The first thing I noticed when the doctor sat down in the examining room were the socks. Tucked into a pair of worn, brown-leather shoes, the socks were juniper green, dotted with a pattern of cartoonish chartreuse-colored frog heads. I couldn’t keep my eyes off of them. They looked exactly like the tacky, unsold socks you’d find in the bargain bin at the back of your local bargain store. If those socks were intended to break the levity of the moment of one of the most consequential doctor’s consultations I would ever have, they were more than up to the task.
“Wow,” I said, “great socks.” With a nod and just the faintest hint of a smile, the doctor lifted up one of his pants’ legs to show off the full display of downright silliness. Playing along with my nervous banter and my obvious delaying tactic, the doctor explained his sartorial choice. “Since I no longer wear a tie,” he explained, “I like to shake things up and have a bit of fun.”
Hoping to extend the light-hearted moment a bit longer and trying with everything I could muster to stave off the inevitable discussion of my medical condition, I asked, “So why don’t you wear a tie?”
The answer was simple but, I have to admit, unexpected. Ties harbor bacteria.
Following that office visit, I decided to delve deeper into the necktie mystery. What I discovered is that recent studies in the United States and Britain have concluded that ties harbor dangerous bacteria and fungus that can be transmitted from patient to patient during the examining process.
The bacteria and fungus found on doctors’ ties in recent research studies are hardly household names, but they can cause serious illness. There’s Klebsiella pneumoniae, which causes pneumonia and can also cause infections in the urinary tract, the lower biliary tract, and infections to surgical wound sites. There’s Pseudomonas aeruginosa, a potentially multi-drug resistant bacteria that is documented to cause more than 50,000 healthcare-associated infections in the U.S. each year. There’s Staphylococcus aureaus, the leading cause of skin and soft-tissue infections. And then there’s the fungus Aspergillus, which causes allergic diseases, respiratory illnesses, and infections of the bloodstream.
To tell the truth, I was shocked by what I read. The list of bacteria and fungus found on a sampling of neckties sounded more like a compendium of disease-causing agents lurking on the filthy surfaces in the toxic swamp of a New York City subway car rather than something hitching a free ride on a doctor’s shirt. As it turns out, there they are—sometimes life-threatening bacteria and fungus— hiding in plain sight in the pseudo-sterile environment of the doctor’s examining room or the hospital room. These hidden bogeymen, lurking in the toxic fibers of the seldom-laundered necktie, can cause infection that is sometimes even life threatening, particularly in patients who are already ill. Who knew?
Unnoticed by most patients, the fact is that doctors and neckties are breaking up. Old ideas of professional attire—for both male and female professionals—are changing. Neckties, which along with the white coat have been de rigueur at least for the male contingent of the medical profession throughout the twentieth century, gradually are disappearing in the workplace. As an accessory of choice, as a traditional symbol of white-collar work, and as a potent symbol of individuality, I understand why doctors’ are reluctant to give up the tie.
But now I also understand how significant and responsible was the choice by my doctor that day to demur on the necktie and to choose instead to wear colorful, frog-printed socks.