End of the hospital white coat brigade

The best thing you could say about the face that glowered from a page of the medical journal was that it was modern. The beard reached the chest, the floppy fringe cascaded down, and the muscular arms were tattooed in pastel shades, like a stained-glass window in the twilight.

He was an expert on pain – not on inflicting it in a mixed-martial-arts ring but on alleviating it in an outpatient clinic. This McGregoresque character was a consultant anaesthetist.

It occurred to me that Britain was far ahead of us in medical fashion and that it would be a while before our wards would see such a sight – but at meeting at a large teaching hospital that day I was impressed to see the avant-garde style of the senior house officers and interns.

Most seemed to be West Ham supporters, in their scrubs of claret and blue, but there was the occasional Ireland fan, in tasteful green. One had a shirt open to the chest, in the style of Elvis during his Las Vegas period. Most of the lads had beards; the rest sported designer stubble. The odd nose stud, tattoo and dangly ear-ring was on display. Yet again Ireland had caught up with the rest of the world.

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When I was at their stage an intern was supposed to look like Leonardo DiCaprio in The Great Gatsby, all pink cheeks and white coat. Now they look like DiCaprio in The Revenant, just after the bear got at him.

Physiotherapists would sashay through the wards in tracksuits while the nurses stared after them with thoughtful looks in their eyes

My foremost reaction was envy. How did they get away with it when we didn’t? The only hospital workers who wore clothes suited to the job 30 years ago were physiotherapists. They would sashay through the wards in tracksuits while the nurses, who were doomed to wear impractical white dresses, stared after them with thoughtful looks in their eyes.

Things had to change, and soon the nurses were wearing their own tracksuits and scrubs, but the doctors still had to tog out as if they’d come from central casting in the 1970s.

The idea was not to frighten old women, who were believed to expect doctors to look as they did in elderly people’s youth – not that anyone actually asked them. Now they will rarely meet anyone older than Keith Richards, so that is not really an issue.

A friend who trained apprentice electricians used to maintain that work clothing should be appropriate. A junior electrician on a building site should dress accordingly, with the right boots and overalls. If he worked in a nightclub you would expect something different. The thing about hospital work is that it involves a surprising amount of running about, clambering around machinery and generally working out.

So why would you want to be got up like a soccer pundit in a suit and tie? The two main issues for appropriate dress are comfort and hygiene. If a doctor on call is supposed to stay up all night, computing fluid balances and blood gases, and interpreting ECGs and X-rays, while dressed like a bank manager it just seems like unnecessary stress in their lives. Nobody expects firefighters to look as if they’re going to a garden party.

Why expect a doctor on call to stay up all night while dressed like a bank manager? Nobody expects firefighters to look as if they're going to a garden party

It is many years since some researcher found that the tie around a doctor’s neck carried enough germs to kill a rugby team. I imagine that whoever thought to even think of looking for such a thing must have hated the tie, as I did, and saw it as a symbolic chain of the tyranny of convention. Wearing outside clothes in the hospital, and bringing hospital clothes home, are now regarded as dangerous.

Once we were set free of the tie, fashions moved fast. Remember, it only took four years for The Beatles to move from suits to kaftans. So what should a doctor look like? I think a doctor should look like anyone else.

The dress code was implemented at medical school before we ever saw a patient. The ties and skirts were to let us know we had joined a stuffy and conservative profession. We had to have a look, like priests or gardaí. We were now one of a gang, and, like barristers in their gowns, we should let everyone know it.

Some hospitals have a ceremony at which you are presented with a white coat. Any sort of celebration and rite of passage on your journey is to be generally welcomed, but nobody wears white coats any more.

My young informant tells me that after you trot up and get your white coat, to general applause, you put it away and never wear it again – unless you are painting the living room. He wears what he likes as a medical student. When he qualifies he can tog out like David Bowie in his heyday, for all I care, as long as he is happy in the job and does it well.