‘Are you limping?’ my father asked, after a 5-mile walk on Boxing Day, 2002. He was 79. I was 48. His concern prompted action.

It is said that no one is objective about themselves, and reflecting on my symptoms, it is true. I rationalised, never connecting them until I passed from orthopaedics to neurology. I doubt that motor neurone disease (MND) would have been diagnosed had I sought advice in 2002. I attributed numb-feeling toes, painful when driving and a feeling of altered gait to foot abuse by high heels, and ignored it. I wouldn't have volunteered anything else, due to rationalisation and failure to assign significance. (Interestingly, while the numb toes gave no sensory signs, I experience some areas as hypersensitive and others as ‘pseudo-numb’, presumably from denervation.)

Putting severe cramps and carpal spasm together, I made a mental note to check parathyroid function, but blamed theatre clogs for tripping and attributed difficulty climbing stairs to being unfit. The limp sent me to orthopaedics in January 2003, where nerve conduction studies indicated a more global problem. Referral to a spinal surgeon followed, with MRI scans and more electromyography, before transferring to neurology 6 months later. I have to admit my expectations were not very high, as neurology is not associated with a wealth of effective treatments and cures!

Various …