I have recently written about the great #hellomynameis campaign. About doctors introducing themselves. I raised the issue of the choice we have when we introduce ourselves, from very formal all the way to the diminutive forms of our names. But there is the other side of the introduction problem. Who am I for you, doctor? What do you call me?

A few years ago I was waiting to see a consultant in a local hospital, as an elderly woman sitting next me was approached by a nurse and asked to follow him. There would have been nothing particular about it, except that the nurse used the woman’s first name. The nurse was polite, smiling, friendly, and I have no direct evidence as to how the patient felt about it, yet, I was pretty certain she didn’t like the way she had been approached. There was a flinch…. But I might be wrong.

What I didn’t like about the scene was that a man, by the look of it, 30-40 years the woman’s junior simply called her by her first name. I don’t know whether it is my Polish (fairly traditional) upbringing and not getting in touch with the British culture, the first name struck a false chord.

As I was writing it, I was reminded of a fragment from Dr Tomlinson’s blog. He writes:

“Fatima!” Dr Brown cheerfully called her next patient in by her first name. Fatima stood up, obviously in discomfort, but greeted her GP with reciprocal warmth, and they walked down the corridor side by side.

It’s basically the same kind of scene, yet, Dr Tomlinson sees calling the patient by her first name positively in terms of warmth. Moreover, the patient responded in kind.

OK. Time for some theory. Terms of address are not ‘innocent’. Ever since Brown and Gilman (1), they have been thought of in terms of power and solidarity. And so, the more ‘professorially’ I am addressed, the more power is rendered through it. The more ‘Darekness’ is emphasised, the more solidarity is claimed. In his blog Dr Tomlinson pays attention to the solidarity dimension of the first name address.

But there is another important aspect of terms of address: symmetry. Teachers call their pupils by their first names and it is not (at least not primarily) for solidarity. Primarily, it is to show the asymmetry of the relationship.  When pupils respond with “Mr/Miss”, the asymmetry underscores the power imbalance between them. And here is the question: can Fatima call Dr Brown by her first name? Can Fatima say something like: “Hello, Jane.”? I suspect the answer is affirmative, but does she know? Well, I didn’t.

My GP has always called me Dariusz. I suspect this is to a considerable extent an expression of solidarity. And yet, what do I call him? Funnily enough, for years I wondered. I quite disliked being called by my first name at my age without the obvious social sanction to call him by his first name. Until recently, when I started. I don’t think he liked it very much, but said nothing, pretending not to hear it. After all, the moment he’ll ask me not to call me that, I will reciprocate and demand that he call me professor. I imagine he realises it.

Power in medical settings moves in mysterious ways. Terms of address is one of them. They are never innocent, they should always be given some thought and reflection. Particularly to this point: the more you want to show me solidarity, the more you must ask yourself the question whether you would be prepared for me to reciprocate. Not only that – you must also ask yourself whether I know you would be prepared for my reciprocation. For just because you use my first name doesn’t mean at all that I know I can use yours.  If not, you’re just taking liberties and stress the asymmetry between us. And if so, I prefer that you construct our relationship in terms of power. Both yours and mine.

Reference.

Brown, R. and A. Gilman. 1972. The pronouns of power and solidarity. In P.P. Giglioli (ed.). Language and Social Context. Harmondsworth: Penguin. 256-82 [first published in: T.A. Sebeok (ed.) Style in Language, Cambridge, Mass.: MIT Press. 1960, 253‑77.]