The Pharmaceutical Journal
Vol 272 No 7285 p164
7 February 2004

This article
Reprint
Photocopy

PDF* 70K

Tales of the white coat more
Fear keeps foreign scientists out of US more
Psychology and the culture of consumerism more
And I quote ... more

Tales of the white coat

In the 3 January issue of the BMJ a specialist in general practice reflects upon the strange folklore of the white coat in medicine. The argument is that if a white coat was ever distinctive it no longer is. Most modern hospital staff wear one regularly, but least so the doctors. It is emphasised that “the woman in charge of the kitchens, the phlebotomist, the laboratory assistant, the blood porter, the electrocardiography technician, the pharmacist, the podiatrist, the dietitian and of course sprightly first-year clinical students (enamoured of the mystique and novelty of the garment) all don the great white symbol.” There are exceptions, notably found among specialties beginning with the letter “p” — paediatricians, psychiatrists, pathologists and public health doctors, in particular.

When the white-coat was introduced in the 19th century it was intended to prevent cross-contamination, a function on which great doubt has since been cast. But it became an icon of authority and healing, and an almost sacred image was created. In the United States, for example, many medical schools have a formal white-coat robing ceremony for student entrants.

Those engaged in surgical specialties have perhaps more justification to adopt the white coat. “No one wants to get blood, pus, bile or urine over their clothes, after all, not to mention faeces or vomit.”

However, a white coat tends to create a communication barrier between doctor and patient. There is no convincing evidence that it makes the professional any more approachable. The time when the white coat was a defining feature to identify the doctor has passed, and any patient who ventures to rely upon it is heading for trouble.

Back to Top

Fear keeps foreign scientists out of US

An editorial in the 15 January issue of Nature draws attention to the sorry plight of scientists who seek to take up appointments in the United States. In view of the recent alarms over terrorist activities, the US government has tightened up its procedures for allowing foreign nationals into the country, security being a prime issue, calling for elaborate screening and examination of visas.

“No one,” runs the editorial, “disputes the need to exclude potential terrorists, but the resulting controls on immigration have become an unwieldy mess, arbitrarily ensnaring individuals who would previously have been welcomed into the country with open arms”. As a result, visiting scientists, more than members of other groups, have experienced degrading treatment which has brought missed conferences, wasted laboratory time and delay in the education of students.

Scientific enterprise in the US may be sorely damaged by this situation, since it has been to that country that much of the interest of young scientists has been directed, and there is some danger that some students will turn to other academic paths. Senior officials have given the distinct impression that foreign scientists are no longer valued. Yet since the early years of the last century more than a quarter of the Nobel prizes in the US for physics, chemistry and medicine have gone to immigrant scientists — many of them having fled from discrimination, war and genocide in their own countries, regarding the US as a land of freedom and opportunity.

Today, foreign scientists seeking to enter the US are finding themselves in stressful and humiliating situations. If they are of Iranian or Arabic ancestry they may even find themselves hated and liable to be criminally assaulted.

In contrast, other Western countries have made efforts to become more receptive to talented foreigners, immigration rules being relaxed in their favour. If a crisis is to be avoided, these problems will need to be addressed.

Back to Top

Psychology and the culture of consumerism

To the great detriment of our planet, as we consume commodities that we value, we produce harmful by-products in pursuing our desires. The culture of consumerism in which we seek to acquire material goods regardless of whether we need them or can make full use of them is being increasingly studied by psychologists, according to an account published in the 24 January issue of The Lancet. This culture is glorified by our industrial and political leaders and shamelessly promoted by traders at all levels who stand to make a profit from our human weakness.

Psychologists so far have failed to face the problem of an ever-increasing fascination with shopping — an activity that we may enjoy or detest, but one that occupies much of our leisure time. Experts argue that psychologists have previously been more concerned with individuals and families than with the demands of culture. However, now that children in particular spend much of their day watching television programmes and scouring advertisements, these activities, may prove to exert more influence on their later development than the factor of peer pressure which has received attention in the past.

It is claimed that, in the US in particular, an unwritten social taboo condemns any criticism of capitalist principles that affect economic or social behaviour. The psychologists themselves have done much to encourage or create modern marketing techniques.

Unfortunately, when we examine the current syndromes of anxiety and depression we discover that the relentless pursuit of consumer commodities reduces our capacity to achieve happiness and content. There is at the same time a widespread belief that material possessions and the social prestige that accompanies them can convey a sense of freedom and wellbeing. Yet it has been shown that people who set most value on material culture will also be more prone than others to resort to drugs such as alcohol and tobacco, and worse.

On the other side of the picture, the real prime possessions are self-knowledge, family values and social friendships. Having a sense of this inculcates a happier, more satisfied disposition that will benefit not only those who have achieved it but also the society in which they move. Our future, indeed, lies in greater tolerance of one another, regardless of race, colour and creed, more sympathy and empathy, and less of the competitive spirit that renders our world a theatre of perpetual warfare.

Back to Top

And I quote ...

Keep wondering
The joy of science lies, for me, in the sense of adventure and the retention of a child’s sense of wonder, even to my dotage.
— James Lovelock: ‘Homage to Gaia’ (OUP 2000).

Way forward
Civilisation advances by extending the number of important operations which we can perform without thinking about them.
— Alfred North Whitehead: ‘Introduction to mathematics’, 1911.

Back to Top

  * PDF files on PJ Online require Acrobat Reader 4 or later