The White Coat

The white coat.

The thing that induces hypertension in millions.  The signature of medicine so strong that there are entire ceremonies dedicated to strapping them onto first year medical students as a symbol of things to come.  The harbinger of all things infectious.

I don’t like white coats.  Sure, the look professional, but outside of a lab, they are just not good ideas.  I have my reasons.  We will get to those.

My medical school has a policy that clerks are to wear lab coats on all rotations with the exception of psychiatry and pediatrics (family is preceptor dependent)… Don’t scare the p-patients.  By the end of one rotation, most people have ceased to wear them… Or at least they try not to except when lectured by administration or other senior staff.

To be honest, I am a rule-follower, so I wore it fairly religiously through the required core rotations.  But, for my electives and selectives… Not so much.  Except lab medicine… Because playing with formaldehyde and human tissue should not occur without a thin layer of protection of the lab coat I take home and wash with our towels (yum).

Why, might you ask, would I hate something that represents such a noble profession.  Well, I will tell you.  In organized bullet form.

• They are gross.  White coats are worn in hospital.  Hospitals are places where sick people are.  Sick people have germs.  Germs get on white coats.  White coats go from person to person and drop the germs behind them.  Delicious.
• White coats are white.  Therefore, they get dirty, well, visibly dirty faster than most other colors.  Big pain in the neck.  Mine has pen stains and coffee stains generally by day 2 of wear.  Nothing coffee loves to fall on more than a fresh white coat.
• They are not temperature friendly.  White coats are convenient if you are cold.  They can make you warmer.  But not warm enough that you stop being cold.  The reverse, however is untrue.  A white coat is not cool enough to keep you from broiling to death.
• They are yet another thing to bring places.  As a clerk at my school, we are required to travel a fair bit.  Packing your white coat is not at the top of your priority list.  It usually gets jammed into the top of a bag or forgotten.
• White coats scare people.  I don’t want to scare people.  I want to help them.
• White coats represent a lot of what I don’t like about medicine.  The paternalistic old boys’ club past.  The elitism.  Ugh.
• They make you stick out.  Everyone not medical assumes because you are wearing a white coat, you are clearly a doctor and therefore know what you are doing… WRONG.  A proportion of people who are medical sorts assume that you are a clerk.  This is good because they then know your appropriate knowledge level.  But then, they ask you questions excessively in rounds.  And you get volunteered for the not-so-fun jobs.  And then you get grilled more.
• They have pockets… And the pockets get filled and then they get heavy.  And you develop this weird shoulder pain… That is bilateral.  And you can’t figure out why.  Until, at the end of the day, you remove your white coat.  And suddenly even your giant winter coat doesn’t seem all that heavy.
• They get caught on things.  Stair rails, bed rails, door knobs… You get the picture.  I am a klutz.  The white coat does not help the situation.

As you can see, the white coat can cause a whole whack of trouble.

It has a good point, though.  The only redeeming quality of the white coat aside from statistical significance are the pockets.  Ah, the pockets.  You can keep a lot of stuff in a white coat.  Papers, notebooks, iPods, pocket guides to everything, little pen lights, pens, post-its, lists, a snack for when you get hypoglycemic after rounding for hours… The list can go on and on. Heck, you might look ridiculous, but a water bottle could fit in one of those pockets.  I may or may not have tried it once.

I am not a fan of the white coat, except for the pockets (until they cause strange shoulder injuries).  It represents much of medical history, but in an age when we are so well educated about infection control and patient centered care, it is ridiculous to strap them on outside of a special ceremony.

**This post reflects my views only and not the views of my peers (okay, well most of the people I talk to agree, but not the others) and definitely not of my medical school (which outside of the white coat thing is lovely).

Related posts:  White Coat Problems (sugarandscrubs.wordpress.com), Doctors Should Stop Wearing White Coats (getaheadwithdrg.wordpress.com), Why Doctors Wear White Coats (numberneededtotreat.wordpress.com), Why do Doctors Wear White Coats? (slate.com), Considering the Significance of a Doctor’s White Coat (medicallessons.net).