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On the Brain
December 10, 2018

Walking Home

Author Affiliations
  • 1Medical Service, Palo Alto Veterans Health Care System, Palo Alto, California
JAMA Neurol. 2019;76(2):138-139. doi:10.1001/jamaneurol.2018.3925

A new patient recently came to see me for his first medical clinic visit, and he brought his wife with him. I began my evaluation by welcoming and watching them as they entered my office. They sat next to each other. I sat before a computer, but I did not look at the screen; I did not have to. He was thin but not gaunt and dressed casually. His face was expressionless and he had flawless skin. His wife held his right hand in both of her hands, and she answered my questions about her husband. “He seems to lose his way in the home,” she said, but quickly added that he is very good at putting away the dishes from the dishwasher and never misplaced a single item. She told me that he is not eating much but she added that he was always a fussy eater. “He does not complain of anything, but he does not express himself too much either, and he faithfully walks the dog around the block twice a day.” He chuckled when he heard this information as if she was sharing a private and embarrassing detail of their relationship. “I know where I am walking to when I walk the dog,” he said with a wry smile. “I am walking home.” I looked at her and she looked at him. He was looking straight ahead, but I am not sure what he was looking at.