Call people by their rightful name. It matters more than you think.

There are several Tumblr sites where people submit their actual name and compare it to the name the Starbucks employee writes on the cup.  There’s “Starbucks Name Fail,” “The Starbucks Name Game,” “Starbucks Can’t Spell My Name,” and “That’s Not My Name, Starbucks.”

There aren’t Tumblr sites for calling out Starbucks when they biff your drink.  “Starbucks F***** Up My Drink,” “Would You Just Look at This Beverage,” and “There’s No Foam on My Latte AGAIN,” are nowhere to be found.  It is unclear if people are going to Starbucks to pay six dollars for coffee or fifteen seconds of personal recognition.

In the first fifteen minutes of my emergency medicine rotation, I met the formidable director of emergency services, a person known for many things, mincing words not among them.   The first thing he said to us is, “You are not ever to refer to your patients by cute nicknames.  They are not your honey.  They are not your sweetie.  They are not your dear.  They are adults, and you will call them sir, ma’am, Mr., Mrs., Ms. or Doctor, followed by their last name.”

Two years later, I’m on call for inpatient oncology, dealing with a parent who is screaming at the top of his lungs.  His concern is not his child’s chemotherapy toxicity syndrome, but that we cannot discharge his child home.  In the middle of his rant, he yells, “I bet none of you even know my kid’s name!”

Three years later, I’m seeing Mr. Lastname, a man recently diagnosed with seizures.  In keeping with the teachings of Dr. Formidable Emergency Services Director, I referred to him as Mr. Lastname, as his chart didn’t indicate otherwise.  As I’m reviewing his treatment with him, I ask if his work has been affected by the diagnosis, and he said, “I’m not working.  I was reported to the state medical board, and now I can’t operate because of my epilepsy.”  I don’t remember his actual last name, but I vividly recall his look of humiliation as he said this — as though I, not the epilepsy, had stripped him of his physicianhood.  I apologized and pointedly called him Dr. Lastname for the remainder of our discussion.  I have since had plenty of opportunities to feel similarly when I witness female physicians referred to by their first names and our male colleagues referred to by their last name and the honorific of “Doctor.”

This certainly doesn’t happen only to physicians.  Not being a nurse myself, I always wonder at how they put up with having people bellow “Nurse!” after them, despite introducing themselves … and wearing a name tag.  I want to ask them, who do you think will be first on the scene when you have a problem — or worse, if you need resuscitation?  That’s right — your nurse.  I suggest taking the time to learn their name.

Now that I’ve practiced for a decade primarily seeing newborns and children, I’ve had many conversations with parents in which I have to convey the news that their child is dying.  If there is one fear common among many of these parents, it is that their child will not have lived long enough to have made an impression on anyone outside the family.  This is a particular fear among NICU parents of moribund newborns.  I try to always call the baby by their name with the intent of indicating to their parents that their newborn’s existence matters, no matter how brief that existence may be.

The removal of a name is an act of depersonalization.  The Oxford English Dictionary defines depersonalization as “the action of divesting someone or something of human characteristics or individuality.”  It is used to train soldiers and punish prisoners, in both cases with the goal of breaking down the person by distorting their sense of self.

Depersonalization does not have a place in health care, but we give it one when we fail to call a person by their rightful name.  Knowingly calling a doctor “Mr.” or “Ms.” is an implicit invalidation of their training, particularly when it is pointedly directed at minority or female physicians.  Not calling a nurse by their name reduces them to a job, not a person.  For our teenaged and adult patients, when diminutives are used as a substitute for someone’s name, we have both depersonalized and infantilized them, effectively removing them from the decision hierarchy of their own medical care.  For the dying infant or child, never referring to them by name affirms the parent’s fear that their child will never have impact beyond the boundaries of the family.

This is a big problem with a little fix — the next time you see a patient, check the chart and recognize them by using their appropriate name and salutation.  And maybe consider wearing your nametag to Starbucks.

M. J. Harbert is a pediatric neurologist.

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