Dear Hand Washers,

I was in a bar last night.

Not bragging or anything; it's just a fact.

It was the kind of bar that draws a wide swath of the population as a target demo, and to its credit, not by being generic or schizophrenic. It's one of those rare locales that manages to be youthful without being oblivious, irreverent without being boorish, and bohemian without being smug.

So anyway, after my third drink I went to the restroom, because I like using the restroom there.



Once again, not trying to brag, but she was obviously impressed.

And as I stood at the urinal, trying to decide whether the look of awe was sarcastic or not, an older gentleman saddled up to the urinal beside me, significantly dampening the mood. I looked over at him from the corner of my eye and caught sight of a silver brier patch of a beard, which I assumed, in addition to adorning his face, was also providing shelter to a fox and a tricky rabbit. 

That would have been the end of it, if not for the wheezing. You know how some old, overweight dudes wheeze so loud that you feel like you can't ignore it because you'd be in violation of a Good Samaritan law? This was worse than that. If this guy's CPAP machine ever short-circuits at night he's going to die like the Elephant Man. I kept thinking to myself, "Where is this person's oxygen tank? I know he's hiding it somewhere. Probably inside that beard." but for the life of me I couldn't find one. Respiratory distress aside, he did kind of look like a cool dude. Kind of. It was a weird mix of old man cool and old man gross, like if Jerry Garcia had a colostomy bag.

The man finished his business at the urinal and quickly zipped up his pants. Some might say a little too quickly, especially for a man of his seniority. They call them "golden years" for a reason, after all. And even the youngest and healthiest-prostated among us knows that rushing the end of a pee is a recipe for the three-drop piddle pants. I was suspicious to say the least.

He hoved his way out, turned the corner, and then I heard a whoomp as the door closed behind him. The sound of wheezing slowly faded thereafter. A righteous anger began to fill me.

That filthy son of a bitch had forgotten to wash his hands. And isn't that the euphemism we always use- he "forgot" to wash his hands. Must have slipped his mind. As if he normally always washes his hands. He probably has a near-perfect record this year, but he got distracted by the glittery mirror frames on his way out. I'm sure under normal circumstances, he's a perfectly diligent little washer but today he was out in the sun a little too long and he got confused. These are the stories we make up; the lies we tell ourselves so that we can avoid coming to grips with the cold, hard reality- these people never wash their hands. They piss, they shit, they scratch their scrotums, and then they cruise right out that door, every single fucking time. They do it at home, at restaurants, and probably even at their friends' and families' homes. They never wash, they are legion, and they slither around like Satan's minions, doing the devil's work, shaking hands, handling silverware, and touching doorknobs.

By this time I was myself standing in front of the bathroom sinks, lost in sanctimony. I looked up into those glittery framed mirrors... and I saw Howie Mandel. And then I saw the light.

Why are we maintaining this macabre charade? The Dyson Airblades, the brushed nickel trough faucets, those motion detector soap dispensers programmed with just the right time delay so that you pull your hand away too soon and the soap splatters all over the edge of the sink. What is it all for?

It's time to reexamine cherished convention. It's time to look the sacred cow in the mouth. It's time to climb aboard McCain's legendary circa 1999 Straight Talk Express, next stop Hard Factsville, population you. While we roll down the highway, let's mosey on over to the onboard Reality Bistro, and order a big slice of honesty pie topped with brass tacks and made with truth eggs laid by locally raised, free-range, frankly speaking hens who spend all day out in a field facing facts.

Does hand washing actually do anything?
 
Not the way most of us do it. First off, I have never in my life actually seen someone lather up their hands for the 20 seconds recommended by the CDC, much less the 30 seconds which many other health experts claim is optimal. If 20 seconds doesn't seem like a long time, pull out your phone and run the stopwatch while you wash your hands. I guarantee you wake up around second 15 and shout, "Oh my God- what year is it? Did I just Rip Van Winkle into the 22nd century?"


From personal observation, I'd say the average public restroom hand wash lasts about 5 seconds.

Even if everyone did wash their hands for 20 seconds, I'm still a little skeptical as to exactly how much of a dent that would put in the transmission of the winter flu, for example. I mean, I'm sure it would help to some extent... but it's really hard to kill all the bacteria, and it's nearly impossible to keep a surface (especially a human hand) bacteria free for long. The microbes in and on your body outnumber your own cells after all.




Forget 20 seconds. Unless your post-bathroom routine takes 20 minutes and includes a scrub nurse, latex, and an autoclave, you're still going to be spewing your germs onto everyone and everything you come into contact with. And even all of the safeguards depicted above aren't able to prevent countless patients from being infected during and after surgery anyway.


Of course, you do occasionally see people in the bathroom who are committed to hand sanitation. Most of them look like they should be committed. You know what I'm talking about- these people who wash their hands and then pry open the bathroom door with some combination of long shirt sleeve, elbow, or paper towel as if the door handle were literally made of two tampons and a dog turd stuffed into a used condom. Nice escape, Houdini, but in this case it's like breaking out of a steamer trunk... and into a bigger steamer trunk. What are you going to do after you emerge from the bathroom unscathed? Pull out that traveling germ hotel you call your phone? Sit down at a table that the previous occupant sneezed on? Fiddle with your belt buckle- the same one you contaminated in the stall with your filthy post-poo fingers but then failed to sterilize?

It's the bacteria's world; we're all just living in it.

I don't want to come across as fatalistic here- after all, hand washing certainly revolutionized surgery and has prevented countless diarrhoeal deaths. We owe it a historical debt. But given the public health realities on the ground, hand washing may even be counterproductive much of the time. It turns out that liquid soap dispensers themselves can become contaminated and may actually add, rather than subtract, germs from your hands. Wet hands pick up bacteria more easily than dry hands, which means that failing to fully dry your hands after washing may again, lead to more rather than less germs on your hands. Antibacterial soaps have been (surprise surprise) linked to the rise of new strains of drug-resistant bacteria, and frequent washing can lead to the degradation of skin integrity, which leaves one more susceptible to the transmission of infection.

So why do so many of us stop off at the bathroom sink for that token five-second wash? Why do it if it's just an empty gesture akin to getting an MBA from an online university, or telling your friend that they were "too good" for their recently departed ex-partner?

I'd postulate that hand washing as ineffectual ritual (which is how most of us do it) still serves us in two important ways.





It's not that duck and cover after a nuclear detonation, or sealing up your doors and windows with plastic sheeting and duct tape during a terrorist attack, or for that matter sticking your head between your legs in the event of an airplane crash don't provide some modicum of protection; I'm sure they all make some small (or minuscule) contribution to survival. But I suspect that the majority of the impact they make is in the realm of the psychological. People are less scared of things if they feel that they have some level of control over the situation. People are less inclined to panic if they've got something to do.

Although I'm not sure if hand washing is really analogous to the three examples given above. Duck and cover, airtight safe rooms, and the brace position cost only some minutes of time to learn and perhaps the onetime purchase of a few common household items. Pretty cheap as psychological benefits go. Hand washing may be more akin to the TSA security at airports- only marginally effective but also expensive and inconvenient.

And yes, hand washing is kind of sneaky expensive. True, most of us only spend five seconds actually washing, but then there's the time spent waiting in line behind someone at the sink, and then those of us who aren't moist-thighed, pants-smearing animals have to stick our hands into Dyson's warm embrace or crumple up five paper towels. And that's not to speak of the material and environmental costs of hand washing- millions of gallons of fresh water, the energy to heat it, soap, millions of gallons of gray water treatment, plus paper towels or the electricity to run the hot air dryers. And all of those resources are being consumed and waste generated every hour of every day, forever.

Of course, peace of mind vis-à-vis the bacterial hordes isn't the only psychological benefit hand washing bestows upon us. It's also useful for virtue signaling. It enables us to demonstrate to our fellow man that we are the type of person who washes their hands- hygienic, pro-social, upstanding, and well-groomed. If you see someone washing their hands in public, you know they aren't eating their own boogers in private. It would be nearly impossible, from a psychological dissonance perspective.

You can pretty easily parse the virtue signaling function that hand washing serves by observing the way in which hand washing expectations vary dramatically based upon context. If you see your friend take a piss and then leave the bathroom without washing their hands, you will probably think less of them. If that same friend takes a piss behind a bush on the way home from the bar, you probably won't think anything of it. It's the same behavior, but we get a free pass when there is no opportunity to signal our virtue by washing our hands. Therefore it is not the dirtiness or cleanliness of the hands themselves which we find concerning, but rather the demonstration of character which washing or failing to wash reveals. How many of us have gone backpacking or camping in desolate regions for days or even weeks- perfectly content in our unwashed filth and that of the people we were with?

At this point, the more self-righteous among you are probably thinking, "Well, Sebastian, that's why I keep a bottle of Purell with me at all times." And you know what? That might just be the answer.

Every public bathroom should have exactly one sink- a hand washing and drying station for use by the immunocompromised, germophobes, people who dropped a quarter into the toilet and had to fish it back out by hand, and off-duty surgeons prepping for an emergency tracheotomy on someone with a Bloomin' Onion lodged in their windpipe.

For everyone else we admit defeat, give up on that pipe dream that is the 20-second wash, and just put a couple of alcohol-based hand sanitizer dispensers on the wall near the door for those who wish to avail themselves of it. That has to be more effective than all the half-ass soap-and-water washing going on now, and it will save a ton of resources in the process.

After all I've said about the futility and hypocrisy of hand washing, you may be wondering whether I myself still wash my hands after using the bathroom. 

You bet my well-wiped ass I do. And if I didn't, I sure wouldn't admit it to you judgmental bastards.

Sincerely,
Sebastian Braff

A special thanks to that revolutionary biologist, Genevieve O. Dallenmyer, PhD, for her scientific consultation on this article

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