Hygiene and Medical Uniforms

 
 
I’ve been fascinated by the new show on Cinemax, The Knick, starring Clive Owen. His character, Dr. John Thackery, is a gifted surgeon who early in the series finds himself at the helm of the Knickerbocker Hospital surgery department in 1900 after his mentor kills himself.
One thing about this show that I found quite amazing was the lack of what we would call today “proper hygiene.” Actually, it seems as if surgical hygiene was not much of a consideration at all during this time period, according to the show. As you can see from watching The Knick, surgeons sometimes wore what looks like a butcher’s apron so that blood would not stain their clothes but that was it. No mask, no caps, no gloves.
I’ve done some digging and found that until the 1940s, the aseptic technique that resembles what is practiced in operating rooms today was close to non-existent. During the Spanish flu pandemic after WW1, surgeons started wearing cotton gauze masks to protect themselves from possible infection. Rubber gloves started to be worn around this time to shield their hands from the disinfectants that started to be used in the operating theater.
This is not to say that we did not have knowledge of antiseptic surgery. Using Pasteur’s findings on microbiology as his basis, Dr. Joseph Lister, a British surgeon, sterilized instruments and wounds during the latter 19^th century. Dr. Hunter Robb pioneered surgical gowns at John Hopkins in 1894 and also encouraged steaming them for a half hour to ensure sterilization.
When surgical attire became commonplace, it was white to try to convey cleanliness and sterility but by the 50’s green and blue were favored as these colors are easier on the eyes. Most surgical attire is owned or leased by hospitals to ensure that it is properly cleaned and sterilized.
To emphasize the sterility of modern day surgical ware, the term “scrubs,” which was first used in the 1920’s, has become universally used.  The standard uniform consist of short sleeve v-neck shirt, draw string pants and a cap. Patterned headwear can be worn under a see through paper cap and a nurse friend of mine said she and her colleagues like this because it allows them to express their individuality and at the same time, makes them “seem a little more friendly” to the patients.
There is no doubt that even if a surgeon is wearing butterflies, a Yankees cap or paisley atop their head, surgical hygiene surely has come a very long way. I take this with comfort and continue to enjoy The Knick knowing that those who have to undergo surgery today are much safer having to contend with surgeon who is a fan of a sports team they don’t like than one who is operating without gloves.