Olivia was five, and I could tell by the way she limped into my emergency room that, whatever else she enjoyed in life, she would never enjoy the simple, extraordinary pleasure of a normal walk. The x-ray of her pelvis confirmed what I had suspected watching her scissoring gait from across the ER; that the balls of her hip joints had been out of their sockets since her birth and she would never have the smooth, sliding ball in socket hip joints required to walk without pain.
Olivia was my the first of my teachers about the wonder of the human walk, and I have studied and marveled at this first and best of the human ballets ever since. A person’s walk tells me part of their story, sometimes their story, either of the moment of big parts of their lives. A child’s skipping, a schizophrenic patient’s meandering, and the subtle shift to sauntering mid-stride of young men walking by young women all tell me stories, and I like hearing them in the sounds of how their feet fall.
Few of us understand until we lose it that a normal walk is a great gift. Had Beethoven been in the business of designing human movements, the walk would have been his greatest piece of music, for it is a complex melody played by an orchestra of 200 muscles, all in concert to the harmonious beat of a perambulatory rhythm. Women add sashay to it, men add swagger to it, and it’s been said angels talk to people out walking, but a normal walk does not needs the accessories of sashay and swagger, or angels along its path, for it is a thing of beauty and a reward all its own.
It is an action designed for pure efficiency in our movement from Point A to Point B, at a fuel consumption rate of about one calorie per pound of our weight per minute of walking. That’s why one of the most profound consequences of the loss of a normal walk is a substantial increase in the amount of effort and energy required to do this most simple of things. That can turn walking into something that can be oh, so tiring and so difficult.
The other day I walked past a woman with a markedly impaired walk, our speeds so different she appeared to be standing by while I sailed past on a moving sidewalk. Using a walker for stability, she took steps of a few inches, her feet barely clearing the floor. Balance and the work of walking required her complete effort and concentration, stealing from her the ability that most of us have to let our minds wander happily and often healthfully while we walk.
For such patients, continuing to walk every day and everywhere is an act of courage, of will and determination, for it would be much easier to stop going places, or to only go to them in a wheelchair. For those who walk with pain at every step or other step, a painful walk turns the simple decision to spend time with other human beings doing normal human things into a choice between physical and social happiness, and to make them pay a painful price for all such activity.
When you are having a bad day sometime, consider what it would be like to have to summon courage up just to walk 50 feet. Imagine taking every step anticipating the pain of foot placement, or of shifting weight from good hip to bad hip as must be done to walk. Put a stone in under your heel, hobble your legs together, then walk a mile in someone else’s painful shoes. Imagine doing that for the rest of your life, and your troubles might seem less heavy to bear.
Erik Steele is the former chief medical officer of Eastern Maine Healthcare Systems. He now works at Summa Health System in Akron, Ohio.