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The little black bag

Martin B Van Der Weyden
Med J Aust 2005; 182 (3): 97.
Published online: 7 February 2005

A lot has been written on what doctors should be — committed, compassionate, competent, communicative — but doctors do not have a monopoly on such human attributes; they apply equally to other healthcare professionals.

So, what do doctors do that others don’t?

Since time immemorial, doctors’ primary function has been the consultation: the gathering of information, the diagnosis and explaining of its consequences. In this process, simple technology is critical — the stethoscope, the clinical thermometer, the oro/ophthalmoscope, the sphygmomanometer and humble neurological tools.

Beyond their clinical utility, these instruments are also symbols of the doctor’s craft. The little black bag is another such symbol. Its identification with doctors was captured in the pages of Life magazine in the 1940s, which featured a photograph of a country doctor making a house call, carrying his black bag.

US physician Martin Duke argues that it served as a badge ofprotection.* This idea also surfaced in Sinclair Lewis’s novel Arrowsmith: ‘The Doctor, and the Doctor alone, was safe by night in the slum called “the Arbor”. His black bag was a pass. Policemen saluted him, prostitutes bowed to him without mockery, saloon-keepers called out “Evenin’ Doc” and hold-up men stood back in doorways to let him pass.’

But no more! Public sightings of the little black bag are now rare, and house calls are ranked among medicine’s occupational hazards.

With the ageing of the population and the shift from hospital to home care or residential care, could the little black bag stage a comeback? If it did, the question might arise as to who would then carry the black bag — doctors or nurse practitioners?

*Pharos 2004; Summer: 14-16.

  • Martin B Van Der Weyden

  • The Medical Journal of Australia

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