6 ms·

Hindsight bias is coloring your view of the man. The article mentions unwashed hands is STILL a problem with physicians TODAY - with all the years of training,

Hindsight bias is coloring your view of the man. The article mentions unwashed hands is STILL a problem with physicians TODAY - with all the years of training, knowledge, books, microscopes that can see germs in action and most importantly, hundreds of years of evidence. Changing people's minds is not easy - then or now. Shaming works way better than just talking. You can see how shaming has helped the cause of open source, black lives matter, pollution... But even with multiple champions, these causes are struggling, not a runaway success as you'd expect. Compare this man to Richard Stallman - see any similarities? I'm sure Stallman would have been remanded to mental institution if he lived in the 1800s. Even if this doctor was a giant asshole, I applaud his use of scientific-ish methods - methodologically cutting off unlikelies until arriving at the root cause - unwashed hands.

IAmEveryone 6y ago
Not just handwashing... There's a theory popular with jaded biologists that neckties alone may have killed more people than some minor genocides. And the failure to perfect the practice of hand-washing is somewhat easy to understand: it's tedious, especially when done dozens of times per day. Some people suffer skin irritation. The cause of any infection can almost never be traced, making it hard to learn and/or punish the guilty. Banning neckties is a rather binary policy decision, and compliance would be extremely easy to monitor. One would think people with advanced academic degrees would see the upside, and don't need to signal status with superfluous items of clothing in addition to that doctorate.
- jraby3 6y ago
  How do neckties cause deaths?
  - mattkrause 6y ago
    A possible source of infection. Ties are pretty mobile and can easily brush against a patient or instrument, especially if the doctor is leaning forward. Unlike other clothing, they are also rarely washed and they seem less essential than, say, pants. A few studies have isolated MRSA and other nosocomial nasties from ties. However, it's unclear how much of an actual risk this is, and ties are thought to convey some sense of professionalism that makes the patients take medical advice more seriously and...tradition (ugh). This bit from The Lancet has some back-and-forth about it. https://www.thelancet.com/pdfs/journals/lancet/PIIS0140673607618911.pdf https://www.thelancet.com/pdfs/journals/lancet/PIIS014067360...
  - nextaccountic 6y ago
    some links: https://www.infectioncontroltoday.com/view/hospital-ban-physician-neckties-other-attire-proposed-ny-bill https://www.infectioncontroltoday.com/view/hospital-ban-phys... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878945/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878945/
  - stemcc 6y ago
    Seems like they can be vectors for bacterial spread. https://pubmed.ncbi.nlm.nih.gov/18205553/ https://pubmed.ncbi.nlm.nih.gov/18205553/
tedunangst 6y ago
Are the surgeons who aren't washing their hands today not doing so because they don't believe in bacteria?
- redis_mlc 6y ago
  Youtuber SerpentAZ has reported that in China, doctors generally don't wash their hands because: 1) washrooms are not stocked with soap. (In general, after something is built, there's no on-going maintenance.) 2) the older generations of doctors don't believe in bacteria 3) the current generations of doctors halfway believe Chinese traditional medicine and Western medicine. With corona and a shortage of PPE, it's also likely gloves are not being changed between patients. OTOH, most of the hospitals in Silicon Valley are on a watch list for MERSA contamination, so hygiene is a struggle even with hand-washing.
- sammalloy 6y ago
  There was an article that explored this question many years ago, and IIRC, the answer was because the surgeons were in a hurry and didn’t have much time. This problem isn’t as common today with the ubiquity of hand sanitizer dispensers.
  - corty 6y ago
    Also, try washing and desinfecting your hands 20 times a day. Your skin will start causing problems after a few days, usually dryness, itching, rashes, blisters. Cream helps a bit, but not always. Medical personnel invariably do have skin problems on hands and forearms.
kerkeslager 6y ago
> Changing people's minds is not easy - then or now. Shaming works way better than just talking. You can see how shaming has helped the cause of open source, black lives matter, pollution... But even with multiple champions, these causes are struggling, not a runaway success as you'd expect. I keep seeing this narrative, that shaming is the most effective strategy, and it continues to puzzle me. You're literally saying this in response to an example of shaming not working, and the examples you're using are pretty bad examples of shaming working. Everything I see here is that putting the truth in front of people is what works. The video of George Floyd is powerful because it shows us the truth. I've seen more of my white friends realize their privilege in 8 minutes and 46 seconds of video than I've seen in decades of shaming people over dog whistles. If shaming works, when why hasn't it worked yet? Where are the results?
- vezycash 6y ago
  >I keep seeing this narrative, that shaming is the most effective strategy I never said it's the most effective strategy. I said, it's more effective than just talking. >If shaming works, when why hasn't it worked yet? Where are the results? As far as i'm concerned, this question is like someone doubting the existence of gravity. The effects of shaming is all around us. Fashion is an industry that built its foundations on shaming. Kids are shamed into buying iphones, and designer shoes. Millions of kids are being shamed into early sex (ashamed of being virgins), and trying out drugs to be deemed COOL. For programmers - PHP programmers are being shamed right here on HN. When Google and other high profile companies do something really stupid like locking someone's account unjustly or some new policy, Twitter and Hacker news use shaming to get these guys to speedily reverse course. >The video of George Floyd is powerful because it shows us the truth. Isn't the video in question is an example of shaming - the police? Why do you think police, FBI and the rest works hard to bar public access to ALL their activities?
  - aidenn0 6y ago
    Shaming someone hardly ever changes their mind; it can change their behavior, but usually only their public behavior. >> The video of George Floyd is powerful because it shows us the truth. > Isn't the video in question is an example of shaming - the police? The people whose minds were changed by the video were people horrified by it, not people shamed[1]. > Why do you think police, FBI and the rest works hard to bar public access to ALL their activities? Because all this shame hasn't changed their mind a single bit, it just makes them want to hide what they are doing. ---- 1: Most police already knew shit like this happens, and most of them are already ashamed about it. However, they also know that their reports better include whatever makes the department the least legally liable, rather than the truth. Reporting a truth that causes the department to have to settle a lawsuit for more than they thought they could is the #1 career limiting move a cop can make. Reporting bad behavior of coworks is a tough call to make in the best of situations. Mix in the following and it takes people of unusually strong moral-fiber to do it: 1. You will get fewer hours of OT (a de-facto pay-cut) 2. You will be passed over for promotion down the road because of it. 3. The coworker you reported on is very unlikely to be fired so you will be working along side them, quite possibly for many years.
chrisseaton 6y ago
> Shaming works way better than just talking. I think shaming is never acceptable, under any circumstance. It's trying to make someone feel emotional pain in order to force them to do something. It's basically applying torture, except instead of physical pain it's emotional pain.
- newacct583 6y ago
  > It's trying to make someone feel emotional pain in order to force them to do something. But the "something" in this case is "not kill people". I'm sorry, I can't understand that absolutism. If I can save a million people by making some innocent babies cry from an immunization shot, I should be able to make their parents angry by shaming them into wearing a mask or washing their hands, right?
  - chrisseaton 6y ago
    > But the "something" in this case is "not kill people". Yes it's a worthwhile cause to speak up for! > I'm sorry, I can't understand that absolutism. I don't believe in 'the ends justify the means' except in some limited cases such as an imminent existential threat. > If I can save a million people by making some innocent babies cry from an immunization shot, I should be able to make their parents angry by shaming them into wearing a mask or washing their hands, right? I think you should use your logic to campaign for legislation or regulation, not try to force people by applying pain.
    - Klinky 6y ago
      >I think you should use your logic to campaign for legislation or regulation, not try to force people by applying pain. There are already legal mandates around mask wearing and there are many who still refuse.
      - chrisseaton 6y ago
        So call the police or begin a private prosecution if a law is being violated. If you are in imminent actual physical danger with no means to extract yourself from the situation, then use self defence. But if a law isn't being violated, and you're free to leave, then mind your own business. Feel free to lobby for new legislation or regulation. In whatever situation: don't try to force your will by applying mental health pain. That's truly a 'dark side' solution to any problem.
newacct583 6y ago
> Changing people's minds is not easy - then or now. Shaming works way better than just talking. Tell that to the "masks are oxygen-depriving freedom infringement devices" set. I mean... I agree that on the margins most people aren't nuts and even if they don't understand masks will put one on just to avoid a scene. But... yeah, we haven't come very far, have we?
- umvi 6y ago
  Is there any reason we should ever stop wearing masks? From a public health perspective I think they are here to stay - possibly for the rest of my life.
  - ghaff 6y ago
    There are a lot of more or less inconvenient things that people can do to improve societal safety. Never drive your car over 40 mph. Don't let subway cars get so crowded. And so forth. Arguably masks fall on the less inconvenient side of things but they're not even the norm in Asia during normal times in countries which have had their share of epidemics. So, no, I don't expect they'll be the norm most places and that will make some people unhappy.
  - newacct583 6y ago
    That's the way it works in most of east asia. People who are sick, or might be sick, or have the sniffles will put a mask on when they go out. But no, no one wants to wear these full time forever. The collective danger[1] of a pandemic makes them worth the inconvenience. No one would make that trade for routine seasonal flu. [1] Which, it has to be pointed out, even on this site, and even after months of pandemic spread, is not remotely the same thing as the personal risk to the mask-wearer.
    - astrange 6y ago
      > That's the way it works in most of east asia. People who are sick, or might be sick, or have the sniffles will put a mask on when they go out. Celebrities also wear them if they don't want to be recognized, and people wear them on planes because it's thought to help with dehydration. The important thing is that it's normalized, so you don't stand out by doing it.
Orou 6y ago
>You can see how shaming has helped the cause of open source, black lives matter, pollution... I think there's a stronger argument to be made that shaming has hurt each of these causes more than it has ever helped. If you want to make people antagonistic towards you, belittling or demonizing them for not holding ${belief} is a great strategy. Public shaming is a threat-by-example to the broader community that certain behaviors and beliefs are forbidden. It doesn't encourage individuals to seek the truth, whatever it is, but to conform to safe beliefs (and if you're playing the status game, evangelizing those beliefs is a great fast-track to power). Semmelweis may well have succeeded if he hadn't shamed people with an air of absolute certainty (an attitude which seems to be increasingly in-vogue for any kind of popular issue today) but had acknowledged the complexities of the problem and focused on ascertaining the truth.
umvi 6y ago
> Shaming works way better than just talking. You can see how shaming has helped the cause of open source, black lives matter, pollution It "works" but has hidden bad side effects. Shaming is a terrible way to enact change and should only be a last resort as it sows seeds of resentment and discord that push people to political extremes. It's like saying violent crusades are the most effective form of Christian missionary work. Technically true in terms of measured "conversions", but... also the side effects are really bad. Plus, if you shame people and you turn out to be wrong, well... what should your punishment be?

IAmEveryone 6y ago

Not just handwashing... There's a theory popular with jaded biologists that neckties alone may have killed more people than some minor genocides. And the failure to perfect the practice of hand-washing is somewhat easy to understand: it's tedious, especially when done dozens of times per day. Some people suffer skin irritation. The cause of any infection can almost never be traced, making it hard to learn and/or punish the guilty. Banning neckties is a rather binary policy decision, and compliance would be extremely easy to monitor. One would think people with advanced academic degrees would see the upside, and don't need to signal status with superfluous items of clothing in addition to that doctorate.

jraby3 6y ago
How do neckties cause deaths?
- mattkrause 6y ago
  A possible source of infection. Ties are pretty mobile and can easily brush against a patient or instrument, especially if the doctor is leaning forward. Unlike other clothing, they are also rarely washed and they seem less essential than, say, pants. A few studies have isolated MRSA and other nosocomial nasties from ties. However, it's unclear how much of an actual risk this is, and ties are thought to convey some sense of professionalism that makes the patients take medical advice more seriously and...tradition (ugh). This bit from The Lancet has some back-and-forth about it. https://www.thelancet.com/pdfs/journals/lancet/PIIS0140673607618911.pdf https://www.thelancet.com/pdfs/journals/lancet/PIIS014067360...
- nextaccountic 6y ago
  some links: https://www.infectioncontroltoday.com/view/hospital-ban-physician-neckties-other-attire-proposed-ny-bill https://www.infectioncontroltoday.com/view/hospital-ban-phys... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878945/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878945/
- stemcc 6y ago
  Seems like they can be vectors for bacterial spread. https://pubmed.ncbi.nlm.nih.gov/18205553/ https://pubmed.ncbi.nlm.nih.gov/18205553/

tedunangst 6y ago

Are the surgeons who aren't washing their hands today not doing so because they don't believe in bacteria?

redis_mlc 6y ago
Youtuber SerpentAZ has reported that in China, doctors generally don't wash their hands because: 1) washrooms are not stocked with soap. (In general, after something is built, there's no on-going maintenance.) 2) the older generations of doctors don't believe in bacteria 3) the current generations of doctors halfway believe Chinese traditional medicine and Western medicine. With corona and a shortage of PPE, it's also likely gloves are not being changed between patients. OTOH, most of the hospitals in Silicon Valley are on a watch list for MERSA contamination, so hygiene is a struggle even with hand-washing.
sammalloy 6y ago
There was an article that explored this question many years ago, and IIRC, the answer was because the surgeons were in a hurry and didn’t have much time. This problem isn’t as common today with the ubiquity of hand sanitizer dispensers.
- corty 6y ago
  Also, try washing and desinfecting your hands 20 times a day. Your skin will start causing problems after a few days, usually dryness, itching, rashes, blisters. Cream helps a bit, but not always. Medical personnel invariably do have skin problems on hands and forearms.

kerkeslager 6y ago

> Changing people's minds is not easy - then or now. Shaming works way better than just talking. You can see how shaming has helped the cause of open source, black lives matter, pollution... But even with multiple champions, these causes are struggling, not a runaway success as you'd expect. I keep seeing this narrative, that shaming is the most effective strategy, and it continues to puzzle me. You're literally saying this in response to an example of shaming not working, and the examples you're using are pretty bad examples of shaming working. Everything I see here is that putting the truth in front of people is what works. The video of George Floyd is powerful because it shows us the truth. I've seen more of my white friends realize their privilege in 8 minutes and 46 seconds of video than I've seen in decades of shaming people over dog whistles. If shaming works, when why hasn't it worked yet? Where are the results?

vezycash 6y ago
>I keep seeing this narrative, that shaming is the most effective strategy I never said it's the most effective strategy. I said, it's more effective than just talking. >If shaming works, when why hasn't it worked yet? Where are the results? As far as i'm concerned, this question is like someone doubting the existence of gravity. The effects of shaming is all around us. Fashion is an industry that built its foundations on shaming. Kids are shamed into buying iphones, and designer shoes. Millions of kids are being shamed into early sex (ashamed of being virgins), and trying out drugs to be deemed COOL. For programmers - PHP programmers are being shamed right here on HN. When Google and other high profile companies do something really stupid like locking someone's account unjustly or some new policy, Twitter and Hacker news use shaming to get these guys to speedily reverse course. >The video of George Floyd is powerful because it shows us the truth. Isn't the video in question is an example of shaming - the police? Why do you think police, FBI and the rest works hard to bar public access to ALL their activities?
- aidenn0 6y ago
  Shaming someone hardly ever changes their mind; it can change their behavior, but usually only their public behavior. >> The video of George Floyd is powerful because it shows us the truth. > Isn't the video in question is an example of shaming - the police? The people whose minds were changed by the video were people horrified by it, not people shamed[1]. > Why do you think police, FBI and the rest works hard to bar public access to ALL their activities? Because all this shame hasn't changed their mind a single bit, it just makes them want to hide what they are doing. ---- 1: Most police already knew shit like this happens, and most of them are already ashamed about it. However, they also know that their reports better include whatever makes the department the least legally liable, rather than the truth. Reporting a truth that causes the department to have to settle a lawsuit for more than they thought they could is the #1 career limiting move a cop can make. Reporting bad behavior of coworks is a tough call to make in the best of situations. Mix in the following and it takes people of unusually strong moral-fiber to do it: 1. You will get fewer hours of OT (a de-facto pay-cut) 2. You will be passed over for promotion down the road because of it. 3. The coworker you reported on is very unlikely to be fired so you will be working along side them, quite possibly for many years.

chrisseaton 6y ago

> Shaming works way better than just talking. I think shaming is never acceptable, under any circumstance. It's trying to make someone feel emotional pain in order to force them to do something. It's basically applying torture, except instead of physical pain it's emotional pain.

newacct583 6y ago
> It's trying to make someone feel emotional pain in order to force them to do something. But the "something" in this case is "not kill people". I'm sorry, I can't understand that absolutism. If I can save a million people by making some innocent babies cry from an immunization shot, I should be able to make their parents angry by shaming them into wearing a mask or washing their hands, right?
- chrisseaton 6y ago
  > But the "something" in this case is "not kill people". Yes it's a worthwhile cause to speak up for! > I'm sorry, I can't understand that absolutism. I don't believe in 'the ends justify the means' except in some limited cases such as an imminent existential threat. > If I can save a million people by making some innocent babies cry from an immunization shot, I should be able to make their parents angry by shaming them into wearing a mask or washing their hands, right? I think you should use your logic to campaign for legislation or regulation, not try to force people by applying pain.
  - Klinky 6y ago
    >I think you should use your logic to campaign for legislation or regulation, not try to force people by applying pain. There are already legal mandates around mask wearing and there are many who still refuse.
    - chrisseaton 6y ago
      So call the police or begin a private prosecution if a law is being violated. If you are in imminent actual physical danger with no means to extract yourself from the situation, then use self defence. But if a law isn't being violated, and you're free to leave, then mind your own business. Feel free to lobby for new legislation or regulation. In whatever situation: don't try to force your will by applying mental health pain. That's truly a 'dark side' solution to any problem.

newacct583 6y ago

> Changing people's minds is not easy - then or now. Shaming works way better than just talking. Tell that to the "masks are oxygen-depriving freedom infringement devices" set. I mean... I agree that on the margins most people aren't nuts and even if they don't understand masks will put one on just to avoid a scene. But... yeah, we haven't come very far, have we?

umvi 6y ago
Is there any reason we should ever stop wearing masks? From a public health perspective I think they are here to stay - possibly for the rest of my life.
- ghaff 6y ago
  There are a lot of more or less inconvenient things that people can do to improve societal safety. Never drive your car over 40 mph. Don't let subway cars get so crowded. And so forth. Arguably masks fall on the less inconvenient side of things but they're not even the norm in Asia during normal times in countries which have had their share of epidemics. So, no, I don't expect they'll be the norm most places and that will make some people unhappy.
- newacct583 6y ago
  That's the way it works in most of east asia. People who are sick, or might be sick, or have the sniffles will put a mask on when they go out. But no, no one wants to wear these full time forever. The collective danger[1] of a pandemic makes them worth the inconvenience. No one would make that trade for routine seasonal flu. [1] Which, it has to be pointed out, even on this site, and even after months of pandemic spread, is not remotely the same thing as the personal risk to the mask-wearer.
  - astrange 6y ago
    > That's the way it works in most of east asia. People who are sick, or might be sick, or have the sniffles will put a mask on when they go out. Celebrities also wear them if they don't want to be recognized, and people wear them on planes because it's thought to help with dehydration. The important thing is that it's normalized, so you don't stand out by doing it.

Orou 6y ago

>You can see how shaming has helped the cause of open source, black lives matter, pollution... I think there's a stronger argument to be made that shaming has hurt each of these causes more than it has ever helped. If you want to make people antagonistic towards you, belittling or demonizing them for not holding ${belief} is a great strategy. Public shaming is a threat-by-example to the broader community that certain behaviors and beliefs are forbidden. It doesn't encourage individuals to seek the truth, whatever it is, but to conform to safe beliefs (and if you're playing the status game, evangelizing those beliefs is a great fast-track to power). Semmelweis may well have succeeded if he hadn't shamed people with an air of absolute certainty (an attitude which seems to be increasingly in-vogue for any kind of popular issue today) but had acknowledged the complexities of the problem and focused on ascertaining the truth.

umvi 6y ago

> Shaming works way better than just talking. You can see how shaming has helped the cause of open source, black lives matter, pollution It "works" but has hidden bad side effects. Shaming is a terrible way to enact change and should only be a last resort as it sows seeds of resentment and discord that push people to political extremes. It's like saying violent crusades are the most effective form of Christian missionary work. Technically true in terms of measured "conversions", but... also the side effects are really bad. Plus, if you shame people and you turn out to be wrong, well... what should your punishment be?