The Demise of the Handshake

As we continue to debate the fallout of a possible bird flu pandemic, it seems that among other things, we may have to reconsider a common greeting — the handshake.

The handshake has been documented as early as 2800 B.C. in Egyptian civilization. In medieval times warriors ready to fight would either go for their swords or consider a handshake in an effort to show goodwill. Until more recently (about the second half of the last century), women rarely shook hands.

I probably shake hands with 50 people a day. It is, perhaps, the most common act of civility in our society. We all do it and for many it is a sign of strong character and respect. I am sure that the feel of a handshake when making a deal influences many Wall Street-types.

Let's face it, there are several types of handshakes. There is the "knuckle cruncher," which can cause significant pain especially if you are wearing rings. Then there's the "dead fish," this person usually place his limp, lifeless hand in yours. And these days we have the "sanitary handshaker," here the individual, petrified of getting sick, barely puts three or four fingers in your hand and the withdraws it quickly.

Every time someone talks about the bird flu, or the seasonal flu, some medical expert (myself included) emphasizes the importance of washing the hands to decrease the spread of germs. Family physicians are educating their patients. Hospital administrators are doing everything in their power to make handwashing a common practice in our medical centers. We are teaching children that they should sneeze into their elbows, so the germs don't go into their hands making them, and their playmates, sick. These recommendation are nothing new, during the 1918 flu epidemic the town of Prescott, Arizona actually outlawed handshaking. So it seems that social distancing may be the wave of the future especially if we want to remain healthy. However we are a crisis-oriented society and once fatigues sets in we will all get bored and forget new habits.

There is a new greeting called the "elbow bump." Many scientists are practicing it when they are in the field studying infectious disease outbreaks. It makes sense — you avoid hand contact and therefore minimize the chance of catching some bug. But will it replace handshaking? I'll bet if it takes off we'll see people complaining of sore elbows especially when a "knuckle cruncher" becomes an "elbow crasher". That is why I am now on a mission to come up with a unique type of greeting. I figure that in a hundred years or so I might just get credit for it.

My new invention: The "palm smile" (or PS for short), which is a combination of gently raising your hand (just like taking an oath) and a smile. I added the smile since there are studies to show that people who smiled tend to have lower levels of stress (imagine that!), and more important it eliminates any type of human contact, ergo no chance of transmitting germs or sore body parts. And when you ask somebody to give you the PS, it might just sound like if your were asking for peace! Catchy, no? I think this might just work and will probably be adapted by many interest groups. But, like any other scientist, I am open to new ideas.

Try it, see how it works, and let me know what happens. And if you have any suggestion of how to widely spread social distancing while preserving globalization now is your chance. E-mail me at

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Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit