Up to your neck in it

Br J Cardiol 2012;19:18–9 Leave a comment
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We continue our series in which Consultant Interventionist Dr Michael Norell takes a sideways look at life in the cath lab…and beyond. In this column, he considers a useful accessory.

It is that time of year; cold, grey, wet and windy. I am therefore prompted to put mouse and text to screen on a particular subject that has wound me up (literally) for many years.

In 1978, Douglas Adams (1952–2001) wrote the script for the Hitch Hiker’s Guide to the Galaxy, a comedy that originally aired on Radio 4. It was stated in this memorable series that “about the most massively useful thing an interstellar hitchhiker can have is… a towel”. I would beg to differ.

Five years earlier I had entered medical school and, in keeping with a tradition followed by generations of university students as they begin life as an undergraduate, I had bought a college scarf.


University of London scarves all have a dark blue border and any additional colours are specific to its various colleges. Hence, that for University College Hospital Medical School was further adorned with lighter blue and brown and it was this vestment that accompanied me intimately for the next four decades and which – rather than the towel – is, I submit, the real accessory with no equal.

Over the ensuing years my scarf has fulfilled more functions than even the thickest, most expensive and multi-potent, Swiss Army knife. It has served as a general cleaning device including a dish cloth, floor cloth, serviette or table napkin, a flannel, a towel (naturally), a pillow, a handkerchief (at least that is the polite way to describe it) and a demister of car windows. It has mopped up all manner of spilt or endogenously exuded fluids (not mine). It has acted as a sling to temporarily aid a fractured clavicle (not mine either), a bandage to support a twisted ankle and – on one misguided occasion – a tourniquet.

And that list does include its prime function which comes into its own during the wintery months, namely protecting you from penetrating icy gales and maintaining your body temperature at least in double figures.

How exactly a scarf is donned is a science in itself although this question has attracted little in the way of academic focus and publication (perhaps until now, that is).


Draping the thing around the neck and crossing the free ends over the chest is the basic approach. An alternative is to rotate the crossing point to the side of the neck, allowing one free end to dangle in front and the other to drape aft  in a rakish manner over the shoulder. This trailing end can sometimes be caught by the breeze and give the impression of a World War One Royal Flying Corps pilot strafing a Fokker from his open cockpit. It also makes no secret of advertising the college to which you have sworn allegiance by purchasing the thing in the first place.

The material used and dimensions of the traditional college scarf are such that attempting to construct around your neck any form of knot, hitch or splice is impossible unless the wearer is happy to sacrifice the ability to see anything ahead of him, his view obstructed as it is by a mountain of interwoven cloth.

More modern examples have attempted to overcome this by being longer and thinner, as well as being made of less dense fabric. These can still be worn in the traditional manner as famously championed by Tom Baker’s depiction of Dr Who with yards of cloth coiled repeatedly around his neck and trailing around his feet.

Recently the trend has been to double up the scarf and pass the whole lot around the neck. This is then locked in place by inserting the two free ends through the loop, or bite as it is termed in nautical parlance.  I guess the most well recognised version of this approach is the light blue and white example sported by the Manchester City football manager, Roberto Mancini.

Why is it that Italians can wear anything, in any way they want, and still look stylish?  They can drape jackets or pullovers across their shoulders, never wear socks and unbutton their shirts to the navel, yet still look good. I reckon they could even put underpants on their heads and get away with it.

Death by silk

A word of warning, however. Historically, this particular item of clothing is the only one that has been associated with mortality as the following excerpt from Wikipedia testifies:

“Isadora Duncan (May 27, 1877 – September 14, 1927) was considered by many to be the creator of modern dance. Born in the United States, she lived in Western Europe and the Soviet Union from the age of 22 until her death at age 50. In the United States she was popular only in New York and then only later in her life, but she performed to acclaim throughout Europe.

Duncan’s fondness for flowing scarves was the cause of her death in an automobile accident in Nice when she was a passenger in a car. A silk scarf, draped around her neck, became entangled around the open-spoke wheels and rear axle, breaking her neck”.

Once a century

Finally, I have a small confession to make. Despite the many years through which I have been attached to my blue and brown muffler, and the myriad of fluids, substances and general grot to which it has been exposed, it has never, until very recently, been actually… cleaned.

I am not proud of this admission and can only claim that its familiar texture and comforting smell have been such that I have never felt the need to sanitize it and so have not got around to putting the thing into a washing machine. My wife, however, was of a different view.

So now the thing is bright and fresh, its colours more stark and its fragrance by no means unpleasant.  I admit that it is an improvement and cannot believe that it took so long for me to latch onto this aspect of twentieth (and indeed, twenty-first) century hygiene. But the odd thing is that it also feels somewhat lighter. I can’t imagine why.