Wednesday, February 28, 2007


It’s been known for centuries that the clothes make a man. Dress him up in a military uniform, he’ll look majestic and formidable; put him in a clown suit, he’ll look like a fool. A man wearing glasses appears more intellectual than a man without them, while a man wearing a tank top and baseball cap appears less intelligent than a man without them. If looking put together didn’t make such a big difference, people wouldn’t be willing to spend so much money for just the right look. In the hospital we don’t worry about such vanities, but like anywhere else, in addition to relying on impressions we are susceptible to them. We also feed them: by placing all of our patients in hospital gowns and accessorizing them with iv poles, we make them look, well, sick.

The power of a hospital gown is really quite remarkable. A grown man, independent and strong in his home environment becomes feeble and helpless when gowned and hospitalized; his power turns out not to be stored in the locks of his hair but in the cotton cloaking his body. I’m always amazed at the degree of patients’ transformations at the time of their discharges. The same patients who minutes before look pale, fragile, and older than their years, when returned to their street clothes suddenly appear young and fresh, entirely rejuvenated both in body and spirit. Occasionally, if I’m feeling a little bit uneasy about a discharge, I’ll be reassured by a repeat visit to the patient’s room just as he or she is leaving; dressed for the road and sitting calmly on the side of the bed chatting with family, the patient will look like a different person from the one on morning rounds. Somebody looking so good couldn’t possibly be sick enough to need hospitalization, I tell myself.

A patient sent home a day earlier is something to value these days when economic pressures demand shorter hospital stays. Indeed, many services that previously required hospitalization now are routinely being performed at home: chemotherapy, subcutaneous blood thinners, iv antibiotics. If we really want to get patients home faster, though, the answer may not lie in medicine at all, but in fashion. Just last week the Oscars showed us that people can look fantastic when done up with the right makeup, hairdo, and gown. A careful look at this country’s hospital gowns is in order – surely with the right designer and enough sparkles and feathers, a gown could be created to make the sickest of the sick look positively bright. With hospital stays running a minimum of $1000 a night, there should be budget room to spare. We’ll empty out our hospitals faster than John Edwards can say malpractice. A cosmetic fix rather than a curative one, you say? Well yes, absolutely, as Americans we should play to our strength, and besides, as a beautiful country we should look the part. Our female patients will love us, and the men will discover sides of themselves they never knew. Best of all, our hospitals will be able to guarantee, with absolute certainty, that each and every patient will look better going out than they did coming in. That, my friends, would be something in which the American healthcare system could truly take pride.