Wednesday, June 2, 2010

What's in a Name?

One of my Facebook friends asked me the other day where I get the names for my patient stories on The Blog. This is a serious issue, as there are laws out there out for maintaining patient confidentiality. So I try to disguise the patients as best I can. I don’t write about patients the day I see them and I intentionally alter the clock, so the casual observer can’t figure out the timing of their ED visit even if they can get hold of my personal schedule. I also try to not to include racial or ethnic characteristics unless they’re vital to the story. Of course, the people who work directly with me often know exactly who I’m talking about, regardless of whatever name I use for the patient. After all, they were there the same as I was, and there’s not much I can do about that. But they’re bound by the same need to protect patient confidentiality as I am.

Names are important, as they make the patient in the story a tangible reality rather than a generic, made-up sample of the species. But coming up with a fictitious name for the patient, especially one that doesn’t sound anything like the actual name, doesn’t use the same initials, and doesn’t reflect ethnicity or culture is a lot harder than it sounds. I don’t know for use, but I think this is because there’s no way you can objectively select a new name for someone you know without the name reflecting something about them. Take five of your best friends and try to think of random names for them. I’ll bet you’ll find that in each case, the new name either reflects something about them (or at least you’ve excluded certain choices) because of what you know about the person’s race, religion, social background, or personality. That being said, you want to write the stories about Life in the ED, and you really can’t do so without having a patient at the center of it.

So avoiding name recognition is the biggest problem of patient privacy, and it’s really a much more difficult problem than you might think. That’s why I’m thankful for the internet-based Random Name Generator ( If I might quote from the introductory blurb:

“The random name generator uses data from the US Census to
randomly generate male and female names. Use it for screenplays,
fake id's, car rentals, pick-up lines, books, prank calls, movies.
Give a random name to that special someone you meet at the bar.”

(I’m not sure about giving random names to someone special from the bar. It makes it a lot more difficult to call them after you’ve got their number, and in my experience women seem to place a premium on you actually knowing their names. I am, however, comfortable with giving myself other names as the situation requires. For example, I always tell the folks at Starbuck’s that my name is Bob. While I try to imbue it with nobility, the fact is that in the waning years of the 20th century and the nascent years of the 21st, Howard is a dorky name. Bob is just easier. Then there was a night in Houston many years ago when a neurosurgeon from the University of Florida and I were on a NASA course and spent the evening drinking top shelf tequila shots at a Mexican café frequented by astronauts. I was the Chairman of the Department of Surgery and he was the Chair of Neurosurgery for the night because those were then names on the University credit cards in our pockets that night. There are also times when I’m discharging a patient and am asked my name. I’m Dr. Rodenberg if they say they liked the service; I could be any one of a number of different names if they don’t. Just kidding, risk management. Maybe.)

The Random Name Generator takes first and last names from Census data and ranks them in order of frequency. You put in the “obscurity factor” you desire…level 1 comprises the most common names, level 99 the least…and the computer matches them up, common first names with common last names at a setting of “1,” vice versa at the other extreme. (I usually use a setting of 20…a bit off the beaten track, but no too obscure as to be unbelievable.)

Here’s a sample of Level 1 names, both male and female:

1. Anthony Woody
2. Anita Silverman
3. Claire Palmieri
4. Frank Daly
5. Bruce Rhoden
6. Terri Braden
7. Hannah Hamner
8. Aaron Hadley
9. Theresa Sam
10. Grace Keeney

Here’s a list of Factor 99 monikers:

1. Ezequiel Bullert
2. Jenette Criton
3. Mure
4. Waylon Gheewala
5. Skye Hadson
6. Lenna Distance
7. Latoria Depietro
8. Letty Ladika
9. Benton Butel
10. Vincenzo Jingst

So that’s how it’s done. Random names keep patient identities private while still letting you tell the good stories. That being said, I am suddenly enamored with the name Vincenzo Jingst. Vincenzo Jingst Rodenberg. Now there’s a name for a kid. Or maybe a puppy. Vincenzo the Dog. My Dog Vinnie. Yeah, I like that.

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