I hate wearing a white coat.

The white coat has always been one of the distinguishing features of the doctor on the ward. He of the didactic proclaiments to both patients and nurses alike. With their stethoscope hung around their shoulders and a gaggle of senior staff; junior staff; students; nurses; and a small granny who got confused by the crowd and ended up following it, the consultant makes his way through the ward, healing all with but his clever mind and his talented hands-on care. Paternalistic? Yes. But he had your best interests at heart. It's important to realise that if he did inadvertently end up killing you, it wasn't personal.

He was that shining beacon of the hospital's front line. And he shone all the more brightly because he wore his starched white coat.

I hate white coats. The doctor that I just described is (mostly) the doctor of yesteryear. In the UK there is a move, especially amongst junior staff, away from the wearing of white coats. The reasons for this are multitudinous, but often it just comes down to a case of personal preference; every junior doctor I've ever known prefers not to wear them. Sorry, did I say 'prefer'? I meant 'would rather sell their darling, cherished mother to the glue factory instead of.' In fact, the only time I've ever seen a qualified junior wearing them is when they're also in scrubs, because otherwise the canteen won't sell them any food. Hunger makes a person desperate.

I hate wearing a white coat.

The wearing of white coats has been a contentious issue in the world of doctors for a few years now. At one stage there was a lengthy debate in the BMJ about it. It's quite a polarising issue; the marmite of the medical arena if you will. I remember when I first started my medical degree, we all dutifully bought ourselves a white coat. Most of us then dutifully wore it for most of our first clinical years. Some people even remembered to wash their white coat between their pre-clinical dissection tutorials and their wearing them on the wards. You could tell those that didn't by the lingering smell of formaldehyde that followed them. After a few weeks on the wards, we then all realised that we looked like complete dicks, and promptly burnt the damn things rather than wear them.

Supporters of the white coat say that it readily identifies a doctor to their patient. It looks professional. It has pockets for you to carry your tendon hammer and other gumph around in. It protects you from the various bodily fluids that patients, with alarming regularity, attempt to cover you in.

I have this to say about the wearing of white coats:

Overheating: As far as I can tell, the main bulk of the NHS spending budget goes on ensuring that the hospital is heated to around 30°C at all times. Yes, even during summer. Wearing a white coat as well as your normal clothing is asking for a fainting fit. The only joy is that you really can test out your chosen deodorant brand's claims of "24hr protection".

Infection risk: One of the original reasons that doctors wore white coats was to maintain hygiene and prevent the spread of disease. Therefore, you'll probably be pleased to know that one study showed that 25% of white coats carried Staph. aureus.

Identification: Do you know how many people in hospitals now wear white coats? Pharmacists. Lab assistants. Phlebotomists. Catering staff. It really isn't that distinguishing any more.

The cut of them: White coats weren't designed for people with waists, and that's all I've got to say on the matter.

Their carrying capacity: Yes, they've got lots of pockets for things. But, and this is probably a girl thing as much as anything, loading up your pockets with everything that you think you might need for the day makes you look like you're wearing saddlebags. You have to walk through doors sideways. Spin around too quickly and everything flies out, probably taking someone's eye out in the process. Anyway, these days, with the advent of modern technology, you really don't need to carry that much around with you; this is especially true for juniors: three pens; a PDA; your wallet; your keys. These will fit nicely in your trouser pockets (men) or a small over the shoulder bag (women). Your tubes go around your neck, your tourniquet and I.D badge clip to your belt, and your folder you'd need to carry anyway. End of story.

You look like a dick: This is the most important consideration for me. A junior staff wearing a white coat feels the same as that the kid at school that wasn't allowed to wear their home clothes on no-school-uniform day like everyone else. You stick out like a sore thumb. People snigger at you behind your back. Not only that, you feel like you've reverted back to being a fresh, third year clinical student again. It's like trying to do a lap of the butterfly while wearing water wings.

I hate wearing a white coat.

I currently have a great deal of bile inside of me with regards to this matter; the consultant of my firm insists on the wearing of white coats. His staff are able to ignore this decree because, what with the potential for taking him to an employment tribunal, they can. I have no such fallback. I tried to have an adult discussion with him about this. I presented my points clearly, backed it up with published evidence, and also gave a clear account of my subjective opinion on the matter. His response can be summed up as "Tough." Since he's the man that grades me, I didn't really have a lot of leeway to argue this.

As I was leaving my halls of residence a couple of days ago, I met a friend who was walking in the same direction as me. You could see the double-take on her face as she took in my white-coated figure. Then she laughed. "I bet you feel really special having to wear that, don't you?" My reply went something along these lines:

"Fuck off. Just fuck off. Yes I feel really fucking special. And it's not the good version of fucking special. It's the 'spefful' version of fucking special. Now do me a favour and fuck off and die somewhere."

I think it's accurate to say that those six sentences really do sum up my opinion on this matter. Thank you for letting me share this with you. I'm running out of real life friends that I can take this kinda crap out on. You, however, are all expendable. I mean that in the best possible sense of course. Now, if you could all just fuck off and die somewhere, I'd be appreciative.

Reference

• Panja A, 2004, "The death of the white coat?", BMJ; 328:57

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