Titles, Distance and Power

As I have worked my way into a whole set of new relationships with my treatment team and their staffs, I’ve been musing on the types of relationships that are created, or not allowed to be created. Almost to a person, my doctors are very careful to maintain their title of “Dr.” Even if they introduce themselves using both their first and last names (using the first name at least adds a little bit of humanity to them), they still expect to be called “Dr.” However, they consistently call ME by my first name.

This seems a rather lopsided bit of intimacy they are allowing themselves. I have to wonder why they feel it necessary for them to maintain that distance (other than tradition). Is it that they need to assert their professional identity (their knowledge and expertise)? Is it so they don’t get involved with me emotionally as a fellow human being? And why does it seem perfectly okay for them to address me by my first name, when I can’t use theirs? A bit like the parent/child relationship in that respect.

It is very like the distance that higher education maintains between its professors and students. Calling your professor “Dr” or “Professor” can connote respect for the stature that person has acquired in achieving that erudite title. It also keeps the relationship less personal. That may be helpful in some instances, but I did not find it comfortable when I was teaching, so I generally asked my students to call me by my first name. Some were comfortable with that, some not.

Where I found it more important to break down that lopsided relationship was when I undertook my own doctoral work. As a mature (in my 50’s) adult and seasoned professional, I was looking for an atmosphere of support and mutual respect, not a power play. Granted, many professors are addressed by their titles and manage to be quite human and respectful in their work with students. But the title also provides opportunity to distance oneself, and also to display the “superiority” of your knowledge. One of the reasons I chose Fielding, where I did my doctoral work, is that it cultivates the relationship between faculty and students as that of two equal human beings, each with something to bring to the table, working together. Fielding faculty earn the respect of their students through both their discipline expertise and their “guiding” and interpersonal skills. I developed many warm and close relationships with the faculty and administrators I worked with at Fielding. All of them were on a mutual first-name basis.

Working with my doctors I find myself back on the more traditional playing field of distance and power. I note that all the support staff introduce themselves to me by their first names. But I have yet to meet a physician who says “call me George.” Interestingly, I find that going through cancer treatment is not dissimilar to the wrenching processes that can happen while working on your doctorate, most especially the dissertation. You have to assemble and figure out how to manage your own team of assorted personalities and sometimes opposing viewpoints. You confront major stumbling blocks, experience significant emotions and often achieve major personal growth. You learn about your support systems and how to make the best use of them. You lose sleep, have significant impacts on your time and life and are frequently exhausted trying to manage everything. You certainly learn to discipline yourself.

Even more than a dissertation, living with cancer is one of the times in your life that you would really like to work with a team of fellow human beings (including your doctors), as equals, each with something important to bring to the table—the physicians bringing their specialized knowledge and skills, and me bringing my knowledge of myself, my values and my support system. I know physicians are not infallible, and they don’t have all the answers. But together we need to sort through the options so I can come up with the best decisions.

It will be interesting to see if it is possible to forge that kind of relationship with any of the team I have assembled, or work with in the future. The only person in my “team” with whom I am on a first name basis is my Chinese medicine specialist. Everyone else is a “Dr.” I wonder if that power relationship would shift if I insisted on being addressed as “Dr. Hutchison.” Nah…it wouldn’t be me.