If addressed as "my love" by total strangers, my grandmother used to say: "I cannot reciprocate as I have only ever had one love and I married him. My name is Mrs. Williamson. And yours?" In those days you could get away with such autocratic behaviour. Today, most people would probably mark you down as a tricky old bat. And Sally Palmer, (I will compromise by using both her names) doesn't want to appear pompous. So if she wants to be formal, she should take the initiative. "I am Mrs Palmer," she should say. "How nice to meet you." Or, if addressed as "Sally", she could say "How nice to be on first-name terms. May I ask for yours?"
Every patient should have a choice as to what they're called but, in a more equal society, first names are becoming the norm. The fashion now is anti-hierarchy, and a good thing too. First names seem to have won out. That means that the hierarchy of the old should be discontinued along with everything else. In the past, you'd never call a middle-aged person by their first name unless you knew them well; but now older people have given up their rights to respect by indulging in all the things they used to have to give up at 45. If, in middle age, you still wear leggings, go to clubs, and have sex and talk about it, you give up your right to be called "Sir", "Mr" or "Mrs" by youngsters.
But there's another way of looking at this, which is in terms of relationships rather than hierarchy. Intimate relationships follow a pattern. Some men call each other by their surnames, then get on to first-name terms and, finally, nicknames. I like to be called Virginia for quite a while before anyone addresses me as "darling" or (a long time on) "fishface". As for professional relationships, I'd like them all to be conducted on Mr, Mrs and Miss lines.
Doctors and patients should have professional relationships, at least initially. Perhaps if you see them on a regular basis you could slide into familiarity. For instance, I regularly consult an eminent psychiatrist called John and an eminent gut doctor called Stephen. But we have earned that relationship. And until she herself wishes to become more pally, I think Sally Palmer should stick to her guns.
The answer is to go private
Your correspondent's dilemma is not in the least trivial - she is encountering the subtler forms of the 20th-century hierarchy, now that forelock-tugging and curtsying are no longer allowed!
I have told my family that if and when I admitted to hospital, they are to take the ward sister to one side and say "If you really want to make Mrs Jefford feel at home, call her by the nickname we use at home - Ma'am!"
But seriously - I became so upset at being addressed by my first name by dentists and gynaecologists, as I lay supine, powerless and with my mouth or legs open, I opted for private treatment. Luckily I could afford it. It's interesting that it seems to take money to retain your dignity.
MRS GILL JEFFORD
This is unprofessional
As a student nurse I was taught never to call a patient by their given name unless invited to do so. The use of "dear", "love", "pet" etc was also discouraged as this was seen to be patronising. In this case I suspect the doctor and consultant feel that by using Mrs Palmer's first name they are putting her at ease and relieving any nervousness she may feel.She should explain to them at the first available opportunity that the whole consultation procedure makes her feel uncomfortable and that in order for her to cope with it more easily she would prefer to handle it on a more professional, formal level. Any doctor worth his or her salt will appreciate the patient's anxiety and thus will not be offended at being asked to address her in a more formal manner.
LESLEY LANGLANDS (Mrs, but you can call me Lesley!)
Canary Wharf, London
Doctors need respect too
Mrs Palmer is right to feel offended. There is no other "civilised" way of dealing with this matter, than a polite request that the doctors address her in the way that she prefers. Good manners surely dictate that they comply.
Personally, I will use a patient's surname until they tell me not to, but I prefer to remain "Dr". I am equally annoyed by patients who feel that their airy "Oh, call me John" gives them the right to call me Andrew...
DR ANDREW ROBINSON
Next Week's Dilemma
I find it difficult to make decisions. I have a big one on my plate at present - whether to move house or not - but that's not really the issue. It's that I am very bad at coming down on one side or the other. People ask me if I want to go to the movies or out to dinner, for instance, and I just can't make up my mind. Do readers have any ideas on how to make decisions, apart from the usual making lists of pluses and minuses? I feel I am an eternal ditherer.
Yours sincerely, Glenn
Anyone who has their advice quoted will be sent a bouquet from . Send letters and dilemmas to Virginia Ironside, `The Independent', 1 Canada Square, Canary Wharf, London E14 5DL, fax 0171-293 2182, or e-mail email@example.com - giving a postal address for the bouquet