LETTER TO THE EDITOR
The Bible the Flock Will Not Follow
To the Editor, Anatomical Sciences Education:
What’s in a name? That which we call a rose by any
other name would smell as sweet.
—William Shakespeare, Romeo and Juliet, 1597
Let’s face it, if a committee had written Romeo and Juliet,
we could have been left with, ‘‘. . .that which we call a mem-
ber of the family Rosaceae by any other name. . ..’’ More sci-
entifically accurate, perhaps, but nonetheless losing something
along the way.
In reading Martin et al.’s (2009) paper, a fine and valuable
review, I was constantly of two minds. The first was admira-
tion and appreciation for the fine FCAT (Federative Commit-
tee on Anatomical Terminology; FCAT, 1998) scholars, many
whom I have long known and respected, who so conscien-
tiously and seriously approached their task. I have in my
mind images of wise sages, books piled floor to ceiling, argu-
ing into the night on fine terminological and etymological
points, their energy, dedication, and knowledge without peer.
I then flash back to images from my youth of equally learned
Talmudic scholars arguing over the intricacies of the good
book in ways average folks could never appreciate. While I
never actually understood what they did, my father would
tell me always to ‘‘hush’’ as we passed them, reminding me
that they were the ‘‘guardians’’ of our teachings.
Unfortunately, while these wise men were guarding the
tenets of my ancestors’ faith, I developed a taste for ham and
cheese sandwiches and going to the movies on Saturday
morning instead of listening to them in synagogue. Some
others may have heard their wisdom; my mind drifted. The
point is, they were learned and wise, and often right, but my
ears did not—or could not—hear, and I went my own way.
Thus, while my first thoughts were for appreciation for FCAT
members and their efforts, my second thoughts were that
those efforts, like those of the Talmudic scholars of my
youth, missed the point and the intended audience.
FCAT’s desire, to establish a type of ‘‘orthodoxy’’ of lan-
guage use in a ‘‘heterodox’’ terminological world—correct in
spirit as it might be—may be a quixotic quest. As can be seen
from Martin et al. (2009), there is clearly lack of acceptance
for many FCAT suggestions even among a brotherhood of
anatomists. While we anatomists are thus not eager to accept
*Correspondence to: Dr. Jeffrey T. Laitman, Center for Anatomy and
Functional Morphology, Mount Sinai School of Medicine, One
Gustave Levy Place, New York, NY 10029-6574, USA. E-mail:
jeffrey.laitman@mssm.edu
Received 5 May 2009; Accepted 5 May 2009.
Published online 8 June 2009 in Wiley InterScience (www.
interscience.wiley.com). DOI 10.1002/ase.87
© 2009 American Association of Anatomists
Anatomical Sciences Education MAY/JUNE 2009
their suggested revisions, it must be remembered that our
clinical brethren—those who will take the lead in directing
our young charges after they leave us—are even less likely to
accept changes created by some anatomical committee, no
matter how well intentioned and learned (and even correct)
they may be. Hope of changing many clinicians in this regard
will likely be a fruitless effort (indeed, legions still unsheathe
their scalpels in defense of their favorite eponyms.) Trust me,
I have tried. For example, in my own inch of the anatomical
world, the larynx, there has been continuing disagreement on
what to call the vocal ‘‘folds’’ (for some of us amongst the
most important structures in mammals; no function 5 no air
in 5 no us!) In 1741, Antoine Ferrein coined the term vocal
‘‘cords’’ comparing their action to those of the strings of a
violin (Ferrein, 1741). Exupere Joseph Bertin (1745) strenu-
ously objected, correctly pointing out that they were the ter-
minations of a plica, or fold, and that the ‘‘correct’’ anatomi-
cal terms should always be used (Bertin, 1745). Anatomists
have ever since championed vocal ‘‘folds’’. The rest of the
world? To the vast majority of clinicians, and any patient I
have ever met, those things in the larynx are the vocal
‘‘cords,’’ and cords they will likely stay.
So anatomists do not agree, and clinicians will always
march to their own drummer. There is yet another problem
with FCAT and their terminological revisions, and one that,
in my opinion, largely doomed their noble efforts from the
beginning: the mode of communicating this material to their
intended audience. Indeed, for any product to succeed, it
must be widely, rapidly, and openly communicated. You may
have the best product, but if no one knows about it, then it
will never have an impact. Publishing an expensive book,
only in Latin and English, is not the way in the Internet age.
How many anatomists beyond an inner circle used, or even
knew, of the book, or about the reasons for suggesting
changes (many of which were very good)?
We in anatomy must also address a deeper question that
the issue of FCAT, their efforts and publication, raises.
Indeed, for me, it is the central question: Is a formal stand-
ardization of terms—a terminologia—needed? On the one
hand, it can be argued that without this effort, or a similar
one, we will have naught but a sea of competing terms.
What is a scientific discipline without a consensus base on
its language? On the other hand, it can be raised that in
this age of revised curricula, reduced hours, integrated mate-
rial, dwindling funds, and fewer ‘‘professional’’ (read: ‘‘in-
the-know, life-long’’) anatomists, is it a ‘‘high priority’’ (or
any priority?) for us to go back and forth revising or stand-
ardizing anatomical terms? Is this the best use of our time
or our students’ time? What image do we project to our
clinical colleagues and others when we argue over what
appear to them as antiquated minutiae? As one of my clini-
cal colleagues remarked at a recent National Board of Med-
ical Examiner’s meeting overhearing some of us disagree on
Anat Sci Ed 2:137–138 (2009)
terms, ‘‘Is that what you anatomists do at your meeting, Indeed, had I been included in discussions with those great
argue about terms?’’ This is surely not the image of us that Talmudic scholars of my youth, with some mutuality of
we want out there. understanding, maybe I would have opened my ears to their
What message can we learn from FCAT, their heart-felt and wise message and put down that ham and cheese sandwich.
well-intentioned efforts, and the response or lack thereof to
their suggestions? I think that one important and strong mes-
sage is that in this world of diversity and change a single com- LITERATURE CITED
mittee sending out a plea for adherence to an orthodox liturgy Bertin EJ. 1745. Lettre à M.D. Sur le Nouveau Systemé de la Voix. Guerre
will not work. Indeed, entering more terms or different ones Anatomique (The Hague) 1–40.
can be counterproductive and lead to confusion and annoy- FCAT. 1998. Terminologia Anatomica: International Anatomical Terminology.
ance, not the hoped for consensus, if there is not agreement Stuttgart, Germany: Thieme. 292 p.
beforehand that the outcome will be implemented. One sugges- Ferrein A. 1741. De la formation de la voix de l’homme. Mem Acad R Sci
tion might be that if we (and that ‘‘we’’ is a question as well) (Paris) 409–432.
decide to do this again, the authors of leading anatomical, sur- Martin BD, Thorpe D, Barnes R, DeLeon M, Hill D. 2009. Frequency in usage
gical, and medical texts might communicate beforehand in a of FCAT approved anatomical terms by North American anatomists. Anat Sci
type of ‘‘compact of understanding’’ on an implementation Ed 2:94–106.
strategy. Second, we can learn that in this day of Wikipedia
and iPhone, Facebook, and instant messaging, how the message Jeffrey T. Laitman, Ph.D.*
is transmitted to the field and the audience is of vital impor- Distinguished Professor
tance. Lastly, we can also learn from the response to FCAT sug- Professor and Director
gestions that we must be more accepting of the diversity and Center for Anatomy and Functional Morphology
reality of other views, and that suggestions—even good ones— Professor of Otolaryngology
that appear strident or on a single path can antagonize the Professor of Medical Education
group you are trying to influence. Perhaps, we can come to an Mount Sinai School of Medicine
acceptance that terms can and do vary—and that’s ok—as long New York, New York
as we all know the synonyms, what we are communicating, President-Elect
and get the message across. The American Association of Anatomists

138 Laitman