What's In A Name?

"A rose by any other name would smell as sweet." So said Shakespeare's Juliet. In his play, Juliet advocated that the names we use don't matter. Rather, it's the reality of the thing that is important.

I wonder, though. Is it true? Does it truly not matter what names we use for each other? It seems to me that there is great importance to not only the names themselves, but how we use them.

At Western University of Health Sciences, there seem to be three primary ways by which others refer to me. The first, apparently only permitted to those with the designation "doctor", may call me by my first name, Jarrod. This familiar use is somehow off limits to students, administrative assistants and most others.

I'm very fond of calling other doctors by their first names. There's something I enjoy about being so familiar with my physician colleagues. It makes a statement that indicates a certain equality. This more casual reference somehow creates a warm, friendly environment that, when used by other physicians, makes me instantly more fond of them.

The second, Dr. Shapiro, is for everyone else besides those at my "level" (students, assistants, patients, and anyone else unfamiliar with me). Interestingly, I don't personally care what my assistants and even patients call me. At Chino Valley Medical Center, where my residency program is based, I'm strictly called Dr. Shapiro, and referring to me as anything but Dr. Shapiro is completely off limits. The head of human resources at the hospital, with whom I work very closely, and is an absolutely lovely woman, simply refuses to call me Jarrod, arguing that I deserve to be referred to with respect (i.e. Dr. Shapiro) after my many years of training.

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The third is simply to call me Shapiro. I don't generally have a problem with the first two designations, but this one really gets under my skin. I'm not completely certain why except from experience. During my training, residents referred to attendings by last name – when they weren't present, of course – when indicating a level of disrespect. I'm very quick to firmly correct any of my students that refer to their attendings without the "doctor" prefix. However, some of my partners refer to each other by last name when in each other's presence, and I'm certain they're not trying to be disrespectful. The last name designation is just too muddy for my comfort.

Let me say that these name patterns are by no means created or maintained by me. In fact, I make it a habit to introduce myself with my full name, omitting the "doctor" part unless I'm deliberately trying to create a sense of authority. I was born with Jarrod, think of myself as Jarrod, and will die with that name. Contrary to Juliet's comments above, I associate my identity with my first name, and I'm OK with others using it. Perhaps I'm simply a more casual person with less need to establish social boundaries.

That's what all this is for, isn't it? Creation of boundaries? Doctors are considered the top of the medical hierarchy, whether we deserve it or not. We – that is, society – create and enforce these designations. They provide clarity of social communication, allowing us a safe set of rules to follow.

I experienced the discomfort of boundary breaches recently during one of my class lectures. During the lecture, I called on one of the students who – unbeknownst to me – started using a different name. Of course, there was a very pregnant pause until they realized I was speaking to them. After they corrected me, I was pretty embarrassed. What happened? Those easy social interactions, controlled by names, had fallen apart, leaving me hanging in the social wind.

The ironic part about this – in fact about this entire conversation – is I'm horrible at remembering names. When I first meet a person, I have to remind myself of his name 1000 times, and I'm still going to forget it. I can remember faces well, but names? Not a chance.

What's in a name? So much. Would a rose by another name smell as sweet? Maybe, but no one would know that I'm talking about a flower. Names have both a place and a power over the human experience. Think about the significance of names at your organization. Do they smooth the social mores or are they a trap for the unwary. Consider carefully. If we meet in the future, will I be Dr. Shapiro or Jarrod? I'll let you decide.

Best wishes,

Jarrod Shapiro, DPM
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