What’s in a name?

“What’s in a name? That which we call a rose. By any other name would smell as sweet…” – William Shakespeare, Romeo and Juliet

We recently came across a really interesting comment on Facebook – a dog owner, who went into her practice to get her dog “neutered”, but then backed out because the vet used the word “castrated”. She thought it sounded so cruel, she never got him done – despite the fact that, of course, it’s two different words for exactly the same thing. In the US it’s sometimes called “altering”, and in Australia “desexing”… but however you dress it up, it is still surgically separating a boy dog from his testicles! So why was the owner so upset by one term but not the other?

I think there are several things going on here – and it’s nothing to do with the pros and cons of neutering, (although I might do a blog on that in the near future).

Firstly, there’s the problem of anthropomorphism (treating other  species as if they thought exactly the same way as us). It’s well recognised, for example, that women who own male dogs are more likely to get them neutered than men are… and any discussion of neutering tends to have the males in the audience crossing their legs! But that’s got nothing to do with the dog’s welfare, it’s far more to do with the owner’s perception. Dogs and cats really don’t care whether they have testicles or not – they feel the way they feel on the day. It is important not to project our feelings onto our pets – they are their own creatures with their own minds and preferences.

Secondly, though, there are real issues of word association.

The word “castration” brings up images of punishment or torture, rather than a sterile and controlled surgical operation, whereas “neutering” sounds more clinical, and less invasive. Even the most innocent of words and phrases can, over time, come to have other connotations – I’m sure we can all think of examples. The real problem comes when that association exists only for one of the parties in a conversation. For the vet in this case, many years of surgical experience had erased the other associations, so all that came to mind was the surgical procedure.

Thirdly, there is a great reluctance in much of the Anglo-Saxon world – and especially, I have to admit, the English – to discuss any matters relating to reproduction without coyly changing the words. This can be really difficult on occasion (I know of clients who refer to “his tail” or “her bottom” to refer to genitals – which can be confusing in a consultation!). However, I’ve been guilty of blurring the issue as well, and it’s a deeply ingrained cultural complex that probably needs some work!

Finally, and to my mind vitally, there’s the issue of precision vs comprehension. The word “neutering” means removal of some or all of the sex organs. However, it’s quite vague – there are multiple possible operations covered by that term. “Castration” is more specific, relating to removal of the testicles only. However, given the problems we’ve just discussed, perhaps the vet should have used the term “orchiectomy” (same meaning, with no unpleasant or sexual connotations). However, would the client have understood what they meant? This is always a knife-edge – how do we ensure that we are being understood, while still being precise? This is the reason for “veterinary jargon” – it’s not intended to make it harder for laypeople to understand us, it’s so that we can communicate efficiently and precisely.

However, the exact balance between all of these components is inevitably going to vary dramatically from situation to situation.

As an example, I know of some vets who avoid using the word “bitch” because they believe it sounds too harsh – but I also know of some clients who have asked to see “a vet who knows what they’re talking about” when presented with a well-meaning (and very competent) vet who avoided using the term. So it will of course depend on the situation.

There have also been some problems reported around talking about euthanasia – “putting an animal to sleep”. There is some evidence that using the phrase “putting them to sleep” if overheard by children can cause psychological damage (and even a sleep-phobia) because they’re afraid they won’t wake up in the morning. Equally seriously, there’s the risk of the animal’s owner, or even other members of the veterinary team, getting confused between euthanasia and sedation of a patient. Some people use phrases like “end their suffering”, which is a great description of what we’re doing – but there have been reports of tragic incidents when the vet said this meaning euthanasia, whereas the animal’s owner meant “cure the suffering” – not at all the same thing!

So, the issue is this: how do we as vets explain what’s happening in such a way that it’s clear to all our clients – from all walks of life and all levels of experience – exactly what we mean, without accidentally misleading them, or distressing them? In many (hopefully, most) cases, we’ll have a rapport with the client and can pitch it just right – but sometimes we won’t, and occasionally that will cause distress or even offence.

Ultimately, I believe that the solution boils down to that most complex of “soft skills”, communication. I also think it underscores the importance of vets staying rooted in the communities they work for, so it’s easier to understand where the client is coming from. (As an aside, I think too-regular job changes and moving to different parts of the country are probably harmful to client communications, where the social mores and ways of describing things are different.)

So what do you think? While most vets are good communicators, not all are – so how do we improve? Are there any terms you’d rather we didn’t use – or particular terms you think we should? Are there any other answers, or are we doomed to keep having the same miscommunications? I’d love to hear what people think!