Tau (tubulin associated unit) proteins:

A group of proteins that help maintain stability of axon microtubules. The accumulation of hyperphosphorylated tau in neurons is associated with neurofibrillary degeneration. Tau kinase overactivity can lead to build-up of neurofibrillary tangles. Abnormal prions, misfolded tau and beta-amyloid proteins can affect function of brain memory storing areas and may be associated with some forms of dementia, including Alzheimer’s.


A way or a path to travel. In Mandarin, it means “nature and its associations.” In tao, every creature finds its way according to the laws of nature. Each of us has our own inner path. The author and travel writer Paul Theroux produced an anthology of travel quotations, snippets, essays and miscellaneous writings called The Tao of Travel.


In pre-pandemic years I travelled regularly – mainly on the medical lecture circuit. I also wrote a few travel articles. Any anxiety I had in those years was when I was actually in the aircraft, the train or the car. Was the sleepy, unshaven pilot who looked like he’d been at a party the night before, now standing at the cockpit door of the Boeing 737, competent? Was the Cambodian Air aircraft (a twin-engine Cessna) mechanically sound? Will this hellish turbulence (usually described on the intercom as “mild” by the captain) break the aircraft’s wings? 

How easy travel was then: a toothbrush thrown into a briefcase, a few clothes thrown into a carry-on grip-bag, a hotel booked when you arrived. I was astonished at the age of 28 when my father-in-law had a paper file with copies of the bookings made for a trip to London. A file!

Pre-pandemic, the flight was the worry. Post-pandemic, with the difficulties of staffing airports, the pre-flight is now the worry. Since the pandemic lockdowns, an anxiety switch has flipped in my mind. Maybe it’s worsened due to an infiltration of hyperphosphorylated tau proteins into my cerebral tissues causing a few neurofibrillary tangles, all leading to a confidence decline, a mildly failing memory, a slowing of brain function – all occurring the older one gets. No longer do I care about the aircraft, the pilot, the takeoff or the landing. It’s the airport that’s the problem. 

Boarding pass Joshua Woroniecki Pixabay.com.jpg
Post-pandemic, with the difficulties of staffing airports, the pre-flight is now the worry. (Image credit: Joshua Woroniecki, Pixabay.com)

I used to cruise in to airport departure gates with maybe 20 minutes to spare. No longer. The main worry for me these days is getting to the airport, getting through security and finding my way to the flight departure gate. This fear is commoner than I realized, and I’m in good company.

Sigmund Freud confessed to what he termed “reiseangst,” a fear of travel – in his case a fear of train travel – such that he would arrive at the station several hours before the train was due to leave, although once on the train, the anxiety would resolve. As usual, he explained this fear in terms of a death fear or a fear related to sexual repression. Sorry Sigmund, but I think it’s more an age-related anxiety of doing something out of your usual routine where an unexpected event can upend your cool.

Cognitive symptoms of reiseangst include difficulty organizing travel-related needs. You imagine negative events: you lose your laptop in security; your rental car breaks down in the middle of nowhere. Or worst of all, your passport and wallet are lost or stolen. These nasty thoughts can lead to physical symptoms: mild nausea, sweating, an ache in the upper abdomen or even full-blown panic attacks! Treatment? Travel more often!

The pandemic’s piles of orphaned baggage lost in airports has led to my preference to avoid checking in bags and instead keeping bags with me under the seat or in the overhead locker. Packing then needs to be more organized. This means you’re going to have to use hotel laundry facilities or your host’s good graces. But it does allow you to exit the airport quickly and grab a cab.

I have friends who recently checked in to a European EasyJet flight and found their roller bags were a couple of centimeters too large for the permitted size for storage under the seat in front (you’re only allowed one “small” bag under 15 kg in the cabin on EasyJet). They had to pay 40 pounds/bag to have it checked into the hold.

I travelled to Britain in May to attend what will likely be my last school reunion in Edinburgh and discovered this hitherto hidden fear – though there may be good patho-physiological tau reasons for its appearance at this time of life. The internet booking arrangements went fairly well with no problems like the folk travelling on WestJet had to go through recently: a threatened pilots’ strike that led many to bite nails in a gloomy will-they-won’t-they go on strike situation. 

But my problems started early. Even something as simple as driving to Calgary airport to park the car revealed that during the pandemic lockdowns, the approach to the airport (formerly simple) now involved new flyovers, closed roads and poor signage. I missed the turnoff for Park-to-Go and had to drive through the airport and make my way back to find a familiar set of traffic lights with an annoyed car driver close behind me. These flyovers seem such an unnecessary added complexity. 

I had dutifully checked in online and printed the boarding pass. But carrying a flappy piece of paper is bothersome for an old Boomer, so I checked in and exchanged it for a proper boarding card. Many trust their phones to carry a boarding pass, but I’ve seen a flustered traveller whose phone image would not elicit a response to a security guy’s camera and who was told to go and get checked in with a formal boarding pass. Also, what if your battery goes flat?

On to security. Not having been in training for a while and responding to an unfamiliar order to get “everything – yes – everything” out of my pockets – even paper money – and ensuring that all liquids (nothing over 100 ml) were in a plastic bag away from my carry-on roller bag, I realized I still had a $20 banknote in my back pocket and rushed back to the line of bags going through the scanner, throwing it beside another bag as they joggled through the x-ray machine. Damn. Too late, I realized I’d neglected to take the laptop out of my carry-on briefcase – an offence punishable by a twenty-minute wait for the security team to go through everything in the bag and put it through the scanner again.  

“I’ve had a hip replacement,” I said, but there was little interest.

“We’ll do a manual,” said a bored security worker. “And take your shoes off.”

Really? I thought that had gone for kids 12 and under and oldies 75 and over, but no, it’s back. That wild-eyed terrorist (R. R.) is permanently in jail (in Colorado), but his plastic explosives stuffed in the heel of his boots on an American Airlines flight in 2001 lives on – is this a case of security immortality? 

I entered the scanner and was told to raise my hands higher. I did so, surrendering to the security staff. After a quick frisking by a bored security person to ensure there was nothing in my pockets, another handed my shoes back, pointed to a chair – a special chair – for me to sit on while wrestling my shoes back on. She handed me a long shoehorn to complete the process. They thought I was under 75!

“That’s very civilized,” I said – and the young lady nodded and smiled. “Yes, we brought it in specially for you.”

AC 850 left on time with no problems, and we landed at Heathrow Terminal 2 on time, where I was picked up and driven via the M25 to stay with an old friend for two days before the next flight at 12:55 p.m. on British Airways to Edinburgh.

“How should I get from Chipstead to Heathrow on Monday morning?” I asked.

“Hmm. At that time, the M25 will be packed. Any accident causes huge delays and missed flights. I advise going by train from Coulsden South to Farringdon. Change at Farringdon for the Elizabeth Line West for a train to Heathrow Terminal 5. And by the way, everybody uses credit or debit cards these days.” Great. Sounds easy.

I got on the train at Coulsden, said goodbye to my friends. And just as the train got moving, there came one of those muffled railway announcements that have not improved since the first public announcement in a railway station in the nineteenth century:

“Ladies and gentlemen, (muffle) problems with signals (muffle, muffle) at London Bridge, all passengers will leave this train (muffle, muffle) at Croydon East. All disembark at Croyden East.”

At Croyden East, a thousand commuters milled about the platform, me the only one with a roller bag and a briefcase – and a growing case of rieseangst. I found a nice woman in a uniform (Cockney accent): “Troy (try) pletfoam (platform) six. Trine (train) to Beddington, usually stops at Farringdon. G’luck.”

Farringdon: Up and down escalators with bags. First train was to Heathrow Terminals 2,3 so I got on – at least it was Heathrow – but I needed Terminal 5. I asked an official on the platform. He said: “Should come in two trines (trains) arfter (after) this 'un, mate.”

Terminal 5 was crowded, but I just made it within the required 40 minutes. The BA flight was fine. The rental car in Edinburgh I won’t get into, but driving in that ancient city is a lot harder than it used to be with bus lanes, bicycle lanes, tramlines, construction zones and pedestrian crossing lights every 100 yards, and then when you get to where you’re going, there’s no place to park – all areas had “permit holders only” signs. It’s like they want you to take public transport, believe it or not. But the taxi service (City Cabs) is excellent. I didn’t try the Uber.

The return Heathrow to Calgary flight used to leave at 12:15 – a convenient time if you’re flying in from another city in the UK, but it now leaves at 10:15 a.m. I had stupidly booked the 7 a.m. BA flight from Edinburgh to Heathrow landing at 8:20 – if you’re lucky, a travel agent would have spotted this error, but the day before the flight, I realized the old days were over, and under two hours to get from Terminal 5 to Terminal 2 was way too tight. I spent the morning trying to access a BA agent, eventually getting one who was helpful, and I flew down to London the evening before, booking into the Sofitel at Terminal 5, thinking it was in the terminal. It was not. A twenty-minute walk from the arriving aircraft gate got me to the hotel. I checked in for 209 British pounds/night, and the receptionist asked me if I wanted to book a taxi for Terminal 2 in the morning. “No. I’ll take my chances on the trains.” 

The receptionist looked sad. “There are strikes,” she said. Was there a bus? No. But I’d still take my chances on the trains. So in the morning, of course, there was a strike. I appeared at the hotel transport desk asking for a taxi. The transport manager said he’d try to get a cab. I paced around the lobby until he said, “A customer booked a cab for 6:40. He’s not here.” (It was 6:45!) “You can have his cab.” The 20-minute drive to Terminal 2 cost me 25 pounds. 

At Terminal 2 security, I again forgot to empty my pockets of cash and to take my shoes off. Once through security, there was a 17-minute walk to the Air Canada lounge, during which time, with the multitude of ups and downs of escalators and lifts, I actually made friends with a couple journeying through the maze. 

“Are you all together?” asked the gate attendant when we arrived. “No,” I said. “We just became friends on one of the two elevators and four escalators.”

The flight was perfect. We arrived in Calgary 20 minutes early. But the immigration check-in machine would not accept my passport, and the machine told me to go to a customs official. The human contact with Canada Customs went perfectly, and I was back in the clear blue skies of Alberta. 

Travel rieseangst has changed for me. It’s no longer the flight. It’s getting to and through the airport to the departure gate that’s become the worry.

But travel is an important exercise. An old friend, Dr. Walt Blahey, hematologist-oncologist, used to say: “I like to take vacations somewhere unusual. It gets you out of your routine, your rituals and timetables. It pushes you away from the safety of your old dog kennel.” 

Yes, Walt. It tests one’s resilience to overcome the inevitable upsets and challenges of travelling that seem to occur more frequently since the pandemic, and it’s good practice for the vagaries, disappointments and challenges of life. It’s important to resist the seduction of daily routine.

Editor’s note:

The views, perspectives and opinions in this article are solely the author’s and do not necessarily represent those of the AMA.

Banner image credit: Lars Nissen, Pixabay.com