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Consumed by guilt, a killer tries to wash away the blood they know is on their hands, but they can't, no matter how much they scrub. This can extend to obsessively trying to clean away imagined bloodstain, or other evidence, when there is no physical trace of the crime left. Can overlap with Shower of Angst.
Please note that examples of this trope need not always involve literal washing. Quite often, in fact, it is manifested in any general sense of feeling "dirty."
This is an example of Truth in Television: the New York Times published a study showing that some people wash their hands when they have feelings of guilt.
Compare with Brain Bleach, which is used to scrub away unpleasant mental images instead of guilt. Can be one of numerous ticks that result from a Sympathetic Murder Backstory... or not so sympathetic. Sometimes accompanied by a Madness Mantra. See also Must Make Amends, Blood Is Squicker in Water. Often part of a Dark and Troubled Past. Contrast These Hands Have Killed, which tends to be a more temporary reaction.
WARNING: This trope quite literally concerns flesh and blood, so possible Squick ahead.
- Inuyasha, two examples. In one, a Jekyll and Hyde slasher-villain/doctor did this after his villain side savagely murdered some people. Earlier in episode 52, Inuyasha tried to clean his hands after he killed a bunch of bandits when his Super-Powered Evil Side took over, but after each frantic scrubbing found he could still smell their blood.
- Shishio Gen from Kekkaishi does this after remembering how he accidentally slashed his sister.
- Done in Pluto, by a robot with shell-shock.
- Kenshin of Rurouni Kenshin, a master swordsman, hates to kill but decides to become an assassin for the Choshu during the Boshin War because he wants a peaceful new era. Much angst and hand-washing during those days.
- In Yami no Matsuei, after Hisoka has to kill Tsubaki at the end of the cruise murder mystery arc, he continues to see blood on his hands even though there is nothing there. His partner Tsuzuki comforts him.
- Neon Genesis Evangelion: After destroying Leliel, Shinji becomes scared of his own hands, because he can't get rid of the smell of blood.
- Kamisama Kiss has two examples. When Tomoe first met Mikage he was trying and failing to wash blood off of himself. Later on, Tomoe kills a literal Demonic Spider and is trying and failing to wash to blood off when Nanami shows up to help.
- The issue of Saga of the Swamp Thing that resulted in the title no longer carrying the Comic Code Authority seal features a truly Nightmare Fuel instance of this trope, after Abby realizes the Awful Truth behind why her husband has been acting differently:
She ripped all of her clothes off, tearing them up. They were dirty. They'd touched her skin. She tried to burn them, but her hands were shaking and the matches kept going out. In truth, she was a little crazy by this time. It was the smell. She couldn't get rid of the smell. In the shower she used up all of the soap, the shampoo, the bubblebath, the perfume... the smell was still there. Have you ever burned an insect with a magnifying glass? Just once, long ago, when you were a kid and didn't know any better? There. You know it. You know the smell. When the soap wouldn't get rid of it, she went to the kitchen and fetched the wire brush that she used for scraping the potatoes... twenty minutes later she passed out. Twenty whole minutes. Even then she could still smell it. She could smell it in her dreams.
- In The Sandman after mercy killing his son Orpheus (who has spent millennia as a disembodied head) Morpheus is seen washing the blood from his hands in a bowl of water looking sadder than he ever has in the series.
- In the Firefly fanfic Forward, River has a few of these types of moments, even using "Out Damned Spot".
- Subverted in the The West Wing fanfic Band of Blood. Toby has this reaction to Josh's blood all over his hands while waiting in the hospital after the Wham! Episode, although he wasn't even indirectly responsible and his guilt was fanciful guilt over the possibility that his decision to take down a protective canopy for PR reasons might have caused the shooting.
- In the ongoing "Axis Powers Hetalia" fanfic Clinging, Ivan (Russia) has a couple of these moments. At 9 years old, he killed his father, who was trying to rape his older sister. Six years later, the owner of the orphanage he and his sisters wound up in repeated Ivan's father's actions, this time directed at Ivan himself. He killed the owner in self-defense. Even though both of them were at least somewhat justified, he has had at least two Out, Damned Spot! moments. So far.
- In Mutant Storm, a X Men Crossover, Harry kills Lucius Malfoy and Bellatrix Lestrange, and then he goes through a Heroic BSOD while he tries to clean himself.
- Done rather melodramatically in the Avatar: The Last Airbender fanfic The Chong Sheng Trilogy. When Jet dies in Katara's arms, she snaps and uses actual blood as bending fluid to kill several enemies before Sokka has to snap her out of her insanity. When Katara realizes what she's done she screams and goes catatonic until late that night, when she leaps into a dangerously rushing river and tries to scrub away her sins. Zuko has to rush in to rescue her before she drowns or is swept away.
- Played very straight in the remake of Casino Royale, during the shower scene. Vesper's consumed by feelings of guilt after watching James kill a bunch of Mooks, and he finds her sitting in the shower, clothed, and sobbing about the blood on her. The original plan was for her to be in her underwear. Daniel Craig, upstanding gentleman that he is, convinced everyone that this wouldn't make sense.
- Specifically, he pointed out that she wouldn't have stopped undressing at her underwear. So she either had to be fully clothed or fully nude.
- Bullitt: Used rather beautifully at the end.
- Repo! The Genetic Opera has Nathan Wallace. He's very good at repossessing organs, but the fact that he actually enjoys his work leads to a lot of Out, Damned Spot! moments. It doesn't help that he's constantly being guilt tripped by Dead Marni and taunted by the Genterns.
- A good example comes at the end of "Thankless Job" - when the song ends, it hits Nathan about what he's doing while his arm is still in the corpse, and he ends up spraying down his uniform and tools.
- As Akira Kurosawa's Throne of Blood is Macbeth in feudal Japan, it is unsurprising that Asaji freaks out over blood only she can see.
- Similarly, in ~Scotland, PA~ (which is Macbeth in a rural 70's Pennsylvania fast-food joint), Pat McBeth gets a small burn from frying oil when Duncan dies. As she sinks into madness, she becomes convinced that the burn is getting worse, even though it completely healed in reality. In the end, she's driven to cut off her hand with a kitchen knife, then promptly faints and bleeds to death.
- Chicago has a bit at the beginning with a character having a hard time scrubbing the blood off her hands in the dressing room before being called up on stage.
- Subverted, in that the character carries no guilt at all about the murder.
- Used in The Machinist: Reznik is constantly seen washing his hands with bleach and even lye. It turns out he once killed a young boy and has repressed the memory.
- Dead Presidents: Cleon (Bokeem Woodbine) is a Bronx-based Protestant minister. He is also a Vietnam War veteran who feels remorse about the atrocities he committed in the jungle, and so he initially refuses to participate in a bank robbery being organized by an unemployed fellow vet. But he eventually agrees to take part in the crime, because there's a lot of money involved. After the violent heist, during which several policemen and two of the robbers are killed, Cleon is inconsolable as the gang counts their money at their hideout. He bleakly proclaims that "we've bought our way into Hell" and "I'm not sure I even want any of this dirty money." It all eventually gets to be too much for Cleon, and he rats out the rest of the gang after being himself arrested.
- The Robe: Pontius Pilate is depicted briefly as washing his hands repeatedly, likely due to unconscious guilt over Christ's crucifixion. 
- Parodied in Batman Returns, by Catwoman: "The thought of framing Batman makes me feel so dirty. I think I'll give myself a bath right here." Then - being a cat-person - she proceeds to lick herself!
- Parodied in Wyrd Sisters (naturally, since it's a parody of Macbeth) where Duke Felmet becomes so obsessed with washing the metaphorical blood from his hand, he tries scrubbing it with a wire brush, among other things. (It's implicit his measures ensure that his hand will always literally have blood in it, just not the victim's anymore.) At one point he's even seen with a cheese grater, and bandages on his hand. The parody starts to turn very dark, though, when towards the end the narration describes "the remnant of his right hand."
- Orson Scott Card
- Xenocide . Han Qing-jao becomes a "Godspoken" after she suddenly starts feeling her hands constantly dirty, washing her hands all the time and scrubbing them with stone until they bleed. It then turns out it's because Qing-jao, as well as all the Godspoken, was born with OCD.
- Alvin Maker series: The trope features prominently in the form of a curse.
- This is taken to extremes in the Ray Bradbury short story "The Fruit At The Bottom Of The Bowl", in which a man becomes so obsessed with removing all his fingerprints from a murder scene that he actually forgets that his main objective is to escape and get away with the crime -- the police eventually find him at three in the morning, polishing old coins he'd found in a box in the attic, by which time he seems scarcely bothered about being caught and is only concerned with making sure he polishes the handle of the door as they lead him out of the house.
- Edgar Allan Poe
- Played in The Telltale Heart, in which the main character murders his master because of an imagined Evil Eye that the man possesses, and afterward, he hears the man's heart beating loudly below the floorboards where he buried the man. The guilt of this beating drives him insane, to the point where he loudly confesses the crime to two policemen who were visiting his house, believing that they heard the sound as well and were playing a cruel joke on him by pretending not to hear.
- Done twice in The Black Cat, where the protagonist kills his cat in a fit of drunken rage and murders his wife and hides her behind a wall. In the first instance, his wife brings home a new cat which is suspiciously similar to the old one, and the shadow of a gallows eventually emerges in its fur. After the wife's murder, the cat disappears, only to later reveal her grave to visiting policemen.
- In Mila 18, which is based on true events in German-occupied Warsaw, Poland during WWII, one of the Nazi leaders is constantly bathing. At least one of the more astute people around him is aware he is trying to wash away his guilt in the slaughter of Polish Jews.
- After hearing Smerdyakov's explanation of events in The Brothers Karamazov, Ivan begins to continuously recount the events prior to his father's death over and over again, trying to convince himself that he is not the one responsible for murdering him. This ends up with him talking to Satan and eventually freaking out spectacularly at the trial of his brother.
- The Dresden Files: The robes of the Wardens are enchanted so that blood will not stain them. Keep in mind that the Wardens are tasked with administering death to anyone found in violation of the Laws of Magic even if they had no knowledge of the Laws and were unaware that they were performing dark magic (most of whom are teenagers). Because of how Black Magic affects people in this 'verse, though, most of the ones they execute are, by that point, less "punishing someone who broke a rule" and more "putting down a rabid beast before it kills anyone else."
- Outcast of Redwall: Veil in suffers something similar. His victim was poisoned, and the Abbey herbalist puts out an announcement that it will be easy to find the killer because the particular poison used will stain one's skin and fur red within two days if one touches it with bare paws. Veil, unaware that this is a complete and utter lie, starts frantically scrubbing his paws at every opportunity, even with sandstone, thus making them look red. He breaks into the infirmary to find the "herbal solution" the herbalist supposedly left there and dips his paws into the basin without looking, only to find that said basin actually contains beetroot juice, thus leaving his paws very obviously red and proving his guilt.
- On My Honor: As the Newberry Award-winning book goes on, the guilt-ridden protagonist keeps smelling the river everywhere he goes.
- Mortal Stakes: Robert B. Parker uses this very line from the mouth of Genre Savvy Private Detective Spenser, who thinks this after he's forced to kill two mob men in self defense.
- Another literary example: The warrior with the red hands, from Gustavo Adolfo Bécquer's Rhymes and Legends, depicts the tragic story of the Warrior Prince Pulo-Delhi of Osira, a Byronic Hero who always wore gloves so nobody would see the permanent blood stains on his palms He got those by killing his older brother King Tippet-Delhi to both end their Sibling Rivalry and steal away his beautiful girlfriend Siannah (who cheated on Tippet with him), so the stains remained there as a symbol of his crime. And they didn't go away until he crossed the Despair Event Horizon and commited suicide to atone for his sins.
- In the novel Stormland by the icelandic author Hallgrímur Helgason, the protagonist Bøddi begins seeing black flies crawling on himself, objects and the faces of everyone he talks to after shooting his brother through the eye and seeing the flies crawl around in his wound. The visions get more intense as his mental breakdown worsens.
- The Hungarian Ballad of Agnes tells the story of a woman who has her lover stab her husband in his sleep, and afterward she spends day after day at the river, trying to wash the (imaginary) bloodstain out of the sheet, though said sheet has already been reduced to a handful of ragged cloth from all the scrubbing. Even when she's taken to court, she just keeps saying she has to go back to her washing; the judges take pity on her and decide her own guilt is punishment enough.
Mistress Agnes in the streamlet
- Robert Harris' Fatherland has a disturbingly understandable version. The protagonist, a U-Boat captain, finds out that the socks he was issued for 10 years are manufactured from the hair of executed Jews. He describes not feeling clean after bathing repeatedly for days; more justified than most given the close physical contact involved...
- A Tree Grows in Brooklyn: After Francie's attack, she begs her parents to help her because she can still feel where it touched her thigh. Her father pours acid over the spot, leaving a permanent scar but Francie is happy to have it rather than the feelings or dirtiness left by her ordeal.
- In Warrior Cats, Hollyleaf killed Ashfur. The official iOS app mentions that she can still taste his blood in her mouth.
- Scrubs, with Dr. Kevin Casey after surgery, though this was due to his OCD.
- Tales from the Crypt: "For Cryin' Out Loud" had a corrupt nightclub owner (played by Lee Arenberg) kill a woman, then imagine his Shoulder Angel voiced by Sam Kinison admonishing him for it. In an attempt to shut it up, he jams tissue and Q-tips in his ear. Later, he stumbles into the club and sees everyone staring at him; assuming that they can see his guilt, he screams a confession to all of them... only to realize that they were actually staring at the wad of cleaning items sticking out of his ear. The story has similarities with The Telltale Heart.
- One Step Beyond: In "The Hand", a piano player at a run-down dive murders a beautiful young woman in a jealous rage with a broken-off beer bottle. After the police arrest a drunken derelict for the crime, Tom figures he's in the clear. Although he at first seems to have covered his tracks well enough, he soon discovers that, no matter how hard he tries, he cannot get the woman's blood off his hands. He forces a doctor to bandage the hand only to cause the blood to seep through. Eventually he breaks down when he is called into witness for the murder and has to lay the hand on the Bible and swear to tell the truth.
- The sitcom Cheers also did a homage/parody of "The Telltale Heart" in one episode; Diane is trying to guilt Carla into a confession, and after outlining Poe's story, keeps making "heart beat" noises. After several rounds of this, Carla hears the noise, finally snaps and yells at Diane to quit it, only to learn that Diane is way off in the other room...
- Kamen Rider Faiz: This is the reason that Masato Kusaka obsessively cleans his hands. He wasn't the murderer but he did witness the massacre of his classmates and was killed himself. They got better. Still, this could partially account for why he's such a manipulative Jerkass.
- Referenced in Mystery Science Theater 3000: While watching a short film about Ross, an animal wrangler who captures wildlife for zoos, Joel's and the bots' commentary makes Ross out to be a villain on par with those from Captain Planet. Then, there's a brief shot of Ross wiping his face off with a towel, at which point Servo quips:
Tom Servo: Ross tries to towel away the evil, but nothing doing.
- The Drew Carey Show: Drew has cybersex with Mimi and doesn't realize it until the deed is done, whereupon we cut to a fully-clothed Drew sobbing in a hot shower.
- Ace Ventura Pet Detective, wherein the title character burns his clothes after he finds out that Finkel is Einhorn. And then at the end, the entire police force starts puking upon that revelation.
- Buffy the Vampire Slayer: "Bad Girls". The final scene of the episode briefly shows Faith desperately trying to clean the blood of the man she accidentally killed, out of her shirt. Also, when Anya becomes a vengance demon again, and murders a frathouse who laughed at a girl who was broken up with at a party. Complete with a "what have I done?"
- Dark Shadows: In the old supernatural soap, the young witch Angelique lays a curse on her husband/enemy Barnabas Collins in a moment of transcendent rage, a curse on him to die and rise as a vampire. She almost immediately regrets it and tries without success to lift it, and tries to scrub up a bloodstain on the floor from the incident, only to find that no matter how hard she scrubs the blood won't come off the wooden floor.
- In The Second Coming: Judith, after she's cooked the poisoned pasta but before Steve's eaten it can be seen drying her hair and rubbing her head in a rather forceful manner.
- Mystery Science Theater 3000. One of Tom Servo's repeated riffs: "But you'll never be able to get rid of the stain on your soul."
- M*A*S*H turns this into a Tear Jerker in "Heal Thyself," when a talented and experienced new doctor has a Heroic BSOD after a grueling session in the OR.
- On Lost, having just killed Ana-Lucia and Libby, Michael asks Eko about Hell while scrubbing Libby's blood off the floor. The conversation ends with Michael going outside to throw up.
- Bad To the Bone: The 1997 TV movie had an example that eerily echoed Macbeth. Francesca ("Frankie") Wells (Kristy Swanson) is a Fille Fatale (she is 19, but often behaves as if she is several years younger) who has killed her own mother in order to get her hands on the family inheritance and then talked her younger brother into killing her latest boyfriend so that they can take over the nightclub the boyfriend owns. Both are eventually arrested and charged with the murders, but Frankie jumps bail, gives herself a false name, and eventually winds up living on a seacoast villa with a rich man she has seduced. She spends one morning swimming in the ocean. The rich man sees her coming in from the surf and mentions that he once heard that the ocean is supposed to wash all one's sins away. In a splendid display of dramatic irony, Frankie tells him that, unfortunately, that isn't the case. A subtle yet effective Cry for the Devil, especially given Frankie's Woobie-ish backstory.
- In the ballad Bonnie St. Johnstone, a cruel mother ballad dating to the seventeenth century, the young woman who has slit the throats of her two illegitimate children attempts to wash the knife in a brook, but the knife keeps looking redder and redder.
- Macbeth, the original. Lady Macbeth, long after she had washed her hands dripping with Duncan's blood, continued to be preoccupied by hand-washing. So great was her sense of guilt that no amount of water and the ritual incantation of "Out, damned spot! Out, I say" could restore her peace of mind or ability to sleep.
- Inverted, interestingly, in the poet's Julius Caesar, in which Brutus suggests:
...Stoope Romans, stoope,
- In Woyzeck, the title character murders his unfaithful girlfriend, and obsesses over fear that someone will find the murder weapon. His determination to hide it in the river and wash off the blood gets him drowned. Probably.
- This is the version of the ending used in the opera Wozzeck and Werner Herzog's film version.
- In Eternal Darkness for the Gamecube, Alex Roivas comes across the ghost of a maid cleaning her grandfather's carpet. When the ghost hears Alex, she looks up and screams "I can't get the blood out!" Soon, she finds her grandfather's chapter of the Tome of Eternal Darkness, and discovers that the maid died on that spot forty years ago.
- Tomb Raider Anniversary has a few moments like this where Lara stares at her hands after dispatching one of the Quirky Miniboss Squad.
- She also looks at her hands in the ending, but feeling less guilty and feeling more confident, knowing her actions helped save the world.
- Silent Hill 2 is essentially the protagonist's guilt over the murder of his wife manifest as a variety of physical monsters.
- In the early FPS Blood, this trope is lampshaded then outright subverted in the first episode. Within the first map, the protagonist (Caleb, an undead, wisecracking cowboy with a sadistic streak as big as Texas) comes across a sink, to which he replies:
Caleb: "OUT! OUT! Damned spot!"
- When he finds another sink, deep within a kitchen area, he goes on to comment:
Caleb: "But I like my hands bloody..."
- In Dragon Quest VI, there's a town that thrives due to their rejuvenating water, which, shortly after you arrive, turns blood red. Investigation reveals that a woman is trying to clean the blood off her sword at the water's source, consumed with guilt because she believes she killed her lover. You have to find him Not Quite Dead, but she'll be cleaning her sword until you do.
- In Alpha Protocol, The Dragon, Conrad Marburg, wears black gloves at all times. At their first meeting, if the protagonist has accumulated enough of Marburg's dossier, he can accuse him of wearing them as a feeble psychological crutch to avoid feeling that he has blood on his hands.
- The line itself was parodied in Irregular Webcomic when Will Shakespeare uses the line to get his dog out of the server room.
- And previously on Carmen Sandiego's Great Chase Through Time, when he tries to get a dog out of his theater.
- On Ren and Stimpy, "Stimpy's Fan Club", Ren rants about having to answer all of Stimpy's fan mail "with these hands... Dirty!! The dirt won't come off!"
- SpongeBob SquarePants also spoofed The Tell-Tale Heart in the episode "Squeaky Boots". Mr. Krabs unloads a pair of unwanted fishing boots on SpongeBob, but is driven mad by the incessant squeaking. He steals the boots and hides them under the floor boards of the Krusty Krab, but the squeaking remains...
- The Simpsons :
- A jealous Lisa hides a girl's Tell-Tale Heart diorama, and then hearing the metronome used to simulate the heartbeat.
- It was also used humorously when Homer became a food critic and was criticized by his editor for an inept review. Lisa finds him in the bathtub repeatedly scrubbing himself and babbling: "Still not clean! Stink of failure still on me!"
- Parodied in a story Marge tells Lisa, wherein she plays a frustrated laundress whose husband's poor acting is keeping her in such a position. "Marge, if you didn't wanna get barbecue sauce out of a leotard, you shouldn't have gone into theater." Later played straight when she ends up encouraging Homer to murder people so he can play the lead role.
- This is a common symptom of Obsessive-Compulsive Disorder -- a feel of "dirtiness" and a compulsion to somehow clean it, often resulting in germ/cleanliness obsessions and frequent, almost continuous, hand- or body-washings.
- This can also be a behavior exhibited by sexual abuse victims. Some severe cases have (in a manic state) reportedly scrubbed their skin raw while bathing, trying to remove the filth that they believe is on and inside their body.
- The version of the story found in Matthew's Gospel actually has Pilate publicly washing his hands in front of the crowd to symbolize that he is not responsible for the death of Jesus. This is an old custom referred to in the Old Testament, and is the origin of the modern expression.
- One of the sequels to Ender's Game