Volume 20.4 
Oct 2004

What's in a name?

 It can make all the difference to be called by your first name, so why don.t medical staff do it more often, wonders Frank King in a view from the other end of the stethoscope

Some years ago I retired and moved house. I had lived with my wife and family close to the small village of Poynton in a very pleasant part of rural Cheshire. We had been there for the best part of twenty years and during that time had developed close and friendly relationships with all those with whom we came into contact from day to day. We especially valued the relationship which we had with our GPs and surgery staff as they helped us through the usual medical hiccups which beset us all. We were on first-name terms with pretty near everyone in the village, but that's how it was round there, though maybe we took it all for granted.

All this was highlighted for me when my mother had to go into a nursing home. She was blind and ailing at the age of 80 years but still as bright as a button within the limitations imposed by her condition. During WW2 she had been a nurse and was awarded British Red Cross medals for her achievements. In later life she worked hard to support her local church. Looking back she was probably the kindest, calmest and most generous person I've ever met and she must have been an excellent nurse. Her experiences with those she met must have been similar to those which we enjoyed because everyone called her by her first name - Annie.

By the time Annie had reached the age of about 78 just about all her friends had died. At home, her medical condition isolated her more than somewhat and eventually she went into a nursing home. Nursing staff were very supportive but it struck me one day that everyone was calling her 'Mrs King'. I was saddened by this as I realised that in her final few months on this earth she may never again be addressed as 'Annie'.

I never spoke to her about this, though I often wondered how much she missed hearing her first name. I wondered if the isolation imposed by her condition was made the more acute because seemingly she had lost a vital part of her identity.

Those thoughts were with me when my wife and I retired to a small bungalow in Wales. We applied to a local medical practice and were accepted as patients. I must add that as it turned out we were so very fortunate in our choice, the treatment which we were to receive during the next few years was quite exceptional. However, there was one problem. We found that we were unable to knock down that little barrier which would place us on first name terms with those at the surgery. I even asked one of the nurses if I could use her first name but she told me that it was 'better' if we stuck to surnames. All this must seem so trivial to some readers, but then life itself is perhaps just a series of trivialities.

I thought a lot about this. I tried to see it all from another angle, but made little progress. Then a remark made by a friend who had been a captain of industry helped me put a different slant on the matter. He was talking to me about employer/employee relationships and the matter came up of how best to address staff. My friend made the point that first names may be fine for most of the time but if a boss had to tell 'Joe Bloggs' that his services were no longer required it would be much easier to tell this to a 'Mr Bloggs' rather than to 'Joe'. It brought home to me that first names could occasionally be barriers in themselves which could make a tense situation even more difficult!

Perhaps those at the surgery were right after all. In similar vein it must be a lot easier to tell this same 'Mr Bloggs' that he has galloping body rot (you will gather that my medical training never went further than a badge in Wolf Cubs) and that he will be lucky if he sees another day; perhaps it's much harder to tell all this to 'Joe' - or for the patient, as 'Joe', to make appropriate responses.

The business does not end there however. It's now many years since we moved to Wales during which my wife and I have been involved with the practice through some difficult times. My wife's illness became quite debilitating but at this critical time surgery staff seemed to know instinctively that it might be reassuring for her if they used her first name.

Sadly she died recently but during the last few years of her illness she was comforted no end by the friendly 'Hello Joyce' which she always received from our friends at the surgery. No matter how poorly she felt when she went in to see the GP she always came out of there confident and smiling.

For myself, I have been working with local medical staff at my own and other surgeries on a matter which affects us all - the decimation of GP dispensing services by what I consider to be the abuse in Wales of the NHS (Pharmaceutical Regulations) Act 1992. The very intensity of it all has inevitably swept aside much of the formality and I have become 'Frank' again. Now that's much better! I have my identity back, at long last I'm back to being 'me'.

There's only one problem which could arise. If ever my GP reverts and greets me with, 'Ah! Good morning Mr King, take a seat please', I will know he's probably about to tell me that I've got galloping body rot and that I would be well advised to get a few estimates from local undertakers.

It's tough at this end of the stethoscope!