• Summer 2021 Editorial - Polysemy


    Polysemous words carry related but sometimes remarkably distinct meanings that vary with context. I was frequently exposed to this issue when attending scientific meetings with my friend, professor Joseph Bogan.

    Joe was a world renown neuroscientist who wrote books and articles attempting to define and understand “consciousness,” and I watched him twist in the wind as he addressed public questions from people who used the term consciousness in varied ways. Think a moment as to what you mean regarding consciousness as you consider: A man versus an ant. Awake versus asleep. Before and after anesthesia. Alert versus in a coma.

    In each of these comparisons, we can see the presence versus the absence of consciousness, but we’re talking about very different things. If one person is a philosopher who considers consciousness to be the defining characteristic of being human, and the other is an anesthesiologist, then the finer points of mind/brain will likely be lost in their discussions. What does that have to do with senior ophthalmologists? We have a similar problem.

    “Senior” is another important polysemy. It can convey wisdom, longevity, accumulated experience, rank or just plain old. When I say that I am the senior most clinician of Doheny Eye Institute, I may be bragging or making excuses. And yet 43% of all ophthalmologists in the Academy are called senior ophthalmologists (SO) by the definition of age. No judgment.

    Polysemous art. “Apres L’amour” part of Manhattan
    Project by Madelon Vriesendorp, 1975.

    But judgment follows depending on context. Why does this matter? I can think of at least two important reasons. The first is that labels are branding and as such tend to filter all future perceptions on the matter. Through the lens of “senior” we may be perceived by some as wise or at least seasoned, but by others as marginal or even irrelevant.

    The second reason is that labels set expectations. When we label ourselves as senior, we may be looking back and congratulating ourselves on our successful careers or looking forward and thinking about retirement. Or we might be feeling the aches and pains in our joints and just complaining. I find myself often muttering, “I’m too old for this,” but rarely mean it. Usually, I’m just comparing how some things seem harder than they were before, and often I’m just grumpy. I’ve tried to cut back on that expression as it probably is a self-fulfilling prophesy.

    A polysemous word is a much more dangerous thing than a homonym for which context is revealing. If someone says, “Don’t be so juvenile,” you can be sure he means don’t act so silly; he’s not saying you should stop being young. But when we are labeled as seniors, we are not sure whether people are concerned for our age, our health, or our status. Worse yet, when we tell ourselves we are seniors by way of explanation, we may also be unconsciously making excuses or lowering the bar.

    At the Academy, I may run into a young ophthalmologist (they have their own group called YOs) and tell them that I am a SO to set up the impression that having been in the field for over 40 years, I know something of how difficult it is to balance a career with teaching, research, and patientcare. But what they are more likely to think is, “Poor guy doesn’t know how to use electronic health records efficiently.”

    We are both right, but without more discussion, we won’t be on the same page. I probably have much to learn about EHRs but maybe something to teach about an academic career. Further talk will provide context, and we may both learn something. But first, let’s not fall into the trap of speaking past each other. British Prime Minister Winston Churchill once said of Americans and the English, “two nations divided by a common language.” Just so, with polysemes.

    One interesting insight is that polysemes probably didn’t arise by coincidence. Someone used a word intending one meaning and someone else heard another meaning which they clung to. Both parties were convinced that clear communication had just occurred. Someone said, “I had too much wine and wasn’t conscious,” meaning they lost social awareness. Their friend may have thought they fell into physical slumber.

    Polysemes can be intellectual, emotional, and psychological traps. As a scholar, they are to be avoided. But polysemes can also be fun and are often the basis of good poetry. The author uses polysemous words to work multiple levels at the same time. Abstract art is said to be a mirror that reflects the viewer’s outlook. The painter’s mindset doesn’t matter as much as the viewer’s mindset. In this sense, some artwork may be the visual version of polysemous words. Indeed, there is work called polysemic art (Figure 1) in which the ambiguity is very deliberate.

    So, should we stop using the label “senior” in referring to ourselves and our SO status? No, labels are helpful too. By saying we are seniors or at the Academy that we are SO, we acknowledge that we have many things in common and that can help set the table for various conversations. We might talk about retirement, grandchildren, or the infirmities of age but we might also take a seasoned perspective on our profession.

    We have a committee that considers SO concerns as well as bringing SO perspectives that may be useful to other members of the Academy. And our journal Scope indulges in topics that are thought to be of interest to at least our SO community. But let’s not get too comfortable with the phrase “senior ophthalmologist.” What we say may not be what is heard. And even in our own heads, when we call ourselves senior may set limits on what we are.