Rings and Strings

When I was a med student on my first surgery rotation, I was taken with the coolness of how the surgeons tied all manner of baubles into the drawstrings of their scrub pants. Rings, watches, bracelets. It just screamed "I'm a surgeon, and you're not." So I did the same thing. And carried it on, halfway through my career. It's one of those things surgeons do, like carrying a stethoscope in their pocket rather than around the neck. Pockets populate scrubs like rabbit holes: for one thing, the outfits are generally reversible, with the same pocket pattern inside as outside; for another, many styles of shirts have not only the usual breast pockets, but at least a couple extras at the lower hemline. Storage? We got it everywhere. But you tie stuff into the drawstrings, because that's what you do. Maybe it's to draw attention to one's genitals: shiny things -- in our genes it is written to turn our eyes toward them.

In our fourth year of med school, one of my pals was on his obstetrics rotation. Called to the ER to evaluate a woman with some problem or other, he left her up in those medieval stirrups while waiting for the resident to come and check his findings. Restive and bored, standing there between the lady's knees with time (and lube?) on his hands, he chose that moment to put his ring and watch back on. As he distractedly began untying his drawstrings he happened to cross eyebeams with his patient, and noticed she was recoiling in dread as she witnessed a man apparently untying himself while well within her personal space. "Oh no, no, no," he said, "I'm sorry, it's not...I was just, y'know, putting on my... I'm not..." But there was no recovery.

Without any deep thought (not a huge priority, this), somewhere along the line, a few years ago, I stopped tying up my bling. It's such a cliche´really. Have all those pockets: why not use 'em. Which was fine until, in the wee hours of a long late night, with bleariness aforethought I tossed my scrub shirt -- wedding ring in the pocket -- into the laundry bin after surgery and staggered home. By the time I got there, realized it, and called the OR to request they "hold the bag," it had already been taken away by the housekeeping staff. Calls to every responsible place failed to stop the inevitable: it was never seen again, at least not by me. It wasn't particularly fancy, but I'd designed it and a matching one for my wife; had 'em made...

So I'm of two minds.

Scrub Club

I've just received an email from a designer, in New York City. She's addressing the issue of surgical scrubs and related attire, and asks for my input. (I love the unexpected connections that have arisen from blogging -- and state once again that it wasn't falling out of love that led to my abloggia. Or the current hypobloggia.) I imagine her contact was a scatter-shot towards all the surgeon-bloggers she could google; still, I'm both flattered and intrigued. And it seems a good topic for a post. Writing about a thing, after all, is the best way to figure out what one thinks.

Simple and entirely functional, scrubs are nonetheless among the most recognizable of uniforms, and make an easily understood statement of authority. And not a little edginess: "I work in an OR. I know things you don't, and never will (unless you read Surgeonsblog.)" Assuming the wearer is legit, which more and more is less and less the case.

I think there are phases of scrub-wearing: at first, as a student, you feel entirely a pretender. But you like it. If you select surgery as your future, when you wear them it feels like a commitment; before long, they become comfortable and practical, and wearing them is a matter of convenience (and saving money on laundry.) Somewhere along the line they become a badge of honor; and, eventually, it's all of those at once. I'm most aware of them, self-consciously and proudly, when I'm talking with family members immediately after completing surgery on their loved one. Which means, among other things, that one wants them neither dorky nor unclean.

In surgery, we wear gowns of some sort over the scrubs. Claims of imperviousness to the contrary, they often allow, uh, fluids to penetrate and stain our scrubs. (I wrote about some implications of that fact here.) And, permeable gowns or not, when an operation is fluidiferous the cuffs of one's pants and the shoes or the covers on them bear witness. It behooves, in other words, a scrub-survey before heading to the waiting room. (I know of one curmudgeonly and generally embittered surgeon who liked to talk to families still engowned -- the bloodier, the better.)

Having checked for nastiness and changed, if needed, into clean scrubs, I nearly always donned some sort of cover before going to the families. Since I eschewed a white coat until the latter part of practice, for many years that meant grabbing a cover gown: color-matched but generally untidy and sloppy-looking. It's only in retrospect that I see the get-up as unimpressive. Functional, efficient, but inelegant. I absolutely don't think that the clothes matter much; but when I began wearing a spiffy thigh-length white coat, I found I liked much better the appearance of a clean and pressed lab coat over scrubs. And I took off my surgical hat, too. I hate how I look in hats, and, having fairly long hair, I always wore a bouffant cap anyway. If there's anything to presenting a nice image, that pretty much tears it.

I worked in one surgery center that provided pink scrubs. Having no choice, I wore them.

And now, let me get to the central issue of scrub-wearing, as it applies to the male of the species. Here, I'll let you in on one of the best-kept secrets of the club. I'll begin with an aphorism known to males of any occupation: "No matter how you shake and dance, the last few drops go down your pants." I trust I needn't explain any further. Whatever else it might be, when wearing normal pants drippage isn't a, uh, cosmetic issue. But thin light scrub pants -- well, a spot is easily spotted. That may play into the controversy of tucking one's scrubs in or not; walking back into the OR having taken a break between cases, there may be, on occasion, reason for self-consciousness. Particularly if the stock of clean scrubs is low.

A friend -- my favorite anesthesiologist -- handled it best. Before returning after relieving himself, he'd put a drop of water on his fingertip, and dab it on his scrub pants, down at about knee level.


P.S: what the heck are those people in the title picture doing, anyway?