The story usually goes like this: in 1914 a San Francisco surgeon dressed his operating team in green, and hospitals have worn green and blue ever since. The surgeon was real. His name was Harry M. Sherman, and he did write about a green operating room in 1914. But when you read his actual article, the room was green, the clothes were not. The gowns Sherman ended up recommending were black.
What scrub colours mean today
Start with the practical answer, since that is what most people are looking for. There is no universal code. Nurse.com, a nursing education site, puts it plainly: scrub colours and their meanings are not universal, and one hospital may give navy blue to nurses while another gives the same colour to medical assistants or technicians. Many hospitals do colour-code by role or department so patients can tell who is who, but each one sets its own scheme. If you want to know what a colour means in a particular hospital, the only reliable answer is that hospital’s own dress policy.
The one broad pattern is in the operating room, where green and blue dominate. That part does go back to 1914.
The green operating room
Sherman’s article, “The Green Operating Room at St. Luke’s Hospital”, appeared in the California State Journal of Medicine in May 1914. His complaint was glare. Operating rooms at the time were white from floor to ceiling, and a surgeon who glanced up from the wound met “a glare of light” and found “his eyes useless for a moment” when he looked back down.
His fix started from the colour of the work itself. “The color scheme, it seemed to me, should start from the red of the blood and of the tissues,” he wrote, “therefore I advised that green, the complementary color to red, should be chosen for the color of the floor and wainscot.” The exact shade was the green complementary to haemoglobin, and “it was found to be the green of the spinach leaf.” St. Luke’s painted one room this way, floor and walls spinach green to six feet, white above, and set it against an all-white room. According to Sherman, nobody who could get into the green room ever chose the white one.
Why the gowns went black
Sherman then tried the same idea on the fabric. White sheets and towels reflected light into the surgeon’s eyes as badly as a white floor did, so the hospital provided green towels and green sheets of galatea. They failed the first real test. “The color in these, however, did not stand the superheated steam in the sterilization,” he wrote. “They became a dingy gray.”
So he went further. He surrounded the operating field with black, “as giving a surface from which no light whatever could be reflected”, and had black gowns made, with black covers for the instrument tables. The only objection, he reported, was a fear that patients would take the dark outfits as a bad omen. Patients operated on under local anaesthetic, he said, raised no objection to “the black dress of the operator, nurses and room”. He also pointed out that no laboratory using microscopes ever had white benches. Theirs were stained dead black.
From black back to green and blue
Black never became the standard, but the argument against white won. A short history of surgical clothing by N. L. Belkin in Today’s Surgical Nurse (1998) sums up the change: until 1914 all surgical apparel was white, and because it caused glare it was abandoned in favour of green, and later ceil blue.
Modern explanations add a point Sherman never made. They say that after staring at red tissue for a long time, the eye can see a greenish afterimage on a white surface, and that a green or blue gown hides it. That may be a real benefit, but it is a later gloss. Sherman’s own reasoning was about glare, and he believed the fabric that answered it best was black.
