Why don't surgeons wear white?

The expression "white-coated professionals" is a colloquial way of referring to people who work in the healthcare field. But when we enter a hospital, we notice that, besides white, their gowns and pajamas come in many different colors. Is this chromatic variety due to a personal choice, or is it just for a reason?

Until the mid-19th century, doctors operated in their street clothes, which they protected from blood and dirt with leather aprons. It wasn't until 1880, with the rise of antiseptic techniques, that the color white was introduced into operating rooms and consulting rooms for healthcare workers as a new symbol of cleanliness and sterility. This change was part of the 19th-century hygienic movement stemming from the discovery of germ theory, which, to reduce contagion, recommended ventilation, reducing curtains and mats, and incorporating smooth, unadorned floors and walls that would accumulate dust. White in hospitals and clinics made it easier to identify and remove blood or dirt stains, while also reflecting more natural light to better illuminate the spaces. As for uniforms, white was easier to clean with the recently improved modern bleach, which could disinfect not only clothing but also water, surfaces, and wounds. In fact, in the 19th century, when doctors began washing their hands with bleach before birth, there was a dramatic reduction in mortality. White, established as a new symbol of medical modernity, conveyed a sense of control and confidence in patients who believed they were in a germ-free environment.

Following advances in medicine at the beginning of the 20th century, with the introduction of intense surgical lights and longer and more complex operations, they began to detect that excessive white color caused eye fatigue in surgeons. The problem was that it reflected too much light and caused glare. Furthermore, looking at deep red tissues, organs, and blood for hours caused the eyes to become saturated, eventually rendering them unable to distinguish the color well. Overexposure to red was compounded by the contrast with white, which caused afterimages on the retina—optical illusions with pink and green spots that could negatively interfere with surgery. Consequently, they began replacing white with shades of olive green and medium blue, which, being complementary to red, neutralized it and reformatted vision. Thus, patients could continue to be exposed to the red during surgery without misleading optical illusions. Around 1960, blue and green were standardized in operating rooms, ICUs, and emergency rooms, and white, which had practically disappeared due to surgery, remained in wards and outpatient clinics as a symbol of cleanliness and sterility.

The 1970s and the emerging environmental awareness meant that ground colors became widespread in street clothes, and some hospitals also experimented with warm tones such as brick, browns, and oranges, especially in military and rural hospitals. The advantage of these colors was that they better concealed bloodstains and slightly reduced eye strain due to their low saturation, while also conveying proximity to patients thanks to the warmth of these tones. However, they didn't quite catch on in operating rooms, as they slightly interfered with the accurate perception of the reds and violets of internal tissues and bleeding. Nevertheless, they are colors that can be found in the clothing of some orderlies, emergency personnel, and even veterinarians.

So, the next time you're in an operating room putting our lives in the hands of people dressed in green and blue, you should remember, while you do the countdown the anesthesiologist told you to, that your uniforms will help you wake up safe and sound.