Rahul was a biker dude who limped his way into my office one day. He wore a French beard and a tight-fitting Harley Davidson T-shirt. An interlocking brass chain around his neck and steely skull-shaped rings on his fingers sealed the look. He had formidable forearms, but they were wrapped around his puny sister, who helped him into a chair. His robust face wrinkled with pain. “I have very severe back and right leg pain,” he mourned, running his palm along the back of his thigh and calf to show me how it travelled. “I can barely stand, sit, or walk,” he continued. “It’s been going on for over a month and I initially took bed rest for a week, but there was no relief. Then, another doctor asked me to start physiotherapy, which didn’t help either, and another gave me an epidural injection, but it’s only getting worse. I saw two other surgeons and they’ve suggested surgery, but I don’t want to have spine surgery because of all the horrible things people say about it. Someone told me I’d get paralysed, someone else said my pain would only get worse,” he prattled on. 

I sat there listening patiently to “his story”. That is why this is called taking “history”. “I’ve also been feeling numb in my balls since the past two days,” he suddenly said, unfiltered. That made me sit up a little. I asked him if he had faced any difficulty in passing urine, to which he shook his head sideways. I had him hobble over to the examining bed to check his motor function, which was good, but he said he was numb all over the back of his leg and around his buttock and groin—a term we call ‘saddle’ anaesthesia. Imagine riding a horse (or in his case, a Royal Enfield). The part of his body that made contact with the saddle or the seat was numb. It was an ominous sign. His sister removed the MRI films that I plugged into the viewing box only to find a very large disc prolapse pressing on the nerves that go down into the leg and also subserve bowel, bladder, and sexual function. I put my fingers briefly on my forehead, much like a doctor in a Hindi movie about to declare bad news.