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Sunday, June 12, 2011

Kissing Caution

Dear Jackie:

I am auditioning for a part that requires me to kiss someone I'venever met. How can I be certain this person is not sick and doesn'thave any easily transmittable diseases, such as herpes?

I am a nurse in a setting where there is a high risk for hepatitisand HIV, and we take grand measures and follow strict rules forpersonal protection when taking care of patients. We wear gloves,gowns, and face shields, and hand washing is no joke. I supposebeing trained that way makes you more aware of this sort of thing.So when I saw I was going to have to kiss someone at this audition,the thoughts "I don't know this person" and "Is it safe?" came overme.

I'm thinking that to be on the safe side, I could excuse myself tothe bathroom afterward, use mouthwash after the kiss, and swab mylips with an alcohol swab. I guess this is one of the risks actorshave to take. Please help.

—Careful Kisser

Dear Careful:

First off, I doubt you'll be required to kiss at the audition. Mostlikely you'll be reading with a reader or a casting associate, andthey certainly don't plan on kissing every actor who comes throughthe door! Even if you read with another actor, it's probably notexpected that you smack at your audition—no matter how steamy thekiss in the script. Often a sensitive peck on the cheek or someintimate eye contact is enough to convey the idea. If you get tocallbacks, you can go with what worked in the initial audition—or,if there's any doubt, ask the casting director what he or she wouldlike for that moment, given the setting.

If the CD says, "I want you two to share an intimate, sloppy kissright now, because I can't imagine that part and need you to proveto me that you know how to get down" (or something along thoselines), you'll need to explain that you are a nurse with extensivetraining in communicable disease prevention and can't afford torisk your health by kissing a complete stranger in an audition.Ideally, this conversation will take place quietly and not with youpointing accusingly at your scene partner. But if he or she ispresent, simply add that it's nothing personal—just yourprofessional rule of thumb.

At this point, hopefully, the casting person will drop it. Yes,there may be some eye-rolling from the CD, but that doesn't meanyou didn't do the right thing.

I spoke to Dr. Margarita Sanchez-Padilla, a family practicephysician, about the situation, and she was very clear in heradvice: "Don't take the risk."

Herpes is just one of the things we can pass to each other througha kiss. Strep throat, the Epstein-Barr virus (which causes mono),the common cold—there are so many microbes to choose from."Obviously, if you know you're sick, you shouldn't have closecontact with others," says Sanchez-Padilla. "But if you don't knowwhether someone else is sick, don't have intimate contact withthem."

As for private, post-audition de-germing, Sanchez-Padilla isskeptical. "Mouthwash probably wouldn't help; that's more fordental health," she says. "And there's not really an 'anti-viralwash.' "

I tried to explain the pressure inherent in an audition situationand how actors might feel like they need to comply with casting'sdemands. "That's awkward," Sanchez-Padilla replied. "That's scary.…That's worrisome."

I turned to Dr. Matt Katics, who has an undergraduate degree inacting and spent several years living the actor's life in LosAngeles before becoming a doctor. He understands well the pressurefor actors to say yes to anything that casting directors requestand is somewhat reassuring about the risks.

"Regarding medical concerns for auditions, one is probably okay ifyour partner is generally healthy, there are no visible lesions,and not more than saliva is being exchanged," begins Katics, aboard-certified family medicine and hospice and palliative medicinephysician. "For herpes and other oral viruses, if there has been norecent illness and no lesions are present, risk of transmission isextremely low. For serious chronic illnesses such as HIV orhepatitis, kissing—no biting—is generally considered safe if nooral lesions are present."

There are situations, however, where Katics feels thatmore-extensive precautions should be taken: "If an actor was askedto audition with multiple people in a kissing scene, it would bereasonable to ask that the production team screen actors with aquestionnaire about communicable diseases such as oral herpes,although for legal and medical privacy issues, such informationcould probably not be required. If you were working on an extendedproject, such as a play or film, and your partner did have ahistory of oral herpes, then he or she would need to watch foroutbreaks and consider going on suppressive anti-viraltherapy."

As actors, we will have to kiss and become otherwise physicallyintimate with people we don't know very well, but usually onlyafter we are cast and have the opportunity to talk with ourkiss-mate about suspicious cold sores or possible viruses. Mostactors—most people—are ethical and concerned for the well-being ofothers, and as such, an audition infection is unlikely.

Unfortunately, just as in dating, intimacy brings risk. Whetheryou're matched with a scene partner who didn't inform you of his orher illness or who simply didn't realize that he or she was sick,the risk is there. But actors aren't the only professionalsaccepting such risks in the course of their jobs. Athletes oftenend up swapping sweat and sometimes saliva or blood during a boxingor wrestling match, or even a very physical basketball or hockeygame. And, as you well know, health-care professionals need toprotect against infection daily. Sanchez-Padilla is clear that, nomatter the situation, people "really do need to protectthemselves."

"I had the most horrible situation when I was a resident," shesays. "I was going to a detox program for alcoholics and drugaddicts, and I would sit in with their therapies, to learn abouttheir treatment. One day there was this new, very loud man there.The next day he was gone. It turned out that he was a cocaineaddict and he left the detox to get high. When he returned to thehospital, he had relapsed and was on oxygen and in really badshape. On a break during the next therapy session—many of thepatients went outside and smoked during the break—all of a suddenthey all came running back in. This man's heart had failed. I ranout there and…this guy was a crackhead…and I thought, 'I'm supposedto give him mouth-to-mouth.' I saw my kids flashing before my eyesand my husband flashing before my eyes. And I said to myself, 'Ican't do this.' I learned right then and there not to put yourselfor your family at risk. Later I learned that I had done the right[medically ethical] thing."

Kissing CautionBy Jackie ApodacaJune 2, 2011


Dear Jackie:

I am auditioning for a part that requires me to kiss someone I've never met. How can I be certain this person is not sick and doesn't have any easily transmittable diseases, such as herpes?

I am a nurse in a setting where there is a high risk for hepatitis and HIV, and we take grand measures and follow strict rules for personal protection when taking care of patients. We wear gloves, gowns, and face shields, and hand washing is no joke. I suppose being trained that way makes you more aware of this sort of thing. So when I saw I was going to have to kiss someone at this audition, the thoughts "I don't know this person" and "Is it safe?" came over me.

I'm thinking that to be on the safe side, I could excuse myself to the bathroom afterward, use mouthwash after the kiss, and swab my lips with an alcohol swab. I guess this is one of the risks actors have to take. Please help.

—Careful Kisser

Dear Careful:

First off, I doubt you'll be required to kiss at the audition. Most likely you'll be reading with a reader or a casting associate, and they certainly don't plan on kissing every actor who comes through the door! Even if you read with another actor, it's probably not expected that you smack at your audition—no matter how steamy the kiss in the script. Often a sensitive peck on the cheek or some intimate eye contact is enough to convey the idea. If you get to callbacks, you can go with what worked in the initial audition—or, if there's any doubt, ask the casting director what he or she would like for that moment, given the setting.

If the CD says, "I want you two to share an intimate, sloppy kiss right now, because I can't imagine that part and need you to prove to me that you know how to get down" (or something along those lines), you'll need to explain that you are a nurse with extensive training in communicable disease prevention and can't afford to risk your health by kissing a complete stranger in an audition. Ideally, this conversation will take place quietly and not with you pointing accusingly at your scene partner. But if he or she is present, simply add that it's nothing personal—just your professional rule of thumb.

At this point, hopefully, the casting person will drop it. Yes, there may be some eye-rolling from the CD, but that doesn't mean you didn't do the right thing.

I spoke to Dr. Margarita Sanchez-Padilla, a family practice physician, about the situation, and she was very clear in her advice: "Don't take the risk."

Herpes is just one of the things we can pass to each other through a kiss. Strep throat, the Epstein-Barr virus (which causes mono), the common cold—there are so many microbes to choose from. "Obviously, if you know you're sick, you shouldn't have close contact with others," says Sanchez-Padilla. "But if you don't know whether someone else is sick, don't have intimate contact with them."

As for private, post-audition de-germing, Sanchez-Padilla is skeptical. "Mouthwash probably wouldn't help; that's more for dental health," she says. "And there's not really an 'anti-viral wash.' "

I tried to explain the pressure inherent in an audition situation and how actors might feel like they need to comply with casting's demands. "That's awkward," Sanchez-Padilla replied. "That's scary.… That's worrisome."

I turned to Dr. Matt Katics, who has an undergraduate degree in acting and spent several years living the actor's life in Los Angeles before becoming a doctor. He understands well the pressure for actors to say yes to anything that casting directors request and is somewhat reassuring about the risks.

"Regarding medical concerns for auditions, one is probably okay if your partner is generally healthy, there are no visible lesions, and not more than saliva is being exchanged," begins Katics, a board-certified family medicine and hospice and palliative medicine physician. "For herpes and other oral viruses, if there has been no recent illness and no lesions are present, risk of transmission is extremely low. For serious chronic illnesses such as HIV or hepatitis, kissing—no biting—is generally considered safe if no oral lesions are present."

There are situations, however, where Katics feels that more-extensive precautions should be taken: "If an actor was asked to audition with multiple people in a kissing scene, it would be reasonable to ask that the production team screen actors with a questionnaire about communicable diseases such as oral herpes, although for legal and medical privacy issues, such information could probably not be required. If you were working on an extended project, such as a play or film, and your partner did have a history of oral herpes, then he or she would need to watch for outbreaks and consider going on suppressive anti-viral therapy."

As actors, we will have to kiss and become otherwise physically intimate with people we don't know very well, but usually only after we are cast and have the opportunity to talk with our kiss-mate about suspicious cold sores or possible viruses. Most actors—most people—are ethical and concerned for the well-being of others, and as such, an audition infection is unlikely.

Unfortunately, just as in dating, intimacy brings risk. Whether you're matched with a scene partner who didn't inform you of his or her illness or who simply didn't realize that he or she was sick, the risk is there. But actors aren't the only professionals accepting such risks in the course of their jobs. Athletes often end up swapping sweat and sometimes saliva or blood during a boxing or wrestling match, or even a very physical basketball or hockey game. And, as you well know, health-care professionals need to protect against infection daily. Sanchez-Padilla is clear that, no matter the situation, people "really do need to protect themselves."

"I had the most horrible situation when I was a resident," she says. "I was going to a detox program for alcoholics and drug addicts, and I would sit in with their therapies, to learn about their treatment. One day there was this new, very loud man there. The next day he was gone. It turned out that he was a cocaine addict and he left the detox to get high. When he returned to the hospital, he had relapsed and was on oxygen and in really bad shape. On a break during the next therapy session—many of the patients went outside and smoked during the break—all of a sudden they all came running back in. This man's heart had failed. I ran out there and…this guy was a crackhead…and I thought, 'I'm supposed to give him mouth-to-mouth.' I saw my kids flashing before my eyes and my husband flashing before my eyes. And I said to myself, 'I can't do this.' I learned right then and there not to put yourself or your family at risk. Later I learned that I had done the right [medically ethical] thing."



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