Dr. Campbell in the MEDesign Lab

A Treatise on Neckties

James Stewart Campbell, MD.  2013

I don’t wear neckties.  This is not a new development, but learned over years of Sunday church, dancing class, and military day school.  I’ve tried all types, attempting to find a tie style that I could tolerate.  None suffice.  I can tie the standard overhand knot, a half-Windsor, and a whopping full-Windsor that leaves little tie remaining.  I’ve tried clip-ons, tie-ons, bow ties, clip-on bow ties, and even fashioned a Velcro fastener for cravat safety.  Still, I hate them all.  And don’t get me started on bolo ties.  I don’t want a string around my neck, no matter how big a chunk of turquois it supports. The cravat may be historically linked to the scarf, which was originally wrapped around the neck to prevent escape of bodily warmth, however, like the Jewish Yarmulka which had the same function, it has evolved into a symbolic accessory devoid of its original purpose.

Ties have been shown to be a health hazard to the wearer and to others.  I’m not only talking about the standard long cravat, but also about bow ties.  Bow ties indicate that the wearer has a disconnect between mind and body, but they will deny this is true - further evidence that this separation is real. Their eyeball pressure increases by simply wearing such a symbol, and they probably become impotent early in life and must live on Viagra.   

But we are here discussing the health risks of wearing standard ties.  One very real risk caused by ties is the increased possibility of strangulation.  This is obvious to those who earn their living as bartenders, where an inebriated customer may reach over the bar, grab the cravat of the bartender who is refusing further service due to the aforesaid inebriation, and choke the snot out of the unfortunate mixologist.  I’ve seen it happen.   Besides this hazard, ties do not mix with rotating machinery or the ubiquitous paper shredder.  Many technologists and engineers have lost their lives due to a floppy tie getting caught in a rapidly-rotating drill spindle or lathe.  The sudden snap of a neck breaking may be the last thing they heard.  Or perhaps their strangled cries as the torque twisted the skin off their neck.   Yet the cravat was the required accessory for the corporate technologist throughout the 20th century.  Dress regulations could be deadly in those days.

Necktie in the Shredder!

More recent studies have shown that wearing a tight necktie constricts the veins in the neck, thus raising the pressure in the eyeballs – causing what might be called sartorial glaucoma.  Is wearing a tie worth risking glaucoma and loss of vision?  If the boss says it is, what is the peon employee to reply?  Besides raising intraocular pressure, all types of neckties restrict movement of the neck muscles, causing increased neck pain and musculoskeletal injuries.  Proof positive that ties are truly a pain in the neck. 

Medical studies have also implicated the cravat, but not the bow tie, in the spreading of disease.  Doctors, going from patient to patient, carry disease bacteria, such as staphylococci or clostridia.  As they bend over to examine a patient the tie flops forward to touch the patient’s skin, picking up bacterial hitchhikers in the process. These microscopic transients are then deposited on the next patient, spreading the infection.   Neither hand washing nor alcohol gel will stop this mode of transmission.  Only by ditching the cravat is this vector eliminated.

Ties are always getting food on them - I had a boss once who said he had to keep his ties in a refrigerator to keep them from spoiling. What effect this phenomenon has on health and disease is not known, but it is probably not beneficial to the human organism.

So the wearing of ties involves a definite cost to the wearer which far exceeds the cost of the cravat, as I was able to present to management at a corporate meeting years ago.  I was working as a medical design engineer at Life Sciences, Inc., a small medical device manufacturer in New Hampshire.   The vice-president of production called an early morning meeting of the departments.  As the de-facto director of engineering, I sat down with the heads of manufacturing, personnel, inventory, service, and marketing expecting a pep talk from Vice President Bob.   Bob’s main claim to fame was a stint as master sergeant in the US Marines, and with a body habitus that included a stocky belly and no discernible neck, he looked the part.  After the Marines he had gone on to get a Master’s Degree in Business Administration, but he must have slept through any classes on being tactful.  Bob called the meeting to order, then immediately attacked me:  “Campbell, just what will it take for you to wear a tie?!??” There followed a five-minute rant about my lack of proper dress code – mainly my having no tie.  Apparently my pants, shirt, socks, shoes, coat and hat were acceptable, but the lack of cravat was NOT!   I sat there, trying to be stoic, until he finally ran out of invectives and went on to another topic.  “Wait, Bob,” I injected, “you didn’t let me answer the question.”   “What question?” Bob blurted. Silence blanketed the room.  “You asked me ‘what will it take for you to wear a tie?’”  “OK,” said Bob, taking the bait…  “What will it take?”  “Give me double my present salary and the whole month of August for vacation,” I replied confidently.  A ripple of laughter went around the table.  “It ain’t gonna happen,” said Bob.  “Well, there you go,” I shrugged.  Bob never brought up the subject again.   And that’s why I don’t wear neckties.




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