Here’s the Oxford English Dictionary on ‘men in white coats’:

men in white coats n. (a) medical or laboratory staff, esp. doctors; (b) psychiatrists or psychiatric workers, usually (with humorous exaggeration) referred to in order to imply a person’s supposedly imbalanced or deluded state of mind.

The dictionary has this to say about the first use of the phrase:

1961 W. FENNELL Dexter gets Point 135, I think I’d better phone the man in the white coat.] 1967 L. ANDREWS Hosp. Circles ii. 33 He did not wake when the usual procession of night sisters and men in white coats came in and out. 1968 D. HELWIG in Sat. Night Mar. 37/3 They’re going to put you in jail, do you know that? Or they’re going to send the men in white coats for you.

Of these the third by Helwig would be the most recognizable in the vernacular.  I’ve no idea who he or she is or was.

A famous use of white coat in reference to mental health was by ‘Napoleon XIV‘ in the popular 60s novelty hit ‘They’re Coming To Take Me Away, Ha-Haaa!‘ which includes the lyrics:

They’re coming to take me away ho ho hee hee ha haaa!
To the funny farm,
Where life is beautiful all the time.
And I’ll be happy to see those nice young men
In their clean white coats,
And they’re coming to take me away ha haaa!

I’ve actually never worn a white coat as a doctor, although I was forced to wear one as a student.  More socially, I did wear one on the 2007 RemedyUK London March and made it onto the background of a report on Channel 4 news to other people’s hilarity.  This aside,  they’re uncomfortable, hot and unless changed every day, potentially rather dirty.  I suspect that doctors used to wear them to give themselves an air of professional expertise and that their demise has been as much about fashion and the breaking down of barriers between healthcare professions as much anything else.

If anyone knows any more about the use of white coats in psychiatry, then please comment below.

Where I work  there are several psychiatrists who wear corduroy suits.  Most of them are consultants, but one or two are junior colleagues of mine.  For the moment these pretenders are wearing a jacket only, which suggests the possibility that this is a disease that spreads from the top down.

Why? Oh why?

Not one to keep a gnawing question to myself, I was at an academic meeting when I decided to tackle one of our registrars on this subject.  He’s normally got a sense of humour and so I thought I was on safe ground. 

‘Do you own a corduroy suit?’ I ventured.

‘No’ he shot back.  ‘Why’

‘Just wondering, it’s just that Dr X. has one and so does Dr Y, and I don’t think that they’re very cool’

He looked displeased.  I realised that I had blundered; I didn’t dare talk to him again for the rest of the evening. 

But, why in these days when psychiatrists might wish to be seen as approachable and patient centred, do we seek to distance ourselves from the rest of the human race by our penchant for such disastrous apparel?

The word is that people consider the corduroy is worn by ‘relaxed’ people.  People who are approachable and trustworthy.  They are non threatening and put people at ease. 

So our taste for corduroy brings us closer to our patients.  Which sounds pretty good, and maybe I’ll get one after all. 

But it’s quite a lot for a suit to live up to.