The interactional meaning of Doctor used by itself consists in a particular professed way of thinking about the addressee. My hypothesis is that this includes two different cognitive scenarios which can be captured in NSM as ‘how I think about you when I say this’ and ‘how I don’t think about you when I say this’. The cognitive scenario ‘how I think about you when I say this’ includes an idea of the addressee as one of the people working in a place of one kind and as someone above many other people in that place, the speaker being one of these people. It can be captured as follows:
[B] HOW I THINK ABOUT YOU WHEN I SAY THIS
when I say this to you, I think about you like this: “there are many people in this place,
I am one of these people, this someone is one of these people
this someone does some things in this place, I don’t do the same things in this place this someone is someone above many people in this place”
The component ‘this someone does some things in this place, I don’t do the same things in this place’ is specifically meant to capture the difference in role between speaker (patient or nurse) and addressee (the doctor), not between the addressee and other people in the same place; it does not state ‘other people in this place do not do the same things’, because in a hospital there are many doctors. Moreover, at least in Australia two doctors working in the same hospital do not address one another as Doctor, but by first name (Chapter 12); therefore, the component ‘this someone does some things in this place, I don’t do the same things in this place’ would not be consistent with the relationship between two colleagues doctors. My hypothesis is that there has to be a difference in role between speaker and addressee for Doctor to be used by itself as a form of address.
In addition to these components, I posit two other components for the cognitive scenario ‘how I think about you when I say this’ inherent in the meaning of Doctor used by itself as a form of address. Considering that ‘doctor’ is a “caring” profession, I propose that the speaker sees in the addressee a greater potential for doing good things for other people in the hospital than other people who work there. This means being able to help patients and care for them. In the play At Any Cost? (2011) by the Australian playwright David Williamson, which is about euthanasia and the psychological struggle to decide whether or not to end someone’s life, the dialogues illustrate very well the doctor’s potential to do good things for many people in the hospital. All the relatives of the dying patient address Dr. Ali Sharif as Doctor without surname:
(7) ALI: Hello there, my name is Ali Sharif. I’m the Intensive Care Consultant who’s looking after your mother…
KATIE: Could you tell us what’s happening, Doctor?
(8) ALI: You’ve been caring for her?
DES: Yes, but Doctor, none of this is relevant. She’s in here now, she’s desperately ill. […] Doctor, she’s not a vegetable. […] Family was everything to her. Doctor, if you could see her smile…
(9) ALI: I’m going to do my very best to get her back where she was, Mr. Watson.
Be assured.
MEGAN: Thanks, Doctor.
Significantly, in the play the husband of the patient, Des, does not address Dr. Sharif as Doctor until the moment when he has to convince the doctor to let his wife continue to live. Doctor appears to play a major role in such a critical moment; it is used by Des to acknowledge Dr. Sharif’s greater potential (compared to the other people in the hospital) to do something good for his wife, in this case to let her live. The fact that Dr. Sharif himself in (9) assures Des that he will do anything he can to help his wife reflects his potential to do good things for the patient like no-one else in the hospital. This second part of the cognitive scenario can be captured as follows:
[C] HOW I THINK ABOUT YOU AT THE SAME TIME
at the same time, when I say this to you I think about you like this:
“this someone can do some good things for other people in this place other people in this place can’t do the same”
The idea ‘this someone can do some good things for other people in this place’ gives Doctor by itself a somewhat “paternalistic” tone which is not part of the meaning of Dr. plus surname and explains why in English certain nouns cannot not be used by themselves as forms of address, for example *Director. Like Doctor, the semantics of director as a term of reference suggests the idea “I think about this someone like this: ‘this someone is someone above many people in a place of one kind’”; yet, in English there is no form of address *Director comparable to the Italian Direttore used by itself to address the director of a company or of a newspaper (next chapter).
Unlike Doctor, the meaning of the English director does not also include a component “I think about you like this: ‘this someone can do some good things for other people in this place, other people in this place cannot do the same’”. This difference in meaning between Doctor and director suggests that in English-speaking countries the mere fact of being seen as someone
above many people in a place, as the semantics of director suggests, is not sufficient to justify the use of a particular noun by itself to address the interlocutor (e.g. *Good morning, Director). Unlike in Italian culture (next Chapter), it appears that in Anglo cultures to be seen as someone above many people in a place is not per se a culturally relevant factor which could encourage the expression of the meaning “I think about you like this: ‘this someone is someone above many people in a place of one kind’” with one word to address the interlocutor.
The point is that different cultural values encourage the expression of different meanings in one or more words used as forms of address. The syntactic properties of nouns used as forms of address, in turn, reflect their semantics (cf. Wierzbicka 1988); the possibility of using a given noun as a form of address by itself (e.g. Doctor) or with an obligatory surname (e.g. Dr. Brown used to address an academic) depends on the (combination of) meanings which the context of interaction requires to express. Thus, by analysing the interactional meaning of different nouns used as forms of address it is possible to make sense of the hidden cultural values and semantic “rules” which govern their use.
For the cognitive scenario ‘how I don’t think about you when I say this’, I will posit a component “I don’t think about you like this: ‘I know this someone well’” on the basis of the fact that Doctor can combine with a surname but not with a first name (*Doctor Paul). This component is the most plausible one for the invariant meaning, because it excludes that the interactants profess to know each other verywell (in which case first-name address would be used), and does not state that the interactants profess not to know each other at all either.
At the same time, this component explains the semantic difference between Doctor by itself and Dr. Brown. The component “when I say this to you, I don’t think about you like this: ‘I know this someone well’” clashes with the semantics of surnames, ‘I know what this someone’s surname [m] is’. A Dr. plus surname combination merely suggests the idea ‘I know who this someone is’, but not ‘I know this someone’ (well or less well). My hypothesis is that when
patients address a doctor as Doctor by itself, as in Williamson’s play, they are not “identifying” the addressee, but are using a noun to address someone whom they think they do not know very well. It follows from this that Doctor is polysemous; when it is used without a surname it expresses a different interactional meaning from Dr. plus surname, and one of the differences lies precisely in how the speaker purports to relate to the addressee.
In sum, I propose the following explication for the interactional meaning of Doctor by itself as a form of address:
Thanks, Doctor (Coach, Chef, Boss…)
[A] WHAT I WANT TO SAY TO YOU NOW
I want to say something good to you now [B] HOW I THINK ABOUT YOU WHEN I SAY THIS
when I say this to you, I think about you like this: “there are many people in this place,
I am one of these people, this someone is one of these people
this someone does some things in this place, I don’t do the same things in this place this someone is someone above other people in this place”
[C] HOW I THINK ABOUT YOU AT THE SAME TIME
at the same time, when I say this to you I think about you like this:
“this someone can do some good things for other people in this place other people in this place can’t do the same”
[D] HOW I DON’T THINK ABOUT YOU WHEN I SAY THIS
when I say this to you, I don’t think about you like this: “I know this someone well” 5.4Nurse
The noun Nurse as a form of address fits within the proposed category because it matches the syntactic and situational criteria for using Doctor by itself. Syntactically, it is used in short utterances and without a following surname. Situationally, it is used in a specific place by people who do not do the same things as the nurse in the hospital and who can be seen as being “below” the nurse (patients). However, the following examples from British and American
English illustrate that in these varieties Nurse can also be used by a doctor, someone above a nurse in the hospital rank, to address a nurse:
(10) The doctor shook his head. 'So in answer to your question, Nurse, yes, God help him, he'll live.'
(Wordbanks, brbooks)
(11) The doctor motioned to a woman in green scrubs drinking something from a Styrofoam cup. He said, "Nurse, take this patient to room nine. Prep her and get the hose."
(COCA, us fiction)
(12) KUMAR (CONT'D) First, we need to clear his C-spine. I want stat x-rays of the chest and abdomen. Give me two large bore IVs and start a ringers lactate push. Nurse, we need 2 units of O neg on board.
(COCA, us fiction)
(13) "Sorry," the doctor mumbled as he sprayed something on her hands. "Nurse," he called.
(COCA, us fiction)
In cases like these, Nurse does not express the same interactional meaning as when used by patients to address a nurse, because the component “I think about you like this: ‘this someone is someone above many people in a place, I am one of these people’” does not apply to Nurse when the speaker is a doctor.
Further examples illustrate that Nurse is also consistent with the idea ‘this someone can do some good things for other people in this place’. The emotional reaction of the patient portrayed in (3) is particularly suggestive of this; the fact that the patient grabs the nurse’s wrist and desperately asks if he has contracted cancer indicates that he knows that the nurse can help him. In calling her Nurse, the patient acknowledges the nurse’s potential to do good things for him. The same applies to (14), an example from Irish English, where it is explicitly stated both that the man is “seeking assurances that there are no complications” from the nurse, and that the nurse suggests to the man what to do:
(14) Mr. Hilditch is certain that conclusions have already been reached in the waiting room. Twice he has approached the staid receptionist, apologising for doing so, seeking assurances that there are no complications. On both occasions she suggested he should
go for a walk, or simply go home and return later, which is the more usual thing. ‘If you don’t mind, Nurse’ he replied, the same words each time, ‘I’d prefer to be near my girlfriend.’
(William Trevor, Felicia’s Journey, 1994)
In this example, the man’s words reflect not only the construed inequality of roles between patients (or patients’ relatives) and nurses in the hospital, which gives nurses some “decisional power” over patients, but also the patients’ awareness that nurses can do some good things for them in the hospital.
Finally, like Doctor, Nurse cannot combine with a first name, and this suggests that its meaning includes a semantic component “I don’t think about you like this: ‘I know this someone very well’”. Thus, the same explication proposed for Doctor can be used to explicate the interactional meaning of Nurse.