Life

Doctor in the blouse

So men can’t be sacked if they don’t wear a tie. Sorry, I’m not going to kick off my Jimmy Choo’s and dance with joy. Sartorial elegance is easy if you’re male. For girls it is so much harder, especially if you like fashion, and, worse, I have not chosen my profession wisely. I have been dressed badly for too many nights on call: the only bags I now pack are those under my eyes, the size of suitcases.

Such is the life of NHS doctors. Oh yes, the images were abundant when I filled out my UCAS form; I had seen ER, I had witnessed, deep in the unemployed valleys of my teenage years, the hushed tones people used when talking about the dispenser of Sick Notes and Prescription Drugs. Something about it was appealing; something wholesome about tending to the sick. For a good Catholic girl filling out University applications under the crucifixes on the classroom wall, medicine was the clever option. I would wear six years of sackcloth until I qualified, and then, graduating far away, under the rags there would be, at last, lingerie from La Perla and skin radiant from bountiful use of expensive creams. I would now wear the tailored clothes befitting a professional. I would not intentionally dress sexily; but, since knowledge is power, and power is an aphrodisiac, I could not, after years of toil and study, repress my radiant allure.

I have, however, got it all wrong. The doctor-patient relationship, that paternalistic beast, has been dissected. There has been no mercy. Doctors’ clothes matter, apparently, and not in the glamorous, uber-chic way I hoped. The study of what doctors wear and how that affects the relationship he or she has with patients has become a global pursuit. Yes, really: what doctors wear, and what they should wear has been studied by people who know the difference between the complex statistical workings of Crohnbach’s alpha analysis and ER’s alpha males. Researchers have been publishing in the British Medical Journal, and the journals European Psychiatry and Family Practice. P values have been determined for patterned pantyhose, and confidence intervals now relate to the inverse relationship between trusting your doctor and the amount of centimetres from her skirt to the floor. To cap it all, the Medial Journal of Australia reported a study which showed doctors that Hawiian shirts and nose rings were associated were not trusted by their patients much. The study was a Christmas joke, but was taken very seriously by the media- presumably because, going by the rest of the research, nose ringed doctors would indeed be committing a heinous fashion crime and would deserve to be maligned.

You see, I have been a fool. I graduated as a junior doctor in the dark days of rotas that sucked you into the black hole of the NHS. This was way before the European Time Directive and the New Deal, which insists on coffee breaks and the occasional day off. In my few heady days between graduation and the start of my resident junior doctor year, I bought suits, shirts and high-heeled shoes. It was a waste. For years I wore nothing but surgical greens and sweaty plimsolls one night in three. The only siren was the one on the wall insisting I run to a 4am cardiac arrest. It did not look good. My medical spouse promised me it would all get better.

It didn’t. I opted for General Practice where the air smelled sweeter and the clothes seemed better. But now, as I survey the sartorial landscape, I see that I have been left behind on the runway. I see my legal friends dressing clean and sharp with razor heels so high they would impress a clubful of transvestites. I see my teacher friends dress to impress their youthful progeny, soulfully relating to their progeny in Lycra jeans and glittering sandals. Social workers wear leather and biker boot chic with a calm air of bohemian cool. Even boring Bachelors of Engineering have turned dynamite in Eminem-inspired yellow safety helmets and svelte slim line dungarees.

Doctors don’t dress for ourselves; I finally realise, we dress in expectation; patients’ expectations and for our own worst case scenarios.

In a day I might have to pick over a house pooled with vomit to get to a corpse, and then get back to reassure a teenager that she isn’t pregnant, before explaining to someone else about his high PSA. I need clothes that are washable and trendy, yet approachable and trustworthy. Show me a dress or a suit and I’ll show you something that is either dry clean only, fashionable circa 1972 or looking like I should be ordering drinks in the Met Bar. People have been to the surgery before, and they know what should happen and who should be wearing what. While the only compliments I have ever had about my clothes have come exclusively from gay men, all the studies say that it is terribly important to patients how doctors dress. And it’s true; we might be working in a rationing NHS, but the nanny state wants to know what colour of knickers doctors are wearing.

I exaggerate, but not much. We have study after study that tell us how much patients prefer formally dressed doctors. Suits, ties and white coats apparently inspire respectability, confidence and trustworthiness. Female doctors are specifically recommended to avoid mini dresses, shorts, tight clothing, clogs, ruffles, strong perfume and big earrings. Only teenagers seem to say they don’t care what their doctor wears, but surely it would be uncool for them to notice, right? I don’t possess a miniskirt, and am glad of the excuse not to ever wear one. But a white coat? It will never be my new black. White coats are hot, unflattering and, worst of all, they have the microbiologists squirming. They are hoaching with bacteria and I haven’t worn one in years. Only children come right out and say it; they like doctors best who dress casually, but they trust the ones that are in formal attire.

And essentially that’s it: the paradox of the modern day relationship between patients and doctor. As a patient, I want a doctor that I like and identify with. But I also want someone who not only knows much more than I do, but looks like it too. The myth of the doctor as sex god is unfortunately not quite gone; it trundles on, looking more infirm and incontinent than ever. I’m happy that it’s passing. It takes away a certain malingering disappointment in myself. However, dressing like a confidence-inspiring, rather than insipidly-clothed professional while keeping up with the engineers was much too hard.

The final insult to my tired body has been to be told I need to dress better, smarten up and polish my shoes. What galls me is that researchers are asking people what doctors should wear when there are more important things, surely. I have never had a chance to tell patients what to wear; that it is better not to wear a dress and four vests when it would be far more convenient to whip up a single jumper to listen to the lungs. I have not yet pointed out the fact that a home visit when the house smells like a pub is only tempting me to ask how you could make it to the off-licence and not to me. And I was so taken aback by someone taking a call on a mobile while I was fitting her coil that I have not done one since.

Actually, that sex-god myth, and with it the dream of the well dressed, neck-tied, good looking doctor as standard bearer was cremated when Doug Ross left ER. Since then, the whole god-complex thing has been chipped away at by a curious mixture of journalists, doctors, patients and politicians until we are all looking at each other in the eyes. But actually, we’re not. I want to tell my patients about the options they have for dealing with their raised PSA, and they are looking down, apparently deciding if my shoes are right for my job.