I have long believed that first impressions, and even visual clues generally, can cause trouble. Indeed, it is my view that their (mis)use is possibly a key component in the development of prejudices such as racism and sexism. My ideas about first impressions came to me in rather odd circumstances. I was timetabled to give the last lecture on the last day of the Christmas term. The lecture, which was on the clinical pharmacology of phaeochromocytoma, was destined for first year medical students. The lecture theatre would be full, and things were bound to be festive – more banter, certainly some bunting, a few twigs of mistletoe, and an abundance of streamers. Nevertheless the lecture itself, like any other, was a serious business.

Plans were hatched a day or so before the talk. Just after the lecture was due to start a colleague entered the theatre, apologised for my lateness, and told the audience (probably of around 200) that ‘Professor Collier had phoned to say that he could not give the lecture but that he had arranged for someone to give the talk in his stead. The stand-in speaker would be along in minute or so’. As might be expected the students became restive. After a short delay Father Christmas entered through a door at the back of the lecture theatre dressed in full regalia (including a big white beard and red hat), walked up to the podium, apologised on behalf of ‘the Prof’, and started the talk.

After a moment of bewilderment, laughter and cheers (even applause) broke out as the students realised the ruse but I continued with the lecture in my new persona as though nothing was amiss. Within minutes the students hushed, books were opened, notes were scribbled, and later even questions were asked. As a group we had reverted to the norm. To the students Prof Collier was giving a lecture and they were taking notes, but something else was going on. As I spoke I realised how, within minutes, the students were looking through the disguise and were concentrating on the message. They had stripped away their first impressions, the joke, the barrier, and had resumed that student:teacher relationship in which minds speak to minds. At the end of the ‘lecture’, which went on for the usual 40 minutes, cheers broke out and the joke returned. But the students had shown that superficial matters such as appearances, can, given the right circumstances, have no meaning.

Although a powerful lesson in the possible role of first impressions, my Christmas experience had nothing when compared to the importance of a recent ‘experiment’ on television. A week or so back, James Partridge, founder of the charity Changing Faces, read the lunchtime news on Channel 5. He sounded just like any other newsreader, but that was not the point. James is obviously (inescapably) disfigured since his face was injured in a car crash. Moreover, feedback has shown that by the end of his week as a guest reader, he had been accepted by viewers who revised their initial negative first impression and simply concentrated on what was said. In his week, James had elegantly illustrated how disfigurement, which can appear as a bar to communication, can become invisible.

What are we to make of all this? From these two experiences it would seem to me that given the right circumstances, people can and do sweep aside ‘first impressions’. They know what is going on – the disfigurement does not go away – but choose to disregard the potential barrier as they prioritise other demands which in the case of a newsreader is listening to what is in the news. But, if people can do this for disfigurement, why not for other ‘first impressions’, such as skin colour or gender in those who are racist or sexist. It must be the case that these are of a different order. Here the visual impression is just one component of a swath of feelings (attitudes), and the ‘seeing’ seems simply to trigger the other beliefs. So, in conversation, a white racist man can see past (ignore) the black skin, but he is still aware of the colour and this colour triggers the emotions and attitudes that make up racism. Unlike with disfigurement, in this instance, seeing beyond colour is of no real help. Accordingly, it seems that racism is not a visual issue but part of a deep seated belief. 

One has to accept that first impressions are important as they can so obviously determine how we feel and act. However they can lead astray and we need to develop strategies to question our first impressions and modify our views accordingly. The nature and circumstances of the first impression will determine how easily this can be achieved. Major problems can arise when first impressions are tied into other beliefs as in racism or sexism. Here the issue is the linkage rather than the first impression itself, and this has proved much more difficult to resolve.   

Joe Collier is emeritus professor of medicines policy at St George’s, University of London