Naughty Neckties
By way of the Drudge Report, US Today and AP comes a story about a Jerusalem Medical student, Steven Nurkin, at Israel’s Technion University. The soon to be Dr. Nurkin questioned doctor's neck ties as a source of the transmission of hospital acquired infections. http://www.usatoday.com/news/health/2004-06-01-germs-ties_x.htm
Accustomed to the open collar style of Isreali hospitals, Steven noticed colleagues at NY Hospital Queens all wore ties. He does cultures, finds bugs and builds a case for the tie as a source of nosocomial infections.
He has a point. I recall well the times my own tie dragged through, over, or into God knows what in the course of a hospital day. In medicine, there is a tradition of radiologists and perhaps urologists wearing bow ties. In the case of radiologists, it may relate to the rollers in the developer, something like the ringer of a bygone day.
I do feel compelled to speak out in defense of the long tie, however. This herein maligned article of attire may in fact have quite the opposite effect in communicable disease. We speculate about the role that a variety of pathogens, found in cultured ties, might play. Some question the apparent lack of specific transmission/virulence of the pathogens found. The article did not detail how this culturing takes place, but I imagine that for the sake of research the NY doctors were patient with the young enthusiastic researcher as he snipped off their ties.
Indeed, the tie is on the front line of infectious disease. We all know that doctors never get sick. One may ask why? Are we too busy? Is it just bad form? On the other hand, do our contacts afford us some immunity?
I submit that a better working hypothesis rests with the "front line tie." My ties lasted forever. They were never washed. They were dry cleaned, only with the most sordid stains, stains that could not blend in, so to speak, with the design of the cravat. Might the tie not, in time, become a whole ecosystem of microbes? Would they not be a highly balanced diverse population of saprophytes, living off the occasional offerings of gravy, egg or pancake syrup, manna from the gods, but highly competitive with the pathogens from outer space.
As I think about it, I never threw away my ties because just as I would they came back into style. Thus, with generations of evolution the eco system evolves into a living shield, a shield protecting the physician, his or her family and endless patient contacts.
This conjecture of everything would not be complete without an explanation of the bow tie. (Only psychiatrists wear slip-ons so we can dismiss slip-ons as not relevant to our discussion.) The bow tie not only survives for the life of the physician but also passes on to the next generation. Since long ties and bow ties occupy the same tie rack, it can be seen that the bow tie transmits the highly developed microbial colonization from one generation to the next.
The discussion so far fails to take into account the role that the forehand or Windsor knot plays in the protection of Gagemcheck's hole. Professor Gagemcheck was a professor of surgical anatomy at the U of Michigan-- a long time ago. Lets say his picture is near the south end of the tube. The professor described the anatomy, comparative anatomy, surgical anatomy and physiology of the suprasternal notch, and that is just the point. The vital structures of the suprasternal notch have no protection except for a well knotted cravat, weather east coast forehand, west coast Windsor or a bow tie as in radiologist, urologist, I would say OB GYN except he is playing golf in a polo shirt. Therefore, for the sake of the trachea, larynx, the carotids, innominate and recurrent laryngeals, not to mention a certain theatrical interaction with the Adam’s apple, lets keep the tie.
Dr. Ignaz P. Semmelweis
They laughed at him too.
Accustomed to the open collar style of Isreali hospitals, Steven noticed colleagues at NY Hospital Queens all wore ties. He does cultures, finds bugs and builds a case for the tie as a source of nosocomial infections.
He has a point. I recall well the times my own tie dragged through, over, or into God knows what in the course of a hospital day. In medicine, there is a tradition of radiologists and perhaps urologists wearing bow ties. In the case of radiologists, it may relate to the rollers in the developer, something like the ringer of a bygone day.
I do feel compelled to speak out in defense of the long tie, however. This herein maligned article of attire may in fact have quite the opposite effect in communicable disease. We speculate about the role that a variety of pathogens, found in cultured ties, might play. Some question the apparent lack of specific transmission/virulence of the pathogens found. The article did not detail how this culturing takes place, but I imagine that for the sake of research the NY doctors were patient with the young enthusiastic researcher as he snipped off their ties.
Indeed, the tie is on the front line of infectious disease. We all know that doctors never get sick. One may ask why? Are we too busy? Is it just bad form? On the other hand, do our contacts afford us some immunity?
I submit that a better working hypothesis rests with the "front line tie." My ties lasted forever. They were never washed. They were dry cleaned, only with the most sordid stains, stains that could not blend in, so to speak, with the design of the cravat. Might the tie not, in time, become a whole ecosystem of microbes? Would they not be a highly balanced diverse population of saprophytes, living off the occasional offerings of gravy, egg or pancake syrup, manna from the gods, but highly competitive with the pathogens from outer space.
As I think about it, I never threw away my ties because just as I would they came back into style. Thus, with generations of evolution the eco system evolves into a living shield, a shield protecting the physician, his or her family and endless patient contacts.
This conjecture of everything would not be complete without an explanation of the bow tie. (Only psychiatrists wear slip-ons so we can dismiss slip-ons as not relevant to our discussion.) The bow tie not only survives for the life of the physician but also passes on to the next generation. Since long ties and bow ties occupy the same tie rack, it can be seen that the bow tie transmits the highly developed microbial colonization from one generation to the next.
The discussion so far fails to take into account the role that the forehand or Windsor knot plays in the protection of Gagemcheck's hole. Professor Gagemcheck was a professor of surgical anatomy at the U of Michigan-- a long time ago. Lets say his picture is near the south end of the tube. The professor described the anatomy, comparative anatomy, surgical anatomy and physiology of the suprasternal notch, and that is just the point. The vital structures of the suprasternal notch have no protection except for a well knotted cravat, weather east coast forehand, west coast Windsor or a bow tie as in radiologist, urologist, I would say OB GYN except he is playing golf in a polo shirt. Therefore, for the sake of the trachea, larynx, the carotids, innominate and recurrent laryngeals, not to mention a certain theatrical interaction with the Adam’s apple, lets keep the tie.
Dr. Ignaz P. Semmelweis
They laughed at him too.
posted by Clancy Hughes | 6/01/2004 10:06:00 PM
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