My amazing daughters introduced me to the concept of “person first” language. When I asked them to read the earliest version of my memoir, they kindly pointed out places in the text where I didn’t employ this language.
“Person first” language literally places the person ahead of their disease or circumstance in writing or in conversation.
In medical school and residency, we were instructed by a handful of professors that when we spoke about a patient, we should speak of the person, not the disease, as in, “the patient in room 323 with pneumonia,” not, “the pneumonia in room 323.” This manner of presenting a case to our superiors wasn’t named as “person first,” but that’s what it was. The difference was obvious to me, but it seemed to cause a lot of eye rolling among my fellow students.
It’s more subtle, but there is a difference when we talk about “diabetics,” versus “patients with diabetes, or better still, “persons living with diabetes.” That’s “person first” speak. It’s putting the person before their disease, even in how we speak about it.
“A good physician treats the disease; the great physician treats the patient who has the disease.” -William Osler (1849-1919)
Osler would have us see the individual within the context of their diagnoses. This means that we should take into consideration their past history, their social history (habits, socio-economic status, home environment, etc), the medications they are currently on, and any other qualifiers that make an individual who they are.
For example, Suzanne (not her real name), who is married to a man experiencing alcohol addiction, struggles to keep her blood pressure under control while working full-time and parenting two teenagers. I want to treat Suzanne, not “the hypertensive.”
“Person first” medical care is reflected in “person first” language.
This language shift has occurred in the world of Alzheimer’s disease. It used to be standard to say “Alzheimer’s disease patients,” then, “patients with Alzheimer’s disease,” then “patients experiencing Alzheimer’s disease,” then “patients experiencing Alzheimer’s disease and other dementias.” Now it is preferable to say, “persons experiencing Alzheimer’s disease and other dementias.”
You can see the shift from a disease-centered language to a person-centered one. Does it change anything about Alzheimer’s disease care? Of course not. But language is powerful. The words we choose convey more than a concrete set of facts. “Person” is more relational than “patient.” “Experiencing” is more active than “has.” Our newest way of speaking about Alzheimer’s disease places the person ahead of the disease and calls attention to the fact that they are living within a certain circumstance. They are not defined by the disease.
I see eyes rolling these days when we are asked to consider saying “persons experiencing homelessness” instead of “the homeless.” Or “the woman living on the autism spectrum” instead of “the autistic woman.” Or “persons immigrating without documentation” instead of “illegal aliens.” It’s hard to make a shift in our language. And I’m not saying that we should correct other people’s choice of language, but if we make the change ourselves in how we speak, that change may change us.
We become more compassionate as we view persons as individuals and not as their disease or their life circumstance.