Sunday, May 19, 2013

"We are what we eat", but are we also What we Wear?

Before I start, an apology! First it was a viral infection, then a sinus problem and then a recurrence of a back issue .... plus there was much happening with the development of the Trail I am creating called The Pilgrim Trail here in Perth Australia, and so Blogging went to the back burner!

But today I was reading an article in Medscape which pricked my interest! It was about what Docs wear, and so my blogging juices began to flow again!

In the 19th Century, the Doctor - all male at that time - wore a frock coat and perched a tall black hat on his head to give himself an aura of power and wisdom. In that era, before the times of Anaesthetics and Antibiotics, surgery happened quick and fast because Surgeons were ignorant of what bacteria were, and hygiene and antisepsis were unknown. That's why a Surgeon, who often learned his anatomy by dissecting dead bodies supplied by grave robbers, would walk straight into the Operating "Theatre' from the adjoining room where he had been performing such postmortems.
Wearing the same clothes and frock coat they had worn whilst dissecting the dead bodies, and without washing their hands, they would wipe their blades clean on those self-same coats and began to operate. Such procedures occurred at the speed of light on an often conscious patient who was usually held down by strong restraints! Having finished that surgery, the Surgeon would change his coat and went to see their ward patients in a clean coat!

What the Docs wore then was designed to give them an aura of power and wisdom, neither of which they fully deserved, but then they were trying to do their best with the knowledge they had. Fast forward 150 years and some Doctors still need to project that same aura of power and wisdom, but I suspect that "Change" is happening and it's happening fairly fast too. So have attitudes to dress changed at all? When I began my Intern Year in the UK "last century", we all wore our white coats on the ward and our ties usually gave clues as to which school/college/club you belonged to. We followed our "Consultant" in a small flock and always called him Sir - there were still very few women on the wards in those days! Imagine our amazement when an Aussi Registrar joined us for a ward round wearing SHORTS and NO TIE! But to cap it off, instead of calling the Consultant "Sir", he just said "Morning George, how's it going"? I think that was the time when I thought that I wanted to go to Australia and enjoy some of that open, honest attitude.

These days many Docs still feel that the "White Coat" is still an important part of their uniform. It does have the advantage of providing several extra pockets in which to carry various instruments and IT equipment. but then, they can be carried even more easily in an appropriate case/bag.  In Australia dress code would be described as "Smart Casual", but ties are rarely worn by the menfolk; but as these days over 50% of medical graduates are female, ties are definitely a disappearing part of Medical Haute Couture. In fact, in the UK, ties are banned because they have been shown to carry infection that can be passed onto a patient. (I have to admit to a long period when I wore some very snappy Bow-ties, despite being mistaken for a second hand car salesman and an accountant on a couple of occasions!)

Most female Docs I have worked with followed the rule of "Smart Casual" too and usually followed the principal of "If I can't crawl under a desk in it, I won't wear it" - wise words indeed! Here in Oz, because of the really hot conditions in Rural areas, most guys will wear shorts with an open necked shirt and a wide brimmed hat - which gives a very Antipodean feeling.

But this move toward more Office Attire has come as the Aura of Medical Power has waned and the realization that Health Care is a partnership between the patient, the Doc and the wider medical team and everyone has their important part to play. As we move forward with the increasing role that IT will play in all of our lives with its power to monitor so many functions, and then share that information with other team members, what the Doc wears will have little meaning except for the Doc her/himself. Which is a shame really, because those Frock Coats and ivory topped walking canes were really kool!


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1 comment:

Mariodacatsmom said...

I think most of the medical community in our area still uses the white jackets with the multi pockets.