Physicians, royal we, pluralis majestatis

Beware the Royal We

Beware the Royal We

We, the first person pleural pronoun, is used in many different ways. In its purest form, it is used to denote a two or more individuals who have something in common. For example, if asked where Rosalie and I live I would reply: “We live in Sapulpa, Oklahoma.”

There are many atypical uses of the word, however. Teachers commonly use the pronoun to bring a sense of exclusiveness into an exercise. “When we divide 12 by 4 we get the number 3.” A similar, but more patronizing usage, is employed by some doctors and nurses. “How are we feeling today?” A still more condescending use is implied in a statement such as: “Aren’t we looking pretty today!”

Editorialists commonly use the term, implying that they are spokespeople for their publications, or for the community at large. “We hold that the proposed ordinance would severely limit development in our community.”

The most powerful use of the pronoun is called pluralis majestatis, the royal we. Monarchs have traditionally used the plural pronoun to add weight to their edicts. “We decree that from this point forward only those of royal blood shall walk on the palace grass.” The royal we was traditionally used by popes for the same reason. Pope John Paul I was the first to drop the practice, preferring to use the singular “I” when speaking. Pope John Paul II continued the practice introduced by his predecessor.

Ironically, as popes have discontinued the use of the royal we, many United States’ physicians have embraced the practice. Increasing numbers of people are reporting to me that their personal physician has advised them to avoid nutritional supplements because, “we don’t know anything about them.”

The use of the royal we in this context is deplorable. It is not simply that the use of the pleural pronoun in this manner is improper, it is patently dishonest. What the physician should be saying is, “I don’t know anything about them.”

As a society, as a scientific community, and as a profession we know a great deal about nutritional supplements. A search for the term nutritional supplements in the National Library of Medicine data base, which does not begin to encompass the total amount of literature available, identifies 14,571 articles. Searching for vitamins lists 113,154 entries. Searching minerals reveals that 72,592 articles are available. 3382 articles on herbs are found. Clearly, a great deal is known about the need for and use of nutritional supplements.

It is time for sloppy and uninformed physicians to be called to account. Those consulting them must recognize the ill-advised and inappropriate use of the royal we when it appears. When told, “we don’t know anything about that” a patient must appreciate the fact that the physician is actually stating his or her own personal ignorance: “I don’t know anything about that.” It is imperative that the doctor’s royal we not cause the patient to abandon the practice of giving his or her body the supports it needs for maintenance and repair. Rather, when heard, the medical we should trigger a desire to seek out a consultant that does know about such things.