14 December 2014

The Whiter Coat

14 December 2014

            I hadn’t worn it in a year.  Halfway through internal medicine residency, I’ve lost two of my allotted four. But yesterday, for the Millions March in NYC, I donned my white coat under the banner of “White Coats for Black Lives,” over jeans, under scarf and knit hat. Doctors worldwide wear stethoscopes—a necessary tool, used for heart-lungs-belly-neck. A patient feels taken care of if you’ve listened to her heart and lungs. We have the laying on of hands and the laying on of stethoscope diaphragm and bell. Doctors worldwide wear white coats, a tool of nothing but repository for tools, a signifier of identification, power, an instrument of implementing hierarchy, and whatever else (including the positive) that is associated with the profession. With power comes implied responsibility, a mandate to earn the given trust.
            Before even my first day of medical school, we received our white coats in a ceremony, parents came and took pictures, and we solemnly recited the Hippocratic oath, months before touching our first patients. A symbol of induction into the lifelong guild. For students, the white coat is short, still symbolizing power to patients perhaps oblivious to the length, but clearly showing the lowest rank to other doctors. It takes so many years to arrive at medical school. We had made it. Quickly, I learned to hate the coat, resent it, except for its many practical pockets, and I relished the rotations—pediatrics and psychiatry—that didn’t require and even discouraged its use. In my social medicine program, there is something vaguely uncool about the white coat, the long white coat we worked so hard to achieve. I wore it for the protest, yesterday, faint ink marks still visible after hospital dry cleaning, in a contingent of many others---to show we know We are an institution, We are implicit and complicit, and We, in positions of power, are here in solidarity because, among other things, racism is bad for health.
            But to reject the whiteness of the coat requires whiteness, no need for cloth that soon shows sweat stains to confer that final privilege.