Just over two years ago, I had my nose pierced.
It was the end of my third year of medical school, and I preceded my action by seeking advice from many people – I spoke to my family, mentors and other students, and I posted this and this.
I never did post that I got the piercing. I guess it did not seem like massive news then. But I’ve been seeing a lot of searches for “doctors and piercings” directing to my blog, and I figured a follow-up was in order.
Interestingly, if you read the posts above, very few people were supportive of the idea – and that was what made the decision more difficult. People I really respected (and STILL respect) figured it would be unprofessional.
My parents had gradually grown used to the idea (I first mentioned it fresh out of high school), so they left the decision up to me. [My dad did say that if I drank a lot of water and jumped up and down, he feared I would leak from all my piercings. I don’t have that many, honestly: two in each ear and a belly piercing.]
Why would I make a decision when so many people I value were against the idea? I think perhaps sometimes we have to make a decision based on our beliefs, and not others’. And this was a pretty harmless autonomous decision, knowing that I could remove the piercing at any point. Which I probably will, in a decade or so.
Did patients notice?
At that point I had spent a year in the clinical phase of medical training. I strongly suspected that few people would actually notice the piercing – and fewer would have anything against it.
So, my first patient of 2012 was stylish, rather elderly and I judged her as being pretty conservative in terms of speech and appearance. (Actually, my first rotation was forensic pathology, so she was my first live patient of the year. Anyway.)
Halfway during our consultation she noticed my piercing, inhaled deeply and exclaimed, “Oh, what a sweet little gem you have in your nose! Did it hurt?” She was very interested, told me that she would have had one in her youth if she knew it was even possible, and then we returned to our consultation.
I’ve had a few repetitions of that conversation, with variations of “My grandchild has so many piercings I worry she’ll rip off an ear” to “My daughter is so scared of needles she won’t even have her ears pierced” to “I was so worried when my grandson had his ears pierced but he’s still as wonderful as always.”
What did other health workers say?
So far, not a single doctor at my training site has made any mention of my piercing. (I checked: we don’t have anything against it in the official dress-code.) I’ve spent a good amount of time in the offices of our dean, vice-deans and our course-convener, what with student government and Semester at Sea, and not once did they mention anything either. And if anybody had the clout to make me remove it, it would be them.
Perhaps the biggest issue I have had is little kids who are at that stage of grabbing anything that catches their eyes. Then again, I’ve always had to keep them from my glasses too.
One day I was having lunch with some friends and relatives. Among them were a good few medical professionals – some retired and some young professionals. A retired surgeon noticed the piercing and was so surprised, because I had had the piercing for almost a year at the time and he had seen me regularly. But this was the first time he noticed it. I was very worried, but it turned out he thought it was “sweet”.
Another specialist though, one of the younger individuals there, did not like it. Because we know each other quite well by now, he was forthright about it, and we had a civilised discussion about it. That was the only person who openly disliked it, and it was okay with me. I did find it interesting that the most intense discussion I had about it was not an old, traditional physician but a younger doctor. It was a refreshing discussion, actually, but I’m not letting the piercing close up just yet.
What the literature says
The Rehman study in 2005, What to wear today? Effect of doctor’s attire on the trust and confidence of patients concluded that patients overwhelmingly preferred doctors who conform to their idea of professionalism (specifically: professional attire and white coat). Many cite this as proof that the apparent cop-out answer of “it doesn’t really matter what they wear, as long as they are competent” is just that: a cop-out.
But here is my take: these studies’ methodology is to show respondents pictures of physicians in different dress and style. Now read that again: they do not expose the respondents to the physicians. They are not given a mock consultation (obviously, that would be time-consuming). So essentially, this methodology requires of a respondent to judge the picture solely on appearance.
But we know that in a real-life patient experience, this is not the only means patients use to assess whether they are comfortable with their physician. The way the physician greets them. The way the physician talks to them. Whether the physician answers their questions thoroughly. Whether the physician answers a ringing cell phone in the middle of the consultation without an apology.
I don’t mean to discredit the value of first impressions. I just think that there is more than simply appearance that contributes to a first impression, because the human brain is complex enough to handle complex perception.
When I was in Barcelona this year, I visited the Hospital Universitari de Bellvitge briefly, and I saw a big intimidating group of people in white coats (they looked young, so med students or residents? I don’t know) and there were quite a few of them with a number of piercings. I wish I had stopped to talk with them about their piercings and the perception of them in Spain, but after four months of putting myself “out there” and gathering the courage to have conversations and meet people, I was just exhausted. Darn.
I got my piercing and I have not regretted it, but I would not pose this as a cut-and-dry solution to medical students. It is imperative to do your own consultation with mentors and family members, and it is important to make a decision in keeping with your context.
Any new piercing takes time getting used to. If you have done your “research” and decided to go ahead with it, I suggest getting the piercing done at the beginning of summer break. That allows time for the redness and pain to go away (wash with sterile lukewarm water and coarse sea salt), and allows you time to get used to it and even remove it if you don’t like it. A healthy piercing also allows for the jewelry to be removed for short periods of time if you really need to do so for whatever reason. A “fresh” piercing can’t do this.
Just don’t think you absolutely have to remove your piercings just because you are going to medical school. Unless, of course, the dress code strictly prohibits it. That, friends, is a whole new can of worms.
Disclaimer: this blog neither encourages nor discourages piercings; it encourages informed decision making. There are risks attached to any piercing, and you should consult your doctor for this information.
Cool ! I have 2 piercings in each ear. It’s actually a part of indian tradition to get even our nose pierced , though i haven’t! Atleast we don’t have to worry about patients having an issue with it 🙂
Yeah, when I was in India it was so funny because none of the babies seemed perplexed by my piercings as babies in other countries were wont to be! Very lucky that your patients won’t have an issue with it 🙂
What’s the perception of tattoos in India? I mean, non-Henna, permanent ones?
I just realised that I did not clarify that males don’t frequently sport piercing.
As for tattoos …as long as it’s a small one (like one of our ENT residents has her husband’s initials tattooed) nobody minds. But patients (esp the affluent ones in private practice ) maybe a bit wary n prejudiced abt heavily tattooed docs,like in the photo in ur post..That being said , I do know of a paediatrian who has 2 kiddie faces tattooed on his ‘ceps.But then this was specially mentioned to me by the patient ..which just goes to show that it is rather unusual
I think South Africans would probably also be a little skeptical about heavily tattooed doctors. It is hard to let go of all prejudices in one fell swoop, I suppose! Thank you for sharing 🙂
You are going to be a great doctor, because I see it, your humility with regards to criticism is stoic and as a patient I place a higher value on your bedside manner that some conservative nose piercing.
Thank you so much for your encouragement! I’ll do my very best to remain humble.
I suspect you will be a pathologist or a radiologist. They have a lot more freedom to appear as they wish since neither really deal with patients (not live ones) directly. That’s not bad, It just depends on what your ego can stand in dealing with conformity.
Haha! Surprisingly neither of those have been very strong rotations for me. They’re not my strong suit, although there’s quite a bit of pressure from people that I do radiology because of favourable hours, good salary and very little exposure to HIV. We’ll see if I go into that. Currently my top choices are Ophthalmology, Anaesthesiology and Paediatrics. I reckon if it ends up being paediatrics the piercing will leave sooner than expected.
this is really interesting especially about the part about patients and their preferences of the appearance and professionalism of medical staff. I work in a hospital and I have a piercing on my arm, it’s semi-permanent and I can’t remove it but I have to keep it covered at work for infection control purposes. It’s funny because daily people ask me how I hurt myself and when I explain it’s pierced they never seem annoyed but intrigued. I am only a nurse so I’m guessing with being a doctor people might expect more. I once saw elderly patients refuse to a ward round with an intern because he had a black eye!
A piercing on your arm? Is that like a dermal piercing? I don’t think I’ve ever seen those in South Africa. We’re a little slow on the uptake with some things. I can imagine having to cover a piercing on your arm in hospital for infection control though, being that your arms and hands will be so close to patients most time. In surgery I obviously wear a mask but in particularly bloody surgeries I’ve always placed a waterproof steri-strip over the piercing too.
I hope people don’t expect “more” from doctors than nurses though, in terms of piercings and such. You have a lot more patient contact and at our hospitals our nurses usually look way more professional than the doctors (the matron goes around with a book every morning and pens any uniform transgressions of the nurses on her service). Anycase my feeling about piercings are for all healthcare workers, but maybe some people to expect differently…
Super strange about the elderly patient refusing that ward round though. Shame, what if the intern got it from falling somehow? I can see that in some situations I may be required to remove the jewelry and I’ve made peace with that. I’d rather not have a patient refuse a ward round!
If you’re happy with your decision pay no mind to what people say.
Thanks Nisha 🙂
I don’t think there is anything wrong with “tasteful piercings” in medicine. I know quite a few students/residents/physicians with small nose piercings like yours and I don’t think anyone thinks twice about them. I have a friend who has multiple other facial piercings, like eyebrow, tongue, and maybe lip (as well as nose) and she took them all out for her Med interview and now she only keeps her nose piercing in. I think it is always an evolution. The bottom line, piercings don’t change the kind of professional you are… Good for you for doing what you wanted despite other opinions!
Thank you! Interesting to hear about nose piercings being mostly accepted in the States, and the idea of “tasteful piercings”. Two years ago a lot of people told me that they had never seen a doctor with a nose piercing. Maybe I was just talking to a specific subset of people. So I think you’re right, it must be a kind of evolution.
So, I am an older nurse in the US, working in a hospital where anything besides ear piercings (as well as visible tattoos) are expected to be covered up and so end up just as obvious as when modest jewelry is present. We also have a no more than two ring rule (as well as a policy which regulates on which fingers they may be), are only allowed to wear a watch around our wrists – which must be waterproof to at least 30 meters, of course, and “small, simple” stud or hoop earrings (and I think there may be about five pages on fingernails/polish). It seems there are more specifications for acceptable jewelry than anything else! Really kind of silly and not a very efficient use of upper level management time figuring out and processing all of these regulations. A good, alert unit director would be able to handle anything “unacceptably unprofessional” except they are too busy documenting our documentation.
I guess it is just difficult for me to really believe there is or has been that much of a problem. People/patients/family generally recognize good care when they receive it. While I do understand the concept of different social standards coming with different cultures, kurfuffles over whether piercings indicate a lack of professionalism to the point of loosing confidence in a person seem petty. I am old enough to remember when hair length for men brought on similarly silly responses. This reminds me of that.
You have so many more important things to focus on as a medical student, many many more important things. It makes me sad that you even have to consider this stuff. I hope that you will find that people who notice your tiny piercing hole or jewelry continue to appreciate and enjoy it rather than find it “unprofessional”. Your consistently thoughtful, compassionate competence will shine brighter than any other jewel on your face.
thank you for sharing about your work. The dress code sounds about as thorough as the regulations we had at my very English all-girls’ high school! Although to be honest before I got feedback, I assumed that the situation at your hospital was the norm around most of the world.
I certainly agree that there is a lot more pressing stuff upper management can do with their time, and that we shouldn’t really have to worry about little things like this. In a way I can understand that one might want to limit the amount of rings a healthcare professional wears, but at the same time I reckon someone would wear ten rings on each hand to work only once and then never again, realizing how cumbersome and in the way they can be when working with patients. Similarly if I ever wore big hoop earrings to work they would get caught on something once and I would remove them out of annoyance. So the situation would probably reach equilibrium by itself.
I really enjoy hearing about your experience and thoughts in this regard. I always figure I don’t really have enough experience to claim that patients recognize good care when they receive it, so it helps to hear that from someone who does have more experience.
I quite like your reference to men’s hair length years ago. Incidentally, the top students in our sixth and fourth years are both male students with long hair – and really GOOD hair that I’m a little jealous of!
Thank you for your kind wishes, I’ll certainly hold on to them.
They aren’t a big deal anymore. I had my nipples pierced and a tongue ring in medical school. Eventually took out the lower ones, but still have the tongue ring and I’ve been out of med school for eight years now.
Awesome, thanks for letting me know. So you’ve never had a patient comment or anything (or a more senior doctor)?
Thank you for your insight on this matter as I couldn’t find much info on the subject. I want to become a medical photographer, but I have visible tattoos and 3 facial piercings around my mouth and nose. I figure they’d have to go, no matter if you’re just a photographer. It’s the patient’s perception of you’re bodily decorations that causes you not to get the job, right? Even though your mouth and nose will be covered when you see patients for medical photos… I also have small black plugs in my ears. Wonder what would come of that even when I’ve taken everything else out.
I’d like to hear your opinion since the publishing of this article about the prevalence of tattoos and piercings in the medical profession today. I’m also from South African and my doctor at the emergency room had a chest tattoo peaking out from his scrubs. I complimented him on it of course as this didn’t make me lose faith in him, but made me feel at ease because he looked more like me than he did like a stranger. There was a bit of an instant bond at the sight of his body modification, especially as I was there for a very traumatic reason and appreciated not feeling alienated by my doctor.
Wow, that article is a bit of a nasty piece of work. “Tattooing has been correlated with the perception of decreased mental health. Tattooing and body piercing together have been linked to an increased likelihood of “sensation-seeking” behavior.” They say nothing about the sample size or type – it’s too generalised to be trustworthy. I wouldn’t put too much stock in it.
In any case, I must admit I have never met a medical photographer but frankly I doubt you would have to remove your body mod unless YOU want to. When it comes to the “artsy” types, medicine is a bit more forgiving in any case 🙂 can you tell me more about the career prospects for medical photographers in SA? I would love to know more.
I still have not had any negative comments about my piercings, even in the more conservative hospital where I work now. I may remove one of my piercings soon simply because I am tiring of it, and the nice things about piercings for me is that I can remove them whenever I want to. But at any rate, I’ve never felt pressured by anybody else!
Me again, I also found this which is a very interesting read if you also read the comments. http://www.physiciansweekly.com/tattoos-piercings-emergency-lessons/
Thanks for the great write-up. I wandered here looking for comrades in medicine and body mod. 🙂
I’ve had my nose pierced since before starting med school. During clinicals, I had my rook pierced. And recently, since starting residency, have had my tragus and vertical lip pierced. When at work, I wear a retainer in my lip. Otherwise, all other piercings stay in. So far, I’ve been good. I hope it stays that way!
I also have a forearm tattoo on the anterior forearm, an ankle/foot tattoo and two more that don’t really ever get seen.
As far as I can tell, it hasn’t impacted patient opinion at all. No one has requested a new physician yet.
If anything, I try to ensure every other aspect is as professional as can be to give people less a chance to judge me simply based on the ink or piercings. It seems to be working.
Thanks for sharing your story! It’s so fantastic to hear that you haven’t had any negative comments so far. I hope it stays that way. I especially like your last bit: breaking down stereotypes about body mod bit by bit, for sure!