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What Not to Wear
Women and men have been committing sartorial blunders for centuries. Fortunately, physicians have always stood at the ready to diagnose the dangers of fashion.
by Elissa Ely

Our family shares a pleasure I would never admit to anyone I know, though confessing it to an audience of reading strangers seems somehow
different. Each Friday night—like a religious service—we gather in the living room, warm up the television, make a few preparatory snide remarks, and watch our fashion reality show.

In this show, two experts, who are strikingly unfashionable themselves, critique a victim who has volunteered for style dismemberment. Over the course of an hour, they take her wardrobe apart—dress by shirt by shoes. Everything is tossed into a trash can so swollen it could have undergone collagen treatments. The process is conducted in a bantering but merciless way. No leniency is granted for the outfit she wore the night she met the love of her life.

The willing victim is then given a credit card and access to fine Manhattan boutiques to jumpstart a new style. Watching her shop via minicam, our hosts shake their heads and snicker at her fashion choices, while we in the living room shake our heads and snicker at their fashion choices. They are misconceived experts. He wears a sky-blue vest; her lipstick is wrong. The shortsighted are accessorizing the blind here.

After rejecting the clothes she chose for herself, the experts present their client with a wardrobe they selected for her. Hair and makeup people appear, grimace over the raw material, and do their magic. Now the victim is so transformed she hardly recognizes herself, and the show ends when she is reintroduced to friends and family, who weep the same wondrous tears that different friends and family wept the week before for someone else. The dissected body has miraculously resurrected, and it looks better now. In a trembling voice, one reborn woman said, “I look like someone who can go to law school.”

We snap the TV off after this and pack up for bed. On Friday nights we sleep the sleep of the superior, knowing that this show is ridiculous—fashion is not transformational—and that we ourselves have never stooped to such shallow forms of definition.

A brief tour of history might discomfort us, though. We all stoop to shallow forms of definition, and what’s more, we all suffer for it. There is no end to the bad news we have fashionably visited upon ourselves. Let us review.

Maybe it’s best to start long ago and at the bottom, with the corset, that manifestation of the upright and staunch. Difficulty breathing was the least of its consequences. The German anatomist Samuel Thomas von Sömmering argued in the early 1800s that the corset, by compressing ribs and organs, led to tuberculosis, cancer, and scoliosis.

Some years later, a British medical treatise identified 97 different female diseases “produced by Stays and Corsets according to the testimony of eminent medical men.” Among the alleged and actual ailments were deformed offspring, infertility, hypoxia, hysteria, and melancholy. Those eminent medical men worried; between 1860 and 1890, The British Lancet published at least one article annually on the hazards of tight lacing and recommended liberating the waist for health and procreative reasons. The journal’s prescriptions went ignored by short-breathed women. Slender silhouettes spoke more persuasively to them than medical eminence.

Hoop skirts, the corset’s more opulent cousins, improved neither comfort nor health. Wearing them made movement difficult, and sitting too quickly caused them to fly upward with such force that a gracious lady’s nose could be broken. Still, they were worn without protest, and fashion continued to defy nature; in subsequent eras, bustles prevented sitting down, crinoline prevented getting up, and hobble skirts prevented walking. Fashionable women had little voluntary motion left.

Men were not immune to peril, either. Take the codpiece. Manifestly, it was a statement of virility; covertly, it was perhaps perpetuated by necessity.

In the late fifteenth century, Europe was swept by an epidemic of syphilis, untamable in virulence, described by the Veronese poet and physician Girolamo Fracastoro as “pustules…the size of an acorn…constantly discharging an incredible quantity of stinking material.” Treatment was empirical, and male genitals across the continent were swathed in bulky woolen bandages to lessen their swelling. All this created unnatural frontal bulging, a tailoring nightmare. The solution was both discreet and full of innuendo; a man could advertise his potency without advertising his disease.

Textiles, in the mid-nineteenth century, were a rich source of dermatopathology; the effects of fibers, finishes, and fabrics included erythema, lichen, pityriasis, and eczema. Some of the hazard was in the preparation: As they separated fleece into grades, wool sorters were exposed to anthrax. The rest of the risk came in the wearing; flannel underwear caused tinea versicolor and miliaria (though some controversy remains among hair-splitters over whether the culprit was the flannel itself or the coloring), and aniline dye, especially red and magenta shades, inflamed the skin. Even mourning was bad for health; the mordant finishes on English crape caused skin eruptions on widows, and black veils, according to the 1887 manual Manners and Social Usages, “shed…pernicious dye into the sensitive nostrils, producing catarrhal disease as well as blindness and cataract of the eye.”

We think we’re wiser now, but we’re not. Elevated heels shorten Achilles tendons, rotate feet internally, and predispose knees to osteoarthritis. The chemical peel that softens skin also destroys a layer of it. Cell phones, a constant accessory, hyperextend lateral neck muscles. Makeup is a happy home for bacteria (though in ancient times it contained mercury and lead, so perhaps we have advanced on that front). And let’s not even mention body piercings.

Fashion is full of hazards. But it offers a few fixes, too. Although knee-high stockings increase spider veins, support hose decrease complications from deep venous thromboses. For $9.99, a shoe insert recently co-created by an MIT-trained rocket scientist will shift body weight off the endangered ball of a high-heeled foot. Basic white washed cotton shirts are protective against ultraviolet rays—and dyeing the shirts avant-garde blue creates an even more potent barrier. Hands-free cell phones need no neck at all.

It is pleasing to think we can lay salves on conditions we have often caused ourselves. One hopes the great among us will continue to work hard on this. The lesser among us will continue to gather in living rooms on Friday nights, wearing only pajamas, in order to scoff at those who labor to wear so much more. Each week, we are so caught up in family amusement that we forget to discuss the worthier topic: Why bother at all?

Humankind uses its intelligence dissonantly, to study the nature of consciousness with one eye and hemlines with the other. Immense efforts go into judging appearances, and then even greater ingenuity goes into altering them, iteration after iteration, seam after seam, merciless reality show after show. Afterward, we always pay for what we have done—it is the one constant in the ridiculousness of a fashionable life. I suspect that’s why we were happier—and safer—in Eden.

Elissa Ely ’88 is a psychiatrist at the Massachusetts Mental Health Center. She insists that she has no sense of personal style.

Photo: John Springer Collection/Corbis