The Fragile Line Between White Coats and Patient Gowns

Abstract: This project explores two articles of clothing, what they represent, and the delicate line between them. To accomplish this, I produced an acrylic painting of a white coat intertwined with a patient gown, and I wrote an essay analyzing the dual identity of people who are both physicians and patients.

16 x 20 acrylic painting

The juxtaposition of the fabrics emphasizes the stark contrast between doctors and patients, but the intertwined nature of the clothes explores the blurred line between the two groups.

IntroductionWhite, crisp, clean, expensive, trustworthy, professional, authoritative. Unsightly, flimsy, stained, exposing, vulnerable. These two sets of words paint opposite images of white coats and patient gowns, articles of clothing that represent doctors and patients, respectively.

Thesis StatementIn order to understand the powerful relationship between white coats and patient gowns, I will discuss the historical evolution of the two garments and people who have donned both including myself, Dr. Robert Klitzman, and Dr. Paul Kalanithi.

White Coat• Physicians used to wear black

• Black is considered formal• Seeing a physician was the

precursor to death due to primitive medicine

• Toward the end of the 19th

century: shift from black to white garb

• White embodies purity: important in rebranding medicine as it transitioned from quackery to a scientific enterprise

Patient Gown• Not much literature exists

regarding the evolution of the patient gown

• Patient gowns are flimsy and leave a patient’s backside exposed

• Design is unpopular, but hasn’t improved in over 100 years

Psychological Effects of Garments

• A study in the Journal of Experimental Social Psychology explores how clothes influence wearer’s psychological processes (Adam)

• Enclothed cognition: the physical act of wearing certain clothes and the symbolic meaning behind the clothes impacts psychological processes

Doctors as Patients: Myself• Appendicitis complicated by a small bowel

obstruction• Before: medical student sporting white coat on

family medicine rotation• During: patient wearing hospital gown because

they needed easy access to draw blood, deliver medications, and administer rectal enemas.

• Experienced hopelessness and vulnerability

Doctors as Patients: Dr. Robert Klitzman• Experienced crippling grief when his younger sister died

• Originally tried to deny, but eventually came to terms with condition

• After his experience he wrote a book called When Doctors Become Patients, which weaves together over 70 interviews of doctors who, as the title suggests, become patients themselves

• Chapter called Magic White Coats: idea that illness happens to “them over there”, not to “us”

Doctors as Patients: Dr. Paul Kalanithi• Was in his last year of neurosurgical

residency when he was diagnosed with stage IV metastatic lung cancer

• Wrote New York Times bestseller: When Breath Becomes Air

• Speculates on what makes life worth living in the face of death

• Dr. Paul Kalanithi was both a doctor and a patient navigating his dual identities

Conclusion and Significance• My ultimate goal is to appreciate how simple articles of clothing

both create and illustrate a power-differential between doctors and patients, and how that power-differential shatters when doctors become patients themselves.

• This project is significant because the vast majority of healthcare professionals will fall ill at some point--that point may be a lot sooner than we’d like due to the coronavirus pandemic.

Literature Review• Hochberg, Mark S. “The Doctor's White Coat: An Historical Perspective.” Journal of Ethics, American Medical Association, 1 Apr. 2007,

journalofethics.ama-assn.org/article/doctors-white-coat-historical-perspective/2007-04.

• Luthra, Shefali. “Hospital Gowns Get a Makeover.” The Atlantic, Atlantic Media Company, 4 Apr. 2015, www.theatlantic.com/health/archive/2015/04/hospital-gowns-get-a-makeover/389258/.

• McDonald, Emily G. “Inpatient Attire and the Patient Experience.” JAMA Internal Medicine, American Medical Association, 1 Nov. 2014, jamanetwork.com/journals/jamainternalmedicine/fullarticle/1907001.

• Wellbery, Caroline, and Melissa Chan. “White Coat, Patient Gown.” Medical Humanities, Institute of Medical Ethics, 1 Dec. 2014, mh.bmj.com/content/40/2/90?hwoasp=authn:1585677590:69656786:1277084536:0:0:s7eIrLEUlmXoVFNbHvrVwg==.

• Adam, Hajo, and Adam D. Galinsky. “Enclothed Cognition.” Journal of Experimental Social Psychology, Academic Press, 21 Feb. 2012, www.sciencedirect.com/science/article/pii/S0022103112000200.

• Kalter, Lindsay. “Trading Places: When Doctors Become Patients.” AAMC, 4 Feb. 2019, www.aamc.org/news-insights/trading-places-when-doctors-become-patients.

• Parker-pope, Tara. “When Doctors Become Patients.” The New York Times, The New York Times, 8 Feb. 2008, well.blogs.nytimes.com/2008/02/08/when-doctors-become-patients/.

• Kalanithi, Paul. When Breath Becomes Air. First edition. New York: Random House, 2016.