White Coat Ceremony Reflections
From the Class of 2023
Acts of Equity
Putting on a white coat allows you to see all walks of life equally. Whether it is a single mom struggling to raise her kids or a multimillionaire coming in, medicine and illness affect everyone. We get to bridge the gap between groups that have been separated and treat people equally which, unfortunately, doesn’t happen often in this current age. It also means restoring faith in people who may have thought everything and everyone had turned their back on them and let them know that they have me on their side. Sure we can diagnose and use all the fancy knowledge we have learned from our education, but the opportunity to bridge these gaps and try to lessen the burden of a cruel world is what our short whitecoat means to me.
The White Coat as a Shield
I remember when I first wore my white coat on the stage at the White Coat ceremony, I was so proud to turn toward where my family sat and see the looks on their faces. Being the first person in my extended family to attend medical school in the US was a major milestone in my life and I felt that the white coat represented all the work that had brought me to that point.
One time when I was shadowing and going on rounds, a patient who was also a physician in the hospital assumed I was a nurse and asked me to get him ice chips. My first thought was, "I don't even know where to get ice chips." However, I took a step back and realized that I was dressed exactly like the residents who I was shadowing: blue TUH scrubs and Patagonia jackets. Furthermore, there were two other medical students in the room who were also wearing scrubs but they were wearing their white coats rather than a Patagonia jacket like me and the residents. These realizations made me ask myself why this doctor/patient made that assumption about me and whether the white coat is some form of protection against these misconceptions. As my journey continues, I know that I will reflect back on this moment and maybe the answers will become more clear, but as of now I see the white coat as a necessary factor to being taken more seriously when working in the clinical setting. This makes me wonder when in my career will I be taken seriously enough as a medical professional to not have to wear the white coat.
Wearing With Caution
It felt like cutting the ribbon for a grand opening: The White Coat Ceremony, a welcome to beginning our medical education and entering the medical profession. Standing there on that stage, seconds after being coated, watching the crowd clap and cheer, I felt that I was an imposter; putting on a White coat that represented the medical profession when I was barely a week into my medical education. Months away from beginning my third year of medical school, I have flashbacks to that feeling of discomfort each time I put on the white coat.
Personally, when given the choice to wear the white coat during an encounter, I have always opted not to wear it. When I see a white coat worn by an experienced medical professional, I feel a sense of admiration, and inspiration, but I also feel anxious and nervous as well. If as a medical student, I feel this nervousness near an attending physician, then I can’t imagine the anxiousness felt by patients during an encounter due to the presence of my white coat. We learn about white coat syndrome, otherwise known as white coat hypertension, experienced by some patients in the presence of a physician wearing a white coat. Hypertension is something that we can measure and quantify, but what about the feelings or issues that we cannot measure with an instrument?
Prior to even beginning medical school, as an excited undergraduate student on the pre-medical tract, I shadowed physicians and learned so much not only from the interactions between the physician and their patients, but also from the interactions of the rest of the medical care team. One moment sticks with me to this day: the physician had a follow up appointment with a patient regarding his blood pressure and TIA. I remember it seemed like a regular interaction ending with the patient nodding and saying “yes, doc, thank you so much”. In his voice I remember sensing that he almost wanted to say something, but changed his mind last second. I followed the physician out of the room and headed to the break room for my lunch, on the way, I saw that same patient speaking with one of the medical assistants at the practice. She was a patient favorite, making everyone feel heard and empathized with, and I recall that patients spoke to her as if she was a long-time friend. I had overheard the conversation, and the patient was apologizing multiple times and explaining to the MA that he knew the doctor wanted him to take the best medication to prevent a stroke, but that he had to pay for his medications out of pocket and it was just a little too expensive for him “for now”. I felt a sense of guilt and embarrassment for overhearing—I remember wondering why the patient could not just say this to the doctor directly, instead of having to go to the MA who would then have to relate it to the doctor later thereby adding to the chain of communication of care regarding this patient. Did the patient feel shame discussing financial struggle to afford the medication to his physician? Why was he apologizing as if the problem wasn’t the American healthcare System or as if he was disappointing the medical professionals involved in his care? These questions made me feel frustrated and upset, the thought that my future patients could perhaps one day feel embarrassed to tell me what is truly preventing them from staying healthy because of the intimidating white wall made of 65% Polyester and 35% cotton.
I know that my white coat holds power. I know that I can use my white coat to achieve change, for example, potentially influencing legislation in the future. I know that with my white coat, I wear my responsibility on my sleeve. I know that my white coat causes people to trust my decisions. But I also know that my white coat can be a powerful divide, a barrier that may prevent me from getting the whole story from my future patients. I have not decided if I will wear my white coat in the future when I practice medicine, but I know that before doing so, I will understand the meaning behind it, and the potential effects it has on others. Until then, I wear my white coat with caution, being wary of the power it holds.
Rebecca Cruz Mayeda
My white coat
neatly resting on the hanger
clean and bright, adorned
with pins like gems that reflect
light and sacrifice,
long hours and years
to make it here, this moment
pausing to contemplate
time, the journey
behind and ahead.
Smoothing out the fabric
my fingers trace
over the embroidered red thread
elegant yet bold, my name.
I adjust the penlight
with its shining metal,
to the pocket fold.
The teal blue plastic tubing
of my stethoscope
wraps along the pleated collar
like a river, it bends and splits
ready to listen
to the beat, flow,
breath of life.
Leaving the World in Better Shape
Wearing my white coat is a privilege and an honor. Wearing my white coat is an act of rebellion against a country that has for a long time, made it hard for black people to survive. It carries a reminder of the pain of Anarcha Wescott, the dehumanization of Vertus Hardiman, and the exploitation of Henrietta Lacks. However, there is also a lighter side to this whitecoat. It carries the determination of Onesimus, Dr. Charles Drew, Dr. Alexa Canady, and Dr. Susan Moore. Wearing my white coat pays homage to the village that has loved and supported me: my ancestors, my grandmother, every single individual who thought it not robbery to invest their time and love into me so that I can make a difference in the world. For me, wearing a white coat comes with significant responsibility. The responsibility to touch lives and to leave the world in better shape than when I have found it. I gladly welcome such a challenge.
The First Time
As the daughter of immigrants and a budding first-generation physician, my white coat is my embodiment of the American dream. It is nearly impossible for me to put into words exactly what this means to me and my family, whom I think about every time I have the opportunity to put it on.
With third year approaching and all of us eagerly awaiting being able to spend more time with patients than with Pathoma, I often imagine how I will feel wearing my white coat all the time -- not solely limited to certain Wednesdays from 1-3pm. It still looks so crisp and new, so naive to the world of medicine and healing. How will I feel the first time I get blood on it? Or tears? (Whose tears will they be? My patients'? My own? Both?) The first time a patient grabs my arm in shock or grief? The first time a child in pain looks up at me, patiently awaiting a solution? If/when someone mistakes me for a doctor while I'm still a student? And what about all the subsequent times to follow?
Conversely, how will my patients feel about seeing me wear it? I hope that the answer is comforted, but I worry that it may in fact be intimidated or dubious. These are just a few of the myriad thoughts that come to mind when I imagine the countless challenging, yet exhilarating moments that we will all begin to experience shortly.
I ache to think that there may come a day on which the novelty of this privilege has worn off -- when the white coat becomes less of a blessing, and more of a given. I pray that I never become jaded by this routine or lose sight of the immeasurable sacrifices that my family and I have made to get to here; and I pledge to continue to uphold the principles of beneficence, nonmaleficence, respect for autonomy, and justice as we strive to make medicine as equitable and conscientious as possible.
R. Mayeda is a second year MD candidate at the Lewis Katz School of Medicine at Temple University in Philadelphia, Pennsylvania.