Good enough general practice

I had admitted an elderly woman with severe sciatica to the community hospital. She needed care while her pain continued. During her second evening in hospital, nurses became concerned about her deteriorating mobility, and I found that she had developed a flaccid paraparesis suggestive of cauda equina compression. I needed urgent specialist advice and telephoned the neurosurgical registrar in the city 30 miles away.

Suddenly I was struggling to survive detailed neurological interrogation. Were hip flexion and extension equally weak? Just what did I …