The Fashion of Disease

Dr. Brian J. Troth // On January 23, 2020, my ex-fiancé passed away when he was 34. When he was hospitalized, I took great care to select clothes that he loved for his bag and it reminded me of an undeveloped project on my mind: the fashion of disease. Though I haven’t quite threaded the needle, there is something to be said with the intimate way in which cloth has been woven into narratives of medical care, suffering, and comfort: blankets, sick masks, the uniforms of plague doctors, white lab coats. In this entry, I wish merely to point out the myriad places cloth appears in humanity’s suffering and invite input so that these loose ends may someday be tied.

For Brad, I served as a pallbearer. A pall is a simple piece of cloth laid over a coffin, democratizing death by hiding the differences between an elaborate (and thus expensive) coffin and a more modest one. The word pall is not often used in English outside its funerary context or to refer to the cloak worn by Catholic men of the cloth. This religious use supports the borrowing of the word pall from the Latin pallium – a cloak or a coat. The word does pop up in remote corners of our languages: a paltock (a tunic), which gives us paletot in French—a women’s jacket—and pallier, a verb in French that meant to cover something with a coat. 

In the 1960s, doctors in Quebec borrowed the word to coin the term palliative care (soins palliatifs) to provide an alternative to the negatively-connoted hospice. In this case, that which is palliative serves to hide pain without actually providing a cure. It responds to a desire that arose in the 20th century to treat patients more humanely and to provide holistic, multidisciplinary care to patients who were often approaching the end of their lives. 

Clothing is inarguably ubiquitous in our world by sheer virtue of the reality that a near-universal first decision in the morning is what we will be wearing that day. Yet fashion is much more than a simple choice to cover oneself. The hidden-in-plain-sight etymologies of clothing and medical care suggest a deep connection between health & suffering and attire.

The history of the West is intimately linked to the history of the Christian religion, which in turn has placed a heavy emphasis on the relationship between cloth and suffering. The English language continues to refer to men and women who devote their lives to the Church—thereby giving up the pleasures of the mundane—as men and women of the cloth. They are recognizable by what they wear: plain, body-covering garments that signify a life of devotion to God. Similar acts of faith can be seen in Judaism and Islam.

According to Biblical legend, clothing is the external expression of shame and suffering. In the book of Genesis, which offers the Christian account of the creation of the world, Adam and Eve are both naked. They know no shame because they know no sin. That changes, however, when they are convinced to eat from the Tree of Knowledge.  Aware for the first time that they are naked, they cover themselves in fig leaves. When they are expelled from the Garden of Eden, God provides them with the skin of animals to cover their bodies. It is because of their sin that Adam and Eve begin to wear clothes and that pain becomes a part of human life.

The most famous story of suffering from the Bible comes from the New Testament: the passion of the Christ. Like the animals that gave their lives for Adam and Eve’s sins, Jesus is supposed to have given his life for the sins of Man. As a central figure of the Christian church, he is the quintessential sufferer, and again, we see suffering wrapped up, as it were, in cloth. Let us speak of the mocking of Christ and the cloth remnants of Jesus’s passion.

Jesus, known in canon as the king of the Jews, was mocked by placing a robe on him. Though the gospels differ in their accounts (the robe was either purple or burgundy), the effect is the same. An article of clothing is placed on Jesus’s body to simultaneously represent his claim as king of the Jews, to mock him, and to eventually crucify him. In addition to the robe, the soldiers befitted Jesus with a crown of thorns. While it is another form of torture, it should not be lost on us that the crown is another symbol of royalty. While a true royal may be expected to have the best clothing and accessories, the cloth is turned around and used as a method of mockery and torture.

I can enumerate many more examples of the connection between suffering and cloth. Saint Martin, known for his altruism (a less-painful form of suffering whereby one willingly gives up his own comfort for another), shares a piece of his coat to someone in need. A little coat—a capella in Latin—gave us the English word for a chapel. At the beginning of the year 2020, as the world comes to terms with a deadly coronavirus spreading from within China’s borders, we see a rise in the purchase of surgical masks. These masks provoke in many of us a sense of unease as we ascertain whether the person wearing it is a threat. Likewise, though a doctor’s white coat may assure us that we will be well-cared for, a plague doctor’s characteristic uniform, consisting of a long-nosed mask supposed to purify the air the doctor breathes, struck fear into the hearts of anyone who saw him on the approach.  

The story of mankind and its suffering cannot be separated from what man puts on his body. Never was this clearer than when I laid out Brad’s funerary outfit and decided which shirts I wanted to keep, and which it was time to give away. Long after we have passed and our bones turn to dust, a resilient thread of nylon will remain as proof that we were here and, for some of us, that we suffered at the end. Some say that clothes make the man. Yet the same clothes can hide a dark reality, and it is wise to recognize the gloomier price of being fashionable.

For Brad, who kept every piece of clothing he ever owned.

27 April 1985 – 23 January 2020

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