We know the problem with eponyms, the quirky terms we use for diseases, syndromes, or anatomical structures named after the scientist or doctor who discovered them, usually a long-deceased white man. At their most benign, eponyms are vague and non descriptive. At their most egregious, they raise serious ethical concerns, including disease processes named after investigators associated with Nazism such as Reiter’s syndrome and Wegener’s granulomatosis.
As an ob/gyn, you can’t get through a day in the office or OR without an extensive tour through Eponym City. Is it a Bartholin’s cyst? No, it’s more anterior; it’s a Skene’s gland cyst. Something different around your areola? It could be a problem with the Montgomery duct. When we do your “Cesarean” section, we will take care not to injure your “Fallopian” tubes. And the ever–favorite medical student OR question, “What is the artery of the round ligament?” Sampson’s artery, of course.
Over the years, I have felt the oddness of being a woman doctor explaining to my female patient what is going on in her body, using terms named after the men who discovered them. I have often wondered if more female or male anatomical structures carry someone’s name. Are women’s bodies more likely to be linguistically colonized? Although this answer eludes me, research shows that eponyms are the domain of men, with 96% coming from a male namesake.
Now, the counter arguments in favor of eponyms are also well known. They reward scientists who did the difficult work of discovering anatomy and diseases, and they help us remember our medical history. Although nondescript, they can be easier to remember, and replacing them with a proper descriptive term is often cumbersome.
But to give credit where credit is due, we should know more about our discoverers. Take Gabriele Fallopio and his tubes. This one is easy to replace — uterine tubes. There, done. But in researching eponyms, I now have a soft spot in my heart for Dr. Fallopio, a Catholic priest from a poor family who lived in the 1500s and died before his 40th birthday. His main area of research was not even reproductive anatomy, but the face, head, and inner ear. Impressively, he was also an advocate for the use of condoms to prevent syphilis. If ever a man should still be invoked and honored in current medical conversation, I vote for him.
A similar case can be made for John Sampson, MD, and his artery. Again, easily replaceable with a descriptive name, such as artery of the round ligament. But did you know that Dr. Sampson, an American gynecologist, was the originator of the term “endometriosis” and the first researcher to propose retrograde menstruation as a cause? Maybe it’s not so bad to honor him during an OR pimp session while also seizing another teaching point.
But we must draw the line somewhere, and in ob/gyn I know exactly where to draw it. It is at Braxton Hicks contractions. This is stop-the-madness territory. For those who are not practicing obstetricians or haven’t been pregnant themselves, Braxton Hicks contractions are uterine contractions that are not labor. That’s it.
My hatred for this term grew like my belly during my first pregnancy, as I experienced this important medical discovery firsthand. Yes, the uterus contracts and it is not always labor. Most uterine contractions are not labor. Nearly every woman who has ever been pregnant throughout all of time knows this. This is not a discovery made through painstaking dissection in the anatomy lab by candlelight. As far as I can tell, there is nothing objectionable about Dr. John Braxton Hicks, an English obstetrician who lived from 1823-1897, and perhaps this is why his eponym, despite its ridiculously awkward name, seems both unscrutinized and inescapable. An internet search of Braxton Hicks contractions quickly reveals explanations from storied American medical institutions, such as Mayo and Cleveland Clinic, explaining this phenomenon using the Braxton Hicks name.
Despite being a person who overthinks most things and cares about language, I admit I did find myself using this term with patients. Until I didn’t. Maybe it was just too many names, too many Bartholins, Skenes, and Fallopios jamming my circuits, but one day I had enough. I vowed never to utter the phrase Braxton Hicks contractions again. After all, this eponym persists, despite an easy and descriptive replacement — practice contractions. At first, it seemed clumsy, but I persisted. If we know nothing these days, we know that the evolution of language toward greater equity is hard. Yet we must do it. My stumbling over practice contractions lasted literally one to two days. Now it is as natural and obvious as, well, nonlaboring contractions.
So I challenge all of us, but especially ob/gyns, to embark on a personal campaign toward both freedom from nonsensical eponyms and understanding of those we continue to use. It may be more helpful for our patients to know that they have a blockage in their periurethral (Skene’s) glands or their major vestibular (Bartholin’s) gland. (OK, I admit, that one still needs work.)
And when the placenta separates gloriously and easily after a challenging birth, we can thank a healthy and well-functioning Nitabuch’s layer. After all, Dr. Raissa Nitabuch, member of the 4% of women who birthed eponyms and one of our obstetric foremothers, also deserves our remembrance and respect.
Should eponyms persist in medicine? Share your thoughts in the comment section.
Dr. Jennifer Boyle is an ob/gyn in Boston, MA. She also works as a soccer coach and a cheer, hockey, and lacrosse mom. To stay sane, she runs, reads and bonds with her fourth baby, a labradoodle named Teddie. Dr. Boyle is a 2022-2023 Doximity Op-Med Fellow.
Illustration by Jennifer Bogartz
