Dr. Joseph Sirven: The Bow Tie

Published: Wednesday, February 13, 2019 - 8:05am
Updated: Wednesday, February 13, 2019 - 8:18am
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Dr. Joseph Sirven.

Your doctor may no longer be wearing a tie, our medical commentator Dr. Joseph Sirven, explains.

Recently, I received a bow tie as a gift. Given that I never wore one I decided to try it on at work while seeing patients.

My first patient couldn’t stop looking at me and exclaiming, “That is so cute!” The second patient startled me by pinching my cheeks and stating that I reminded her of her grandfather.

By that point, I was anxious, dizzy and sweaty because the tie was creating too much of a distraction. By the end of the day my last patient asked, “Can you breathe? Doesn’t it hurt to wear that tie? I mean, who can think with that on?”

Notwithstanding the psychological toll that wearing that bow tie had instilled on me, my patients may actually have a point. Is it safe wearing any tie? A group of German neurologists and radiologists had the same question. Because compressing certain blood vessels in the neck may cause problems with cognitive function, the researchers assessed whether wearing a tie reduces blood flow to the brain.

The investigators randomized 30 healthy men into two groups — 15 wore a tie using a standardized Windsor knot and 15 did not. They then performed a special MRI of the head that can measure blood flow to the brain. All men (regardless of whether they had a tie) underwent three MRIs before, during, and after the tie analyzing blood flow.

The scientists found a decrease in cerebral blood flow by 7.5 percent after wearing a tie while the control group had no change in their blood flow. The authors concluded that during and after placement of a tie blood flow to the brain decreases. Moreover, they argued that in people who have difficulty with blood flow to the brain such as those with high blood pressure or smokers, might notice dizziness or headache after wearing a tie. The same authors also interviewed their patients to assess whether a lack of a tie changed their patient’s perception of their doctor’s professionalism — it did not.

Most studies about neckties have addressed the infection rate of wearing a tie and whether it can serve as an unwitting conduit for spreading germs. So, based on this German study, a necktie may need a health-warning label.

For me, I still continue to wear my traditional neckties. It's part of my professional uniform  — but maybe I’ll wear it more loosely. Oh, and that bow tie? I re-gifted it.

Dr. Joseph Sirven is a neurologist at the Mayo Clinic.

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