The White Coat

by Joanna Fabris, MSIII


The white coat is a symbol of power, trust, and pureness. For as long as I can remember, the white coat was the symbol of the practicing physician but this wasn't always the case. Previously in history, physicians often wore black to reflect the formal and melancholic nature of their profession. At that time, people saw a physician at the end of their life when not much could be done to change their course of illness. By the end of the 19th century and early 20th century when sanitation and the invention of antibiotics began to revolutionize the role of the physician to one of healer and curer, physicians began wearing white coats, in part reflective of this purity and cleanliness. Along with the white coat came the associated power, hierarchy, and authority.

My introduction to the white coat began my very first week of medical school with the ‘White Coat Ceremony' where we received our coats without ever having seen a single patient. I don't think I had the appreciation or understanding of what it meant at that time like I do now, just over 2 years later.

The first day of our third year clinical rotations, we put on our white coats to see real patients for the very first time. We started the first day with an orientation of the hospital that was given by students a year ahead of us. After showing us how to do blood draws, they told us we could grab some materials from the supply room in order to continue practicing at home. We were nervous and felt uneasy about the idea of taking supplies, and when we questioned them, they emphasized the importance of wearing our white coats in order to be identified as a medical student who has the privilege of having access throughout the hospital. We ventured down to the nurse's station (only after getting lost twice on the same floor), hesitant to enter the supply room. The nurses recognized our white coats and asked if we needed any help. They allowed us in to grab whatever we needed with no hesitation at all. This was only the start of realizing the power of the white coat.

We are allowed in patient rooms and are given access to patient charts. We walk into a patient's room wearing a white coat and they let you into their life, answer any questions we have, and they tell us things that even some of their closest family or friends don't know. Even when the questions seem irrelevant and unrelated, such as the classic student question regarding sexual history in a patient presenting for arm pain, patients for the most part are open and willing to answer without ever questioning your abilities or knowledge. Most importantly, they answer and trust you without knowing the first thing about you, except that somewhere along the line, you earned a white coat.

This white coat has allowed me to be involved in some of the happiest moments of a person's life, as well as some of the most devastating and somber moments. From experiencing an infant's first breath, to a man who presented with a cucumber stuck in his anus, to a diabetic woman facing amputation of her leg, up until the very last moments of life performing compressions on an elderly woman, each moment makes up what it means to be a physician wearing a white coat. It's not only the patients; we are also involved with their families who come to us for answers and support. Regardless of who the patient or their family is, and what their complaint is, when wearing a white coat, there is a sense of respect and a standard of professionalism and knowledge that is expected and that has to be maintained.

As students, we spend our clinical years following residents and attending physicians from room to room like minions wearing our short, above-the-knee length white coat aspiring to graduate, earn the title of ‘Dr', and have the bottom of our coats reach closer to the floor. We also learn that the white coat is something that cannot be taken for granted or abused. Rather, we have to use the power of the white coat to further build relationships that revolve around the patient and their wishes. Every day when we put our white coats on, we have to continue to earn the respect and trust that is so readily given by patients.