Mom Always Said Wash Your Hands

Today is a perfect time to honor our healthcare professionals, celebrate international women’s month, and remind you to lather up. Consider it a threefer. All hail to midwives, nurses, and mom.

Poster from Foodsafetynews.com. October 15, 2016 was Global Handwashing Day, though we might have missed that.

Aqueducts and Aquamaniles APlenty

Contrary to some beliefs, bathing and hand-washing is not a historically recent phenomenon, but was a practice widely dispersed across many cultures for centuries. The Romans, Greeks, Mesoamericans, and Japanese all incorporated bathing into their daily routines. Even into the Dark Ages, where food was eaten mainly with the hands, it was customary to rinse off before dining. Special ewers were provided for noble feasters, but even commoners might prepare a hand-washing solution with herbs, like making tea.

Pour faire eaue a laver mains sur table mectez boulir de la sauge, puis coulez l’eaue et faictes reffroidier jusques a plus que tiedes. Ou vous mectez comme dessus camomille et marjolaine, ou vous mectez du rommarin, et cuire avec l’escorche d’orenge. Et aussi feuilles de lorier y sont bonnes.

To make water for washing hands at the table. Boil sage, strain the water and let cool to a little more than tepid. Or take camomille and marjoram in stead [of sage], or rosemary, and boil with orange peel. Bay leaves are also good.

From Coquinaria, A Recipe for Washing Hands
A medieval aquamanile, for rinsing hands before dinner. Photo at Coquanilia.

It wasn’t until the post-Renaissance, the “Age of Enlightenment,” when bathing fell out favor. This was partly due to a rise in puritanical thoughts; public bathing was linked to houses of ill repute. Women were required to cover up most of their body in public, and washing was recommended only for whatever was left uncovered. Linen had overtaken wool as the fabric in use, which kept people cleaner, but also led to changing clothing less frequently and bathing less frequently. Finally, physicians of the 16th and 17th century believed that disease came from miasma–bad air–and that washing would let the disease in by exposing the body to the miasmas.

The Baby’s Coming–Start Boiling Water!

Think of any movie where a mother is about to give birth at home–especially westerns. Someone invariably shouts for boiling water. There are many theories about why that came into cultural lore, whether it was to keep the nervous husband busy or as a medical practice to aid with afterbirth and healing. But we have long associated washing up with the midwives. They knew, even if the doctors didn’t.

There were two popular early treatises on midwifery from the 17th century, when printing started to put books into the hands of more people. The one often mentioned first is Nicholas Culpepper’s Directory for Midwives (1662), one of many medical books he authored. Curiously, Culpepper himself never actually witnessed a birth. He provided some useful ideas around herbal remedies and had an in-depth diagnosis of puerperal fever, a leading cause of death for women following childbirth. But he didn’t cover much about the “how to” deliver a child portion given that he hadn’t actually seen it.

Meanwhile, Jane Sharp published a lesser known work in 1671 that was a bit more on point. The Midwives Book: or the Whole Art of Midwifery Discovered covered historical medical practices from ancient physicians like Aristotle and Galen as well as the 30 years of practical experience that Sharp herself could impart. It was the first book on midwivery written by a woman, as up until then, all the others had been written by men who were not midwives. ( Until about 150 years ago, aiding in childbirth wasn’t considered a medical practice unless it required surgery. ) Sharp’s book provided not only detailed advice about the technical process of delivery, but also described the growth of the fetus and recommended breastfeeding and nutritional practices. It was the What to Expect When You’re Expecting of its time.

1800 French engraving. Three midwives help with delivery; notice the washbasin. Alamy stock photo.

Semmelweis: The Father of Hand-Washing

If you look up who “invented” or standardized the use of hand-washing in modern medicine… well, you know where I’m going with this. A guy invented hand-washing. To his credit, Viennese Dr. Ignaz Semmelweis was the first doctor to observe a clear link between hand-washing and improved survival rates. Most of his fellow physicians still believed that “miasmas” caused disease and the standard cure for that was bloodletting.

Moreover, in 1847, most doctors considered dirty hands and operating clothing to be a badge of honor. The dirtier the clothing, the more experienced the doctor. Physicians who performed autopsies were even more revered because they were considered the most knowledgeable about causes of illness. This was where Semmelweis came in. He observed two different maternity clinics.

The First Clinic had a mortality rate of over 10% from puerperal fever and other causes. The Second Clinic’s mortality rate was under 4%, a fact well known to prospective mothers,who begged to be sent to the Second Clinic or were willing to give birth in the street rather than be sent to the First Clinic. Semmelweis approached the problem scientifically, keeping meticulous track of data to eliminate causes such as overcrowding, difference in practices, and climate. Finally, he noticed that many of the doctors going over to the First Clinic to assist with surgery for difficult births were coming from the morgue and did not wash their hands after performing autopsies. Those in the Second Clinic were just plain old midwives.

I know. Ew.

But let’s give him credit. Ignaz Semmelweis standardized hand-washing, particularly with a chlorine solution, even before the germ theory of disease and infection was known and put in place.

Photo from Berkeleydailyplanet.com.

The Lady with the Lamp

The other well-known name associated with handwashing is Florence Nightingale, whose pioneering nursing work in the Crimean war set a standard for hospital sanitation still in use. In 1854, when she arrived at Scutari (near Istanbul), soldiers were dying ten times more from dysentery, typhus, and cholera than from war wounds. In 1859, even though it was counter to common medical practice, she made it clear to those in her charge:

Every nurse ought to be careful to wash her hands very frequently during the day

Florence Nightingale, Notes on Nursing

Nightingale was credited with reducing deaths in the Crimean war medical hospital from 42% to 2%. She brought sanitation improvements into hospitals in Britain afterwards, working closely to segregate sewers and implement hand-washing standards based on her experience from the Crimea. She also created training for nurses, especially focusing on those who cared for the poor.

Florence Nightingale, Angel of Mercy. Photo from wikipedia.

Of particular fascination to me, she apparently invented a special way of displaying mortality statistics called the Nightingale Rose. Now also called a circular histogram, data projects outward from a central point rather than in linear fashion. Interestingly, the purveyor of this COVID Rose Chart–just from last week but with outdated data already–cited Nightingale by indicating “he” created it during the Crimean War. I’m not sure why this author doesn’t know the correct gender of Florence Nightingale, but given who often gets credit for improvements, it doesn’t surprise me.

A Nightingale Rose chart of COVID cases from March 18 (already out of date!). From Finereport.com.

Still, I know who first told me to wash my hands before dinner. And it wasn’t my dad.

Extraordinary Woman, Extraordinary Times

Here’s a great story to brighten your day and bend your attention away from That Other Thing that’s on our minds.

Suppose you were Michael Jordan or Tom Brady, the greatest player of a sport in your generation, in the middle of your statistics-blowing career, on your way to winning the Nth of your many championships–and you just decided to take a few years off to help the world? Nuts? Unheard of? No one would do that?

Maya Moore did it.

Maya Moore, as a freshman, in the Boston Globe, photo by Bob Child.

What Makes a Legend

In college, Maya Moore was such an annoying player!–for everyone who wasn’t a UConn fan. Even when she was a freshman, the Boston Globe was suggesting she could be “the best female player ever,” as she began to amass statistics and wipe out opponents. The coach was comparing her to Derek Jeter, and he wasn’t wrong. Moore was always where the ball was, on offense and defense, until opposing coaches would just throw up their hands. She helped lead Connecticut to two back-to-back national championships, a 90-game winning streak, and an overall record of 150-4 in her college career.

I was a fan of northern California teams that she beat and would cringe every time I heard her name. Which was every twenty seconds. When you watched her play, she seemed to be on another level from everybody else. Hold that thought.

Continue reading “Extraordinary Woman, Extraordinary Times”

Trash Dance

Photo of plastic lid to collect compost
How shall I collect compost? Let me count the ways… photo by kajmeister.

The biggest excitement in my life for the past week has been hearing the Bulky Trash people pick up my pile of Things. Last Monday, at 7:02 am, after the morning compost truck had banged its way along our suburban street, I heard the sound of backing up. I was, in fact, waiting for it; had, in fact, already gone out to examine the pile we had sneaked out there after dark on Sunday night to see if it was still humbly awaiting pick-up. (It was.)

Oh beautiful Bulky Trash truck, I was never so glad to see you! I heard the discussions outside in between sounds of metal scraping on concrete; I heard dragging; I heard crunching. Then, the Doppler effect of that engine driving away, and I dared to peek. All gone! All gone! I spent the rest of the day humming to myself and doing a little ceremony and dance, Bulky Trash! Bulky Trash! Everybody do the Bulk-y TRASH! Do you think me simple for getting so excited about trash? Definitely. To paraphrase Jango Fett, I am a simple person just trying to make my way through the universe.

Our Education Regarding Trash

We have come a long way just in my lifetime dealing with the Things we acquire and then jettison. Sesame Street many moons ago had a video with a little song, What about garbage? Where’s it go?Where’s it go-o-o-o? as they showed smiling men putting the trash in the trucks, and the trucks putting it on the barges, and off the barges sailed into the sunset….. Well… not exactly, right?

We learned when we got older and put away childish things that the trash got dumped in the ocean. Or landfills which filled up, begatting new landfills and more and more, until we realized we were going to run out of land for landfills. Voila! Earth Day and the 1970s and recycling, first a few hippies dragging trash bags full of beer cans, then a whole industry, and finally a regulatory imperative. Fast cut to 2020 where we have tri-partite trash, multi-colored cans, and 79% of our county trash avoids landfills.

But it’s not so easy, is it? Even though the Bay Area has some of the highest recycling rates in the country, even San Francisco has had to extend its Zero Waste goal another ten years, stuck at 89% because of leather, rubber, flame retardants. Or, as I found out, because nobody wants a 20-year-old metal bunk bed. We already separate out all the organics, cans, bottles, foil, paper, cardboard, egg crates, hard-molded plastic, yet there’s still cellophane. There are still Cheetos bags. (Don’t judge.)

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Let Facts Go Viral

Spanish flu pandemic of 1918, photo from historyofvaccines.org

The question was asked yesterday: What’s something you’ve longed believed to be true, but now you know is not true?  When it comes to worldwide problems, we often think: It can’t happen here. I mused about this while watching the news, with story after story about the coronavirus, topped by Our Leader at a press conference emphasizing that there are only 15 U.S. cases of the virus, and really that would soon be zero. That same day, the 60th case in the U.S. was confirmed, a case which is literally Here, near-ish to where I live. At the moment, they don’t know how the person became infected, and they don’t know who she came in contact with.

It can happen here.

Americans seem to sway between attitudes of invulnerability and full-scale panic. It can’t happen to us, that’s only for exotic people in China or Iran. Next day, we’re in long lines at Home Depot asking where we can buy HAZMAT suits. I’d like to take a middle road here and discuss some fact facts about pandemics—risks, likely scenarios, treatment, and precautions.

Lessons of History

There have been pandemics before, the most prominent being the Spanish flu pandemic of 1918, where 30 million people died. An estimated 500 million, 27% of the world’s population, became infected, and the death rate averaged around 2%. As many as 675,000 Americans died of the 29 million thought to have contracted the disease. The outbreaks occurred in two waves: one in the winter of 2018 during normal “cold and flu” season and a second, deadlier wave, in late summer. An unusually high number of young adults died in that second wave, unlike a typical flu. The disease hit hard even in isolated communities like the Pacific Islands and Alaska, with communities like Samoa losing 30%. In other places, such as the U.S., the mortality rate was closer to 0.5%. Not everyone was exposed. Not everyone exposed became infected. Not everyone who became infected died.

For comparison, a normal flu season in the U.S. kills between 20-40,000 people annually, about 0.1%. Like the coronavirus, the typical flu spreads when infected people cough or sneeze. People who die from the flu are usually those most vulnerable to respiratory diseases because their immune system is already compromised or they have other risk factors. Not everyone is exposed. Not everyone exposed becomes infected. Not everyone who becomes infected dies.

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The Secrets of Mary Jane …Somebody

She was born Mary Richards, or Mary Jane Richards. Or Mary Elizabeth. She married and became Mary Bowser/Mrs. Wilson Bowser. Also Mrs. John T. Denman and/or Mary J.R. Gavin. Sometimes she used the name Mary Jane Henry or Richmonia Richards. Maybe Ellen Bond, although that has been disputed. Maybe this is her photograph, although that has been disputed.

Grainy photo Mary Bowser
Mary Bowser, but which one? Photo from Wikipedia and Pinterest.

If you were an educated black servant in the slave-owning state of Virginia in 1861, little would be known about you. Your words would not have been written down and what was written about you by others, even the wealthy abolitionist friend whose family you served, would be filtered through their lenses. Scraps of information remembered later by family members who were children when they saw you would come to be taken as fact, whether true or not. Grainy photos replicated might be mislabelled, speculations treated as accurate, oral embellishments become history. All truth would be distorted, like seeing through a glass darkly. This would be especially true if you were a Union spy in the Confederate White House.

Continue reading “The Secrets of Mary Jane …Somebody”