What’s in a name? Nominative determinism
Nominative determinism is the theory that people are more likely to pursue careers that have some connection to their names. (Conversely, names particularly suited to their owners are known as aptronyms.) The late New Scientist journalist John Hoyland coined the term ‘nominative determinism’ in late 1994, and the popular science journal ran a weekly column on it from then onwards.
Among the first examples of the phenomenon mentioned in that article were Daniel Snowman’s book, Pole Positions – the polar regions and the future of the planet; London Under London – a subterranean guide, which includes Richard Trench among its authors; and – more relevant to the health focus of Western Alliance – J.W. Splatt and D. Weedon’s article on incontinence in the British Journal of Urology (1977).
Somewhat surprisingly, several serious examinations of the validity of the nominative determinism hypothesis have been conducted, much of it in the realm of health. In this article, we take a look at this research and reproduce some of the best aptronyms from it.
Nominative determinism – the research
One of the earliest studies of the phenomenon was ‘Why Susie sells seashells by the seashore: implicit egotism and major life decisions’, published in Attitudes and Social Cognition (2005). Brett Pelham, Matthew Mirenberg and John Jones scoured the directories of the American Dental Association and the American Bar Association for names beginning with the first few letters of ‘dentist’ and ‘lawyer’. They found that, relative to female lawyers, female dentists in the United States were significantly more likely to have first names beginning with the letters ‘Den’ (e.g. Denise, Dena, Denice, Denna). In contrast, names such as Dennis, Denis, Denny and Denver were no more common among male dentists than male lawyers.
In ‘What’s in a name? Nominative determinism in the UK dental workforce’, J. Sleigh (British Dental Journal, 2015) described a comparison of the prevalences of dentally related surnames (Brace, Bridge, Brush, Chiu, Chu, Crown, Dent, Fill, Filler, Fillingham, Gumm, Hurt, Pain, Paine, Payne, Root, Roots, Tongue and Tooth) in the United Kingdom (UK) dental workforce (dentists and dental care professionals) and in the UK population as a whole. The article concluded that UK dentists are significantly less likely than the UK general population to have dentally related surnames.
In considering why nominative determinism might not work so well in dentistry, as it seems to in other areas of medicine (see below), Sleigh conjectured:
One possible explanation is that so many of the surnames that relate to dentistry are concerned with negative connotations of dental care (Pain, Hurt, etc.). It is understandable that those considering dentistry as a career may be discouraged at the thought of eventually becoming Dr Pain.
Nevertheless, some of the surnames excluded from the study (due to insufficient frequency in the UK population) were excellent examples of dental nominative determinism. A Dr Fang, Dr Molaro, Professor Ian Needleman and three dentists named Dr Dentith were singled out for special mention.
From dentists to doctors (and their patients). Ernest Abel (2010) conducted three studies of nominative determinism using data from two online directories. Abel initially found that Americans with the word ‘doctor’ as or in their surname were significantly more likely to be doctors than lawyers, whereas those with ‘lawyer’ as or in their surname were more likely to be lawyers than doctors.
Abel then compared doctors and lawyers whose first or last names began with three-letter combinations representative of their professions (e.g. ‘doc,’ ‘dok,’ ‘med’; ‘law,’ ‘lau,’ ‘att’), and again found a statistically significant relationship between name and profession. Finally, he compared the frequency of surnames containing a minimum of the first two letters in five medical specialties: anesthesiology (anaesthesiology), dermatology, neurology, paediatrics (paediatrics) and radiology. Abel reported that, for example, doctors named Raymond were more likely to be radiologists than dermatologists, and doctors named Neal were more likely to be neurologists than dermatologists.
Keaney and colleagues studied the prevalence of the surname Brady among patients suffering from bradycardia in Dublin, Ireland. Symptomatic bradycardia is an indication for permanent pacemaker insertion, so the authors used pacemaker insertion as a marker of the condition. They analysed the names attached to the 161,967 residential telephone listings in the Dublin area and those of the 1012 pacemaker recipients in their hospital between 1 January 2007 and 28 February 2013. The proportion of pacemakers implanted in patients named Brady was significantly higher (1.38 per cent, or eight of 579) than among non-Bradys (0.61 per cent, or 991 of 161,388). Keaney at al. interpreted this as meaning that patients named Brady were at higher risk of needing pacemaker implantation than the general population, and that people’s names and their health were linked.
In 2015, C. Limb, R. Limb, C. Limb and D. Limb, all members of the same medical family, published ‘Nominative determinism in hospital medicine’. They sorted names on the medical register into hospital specialties, and looked for surnames appropriate to the speciality (e.g. ‘Brain’ for a neurologist) or for medicine in general (e.g. ‘Ward’). They concluded that the frequency of names relevant to medicine and to specialties was much greater than expected by chance. Specialties with the largest proportion of relevant names were those focused on body parts with many alternative labels – inevitably, the genitals. Hence, in genitourinary medicine they found Drs Hardwick, Kinghorn and Woodcock, and in urology identified Cox, Dick, Koch, Cox, Balluch, Ball and Waterfall.
As unlikely as it seems, there is some reasonable evidence for the existence of nominative determinism. Accepting the theory makes it less surprising to find there are doctors with the surname Doctor, Blood, Fix, Cure, Heal, Flesh, Gore, Ache and Looney, not to mention an expert on injecting drug use named Dr Needle, a dermatologist named Dr Rash and a rheumatologist called Dr Knee.
Rejecting the theory, despite encountering such aptly named physicians as Drs Seymour (optometrist), Bone (orthopaedic surgeon) and Harte (cardiologist) might eventually drive you to a psychologist named Dr Couch, or even a psychiatrist specialising in anxiety called Dr Angst.