My white coats

The white coat was so practical

I started training at Melbourne University in 1970 after a false start in 1969. I first wore a long white lab coat when I did laboratory work in Chemistry, Biochemistry and Microbiology. I did two years of anatomy dissection in that coat. When I finished anatomy, I put the coat away in a box for the summer break because it smelled of formalin (which is now considered carcinogenic). I opened it when I returned from my break and it had disintegrated, so I threw it away.
In hospitals, I wore a short white coat to indicate my status as a medical student. The irony of graduating from a long full coat to a short coat was not wasted on me. I loved the practicality of that coat. It had large practical pockets. Buoyed by youthful enthusiasm, I scarcely noticed the weight I carried around with me - stethoscope, spiral notebook, compact text book, diagnostic set (a box with a handle containing C size batteries and two attachments of auriscope and ophthalmoscope) and last but not least – a long reflex hammer threaded through the button holes at the front of the coat. Only in later years did I notice that there was no female version of a white coat.

The white coat was so practical, any stain was easily visible and promptly cleansed and starched.

I distinctly remember putting a distressed baby over my shoulder, only to have it vomit down my back and into my right sided pocket! Fortunately – the child was not vomiting because of infection, my other clothing was not affected, the contents of that pocket were easily washed without damage and I did not have to clean the floor! After a quick rinse in the ward I took the coat home in a bag to wash it!
When I became a parent of colicky babies, I often wished I wore short white coats at home with them!

Having finally graduated to obstetrics and was expected to wear white shirt, tie slacks and white shoes. My female colleagues were expected to wear white skirts. This was a tradition instituted as a result of the actions of one of Medicine’s real rebels - Dr Ignaz Semmelweis who proved the value of hygiene - especially hand washing. White clothing allowed the easy detection of soiling and of boiling and starching clothes!

Several of my colleagues revolted and refused to wear this uniform - it was archaic, served no useful purpose and was a needless and onerous expense. There was one very significant issue for us all.
Coloured underwear was visible through all white clothing. I was recently married and my wife detested my wearing of what she referred to as “tidy-whities”.

The revolt was eventually successful and the white uniform was no more.

I graduated and promptly had a short delay in my clinical career caused by my contracting meningococcal septicaemia – probably from patients I had seen in the wards.

I would like to recount a tale of basking in the justifiable pride of the culmination of the then standard six years of academic and practical effort when I donned my first hospital issued white coat, I cannot.

My life was a blur triggered by a significant clinical load and the steep learning curve as I transitioned from theory to practice. I did one year of compulsory internship and then three years of then optional post graduate study.

I cannot even remember when I stopped wearing white coats. I consider that ironic given all the effort I exerted to gain the right to wear them.

Abandoning white coats was, I thought then, a step forward into progressive, patient centred, engaging clinical medicine, a nail in the coffin of the “God doctors” who were distant and isolated from their patients by formality and distance.

However, life has its ironies and when Covid impacted it was suddenly clear that the ideas of the generations behind me were not so crazy after all.

They did not sit next to their patients but were isolated from them across a mahogany desk a metre wide.

Their consultations were brief to the point of being terse.

There was often an open window behind them.

Their rooms reeked of disinfectant.

They washed their hands assiduously.

The only difference for us in Covid times was that we wore scrubs instead of a white coat.

My antecedents were right, I would have apologised to them but they are gone and live only in my recollections.

Associate Prof Chris Hogan

July 2021