Does this white coat make me look old?

White coats are becoming a thing of the past for physician associates (PAs) and for our healthcare colleagues. We drape our dingy, once-coveted mantles over the back of desk chairs, pockets bulging with alcohol wipes, half-opened gauze pads, and a stained ICD-10 reference card. Who needs a white coat? Our bougie designer scrubs have plenty of pockets, plus a color for every specialty. And they are much less likely to transmit pathogens or embarrass us with an unsightly coffee stain. I, for one, still wear my white coat over whatever mismatched shade-of-blue polyester pajamas the hospital scrub machine dispenses. At my age, I look ridiculous in any form of attire that gathers at the ankles—and I know it. Did I say at my age? That is new for me. It has only recently occurred to me that I am a 70-year-old PA. According to the AAPA Salary Report, only 2.4% of PAs in the US are older than the age of 65.1 Evidently, we have become rare specimens. I should not be surprised when colleagues ask, “So, how long 'til retirement?” They must be convinced that I am counting the days on my abacus. I should be flattered when patients ask, “So, how long have you been doing this?” Surely, they must think I knew Lister and Pasteur personally. “Are you okay taking the stairs?” the residents ask politely, not knowing that I have race T-shirts older than some of them or that my next 10K is in 2 weeks. It must be the silver hair, to which I apply shades of honey blonde when I get around to it. Add to that fair, sun-damaged skin and a white coat that offers scant contrast. But make no mistake. Within there resides a high-energy power pack who can hold a 12-hour charge. And who feels much the same, physically and mentally, as she did upon graduating from PA school 20 years ago. In those swift 20 years, I have been privileged to work in primary care, gastroenterology, cardiology, and vascular surgery. Surgical oncology has occupied the second half of my PA career: in the operating room, on the floors, and in the examination room. I have partnered with physicians of all ages and at various stages in their careers. Several of those partnerships have turned into enduring friendships. Most of my age-matched peers have been PAs for twice as long as I have. I envy their formative years in the profession. They grew up acquiring the acute senses and sharp instincts that make for a good, quick-thinking clinician. We “second career” PAs have had to incorporate these things as adults whose calvariums are already full. In return, however, we have enriched the PA profession with our rich and varied life experiences. One of the many occupational hazards of growing older is sagging self-esteem. For a health professional, this can easily turn into a loss of self-confidence, a what-am-I-doing-here feeling. This is unfortunate, especially at a time in our lives and careers when we have the most to offer and are most free to be ourselves. To my inquiring coworkers, I deflect the retirement issue with a smart remark about not being senior center material. For my curious patients, I respond with honest answers, and try to reward their trust with the insight and experience they have come to expect. When my young colleagues open doors or apologize for using expletives, I smile warmly and remind myself how much fun it is to work with them every day. Does this white coat make me look old? Or simply like the PA self I have become? Either way, it's time for more hair color.