Airports and the Science of Observation

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For one who has an interest in the body as text, airports are treasure troves of information. It seems almost un-American to enjoy delays, and perhaps enjoy is not the best word, but certainly a delayed flight, if it does nothing else, allows one the opportunity to make prolonged observations about one's fellow travelers.

"Why airports?" you might ask. Well, for one thing there is the lighting--the big picture windows that allow you to see planes taking off are marvelous at lighting skin, muscle. A turn of a woman's neck, an elegant profile, but also an enlarged thyroid, perhaps not pathologically enlarged, and yet readily seen, an entity that is more common in young women and in pregnancy.

But here is the real asset: airports offer long corridors, miles really, and the leisure of observing a gait as it plays out coming or going or both. The features of an old stroke, the so called "hemiplegic" gait, are readily seen (the arm flexed, the lower limb stiff and extended, the leg making a little outward semicircle as it moves forward --this is the circumducting gait). But at times the only vestige of the stroke is none of these things because there has been an almost full recovery, all but for the fact that the arm on the affected side does not swing easily as the person walks. This last, the arm swing, is an "associated" movement and is the last to come back. It is a rule in neurology, I am told, that the most recently learned functions are the first to go and the last to come back, and so it is with the arm swing.

Other common gaits? The shuffling gait of Parkinson's; the antalgic gait of someone with a bad knee; the occasional foot drop on both sides of a patient with neuropathy producing a decided lift of each leg with every step.

What else does one notice commonly? The furry brown darkened skin at neck creases in those who are overweight--it is a skin condition is called acanthosis nigricans and it suggests insulin resistance, potential diabetes. One also sees cafe-au-lait spots, cherry angiomas, tremors....

I could be here all day.

P.S. If you are wondering what I am doing in airports, I am on a book tour. Details here. I am trying to blog here, and make notes from the road on Twitter (@cuttingforstone) and on Random House's Facebook page for me, but really it is so tempting to just sit here and stare....

Photo credit: joiseyshowaa/flickr


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Abraham Verghese is an author, physician and med school professor. He is the author of Cutting for Stone and his writing has appeared in many major publications. More

Abraham Verghese is a physician and writer. His third book and first novel, Cutting for Stone, was published by Knopf in 2009. He is also known for two acclaimed non-fiction works, My Own Country, which was based on his experiences working with persons living with HIV in Johnson City, Tennessee; that book was a finalist for the National Book Critics Circle award and was made into a movie. He followed that with The Tennis Partner, also a New York Times notable book and a national bestseller. His writing has appeared in The Atlantic, The New Yorker, The New York Times , The New York Times Magazine, Sports Illustrated, and The Wall Street Journal as well as many medical journals. Verghese is board-certified in internal medicine, pulmonary medicine and infectious diseases. He attended the Iowa Writers Workshop at the University of Iowa where he earned his MFA. He currently practices and teaches at Stanford University School of Medicine where he is a tenured Professor and Senior Associate Chair for the Theory and Practice of Medicine in the Department of Internal Medicine.

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