Just Who is Non-Hodgkin's Lymphoma Named For?
You hear the name of a cancer so many times during your cancer treatment — your doctor references it throughout your diagnosis, your treatment, your remission.
You Google the term. You tell your family you have this cancer type. You find support groups with the cancer name.
“I have non-Hodgkin’s lymphoma,” you say to strangers and friends alike.
As many times as you say it, do you ever wonder why it’s called this? Why not lymph cancer, like breast cancer is cancer of the breast?
Just what, and who, is a Hodgkin’s?
A man named Thomas Hodgkin, it turns out.
A life-long social renegade, a Quaker who couldn't marry the love of his life, a physician and pathologist who isn’t well-remembered today in the U.S, Thomas Hodgkin was “an exceptional and compassionate physician who first described the malignant lymphoma that bears his name,” says Marvin J. Stone, M.D.
Thomas Hodgkin’s “efforts on the behalf of underprivileged and oppressed peoples throughout the world were lifelong.” He was anti-slavery, pro-native American Indian advocacy, and a supporter of human rights who often did not charge his impoverished patients. And all during the 18th century when such viewpoints were not wildly popular.
“During his brief career at Guy’s Hospital [London], he made other major contributions to clinical medicine and pathology,” Dr. Stone writes in a journal article on Hodgkin. “He served as first curator of the museum at Guy’s, which became and remains one of the front-ranking medical museums in the world. His adherence to Quaker precepts and strong reformist penchant were constant features of his life. Some of his altruistic efforts were too impractical and unpopular to be successful.”
“Nevertheless, Thomas Hodgkin’s life continues to serve as a beacon for social justice and human rights applicable to physicians and lay persons alike.”
All in an eponym
Non-Hodgkin’s lymphoma (also known as non-Hodgkin lymphoma, NHL, or lymphoma, and then there is Hodgkin's lymphoma as well) is not only a cancer of the white blood cells called lymphocytes, which are part of the body’s immune system, but it’s also what’s called a medical “eponym.” A medical eponym is a disease (or procedure or tool or other things too) that is named after a real person. It also can be a non-medically related person, as this article from the Independent shows.
“Eponyms are a long-standing tradition in medicine,” says Robert P. Ferguson, M.D., and Deborah Thomas, M.L.S.
In their article “Medical eponyms,” published in 2014 in Journal of Community Hospital Internal Medicine Perspectives, they explain that eponyms often honor a researcher who played a key role in the discovery of a disease.
“Under the right circumstances, a disease becomes well known through the name of this individual,” they write. “It is often easier to remember a disease by its eponym than by the more scientific pathologic description; for example, which name is better known, Hodgkin’s disease or any of its five types, to wit, nodular sclerosing, mixed cellularity, lymphocyte depleted, lymphocyte rich, and nodular lymphocyte-predominant?”
Clearly, Hodgkin’s disease.
But the medical community is not united in using eponyms: controversy has surrounded their use, from whether they should have apostrophes to if diseases should bear the name of their Nazi physician founders. The website Whonamedit?, a dictionary of medical eponyms, contains some 8,636 names. But “one quarter of these entries are from the United States and there is a bias against women, non-North Americans, and Europeans leading others to question their use,” says David Kudlowitz, M.D.
“No matter where you stand on the use of eponyms, studying the history of our predecessors gives us insight into our medical culture,” Dr. Kudlowitz says.
Some medical eponyms are so commonplace, you probably don’t realize or think about how they’re named after someone. Like Parkinson’s disease (named for James Parkinson); Alzheimer’s disease (named for Alois Alzheimer); Hashimoto’s thyroiditis (named for Hakaru Hashimoto); Cushing’s disease (named for Harvey Williams Cushing); Crohn’s disease (named for Burrill Crohn). To make things more complicated, an autoeponym is a disease named after a patient who lived and/or died of the disease: one famous one is Lou Gehrig’s disease (also known as amyotrophic lateral sclerosis). And that disease? Charles Bell first described it, but he’s better known for Bell’s palsy.
So just who was Thomas Hodgkin?
Thomas Hodgkin was a man who lived
Thomas Hodgkin was born in 1798 in England into the Quaker religion, and became a man who was “dark haired, short and lean, high tempered and highly appreciated as a lecturer.” He first described the disease he would come to be known for in 1832 in a published paper called “On some morbid appearances of the absorbent glands and spleen.”
It wasn’t until another British physician, Samuel Wilks, was describing the same disease in 1865 that the cancer type was named: “As he [Wilks] later became acquainted with the work of Hodgkin, he recognized the latter’s priority and named the condition for Hodgkin, in an article in Guy’s Hospital Reports titled ‘Cases of enlargement of the lymphatic glands and spleen, (or, Hodgkin’s disease)’ with remarks. Since then Hodgkin’s disease has become one of the best known of all medical eponyms,” according to Whonamedit?
Hodgkin himself was passed over for a prominent role at Guy’s Hospital, which effectively ended his career. He loved his cousin, Sarah Godlee, but was not allowed to marry her because of the Quaker rule prohibiting marriage between first cousins. Their unrequited love lasted 35 years.
His grave is now in a closed churchyard and mostly overgrown, according to Whonamedit?
Why does it matter?
Experts agree: it looks like eponyms are here to stay, despite disagreement over their use.
So why does this matter to you as a patient? It’s helpful to have a name to identify your disease, and it’s helpful to know that this name was after a crusader of human rights, a man who tried to make the world a better place through medicine and social reform.
“One could argue that eponyms exist for two reasons: first, a human desire to be remembered; and second, because there sometimes isn’t a better way of naming a concept without resorting to cumbersome and unmemorable descriptions,” Peter B.M. Thomas writes. “We might have passed peak eponym, but reports of their death are greatly exaggerated.”
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