Cauda equina syndrome

It was like any other cold September day at the immigration office. Busy people with busy lives taking time off to renew their visas and permits, cursing the long waiting line. And I was one of those people.

My fourth time over, I think I've gotten a little wiser. I knew it was going to be a long wait, so I brought with me a copy of the most recent medical magazine i could find. To be honest, i don't usually read academic publications, unless i'm absolutely forced to. But i needed something to soothe my guilt of wasting precious time in a busy office when i should be in theater, scrubbing in for an emergency C-section or a hysterectomy (Note: I'm currently on my Obs and Gynae rotation).

So as i waited, i flipped through the pages trying to look self-important when in fact I was bored to death and not really absorbing any useful info. It was only natural then, that when my turn came, I was still clinching my copy of "Scope: Consultant's Edition - Cauda Equina Syndrome." Besides the obvious reason of it already being in my hand, i thought the magazine, with its big bold statement of a front page, gave me a somewhat intellectual and sophisticated look.

Gardai Jimmy Mc Elroy (oh yes, i know his name) took one long look at the magazine i was holding and asked "What's cauda equina syndrome?"

Darn it, he wasn't supposed to ask me that! But to tell him I haven't a clue would be a huge insult to my pride, so i decided to winged it.

"Cauda equina is the name of the splaying of nerve roots located at your lower back" (thank you Mr Fabio, my anatomy lecturer!).

"Cauda equina syndrome then - in simple terms - would suggest a condition where there is impingement or trauma in this so-called structure (I didn't think I sounded too bad, huh?) causing symptoms such as numbness, tinglings, and in severe cases could turn you quadriplegic." (quadriplegic?? I only realized after saying that how absolutely ludicrous i would have sounded to someone who actually knows a thing or two about medicine, which i prayed he didn't).

"What causes it?" he asked innocently enough. Only this felt more like an oral exam than a fairly innocent conversation in a packed immigration office.

Think Izzy, think!!! I was encouraging my lazy brain to work a little.

"A slipped disc." I answered matter-of-factly, trying to act all clever when in truth my palms were sweating cold sweats of panic.

"....or a bulging disc." he added.

Oh sh*t. He reads medicine? I'm dead meat.

"Yes...." I wanted to sound sure and confident, but what came out was a croak of dread and fear at almost being caught out.

"I had that condition a couple of years back, " he continued. "The pain, goodness, was excruciating. Had to have 2 surgeries before i got better."

"Oh, really? I'm sorry to hear that."

"Yeap. Thank God I didn't become quadriplegic" He winked.

He then turned his attention back to my application without another word, while i sat there dumbstruck and feeling pretty stupid.

Lesson learned!

p/s: i wish i could let you hear the song of shame playing in my head.