking for him, the former Berkeley resident will fly down from Oregon every year to sing.

This Yom Kippur, he will be making up for last year's disappearing act — "I felt bad," he said.

But the appendectomy made him realize how integral he had become to Kol Shofar's High Holy Days.

"I got a lot of cards," Silverstein noted. "They had missed me."