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OPINION

Another white coat in the family

This is what there is in common between 40 years ago and now: On one end, patients still want to be cared for. On the other end, doctors still want to give care.

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On my first day of medical school, it rained. I brought a three-hole notebook and an umbrella with all the ribs intact and felt prepared. Forty years later, on her first day of medical school, a person I know well (having given birth to her) downloaded study guides, academic assignments, and onboarding apps, and checked the inner workings of her iPad the way you might check under the hood of your Formula One car before the flag drops.

This person I know well can hardly wait to learn about neuropathology and epigenetics, differential diagnoses and the pulmonary exam. Staying up all night chasing a mysterious fever thrills her. It is probably fair to say we were equally excited and equally anxious. A world was about to come into view, and that white coat, though not heavy, is full of heft. I carried a tuning fork and lab manual in one pocket and a banana in the other. She will carry an iPhone the size of a piece of fruit in one pocket and, maternally speaking, I hope there will be a protein bar in the other.

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White coat pockets are filled with dreams as well as fruit, and dreaming is the way to start. No one should disturb these dreams … and yet, I probably already have.

For years, she overheard arguments on the phone with insurance representatives, pleas to IT personnel, and refusals to fill out forms assigned by administrators too burdened with irrelevant paperwork. Medication requests were rejected, electronic health records system notes grew increasingly complicated, mandatory (but useless) forms were added to visits. Sometimes as I argued, I could picture faceless people looking out of high windows with long and expensive views. They made big decisions affecting my patients and me. They knew nothing about either of us.

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This is what there is in common between 40 years ago and now:

On one end, patients still want to be cared for.

On the other end, doctors still want to give care.

I hope dreams continue to fill the pockets of my daughter’s white coat, though inevitably the cuffs grow grey over time (white is such an impractical color). But I also hope that my daughter’s capacity to manage the present comes with a capacity to change it — not so much because she is a miraculous being (though honestly, she is) but because she wants so much to be the doctor the world needs, even if she doesn’t know who that is yet.

Elissa Ely is a psychiatrist.