If one were to ask a number of subjects to imagine a physician’s clothing, the unifying factor would likely be the white lab coat. And, indeed, scrubs and a white coat are de rigueur for most doctors. But prior to 1900 this practical uniform was not the standard. Medical attire has changed drastically over the course of the last century, in a manner that parallels medical progress and reflects evolving attitudes and more effective treatments. In the 1800’s, a physician was typically clad in black formal wear. Much like clergymen and magistrates, who also donned dark robes, a doctor’s occupation was a rather sober one. Due to the crude nature of many medical procedures, it was more likely that a doctor’s appointment presaged a visit from the local priest rather than a full recovery. But this, as well as the physicians funereal attire, was soon to change.
The turn of the century brought with it increasingly refined surgical techniques and greater survival rates. Thus, surgeons operated more frequently. Surgical sanitation had not yet been perfected, so doctors simply worked in their street clothes covered by a butcher style apron. This apron often went unwashed, the blood against the bright white canvas a testament to the medical, and monetary, success of the surgeon. The mechanism of disease transfer was still a matter of debate, so germs and illnesses were carried from patient to patient via unwashed hands, contaminated surgical tools and the sullied apron.
Masks, Gloves and the White Uniform
During the Spanish Flu pandemic of 1918, physicians began to wear cotton gauze masks during treatment and in the operating room. Concurrently, interest in Joseph Lister’s antiseptic surgical procedures convinced more and more doctors to wear gloves into the operating theater. The white coat, and often white underclothing, also gained popularity in this era. With medical treatment demonstrating greater rates of success than ever before, the perception of the physician’s presence as an ominous portent began to change. White, associated with healing and purity, became the mainstay of the doctor’s wardrobe.
Antiseptic Gowns in Surgery and the White Uniform in the Office
In the 1940’s, acceptance of germ theory and antiseptic technique led to the adoption of the antiseptic gown as the universal standard for surgical dress. These white robes, unlike the apron, were routinely sterilized. When not in surgery, a white coat, pants and shirt were the identifying garments of the medical professional.
A Change in Color
By the 1950’s and 1960’s, it was no longer necessary to foster the image of the healer by being fully clad in white when the results of medical treatment spoke for themselves. When the glare of the all-white operating room began to take a toll on medical staff’s ability to work effectively, the industry abandoned white for color, particularly green. Darker hues also made blood spatter less conspicuous. The doctor was no longer revered for the preponderance of gore on his uniform. He or she was renowned for the ability to work cleanly and prevent infection.
Scrubs and the White Lab Coat
Scrubs, in their modern incarnation, became the norm by the 1970’s and are still the most common medical uniform. Short-sleeved shirts and draw-stringed pants allow the physician to work comfortably and wash thoroughly. The colored cotton is easily sanitized, helping to prevent the spread of infectious disease. The white lab coat lingers. To some it is a badge of honor, a tangible reward for years of study and a mark of distinction between ranks of staff. To others it is a relic that harbors bacteria, envelops the practitioner in an unwarranted aura of mystique and separates him from his peers in an environment where teamwork is key. Whether the lab coat will fall into the obscurity of its predecessors remains to be seen. What is certain is that the doctor no longer has to rely so heavily on the outward appearance of a healer when his skill can portray him as such. With or without the lab coat, the trend is likely to remain one of comfort, cleanliness and color.
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