Janet Farrell Leontiou, Ph.D.
I have spent several years thinking about patient-doctor communication–mostly within hospitals. In my attempt to understand the patient-doctor relationship, I grew curious about the etymology of both the words “patient” and “doctor” as well the word “hospital.” Of course, my use of the word “trinity” suggests divinity and the association may be as farflug as it seems. I have collected words over the years that have a religious association revealed through the words etymology. For instance, the word contemplation in its Latin origins means to look for a holy place on which to build a temple. The word’s origin tells us that thinking is a holy act.
Many words are ambiguous because they have the element of choice built in.
To label a person consumer, patient, or user makes a difference because they offer different ways of seeing. Not much is revealed to us when we use words or think of words as tools1 because then we think of them as a means to an end and strip words of generating meaning. Speaking of words as tools is metaphor. A metaphor is not just a figure of speech but also a figure of thought that take our thinking to new places.
The ancient Greek rhetoricians understood the power of words. We have forgotten that words are forms of symbolic action. We are creating a symbolic world through our words and it is within this world that the speaker and the listener reside. We are seduced into keeping the power of words hidden. The veil remains closed when we say things like “those are just words.” Communication, instead, comes from the ancient idea of “commonness.”2 Words create a common place between us; it is the shared space between.
How medical students are presented with the trinity will shape how they see themselves, the other engaged in their care, and the place in which these two people meet.
The Patient
The word “patient” offers three choices: to be able to accept or tolerate delays, a person receiving medical treatment, or one who is acted upon. The patient is someone who waits, receives, or is the object of other’s actions. The etymology of the word “patient,” instead, connects it with suffering, passion, and pathos. The etymology takes us into the realm of the existential defining quality of what makes us human. The denotations, nor the personal connotations, will not invite us into this relationship. Using the word and thinking only of its denotation will keep the patient at arm’s length. Giving freely to the sufferer, expecting nothing for oneself, will always result in the giver receiving more than imagined.
1. Language is not a tool or an instrument.This point made clear by philosophers like Gadamer, Heidegger, Arendt and Merleau-Ponty. See Ponty, Signs (Evanston, IL: Northwestern University Press, 1964), 62.
2. The Greek word for this idea is koinon meaning common to all.
The Doctor
The word “doctor” offers four choices: a qualified practitioner of medicine, someone who holds a doctorate, to falsify a document, or treat someone medically. Denotation shows that a doctor is one who practices medicine, has a higher education, or refers to something deceitful. The etymology reveals that the word is Latin and it means to teach. The purpose of academicians and physicians is the same–to teach. The education one receives is meant to be shared with those who address us as “doctor.” I can think of no better preparation for a conversation on informed consent than the doctor embracing the role as teacher.
The Hospital
The word “hospital” means either a charitable institution or an institution where the sick are given medical care. The word offers two ways of seeing healthcare: the Greek model of the practitioner as craftsmen or a way to make a good living as opposed to the religious model of caring for the sick as a duty of charity. The denotation provides two paths: medicine as business or medicine as altruism.3 The word “hospital” comes from the Latin word “host”: meaning either receiver of guests, receiver of enemies, or the eucharist. These three meanings tells us that the person suffering before you may be seen in a hospitable, hostile, or godly manner. We have a choice and the choice has consequences.
Conclusion
In the end, the world we create is the product of the choices we make. As a physician, I can see my patients as the workload to be managed by a doctor who is superior. Alternatively, the patient may be seen as manifesting the suffering that is central to human existence. As a physician, I am able to show the patient how to walk the path of suffering. Despite all the constraints of healthcare, it really does come down to how we see the trinity of these three, related words. All of these meanings are fully present within the words. We need to choose the one that we wish to create.