It gave us an identity: The story of the ACEM logo
The entwined snake gazes out from its staff, bold and golden against a background of forest green. It might sit on your scrubs, a letterhead, the corner of a web page or your Fellowship certificate.
It’s easy to take it for granted, but the staff, the snake and the clashing red and green of the ACEM logo were a crucial way to legitimise an emerging field, and for nearly 40 years has situated the College and its story as part of a larger, grander and all encompassing medical history.
But while it’s now part of College lore, the story of how the logo became entwined with ACEM’s identity started with the need to officially certify the College as an organisation.
From humble beginnings
It was 1984, a year after it was decided the College would form, and ACEM’s original Council started developing official certificates. Upon doing this, they discovered that in order for ACEM to become officially certified, it would require a logo and an identity.
Dr Bryan Walpole, the Director of the Emergency Department at the Alfred Hospital in Melbourne, Victoria, and one of just six ACEM Council members at the time, volunteered. “I’ll sort it out.”
““Imagery is quite important because it’s your public face. If you’ve got something that whenever people see it, they think about you, that’s a really powerful connection.””
A local advertising agency quoted him between $5,000 - $10,000 – approximately $25,000 today – to design a logo. Bryan thought, “This is absolutely ridiculous – we don’t have this sort of money! It’s not like we’re a commercial organisation just wanting to sell a product. We were just a bunch of enthusiastic doctors trying to get a college together.”
He decided to take it into his own hands. Bryan said, “It was completely spontaneous. I came into work – maybe Monday or Tuesday after we had the College meeting – and said, ‘Can anyone give me a hand with this?’ Dr David Eddey, at the time an intern and now an emergency physician, said ‘Oh, I’ll have a go.’”
Back then, there would only be a couple of patients left in the emergency department overnight so the doctors who were on that day had some free time in the morning. David and Bryan sat down at the workstation to determine what elements they would use in the logo. Bryan said, “Imagery is quite important because it’s your public face. If you’ve got something that whenever people see it, they think about you, that’s a really powerful connection.”
This was especially the case when establishing a medical college that needed to fight to be seen as a legitimate specialty. In the 1980s, when the logo was developed, it was paramount that it acted as a symbolic marker of the College’s place within medicine, as a way to legitimise its very existence.
A small snake with a big history
David and Bryan decided to place the ancient medical symbol, the Rod of Asclepius – the snake wrapped around the staff – as a centrepiece of the logo, to symbolise medicine and healing.
The Rod of Asclepius is globally recognised as a symbol of medicine, and features in logos of major health organisations across the globe, including the World Health Organization and as part of the Star of Life symbol for emergency medical services. The staff has also been attributed to medical practitioners and has symbolic associations with wisdom and knowledge. In Ancient Greece, physicians would often carry rods as they had to transport medicine and equipment to the patients they visited, and the rod helped them navigate across rocky terrain.
According to Dickson D. Despommier, a professor of public health and microbiology at Columbia University, the first reference of the rod is in an ancient Egyptian document called the Embers Papyrus, one of the first recorded medical records dating back to around 1550 BC.
In this text, a procedure for treating Dracunculiasis – or Guinea-worm disease – is described. This procedure involved physicians making a slit in the skin just in front of the worm’s path and wrapping the parasite around a rod to remove it from the patient’s body .
A drawing of a worm wrapped around a stick is thought to have been displayed outside the homes of people who could perform the procedure – and who could often perform other medical practices.
Gustave Doré’s “The Brazen Serpent” (1866), as found in the French translation of the Vulgate Bible.
The symbol can also be found in the Jewish Torah, or the Old Testament, dating back to 1410 BC, illustrated in the Book of Numbers. The Israelites were growing impatient during their 40-year journey through the desert and, in response to this, God sent fiery serpents among them, and many died from poisonous snake-bites. The Israelites implored Moses to help them, so Moses prayed to God, who instructed him to place a fiery serpent upon a pole. Moses then crafted a snake from bronze and all the Israelites who gazed upon it survived their bites, reinforcing the image of a snake as a symbol for the dual nature of harming and healing.
Bryan said, “The snake and the staff of Asclepius pointed a bit towards toxicology which we’re pretty good at – snake and snake bites – and towards renewal,” adding that snakes are often used to symbolise rejuvenation and recovery due to the way in which they shed their skin, this process seemingly imparting them with new life.
Bryan said, “The snake takes off its skin and renews itself, and is sort of fresh and clean every season, which is exemplified a bit by what emergency medicine is: Something new and fresh and clean and continuing to refresh itself.”
The College almost accidentally used the Caduceus – a similar symbol that has two entwined snakes around a winged staff. It is used largely in the American medical field but was originally aligned with commerce, gambling, and thievery.
Bryan said, “A couple of people wanted the double-winged one, but the double-winged one has got nothing to do with medicine.”
The shapes of emergency medicine
The shapes that make up each component of the logo were carefully chosen and curated to create symbolic meaning.
The cross in the middle of the logo is a reference to the red cross, widely recognised as an international symbol for protection and neutrality in armed conflict.
Initially designed in 1863, the red cross was created in honour of Jean-Henri Dunant, whose advocacy for wounded soldiers in 1859 inspired the formation of the International Foundation of the Red Cross. The cross references Dunant’s Swiss heritage, as an inverse of the Swiss flag .
On a more practical level, the cross was designed to be easily recognisable from a distance to prevent people from being shot, and to be the same symbol for friends and foes.
Nowadays, it is often seen as generally being aligned with health and emergency services. The cross was also chosen to represent the fact that emergency medicine is largely hospital-based, with a plus sign often used to indicate hospital or medical settings.
The logo’s circular design also holds relevance. Circles have associations with security, continuity and protection. The lack of hard edges in this design reinforces semiotic associations with wholeness, perfection and completeness, as well as associations with warmth and community. When designing the ACEM logo, Bryan wanted to include a ring to symbolise inclusivity, as emergency doctors look after a broad range of other specialties.
““Everybody used first names, compared with just about every other branch of medicine. We established early on that we were all in this together as a fellowship.””
“Everybody used first names, compared with just about every other branch of medicine where people were referred to as “doctor” or sometimes called “mister”, but always by their surname. Yet we established early on that we were all in this together as a fellowship, so we all used first names,” Bryan said.
David agreed. “Bryan was my first boss ever as a doctor, and emergency medicine was a pretty dynamically evolving specialty,” he recalled. “I loved it. Bryan was a great mentor, a real character, very charming and personable and witty, so we got along really well. It’s one of the reasons I fell into emergency medicine.”
Emergency red, and other colourful decisions
The colours in the logo are also deliberate and symbolic, and Bryan and David worked together to choose them. According to Bryan, the big red ‘ACEM’ across the logo gives it emphasis, and it references the blood emergency doctors often see as they try to stop bleeding and tend to wounds. David believes the red ACEM placed across the centre of the design made the logo immediately and easily recognisable to emergency physicians.
Traditionally, the colour red is associated with emergency services because it is easy to sort by the human eye, allowing people to recognise highlighted critical information emphasised with red more quickly and easily. This is because human eyes are ‘generally’ more sensitive to colours with longer wavelengths such as red, orange and yellow. Furthermore, while green is most visible from a distance, red is the most easily visible colour when visibility is hampered by fog or smoke, as these tend to filter out shorter wavelengths of light.
The ACEM emergency department sign guidelines state that emergency signage should be standardised with white lettering on a red background, so mimicking this colouring in the logo aligns the College with the physicality of emergency departments in its design.
The gold was chosen to reflect the gold standard that the College aspires to. It also relates to other depictions of the Rod of Asclepius, which portray the snake as golden; perhaps in reference to the biblical depiction of the bronze snake statue.
Meanwhile, green was chosen in reference to the international colour of hospitals.
Green was established as the colour of hospitals in the early to mid-20th century but has since fallen out of use. The association of green with hospitals began in 1914 when Harry Sherman, a surgeon in San Francisco, found it difficult to differentiate anatomical features under the too-bright white lights of the operating rooms, which would have created glare against the white tiled surfaces.
Green was used in operating theatres to contrast the red.
Sherman used colour theory to determine that the contrast of the red against green allowed him to focus on the detail and texture of the wounds without his eyes having to compete with glare. Throughout the 1920s, more surgeries began adopting this colour scheme.
In conjunction with this, the field of “colour therapy” was evolving. Architect William Ludlow argued that white was a negative therapeutic colour, and that soft greens promoted rest and contentment as, due to evolution, the eye is most comfortable in mostly green environments.
The field gained popularity in the 1930s, led by Faber Birren, who aimed to incorporate colour into every hospital and was convinced that green hues would calm and ground both patients and hospital workers. The 1950s was the height of this movement, when a neurosurgery unit at the Royal University Hospital in Saskatchewan, Canada, opened an entirely green tiled operating suite. This would be a major feature in hospitals well into the 70s and remains a symbolic marker of hospitals to this day .
A logo that still holds up
With all the elements decided, David went away and worked on the logo in an on-call office at the hospital, looking over Fawkner Park. In between calls he would draft the logo with ink, pen, and compasses and protractors borrowed from the Alfred audio-visual department, as well as “Letraset” rubon lettering purchased from Eckersley’s on Commercial Road.
“I think it’s a simple, basic design that conveys a message,” David said. “It conveys what the organisation is without being too fancy or complicated.”
““In the early days ... a lot of people said that we had no place in medicine. What we had to sell is that the department’s got people, and we’ve got time. And developing a logo gave us an identity.””
The design took approximately 10 days to refine and get ready for presentation. After Bryan saw David’s design, he was so confident in it that it was the only one he put forward for acceptance, despite having other designs sent to him for consideration. In return for his efforts, Bryan presented David with a telescopic metal “plessor” which David still uses today. David’s design received unanimous support.
Bryan said, “Seventy per cent of the credit goes to David Eddey, because he provided the direction and the input and the presentation of the College.”
David noted that most of his more junior colleagues don’t know that he designed the logo and are surprised when he tells them about his crucial involvement in it. Nonetheless, he feels very proud and fortunate to have contributed to ACEM in this way, as well as his other contributions to the College through mentoring and his time as an ACEM examiner.
Both men feel that the logo helped solidify the profession as a legitimate specialisation.
“In the early days we were all called casualty doctors,” said Bryan. “A lot of people said that we had no place in medicine. Everybody in all the other specialties said, ‘We look after our own emergencies, we don’t need you.’ What we had to sell is that the department’s got people, and we’ve got time. And developing a logo gave us an identity.”
Almost 40 years later, and the logo remains. Bryan said, “No one has ever thought about changing it, so we did a pretty successful job.”
