Putting on the white coat shouldn’t change the person who wears it.
On October 17, 2015, Clinical Associate Professor of Medicine Jon Elion delivered the Charles O. Cooke, MD, Distinguished Visiting Lecture to the MD Class of 2019 at the annual Ceremony of Commitment to Medicine, where students receive their first white coats. This essay is the text of his speech.
When I was a medical student, I hated any story that started, “When I was a medical student …”
When I was a medical student, I had long hair, a beard, and a collection of tie-dyed scrub shirts. Looking around, I can see that many of you here today know all about this fashion trend popularized by the Grateful Dead, and maybe even owned something similar yourself. For the rest of you, perhaps you have read about this in the history books. My scrub shirts look suspiciously like those that were stocked by the hospital. But I digress. 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 (tucked into my shirt), and would put on … my white coat. Donning the mantle. My superhero 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 met a pretty red-haired nurse working in the intensive care unit. Little did I know that ICU nurses had no use for smart-aleck medical students. She hated me right off the bat, even if I did have a white coat. She reported me to the head nurse, and said she never wanted to see me again. We were engaged three months later and married eight months after that. That was more than 41 years ago. Kathy’s here today, sitting in the front row. She still thinks I’m a smart aleck.
When I was a medical student, I worked at WBRU, which at the time was the No. 1 radio station in the Providence market. “You’re listening to 95.5 … just a little left of center on your radio dial … .” Some of you may remember when radios had dials. 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. Working in the computer research lab, then tucking in my shirt, putting on my shoes and a tie, donning the superhero costume, and going to make rounds on the intensive care unit. From algorithms to cardiac rhythms. Saving lives—it’s a tough job, but hey—somebody has to do it!
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 OK to cry. OK to be seen crying. Perhaps people in white coats should cry.
A few weeks after her mother died, Judy sent me a note that 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.
I think that most of you have guessed by now where this is going. Parents and friends—you should be incredibly proud of the accomplishments to date of these students here today. And students—you should be incredibly proud to be sitting here today, awaiting the opportunity to don your white coat. To take another big step toward joining a centuries-old tradition and profession. But 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. As the saying goes, “Be yourself; everyone else is already taken.”
Jon Elion adapted ’60s anthem “Teach Your Children” for the first-year students. Watch the video here.