A hands-off approach

The Baltimore Sun

The bouquet of plastic flowers hanging on Gayle Westmoreland's front door disappears as she swings the door open and steps forward. "Welcome," she says, smiling and offering a well-manicured hand that hovers in midair, awaiting your grasp.

Here's where things get awkward. Westmoreland's outstretched arm belies her distaste for shaking hands, a custom she views as unsanitary and intrusive. She feels so strongly about the matter, in fact, that she published a treatise, Hands: Stop Shaking Them! A Cultural Shift to End Handshaking in America!

Knowing of her aversion, you suspect Westmoreland is offering her hand only to put you at ease. Yet the effect is just the opposite, since you came prepared to greet her with a nod.

Westmoreland, a 61-year-old Columbia resident, hopes that one day the nod will be considered a legitimate alternative to the handshake, and she has a plan to make that happen.

"My goal is to have one of my books in every household in America," she says, seated at her dining room table. "I don't want to get rid of the handshake altogether. I just want a choice."

Her strategy is to spread the message to schools, churches and community groups. To get people's attention, she proposes National Shake-It Month, a yearly, government-approved moratorium on handshaking that would make some room for the nod. To bring the mass media on board, she has written a collection of slogans.

Some are thought-provoking: "America, where have your hands been today? Please give me a nod." Others are provocative: "Hand, hand, fingers, thumb, I don't need your germs or your scum!"

She sees the campaign akin to efforts to ban smoking in public buildings, a public-health hazard once accepted but now generally frowned upon.

Westmoreland acknowledges her views put her outside current cultural norms, but she points out that government health agencies also have targeted handshaking as a vector for disease.

In the event of an influenza pandemic, for instance, the U.S. Centers for Disease Control and Prevention suggests resisting the urge to shake. The same goes for hurricane evacuees living in cramped storm shelters where flu and other respiratory diseases spread quickly.

Official bans on shaking have some precedence. During the 1918 "Spanish" flu pandemic, which killed about 5,000 people in Baltimore and an estimated 50 million worldwide, the Town Council of Prescott, Ariz., outlawed shaking.

More recently, Vermont health officials warned of a shortage of flu vaccine during the 2004 flu season. In response, Bishop Kenneth Angell, then leader of the state's Catholic diocese, urged worshipers to skip the tradition of shaking hands during Mass.

In some instances, concerns about germs have prompted a change in greetings. Infection control experts at the World Health Organization reportedly bump elbows when working in areas where Ebola and other dangerous diseases are spreading.

Kellogg Schwab, an environmental microbiologist at the Johns Hopkins Bloomberg School of Public Health, says outbreaks of norovirus on cruise ships resulted in a similar shift. The virus is highly contagious and causes nausea, vomiting and diarrhea.

"As you board cruise ships, especially in Europe," Schwab says, "the captain will look at you and bow, keeping his hands behind his back."

"Hand transmission," he says, "is one of the many routes of infection, especially if you're a captain shaking hands with a thousand people coming on a ship."

To avoid germs, the CDC recommends using warm water and soap, and scrubbing for as long as it takes to sing the "Happy Birthday" song twice. Alcohol wipes also work, Schwab says, but he cautions against anti-bacterial soaps, which might help produce antibiotic-resistant bacteria.

Schwab emphasizes that good hand hygiene is more important for curbing the spread of disease than refusing to shake hands. "You can take it to the extreme," he says, "but it comes down to common sense. Washing your hands is critical."

He acknowledges, however, that research shows many people fail to wash their hands regularly or thoroughly.

Westmoreland is not one of them. "I don't have obsessive-compulsive disorder," she says, "but I am a bit fanatical about my germs."

She keeps wet wipes in her car and a container of hand sanitizer in her purse. In public restrooms, she uses paper towels to turn the sinks off and to open the doors when exiting.

She traces the abundance of caution to her childhood in West Baltimore and her late mother, who taught her to avoid touching escalator railings. "We would just sort of lean against them," she says.

Westmoreland taught elementary school for 10 years after earning two education degrees -- a bachelor's from Morgan State University and a master's from Johns Hopkins University. After a divorce, she left teaching in the 1980s for a job as a strategic pricing manager for AT&T.;

"As a single mother raising a son," she says, "I couldn't live on a teacher's salary. I also couldn't afford to be sick, so I worked not to be sick."

Along with eating well and playing tennis, cleanliness keeps her healthy, she says. Her house is a reflection of her personality, busy but tidy. Gesturing toward her living room dismissively, she says: "You'll find some dust around here."

None is apparent.

Despite her best efforts to keep her life clean, orderly and healthy, just when she has got germs on the run, someone inevitably thrusts a hand of dubious cleanliness toward her in the age-old gesture of greeting.

"It truly is an invasion of your personal space," she says.

The origins of the handshake are murky. The most common accounts attribute the custom to ancient encounters between men who saluted with their right hands to prove they held no weapon and intended no malice.

Depictions of people shaking hands appear in Greek art dating to the archaic period, which began about 750 B.C.

While traveling in Japan and Korea in the late 1980s, Westmoreland says she found the Asian custom of bowing more graceful. "It's so elegant and humble," she says. "That's where I first got the idea for the nod."

She later dated a man who habitually picked his nose but rarely washed his hands. He was further evidence that personal hygiene standards are wildly variable.

"You just don't know where someone's hands have been," she says.

Reaction to her homespun public health campaign has been mixed. She has distributed about 40 of the 450 copies of her book. She has also launched a Web site to get the word out: StopShak ing.com.

She says people who read her book tend to agree that strangers' hands can be filthy -- and then proceed to defend their own habits. "They talk about hand-washing," Westmoreland says. "They don't talk about handshaking. Everyone feels like they have to show me their hand sanitizer."

Francis Beverly, a friend of Westmoreland's from Catonsville, says the book voices concerns he has had for years. He served in Vietnam, where he noticed a lot of soldiers had grubby hands but still insisted on shaking.

Now he tries to avoid shaking. "I prefer to nod, or at church I will just give a gentle Christian hug with the body away," says Beverly, 69. In the long run, he thinks Americans can adapt to different types of greetings.

"The government tells us about not smoking and safe sex," he says. "Why not handshaking?"

Westmoreland's tennis partner, Shirley Hobbs, 67, of Columbia, says she also worries about germs, particularly after reading the book. She takes precautions such as dipping her bread in the Communion cup during Mass instead of drinking from it.

But she was less optimistic than Beverly about weaning Americans off the handshake. "In church, it would be insulting if you didn't extend your hand," she says.

"But who knows?" she adds. "A lot of other things have changed in this country."

chris.emery@baltsun.com

Shaking the habit

During the 1918 "Spanish" flu pandemic, the town of Prescott, Ariz., outlawed handshaking.

During the 2004 flu season, Bishop Kenneth Angell of Vermont urged worshipers to skip shaking hands during Mass.

To avoid the spread of diseases such as Ebola, some World Health Organization workers reportedly bump elbows instead of shaking.

After outbreaks of norovirus that sickened cruise ship passengers, some captains now nod instead of clasping hands.

Source: News reports and interviews

Meet and greet

In addition to shaking hands, below are some common salutations and greetings in other countries:

Japan -- There are varying degrees of the Japanese bow. Generally, the hands slide down toward the knees or remain at the side. The back and neck are held in rigid position while eyes look downward. Longer and lower bows signify deep respect and humility.

China -- Handshakes are common today, as are nods; however, the traditional greeting involves cupping one's hands, left over right, at chest level and bowing slightly.

India -- Place your hands together in front of your chin in a prayerlike position, then nod your head. Men shake hands with men, however, not with women, in general.

France -- A quick, firm handshake is used. However, friends and family may greet each other with a kiss upon both cheeks.

Middle East -- Embrace and kiss each other on the cheek. Appropriate for both men and women, but avoid body contact with the opposite sex. Handshakes between men are also common.

Source: Sun research, eDiplomat.com and "Hands: Stop Shaking Them!"

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