The new white coat.
(As aired on All Things Considered, November 29, 2002)JACKI LYDEN, host:
At medical schools all over the country, first-year students participate in a ceremony that seems like an ancient ritual, but is actually less than 10 years old: the white coat ceremony. Commentator Joe Wright just had his.
JOE WRIGHT:
The equation of doctor equals white coat began in the 19th century when a set of doctors decided they should ditch older traditions and embrace the new world of science. They put on lab scientist drag to help convince their patients and themselves of the transformation. The lab outfit became an icon of doctordom; a symbol for the knowledge and the authority of the physician. But people came to resent the arrogance and remoteness of many physicians, so the white coat also came to stand for a kind of remove. In fact, many psychiatrists have ditched the white coat entirely. They want a more direct, humane appearance.
The white coat is still a cherished icon, though. So instead of abandoning the coat, a doctor named Arnold Gold wanted to add to its meaning values or care and compassion. In 1993, he invented the white coat ceremony, designed for the very first moment of medical school. Dr. Gold and the Robert Wood Johnson Foundation support ceremonies around the country now, giving medical students a book of essays, stories and poems called "On Doctoring" and a pin for our coats that says "Humanism in medicine."
At my own white coat ceremony, watching my classmates put on their coats and receiving my own, I was near the edge of tears, moved by the sweet sincerity of some of my classmates and by my own feelings of hope about this new beginning in my life.
And yet, that can't be the end of the story. When doctors first put on white coats, it was because they hoped to become scientificnot necessarily because they were, in fact, scientific. Now my elders are trying to reinvent the white coat to make it stand for something new. Will it work? When I was applying to medical schools, one of my interviewers said, "I can't teach you compassion. Your mother teaches you that."
Whoever will teach us kindness, or however we'll find it and keep it alive within ourselves, these days we doctors and future doctors seem to want to embrace the long-held ideals of nursing: care, concern, knowing patients as whole people. I hold those ideals dear, and I thought a lot about becoming a nurse. But I wanted to be an expert and I wanted to be in charge, at least as much as I wanted to be kind.
When I was a teen-ager, I thought I should get some kind of award every time I did the dishes. I think doctors sometimes act the same way about being compassionate: "Look at me. Aren't I good?" There are doctors worth praising. On the other hand, in the United States, health care is still a product to be purchased. Seen in that light, "compassion" is just another word for "customer service."
copyright 2002 joe wright
broadcast and transcript, copyright 2002 national public radio
