"Whenever I go into a restaurant, I order both a chicken and an egg to see which comes first"

Saturday, November 23, 2013

Fist Bumping Saves Lives

Fist bumping should replace shaking hands, say public health officials. Hand shaking is disgusting.  Just imagine where your hand has been let alone everyone else’s.  ‘The Cook’s Thumb’ was expatriate epidemiological shorthand.  Flies, dust, undercooking, and dirty plates were the usual suspects when the squirts hit, but more than likely it was the cook’s thumb stuck in the chicken korma, a thumb that had been in and out of very dirty places a few minutes before, that did the trick.

Germ-conscious 30-somethings today have become very acrobatic and have learned how to use center-of-gravity, balance, and kinetics to avoid touching anything on the Metro as it rocks and sways towards Farragut North.  Every leanable space on the train is taken – the outer doors, the doors between cars, and the uncomfortable space under the system map – so that these young commuters don’t have to touch the poles or the seats.

“Can you imagine how disgusting those poles are?”, remarked a young friend. Ten thousand cooks’ thumbs a day and countless boogers, smeared snot and dog shit, covered with come, salmonella, shigella, and e-coli.

“Hands put all of that mess there”, my friend went on, “so if you shake hands you are going back to the source – hands that ass-wiped, trapped a sneeze, dug out a booger, scratched private parts, and picked up dog shit.”

Enter the fist bump.

Obama Fist Bumping White House Janitor

The janitor is playing it safe and is fist bumping the President with his glove on.  Fist bumping, after all, is not foolproof since it is not hard to picture someone wiping his nose with the back of his hand; but it certainly is safer than two open hands mixing their dried scum, bilge, and refuse. As much as you might wonder where the President’s knuckles have been, you need to be very concerned about his palms.

The safest of all is the air bump.  Like the air kiss, it gets the point across without transmitting any nasty bits.


Obviously things have gotten way out of hand.  Pretty soon germ paranoia will drive us all to disposable gloves and masks. It doesn’t have to be this way.  If children are allowed to build up their immune systems by exposure to bacteria, viruses, and allergens, then they as adults can hold on to subway poles and shake hands with little concern.  As it is, young mothers are scrubbing every surface within reach.  The two-second rule is long gone. Handiwipes and Purell dispensers are everywhere.  Clorox, Mr. Clean, and Spic ‘n’ Span are doing a land office business.

Mommy minesweepers check playground sandboxes for leftover pacifiers, drooled-on toys, and food-encrusted dolls; and set up sanitary cordons for their children. Nothing is shared – not a mitten, scarf, sock, or baby booty.

By today’s standards, earlier generations of children grew up in filth, crawling on dirty floors, licking table legs, playing with free-range dogs, sharing cookies, sleeping on common sheets….Yeccch. Yet those of us who survived that cesspool may be better for it today.

Shaking hands has never been that common in America.  It is reserved for greeting new people, a show of respect and openness – the way the tradition got started over two millennia ago.

          Hera and Athena, 5th Century BC

In Europe, however, hand shaking is common, universal, and frequent.  When a new guest arrives at a party, he shakes everyone’s hand; and repeats the gesture when he leaves.  It would be incredibly bad manners to just  grab your coat and wave good-bye.

In West Africa hand shaking is even more common. If you ask for directions, you shake hands.  If you go into the post office to pick up mail, you shake hands.  You shake hands with the grocery clerk, the taxi driver, and the policeman.  Every day, hundreds of handshakes. Men’s hands, women’s hands. Tough, horny, workers hands.  Soft, delicate, aristocratic hands.  Stubby fingers; long, tapered fingers. Ringed fingers, plain fingers.

At the opposite end of the spectrum is India.  Although the country is rapidly Westernizing, one still greets men and women with a handless Namaste.  It took me a long time to learn to keep my hands to myself. As far as hygiene is concerned, however, shaking hands didn’t make a whit of difference.

I worked for a number of years for the World Bank as part of the International Water and Sanitation Decade (80s); and as part of my assignment, I had to inspect traditional sanitation facilities in Indian towns.  Few dwellings had modern sanitation at the time, and most people used what were euphemistically called ‘wet’ latrines and ‘dry’ latrines.  Wet latrines were multi-story waste disposal system. A resident shat into a hole on the second floor.  It splattered on a concrete plinth on the ground floor, and was scraped into wicker baskets by ‘sweepers’ who carried it away on head loads to be dumped into the river.  A dry latrine was simply a corner of a common courtyard designated as a shitting ground, and residents of the surrounding apartment blocs went there to relieve themselves.  The waste was picked over by dogs, chickens, and crows.

Needless to say, worrying about shaking hands was the last thing on my mind. In fact it was India which cured me once and for all about germs.  If I survived that pestilential environment where I was exposed to hepatitis, amoebic dysentery, brucellosis, worms, trichinosis, plague, and typhoid, the United States would forever be an antiseptic, gleaming, steel-and-chrome temple of cleanliness.

In an article in The Atlantic (11.23.13) James Hamblin writing about the fist bump vs. the handshake records how some people think the fist bump is too dirty:

"Some have even advocated for an elbow tap," Lahey added. Earlier this year in New York, a youth soccer league banned high-fives and bumps in fear of flu transmission, but allowed elbow taps. The mid-air hip bump is also popular in Major League Baseball, especially when a player is crossing the plate after a home run, but poses logistical challenges in many workplaces.

This reminds me of a friend of my father’s who was a hypochondriac.  Not only did he avoid shaking hands, but he used his elbows, knees, and feet to open doors; found excuses to shield his nose and mouth when others were speaking; and in general tried to stay at least two feet away from everything.

He got quite good at it.  I saw him once pick up a bottle of milk with his forearms, take the cap off with the pointy part of his elbow, and pour with his wrists.  He would have been right at home today.

The number of things we touch every day is staggering.  Without ever leaving the house we have touched contaminated outside material from the time we get out of bed.  The money we stuff into our pockets, the papers from the office, the briefcase which has lain on subway seats, the shoes which have scuffled through spit and pizza bits, all are vectors for disease.  So avoiding hands is not a bad idea, because every hand you shake has touched its share of dirty money, hotdog wrappers, and saliva. Yet at what cost?

We Americans are convinced that we can live forever.  We sort of know we can’t, but since every day we witness new, life-saving drugs, bionic implants, body flushes, and genetic modification, we see life being extended.  So maybe it is possible to beat the Grim Reaper after all.  But you have to work at it.  Purify indoor air and lobby for clean air outside. Scrub, cleanse, and sanitize. Look but don’t touch.  Be careful.

Research has proven that a dog’s mouth is far cleaner than a human’s – with all the nasty stuff a dog gets into, his maw has to be filled with acids and solvents that can destroy pathogens of any stripe. A human mouth is a cesspool by comparison.  The gunk between the teeth festers overnight, and virulent pathogens burrow down into the gums and over the lips and past the tongue.  Every disease we carry circulates through the mouth via the bloodstream.  A good, juicy French kiss is disgustingly dirty.

Which only goes to show that we are not very logical in our desire to keep clean and sanitized.  We avoid a perfectly good handshake and then kiss or go down on our partner.  Yeccch.

In any case, I don’t find the move to fist bumps surprising, although funny.  Once again, we have to thank African Americans for introducing yet another hip style into the mainstream. But this, more than saggers, Doc Martens with untied laces, bling, half-cocked baseball hats, oversized jerseys, and gangsta rap, is good for you.

The fist bump is not only plausibly hygienic," Lahey said, "but it has the advantage of also being kind of cool. Perhaps our patients will appreciate our attention not only to their health but also to hipness."

Attentiveness to hygiene is the definition of cool. The doctor is not trying to bro down; it's even bigger than that. Respect knuckles.





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