Doctor Curmudgeon The White Coat

By Diane Batshaw Eisman, M.D. FAAP Doctor Eisman is in Family Practice in Aventura, Florida with her partner, Dr. Eugene Eisman, an internist/cardiologist

As I wrestled a clean white coat from its hangar, I wondered why this had become symbolic of the medical profession.

When did the idea of wearing a white coat begin?

I was astonished to learn that until the latter part of the nineteenth century, doctors were garbed in black. Doctors of that time did not have much formal education and were not looked upon as scientists. When a physician attended to a patient, he/she wore formal street clothes, usually black. Since the Clergy wore black and were respected, physicians donned black in the hope of signifying professionalism, respectability, formality, and solemnity. It was believed that wearing a black coat would express the seriousness of the profession. And wearing a dark coat presented another benefit– blood and messy stuff did not show up as easily as on a lighter color.

Until the late nineteenth century, seeing a doctor was a last resort– often as a precursor to death. Even paintings depicted physicians in dark coats. Thomas Eakins, a famous painter, created “the Gross Clinic” showing Jefferson Medical College’s amphitheater where a team led by Dr.Samuel Gross removed a leg—and all were dressed in black.

In those early days of the nineteenth century, visiting a doctor was not a good experience and was to be avoided if at all possible. Mortality rates were high. The doctor would come to the patient’s home. There was a lot of bloodletting and it was believed that sweating cured many ailments. Enemas were often given. Procedures were painful and could result in fatal infections. Even surgery without any anesthesia was carried out in the home of the patient.

It was not until the twentieth century that the white coat emerged as a symbol of medical authority and respect. Anesthesia arrived and surgeons could operate more slowly and precisely—less blood and mess. They could now toss their black coats into the trash.

Antisepsis and the understanding of infectious disease arrived. With scientific advances, doctors had a new found respectability and seriousness of purpose. The white coat was now established as the symbol of the doctor-patient encounter. It now represented respect and medical authority.

(EDITOR’S NOTE FROM GALAHAD, THE SIBERIAN HUSKY WHO IS DOCTOR CURMUDGEON’S COUSIN:

TODAY, MANY DOCTORS DO NOT WEAR WHITE COATS, PREFERRING SCRUBS. BUT THE WHITE COAT DOES STILL LIVE ON).

Dr. Curmudgeon suggests “Bitter Medicine”, Dr. Eugene Eisman’s story of his experiences–from the humorous to the intense—as a young army doctor serving in the Vietnam War.
Bitter Medicine by Eugene H. Eisman, M.D. –on Amazon

Doctor Curmudgeon® is Diane Batshaw Eisman, M.D., a physician-satirist. This column originally appeared on SERMO, the leading global social network for doctors.
SERMO www.sermo.com

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