Stop Washing Your Hands: The Science of Strategic Filth

David Carson: 00:00:01

So this is embarrassing, but I need to confess something. I was at my local coffee shop. You know, one of those aggressively hip places where the barista has a philosophy degree and charges $7 for what's essentially hot bean water. And I'm standing in line minding my own business when the guy in front of me starts his ritual. He pulls out this bottle of hand sanitizer and applies it like he's prepping for surgery. Then he grabs antibacterial wipes and cleans his phone, his credit card, even the outside of his coffee cup before he's touched anything.

I'm watching this whole performance thinking, "My guy, you're about to put your mouth on something that 10 people have already touched and hundreds of people have breathed near today." But here's the really embarrassing part. I started feeling inadequate, like I wasn't clean enough. So when it's my turn to order, I find myself asking for extra napkins, wiping down my own phone, basically mimicking his entire germophobic routine because some primitive part of my brain whispered, "He knows something you don't."

Here I was standing in a coffee shop copying a stranger's anxiety-driven hygiene theater because I've been trained to believe that clean equals safe and dirty equals dangerous. But walking home, sipping my overpriced coffee, I started wondering, what if everything I think I know about germs and cleanliness is completely backwards? What if the guy with the hand sanitizer ritual is actually making himself sicker? What if our obsession with killing 99.9% of germs is like dropping a nuclear bomb on a garden because we're afraid of one weed? And what if the dumbest-sounding advice of all time is maybe something like, "Go ahead. Get dirty. Get as absolutely, disgustingly dirty as you like. It could be your new path to wellness or wrongness. Either way, potentially super fun." Welcome to Dumbify, the only show where public health officials would probably stage an intervention. I'm your host, David Carson. Let's get dirty.

SONG: 00:02:17

Dumbify, let your neurons dance. Put your brain in backwards pants. Genus hides in daft disguise. Brilliance wears those googly eyes. So honk your nose and chase that spark. Dumb is just smart in the dark. Dumbify. Yell it like a goose. Just thinking wrong on purpose with Juice.

David Carson: 00:02:45

Today we're exploring why deliberately exposing yourself to dirt, germs, and unsanitary conditions might be the smartest thing you can do for your health. And I know that sounds like medical malpractice waiting to happen, but stick with me. Let me tell you about Joel Weinstock. He's a guy who in 1999 did something that made every infectious disease specialist in America want to revoke his medical license. Weinstock was a 45-year-old gastroenterologist at the University of Iowa treating patients with inflammatory bowel disease, Crohn's disease, ulcerative colitis, the kind of autoimmune conditions that turn your digestive system into a complete war zone. Traditional treatment was immunosuppressive drugs, sometimes steroids, sometimes surgery to remove parts of the intestine. But Weinstock noticed something really weird in his research. These autoimmune diseases were pretty much nonexistent in developing countries, places where people lived with parasites. So Weinstock has this crazy medical hypothesis that's probably one of the most disturbing in modern history. He goes, "What if I deliberately infected my patients with parasitic worms?" Um, okay. What kind of parasitic worms? Apparently the kind of parasites that make epidemiologists break out in stress sweats. Something called whipworms. And his idea was that these worms had co-evolved with humans for thousands of years and our immune systems expect them to be there. Without them, our immune systems are basically unemployed security guards looking for trouble where none existed. The medical establishment was apoplectic. They called it medieval medicine. Infectious disease experts said Weinstock was essentially poisoning patients. But what's wild is that Weinstock wasn't just theorizing. He was already running these secret pilot studies. He'd take these pig whipworm eggs, which I guess can't reproduce in humans, and then literally had patients drink them in some kind of solution. Patients who had tried everything possible, who were facing potential colostomies, who had exhausted every conventional treatment said, "Okay, let's give it a whirl, I guess." And amazingly, it worked. Not just a little bit, like a lot. In his first clinical trial, 79% of Crohn's disease patients went into remission after drinking worm eggs.

79%. The best conventional treatments were hitting maybe 30% remission rates. So patients who hadn't been able to eat solid food in months were suddenly symptom-free. But of course, the medical community didn't exactly celebrate. They kinda panicked. The American Gastroenterological Association fired off statements warning against unproven parasitic therapies. And the CDC launched their own investigations. Medical journals rejected Weinstock's papers, saying the research, quote, "Encouraged dangerous self-experimentation."Today, this very therapy is being studied at Harvard, NYU, and medical centers worldwide. And it took 20 years for the medical establishment to admit that maybe, just maybe, deliberately infecting people with parasites wasn't medical insanity. It was a medical breakthrough disguised as Medieval madness, but Weinstock wasn't the first person to discover that our war on germs might be backfiring spectacularly. Let me introduce you to the work of David Strachan. Strachan was a young, 34-year-old epidemiologist at the London School of Hygiene and Tropical Medicine, and he'd been studying something that was driving pediatricians crazy, the sudden explosion of children with allergies and asthma. Conventional wisdom at the time said allergies were caused by exposure to allergens. The more pollen, the more pet dander, the more dust mites the kids were exposed to, the more allergic kids you got. So the solution was, of course, to keep everything clean and spotless. HEPA filters, air purifiers, antibacterial everything. The cleaner the environment, the healthier the children. But Strachan looked at the data and noticed one small thing that made absolutely no sense. It was that kids from large families had fewer allergies than kids from smaller families. Also, the kids with older siblings were much less likely to develop asthma than the first-born child. And the absolute kick in the head was that the data was pointing to something that baffled his already-blown brain, that the dirtier the household, the lower the allergy rates. So Strachan digs in and proposes what he calls the Hygiene Hypothesis. The idea was basically that early childhood infections and exposure to microbes actually protected against allergies later in life, that our immune system somehow needed practice fighting real threats. And if they didn't get that practice early in life, they'd start attacking the harmless stuff that entered your body, like peanuts and pollen. Needless to say, the pediatric community kinda lost their minds. This sounded super crazy, so the American Academy of Pediatrics issued a statement saying things like the Hygiene Hypothesis is, quote, "Dangerous misinformation." Public health officials warned that Strachan was basically trying to encourage parents to neglect basic hygiene with their kids. And of course, the cleaning product industry started funding studies trying to debunk all of his research, because science can't have a say in this world without the expressed interests of the money dudes.

years later in: 1999

SONG: 00:10:59

We really, really, really, really, really don't want you to hear this now. We're the cleaning product industry and we won't and don't and can't condone what you're about to hear because we really, really, really, really, really want you to keep buying stuff.

David Carson: 00:11:23

So what's actually happening in our bodies when we sanitize everything into oblivion? Let me break down the science, because it's both fascinating and kind of terrifying. Your body contains roughly 37 trillion human cells, but here's the thing about all of this that should humble every germophobe on the planet. You also contain roughly 100 trillion bacterial cells. You are literally more microbe than human. You're essentially mostly bacteria with some human cells along for the ride. And this isn't coming from some wellness hippie. This is hard science from places like the National Institutes of Health and Stanford University.

Doctor Justin Sonnenburg at Stanford has spent the last decade mapping what he calls the invisible organ, the collection of microbes that live in and on your body. And here's what's really wild. These microbes are actively managing your immune system. They're producing vitamins. They're fighting off pathogens. They're even influencing your mood through the gut-brain connection. They're like this little microscopic workforce that's been fine-tuning human health for millions of years. So here's the big 21st century problem. When you use antibacterial soap, hand sanitizer, or take any unnecessary antibiotics, you're pretty much just carpet-bombing your entire microbial ecosystem. It's like using napalm to kill one weed in your garden. Doctor Martin Blaser at NYU has documented this, and he calls it the antibiotic apocalypse, where each use of unnecessary antibiotics permanently reduces the diversity of your microbiome. And once some certain beneficial bacteria are gone, they might never come back. So we're essentially passing this microbial poverty to our future children who will start life with fewer beneficial bacteria than us-

SFX: 00:13:21

[gasps]

David Carson: 00:13:21

... or previous generations.

SFX: 00:13:23

Oh my God.

David Carson: 00:13:24

That's wild. I mean, I'm all for taking an antibiotic when I'm really sick, but I have to admit I've taken more than my share of antibiotics when I likely didn't need them at all.

SFX: 00:13:36

Boo.

David Carson: 00:13:37

I'd like to send my condolences to my microbiome and to my offspring for being such a knucklehead.

SONG: 00:13:43

I'm sorry.

So sorry.

Sorry for being such an antimicrobial bastard.

I didn't mean it.

I'm so sorry.

Now go play in some dirt. And see if you can heal yourself.

David Carson: 00:14:36

I mean, the research is pretty damn staggering, especially the study about kids who receive antibiotics in their first year of life. They apparently have dramatically higher rates of allergies, asthma, and obesity. Countries with the highest hygiene standards have the highest rates of autoimmune diseases. And I suppose the really uncomfortable thing about all of this is that the cleaning product industry has spent billions convincing us that 99.9% of the germ-killing their products do is good, when the science shows it catastrophically is the opposite. And the resistance to this research has been super fierce, because admitting that our obsession with cleanliness is making us sick threatens a multi-billion dollar industry built on selling us antimicrobial everything.

SONG: 00:15:27

Dumb, dumb, dumb, dumb, dumb word of the day. Dumb word of the day. It's a word. It's dumb. Use responsibly.

David Carson: 00:15:38

All right, it's time for my favorite part of the show. It's time for dumb word of the day, where we dig up weird words that sound like they've escaped from a medical textbook that nobody wants to read. I think I love this segment so much because it gives me an excuse to mispronounce words with confidence and also pretend I'm some kind of linguistic archeologist, like Harrison Ford in Raiders of the Lost Ark, but I don't go outside, and I have a dictionary instead of a whip and a cool hat. Plus, it makes me super happy to say completely unnecessary words in casual conversation and watching people's faces kind of scrunch up, like they just smelled expired milk. Anyway, today's dumb word is mysophobia, spelled M-Y-S-O-P-H-O-B-I-A. Mysophobia. I bet if I say that really fast, it'll sound like I'm having an allergic reaction to the alphabet. Mysophobia is basically the pathological fear of contamination and germs. It's the clinical term for people who treat every doorknob like it's personally plotting their demise. And here's what I love about this word. It sounds way more sophisticated than germaphobe, doesn't it? Like instead of saying, "My aunt Janet won't touch shopping carts without wearing surgical gloves," you can say, "Aunt Janet suffers from acute mysophobia, particularly triggered by retail-based bacterial transmission vectors." Suddenly she sounds less crazy and more scientifically crazy. That was really kinda weird, and also kind of beautiful.

Here's your big dumb challenge for the week. I'm calling it the delightfully disgusting lifestyle makeover. And yes, I know that sounds like a reality show that would get canceled after one episode, but hear me out. This is about becoming just gross enough to horrify your most hygiene-obsessed friend, but not so gross that you actually endanger yourself. Think of it as walking the fine line between charmingly rustic and probably needs an intervention. So first things first, I want you to have a ceremonial dumping of at least half your antibacterial products. Pour them out dramatically while saying something like, "It's not you, it's me."... actually, no, it's totally you. You're making me weak, and my microbiome hates you. Make it theatrical. Your bathroom cabinet will thank you. Then start eating with your hands more. Not everything, obviously. Soup is still off limits unless you want to look like a complete lunatic. But things like sandwiches, fruit, even pizza. Your silverware has been enabling your fear of finger food for too long. Oh, and here's a fun one. The five-second rule? Upgrade it to the 30-second rule. When you drop food, pick it up, look at it thoughtfully, maybe give it a little dust-off, and eat it anyway. Bonus points if you do this in front of someone who visibly cringes. Double bonus points if you offer them a bite. Next up, pet a random dog, with permission from the owner, obviously. I'm not advocating for dog harassment, but find a friendly dog, give it some good ear scratches, and then this is the crucial part. Don't immediately sprint to find hand sanitizer. Just exist with dog germs on your hands for a while. They're probably better company than most of the bacteria you've been trying to cultivate anyway. [Dog barking] And here's the ultimate test. If someone asks you about your new hygiene philosophy, explain that you're developing a more collaborative relationship with the microbial community and see if you can keep a straight face. If they back away slowly, you're doing it right. The goal isn't to become a walking Petri dish. It's to remember that humans survived for thousands of years without Purell and most of us turned out well. Okay, maybe that's not the best argument, but you get the idea.

Fair warning, your mysophobic friends will think you've joined some kind of dirt worshiping cult. Let them. You'll be the one with the superior immune system, laughing from your microbiologically diverse high horse. And that's our show. Thank you for getting dumb with me today.

If this episode made you want to throw away your hand sanitizer and roll around in some garden soil, share it with someone who color codes their cleaning products and has strong opinions about the five-second rule. If you want more scientifically backed rebellion delivered to your inbox every week, subscribe to the Dumbify newsletter at david-carson.com. Until next time, stay curious, stay slightly contaminated, and remember, sometimes the best way to stay healthy is to stop trying so hard to stay clean. This is David Carson signing off from the beautifully messy world of beneficial bacteria.

See you next week.