By JONATHAN ELION, MD, FACC
When I was a medical student, I had long hair, a beard, and a collection tie-dyed scrub shirts. Each day I would put on my tie-dyed scrub shirt, hop on my bicycle, and race to the hospital for my clinical rotations. My hair would stream out behind me, barely kept in check by a leather headband. When I arrived at the hospital, I would change into a dress shirt, tie my hair back in a ponytail and would put on ... my white coat. Donning the mantle. My super-hero costume. My own little White Coat Ceremony. For when I was wearing that white coat, I was part of a longstanding tradition, going back hundreds if not thousands of years. I could feel the transformation from Hippie to Hippocrates as I slipped on that coat. It gave me a code I could live by.
When I was a medical student, I worked at WBRU, which, at the time, was the number one radio station in the Providence market. "You're listening to 95.5 ... just a little left of center on your radio dial ..." At the end of the day at the hospital, my personal White Coat Ceremony would reverse. The white coat was carefully stowed away in the saddle bag, the dress shirt was exchanged for the tie-dyed scrub shirt, and I let my hair down, both literally and figuratively. Then I hopped on the bike and raced to the WBRU studio, where I had an evening shift playing "progressive rock" or "album rock."
Over the years, this mini-ceremony was repeated often, and gained many different variations.
For the longest time, I considered my white coat as transformative, covering up and disguising the hippie and turning me into something decidedly more medical. Until one day... I was on the Intensive Care Unit caring for an elderly woman who was at the end of her life. Her organ systems were shutting down one at a time. It was like standing outside of a house at night, watching the lights being turned off one at a time. I was at her bedside with her daughter, Judy. Judy, with tears streaming down her face, and me in my white coat. I was terribly saddened by the unfolding events. It would be death with dignity, but it was death nonetheless. Old wounds that I harbored were being torn open, and I knew I was going to start crying, too.
But people in white coats don't cry. So I turned to walk out of the room so Judy wouldn't see me crying. To this day, I don't know why, but I stopped in the doorway instead, turned, and went back to the bedside. I decided it was okay to cry. Okay to be seen crying. Perhaps people in white coats should cry.
A few weeks after her mother died, Judy sent me a note which I have kept to this day:
Dear Dr. Elion,
It has taken me this long to write to you because I have been searching for the words to express my profound gratitude for your kindness as my mother was dying. Your intuition is remarkable; you knew what I needed to hear even before I asked the questions. I don't think anyone could have guided me as gently, as thoughtfully, or as wisely as you did through the waiting, the decisions, and the end of my mother's life.
I hope you are involved in teaching new, young doctors. They will be privileged to learn more than cardiology from you.
Please accept my thanks from the depths of my heart. I will never forget your kindness.
I am convinced that this unfolded as it did because I did not let the white coat transform who I am, but rather, let it augment and enhance who I am. That long-haired hippie in the tie-dyed scrub shirt. The computer geek. The guy with a weird sense of humor, and with his own set of experiences, wounds and pains.
Be sure that the white coat adds to who you are, enhances who you are; and does not in any way cover who you are. In the words of Oscar Wilde, "Be yourself... everyone else is already taken."
Jonathan Elion, MD, FACC, is a practicing board-certified cardiologist and an Associate Professor of Medicine at Brown University with more than 25 years of experience in medical computing and information standards. Jon is the founder of ChartWise Medical Systems, Inc. Visit www.chartwisemed.com
