Tuesday, October 16, 2007
... And A Pink Carnation*
Before arriving in town to begin life as a practicing surgeon, I got a call from my pre-assigned medical assistant, asking what size and style white coat I'd prefer. Well, I thought, these guys think of everything. This private practice stuff might be cool. But then I wondered, who says I have to -- or even want to -- wear a white coat? Having spent the past ten years or so wearing the white coats of learning, and despite thinking those thigh-length ones that some of the professors wore looked pretty spiffy, I couldn't wait to get out of them. I'd also noted that in the teaching hospitals at which I'd spent all my time, the full-time professors were generally the only ones who wore white coats. The private guys mostly didn't. Not that I was emulating one or the other. But it said there was a choice, and I went nolo-alba.
I've only owned a couple of suits in my life, but I do have a few sport coats, and that's what I wore in practice. Always, back then, with a tie. Gathering dust in my closet are a couple of racks of generally garish and outlandish ties which, for some reason, I chose to wear for several years.
Ahead of my time (recent reports have, disgustingly, showed the amount of bacteria lugged from room to room on doctors' ties), I long ago ditched the ties. Within a couple more years, it was shirt and slacks sans coat, and that's where it stayed for the rest of my time in practice (now, as an assistant, I show up in jeans and whatever.)
Without any data or real basis for it, I'd always felt that white coats were off-putting; a barrier, of sorts. There is, after all, the white coat syndrome. But it really wasn't a plan, or even an overtly thoughful decision. I just didn't feel right in a white coat in my office, and the subsequent divestments were simply a matter of comfort. The only time I got negative feedback was when my mother asked my wife why she couldn't get me to dress better. A generational thing, on several levels.
It changed when I did my surgical hospitalist gig. Then, it was a considered decision. I figured it most practical if I were to spend the day wearing scrubs, and whereas there are usually available some scruboid cover gowns for running out from the OR to the floors, I figured a little decorum was called for. In particular, since I'd be seeing patients only in a hospital setting, people acutely ill having a surgeon thrust upon them cold, I thought some visual cues would be good. So I ordered, for the first time in about twenty-five years, some of those nice patrician thigh-length jobbies. With my name, MD, and Department of Surgery embroidered thereon.
Funny thing. I really liked wearing them. And it wasn't just because of the capacious pockets (I'm a surgeon: the stethoscope does NOT go around the neck. Plus, there's note cards, several rolls of paper tape, couple of gauze pads...) As I frequently lacked the time to establish rapport which the office setting tends to afford, that coat was an anthropomorphic business card. This guy's legit, it said. To a potential patient already in tough shape and low on time to think things over, that's good. Worn with scrubs, it was a way to be comfortable and appear serious. Looking back, I suppose I could have been wrong all those years.
*Only old people and/or dorky ones will get the musical reference.
Moving this post to the head of the list, I present a recently expanded sampling of what this blog has been about. Occasional rant aside, i...
Among many, many who've needed it and accepted it, I've had two patients who refused colostomy . One is dead, the other alive and we...
In no way is it false modesty to say that physicians are not healers. At best, what we do is to grease the way, to make conditions as favora...
Most of them were crazy, or demented. Sometimes they were brought in by an obviously discomfited relative, a daughter, and there was always ...