Nazi Eponyms and Medical Training

I came across this article today: Modern Medical Terms Are Still Named After Nazi Doctors

The author's analysis is excellent, but since this is something I've been thinking about for a long time, I wanted to draw out a couple of other points.  Specifically I think the struggle over eponymous terms highlights one of the most confusing things about medical training: how subject it can be to individual variation.

It's important to note that in medical school, all your courses are broken up and taught be experts.  At our institution, there are one or two individuals responsible for ordering and organizing each class, but they do not give all or even necessarily a majority of the lectures themselves.  Most learning content comes from pHD's and MD's (occasionally JD's and MPH's as well) who are specifically expert in the topic of the day.  This may mean I have 12 different lecturers in the course of a 15 lecture week.  We work more closely with younger faculty members, such as fellows, who lead smaller group discussions.

The point is, there is ample room for disunity.  While in one class the course director stood up and apologized for the phrase, used by a visiting lecturer, "breast-feeding Nazis;" in another we were introduced to the Clara cell without pause or caveat.  Until I read the article above I had no idea it connected with Nazi doctors.  It's hard to eradicate terminology when there is no continuity in the training of the next generation.

One disease in particular highlighted the challenges I see: granulomatosis with polyangiitis, formerly (and often currently) known as Wegener's.  The day we were supposed to have a lecture on that particular disease was the day of Hurricane Sandy.  So we were all instructed to stay home and instead watched last year's videos.  In that video the doctor giving the presentation went into some detail about the Nazi link to the name Wegener's and in fact showed us several papers he had co-written advocating the name change.  This year's lecture was scheduled to be given by a different doctor, whose slides showed no sign of discussing the controversy - although he did use the updated name, unlike some of the fellows who taught our discussion section.  Topping this off,  this disease is complex and influences multiple systems meaning we see it referred to again and again and again.  When we see the same disease presented repeatedly with no unity in the name, it's not hard to see why this terminology is still around.

Could this same phenomenon be at work when it comes to vast differences in outcomes across hospitals and regions?  When we may be taught by one person to describe consciousness in specific terminology, then by another to do it completely differently doesn't it impact quality of care?  My classmates and I will go our separate ways after graduation, scattering across the country to work with diverse institutions and instructors. Even as soon as next year we will all be working at different sites with different doctors teaching us their preferred methodology for each task we must do.  Medicine, for a discipline that claims its roots in science, is absurdly subject to its own history and to local cultural fluctuations.  This can make it a delightful and unique journey, or it can make it imprecise and fallible.  We must acknowledge its vagaries to ensure that we are not falling into the latter category.