in Musings

The men in white coats

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.

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  1. I lived in one as a junior doctor. Well, more than one since you had to change them as they did become rather offensive after living in them for days on end whilst on-call, with opportunity to decorate it with every body fluid daubed all over.

    At that time I wore one purely for practical reasons. I needed somewhere to keep Vecafix dressings and micropore tape for securing the IV cannulas I’d site. I needed somewhere to keep a spare pair of gloves. I had to carry my Oxford Handbook of Clinical Medicine. I needed a place for a notebook and pens. Somewhere for a stethoscope. Extra bleeps when covering for several friends who needed some sleep.

    So for HO and SHO years I was wedded to my white coat. As a GP Registrar I had a case to carry all my gubbins so all was good. In mental health I’ve never worn a white coat.

    In physical health medicine I can see they’ve some utility, though.

  2. You would be surprised to learn that in Spain, hospital psychiatrists still wear white coats (both in the private and in the public sector). i do not think that this is a widespread habit in the equivalents of the community mental health units in the UK. Further, in-patients have to use hospital jammies, making them look sort of zombies/inmates.

    so it is not an unusual practice outside the UK.

  3. Hello FP

    James Warner has done a bit of work looking at this issue. I found this in the BJPsych (Gledhill et al. 171 (3): 228-232) but i also remember reading another article by him but can’t quite locate it.
    There is an appreciable patient population that would like us to dust off the mothballs. I might move over to the continent in future – would i be seen as a maverick not wearing a white coat?