New York City welcome

Jonn Elledge begins his North American Odyssey in the traditional manner - stuck in a queue waiting

In the immigration hall at New York's Kennedy airport there hangs a picture of a happy, helpful custom official. Beneath it, in large, friendly letters, a caption promises that the US Custom and Border Protection Agency 'pledges to cordially greet and welcome you, and treat you with courtesy, dignity and respect.'

As reassuring as this is, it's of precious little use when you find yourself standing in line for an hour and a half, surrounded by overheated Welsh teenagers, at a time your body insists is 3am.

The reason for the hold up was that the ever helpful Department of Homeland Security now requires every foreigner who enters the US to provide two finger prints, a retinal scan, and a convincing justification for their visit. Doing this 400 times takes a while.

After we'd been waiting 20 minutes, the tannoy crackled and an irritable voice warned us that any mobile phones in use in the queue would be confiscated and destroyed. After 30 minutes, a second voice chided us that our bags were clogging up the carousel, and announced they were about to be dumped on the floor. After 40, another flight landed, the queue doubled and three of the five immigration booths in use were helpfully designated "US Citizens only".

This combination of delays and suspicion is likely to be familiar to anyone who's visited the US in recent years. A 2006 survey ranked the country as the most unfriendly in the world to international travellers, with half of respondents complaining that immigration officials are rude and two-thirds admitting they expected to be detained because they "said the wrong thing". (One friend of mine once made the mistake of wondering aloud what the hold up was. The customs officials sent him to the back of the queue.)

None of this seems to be worrying the authorities too much: there are, after all, more votes in tight security and immigration controls than there are in being nice to foreigners.

But the tourism industry, at least, is starting to fret. The Discover America Partnership, which sponsored the survey, warned it was denting revenues by driving visitors away. Others worry that it will wreck the country's competitive edge. The more unwelcome foreign grad students feel in the US, the more likely they are to stay at home - and the more likely it is the next Google will come from Bangalore rather than Berkeley.

Only after nearly two hours of courteous treatment at the hands of US immigration we were finally allowed to escape the airport and make our way to the hotel we'd booked in Manhattan. This, it turned out, was a former transient hostel with bin bags on the mattresses and a sign on the wall reading 'No spitting.'

Welcome to New York.

Jonn Elledge edits the New Statesman's sister site CityMetric, and writes for the NS about subjects including politics, history and Brexit. You can find him on Twitter or Facebook.

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear