The Medical Detectives: Zoe's Story – "24 Hours from Paralysis"

Podcast: The Medical Detectives
Hosts: Dr. Erin Nance (B), Anna O’Brien (C)
Guest: Zoe (A)
Date: September 3, 2025

Episode Overview

This gripping episode features Zoe’s harrowing journey through years of worsening pain, numbness, and repeated medical dismissal—culminating in a shock diagnosis of cauda equina syndrome with mere hours left before potential paralysis. Dr. Nance and Anna guide Zoe through her story, discussing the impacts of medical bias, the complexities of self-advocacy, and the systemic pitfalls patients often encounter. The episode is a vivid, first-person detective story through the labyrinth of American healthcare, patient gaslighting, and the dangers of being misheard.

Key Discussion Points & Timeline

1. Zoe’s Upbringing and Early Health Experiences

[03:03] Zoe describes growing up as the youngest of five in a “Viking babies don’t cry” household, where stoicism was valued and doctors were avoided:

“Going to the doctor was never really seen as...you just get over it. Out of sight, out of mind.” —Zoe [03:03]
Isolation in early teens triggers depression, anxiety, and self-harm; first migraines also emerge.

2. The Onset of Medical Mysteries

[07:03] Zoe develops chronic migraines with persistent visual aura (never losing peripheral vision but seeing “stars and stuff”).
[07:01] For the first time, a doctor links her migraines with mental health—“If you don't let these feelings out, your body will figure out a way to push it out.”

3. Tingling, Numbness, and A Dismissive System

[09:00-14:00] In 2015, Zoe develops insidious tingling in hands and feet, which worsens. When she begins losing sensation while driving, she seeks medical attention.
PCP suspects MS; neurologist dismisses concerns, floats brain/spinal tumor before running inconclusive tests—EMG and muscle biopsies.

“He was like, we can’t really find what’s causing this, but I think you just need to accept that you have the nerves of a 60 year old diabetic...you just have polyneuropathy. You’re just one of the lucky people.” —Zoe [14:30]

Dr. Nance Interjects:

[16:09] “That term, stocking and glove neuropathy, is used for people who are pretty significantly diabetic who lose the sensation to their fingers and their toes...No, not a 20 something year old. No.”

4. Unexpected and Dismissed GI Symptoms

[17:16] Zoe’s digestion collapses—fibrous foods induce vomiting or diarrhea, and she can’t process salads. A doctor’s advice:

“Well then just stop eating salads.” —Zoe, quoting physician [18:00]
Loss of bowel control becomes an embarrassing, normalized part of life:

“Well, I didn’t shit my pants today, so we're gonna count that as a win.” —Zoe [18:48]

5. Years of Pain, Mobility Issues, and Medical "Girl Math"

[19:26-31:30] Zoe bounces between providers, receiving a degenerative disc disease diagnosis at 32, told nothing can be done. Pain worsens, mobility declines, and heavy drinking becomes a pain management strategy.
Zoe tries interventions—chiropractors, physical therapy, podiatrist—but continues to decline. Providers repeatedly assume issues are psychiatric or due to weight/drinking.

6. Increasing Disability & Systemic Barriers

[33:00-41:00] By 2022, daily life is functionally limited. Zoe describes her shrinking world—choosing between food, showering, or walking the dog; legs fall asleep after mere minutes.
Attempts to advocate in residency clinics fail; care is fragmented, and concerns are consistently dismissed: “They felt that I was just being dramatic or crazy.” [33:54]

7. Red Flags, New Symptoms, Continued Dismissals

[40:07] A chiropractor is first to mention “saddle anesthesia” (numbness in groin area) — a classic emergency sign.
Zoe asks for MRI, is told to lose weight and lessen drinking first. Insurance and provider stonewalling continues.
[41:25] Dr. Nance (heated): “This is just gross negligence from the physicians and providers. I can’t even think—”

8. The Final Days Before Paralysis

[47:00+] Zoe’s symptoms escalate—saddle anesthesia comes and goes; can walk only minutes; unable to urinate normally. Makes a plan to go to ER as soon as she can leave pet-care duties.
[53:45] “...as soon as this house gig is up, I'm gonna go to the ER in Seattle. Something's wrong."
Collapses at home, relies on a friend to get to the ER.

9. The ER Visit: Diagnosis at Last

[55:00] ER nurse quickly recognizes seriousness, finally gives pain medication—a dramatic relief (“I just started bawling because I didn't even know I could ask for it…” [56:13])
MRI performed; immediate surgical emergency declared. Diagnosed with cauda equina syndrome:

“You have had cauda equina syndrome for months, possibly even years. I've never heard of someone having cauda equina syndrome going on that long without someone diagnosing it. It is so ridiculous...” —Dr. Nance [59:09]
Zoe’s surgical findings: herniated disc, compressed spinal cord, thecal sac fused to cord.

10. Emergency Surgery & Aftermath

[61:39] Zoe undergoes surgery; pain is immediately and markedly reduced, though with complications (CSF leak, temporary inability to void bowels/bladder).
[64:31] Dr. Nance: “It’s really upsetting to me because it's in my own field...That was a delay in diagnosis that led to developing true cauda equina. Full blown cauda equina.”

11. Systemic Bias & Gaslighting

Discussion highlights repeated errors: over-focus on mental health history, weight, substance use, and gender bias as obstacles to care.
The team's outrage is palpable.

“I think she’s suggesting that there are money in them hills for this. Ridiculous. Not to be an opportunist, but... you basically couldn't have a life for many years in which you also gaslit yourself.” —Anna [65:04]

12. Looking Forward: Lessons & Recovery

Zoe describes new gratitude for being able to walk, yet ongoing numbness and medical trauma.
Dr. Nance theorizes underlying connective tissue disorder as the possible root:

“...This seems more of a failure of your connective tissue. All of the tissues that are supposed to help keep your body in line...” [68:31]
Zoe's message: with the right vocabulary, support, and team, self-advocacy becomes possible, though trust remains hard to rebuild.

Notable Quotes & Memorable Moments

On gaslighting and internalized doubt:

“You were so gaslighting yourself because you'd been gaslit by others—that your legs are doing, I don't know what dance down below you can't control, and in your mind you go, that's my fault.” —Anna [46:09]

On systemic failure:

“This is just gross negligence from the physicians and providers.” —Dr. Nance [41:25]

On gender and stigma in medicine:

“You should get to fight someone who says [‘it’s your cycle’] to you. Like, I'm sorry, sir. You said the fight words. And then fight club should commence.” —Anna [42:13]

On bringing data, but not being believed:

“I have an entire page of, like, punch words that I thought would get attention...I was like, say these words, someone will listen to you. And they weren’t.” —Zoe [49:29]

On the emotional toll:

“Zoe felt like at times she was punished for being honest with her doctor. And that is, I think, the crux of this lesson.” —Anna [75:28]

Thematic Takeaways

Biases kill: Mental health history, substance use, and obesity led to dismissals and catastrophically delayed care.
Self-Advocacy: Zoe’s experience demonstrates the necessity and burden of relentless self-advocacy, even in the face of repeated dismissal.
Clinical Red Flags Ignored: Classic signs of cauda equina syndrome and progressive neurological deficit went unrecognized for months, nearly costing Zoe her mobility and life.
Systemic Barriers: Populating residency clinics, insurance gatekeeping, and lack of continuity in care deprive vulnerable patients of timely, accurate diagnoses.
Burden of Proof: Zoe’s “notebook of punch words” symbolizes how patients must “perform” sickness to be heard rather than simply believed.

Final Reflections

Dr. Nance and Anna issue a call for providers to recognize and challenge biases in diagnosis and documentation, and to appreciate that clinical complexity is not “psychosomatic” simply because it is poorly understood.
Dr. Nance:

"There are only three orthopedic surgery emergencies. …Cauda Equina Syndrome...This is a red, red, red flag. Do not pass go." [60:02]
Anna closes by emphasizing the need for empathy and inquisitiveness in medicine, not moral judgment:

“When a person comes in and says, ‘I've gained weight’, the first thing a doctor should do is...ask what's happened to cause their previous behavior to change. …That should be the discussion point, not the weight.” [78:12]

If you liked Zoe’s story or have a mystery of your own, The Medical Detectives encourages you to share your experience. This episode is available wherever you get your podcasts, and the conversation is ongoing.

Key Timestamps:

[03:03] Zoe’s medical upbringing
[07:03] Visual aura / migraines explained
[14:30] Neurologist dismisses findings
[16:09] Dr. Nance calls out misdiagnosis
[18:00] GI dismissal (“Just stop eating salads”)
[41:25] Dr. Nance labels provider response as negligence
[49:29] “Punch words” and the notebook
[59:09] Dr. Nance explains cauda equina emergency
[62:20] Post-surgery experience
[75:28] Anna on being punished for honesty

For medical professionals and patients alike, Zoe’s story is a stark reminder: listen, believe, and never judge a patient’s distress—the cost of being wrong can be everything.

The Medical Detectives: Zoe's Story – "24 Hours from Paralysis"

Podcast: The Medical Detectives
Hosts: Dr. Erin Nance (B), Anna O’Brien (C)
Guest: Zoe (A)
Date: September 3, 2025

Episode Overview

Key Discussion Points & Timeline

1. Zoe’s Upbringing and Early Health Experiences

[03:03] Zoe describes growing up as the youngest of five in a “Viking babies don’t cry” household, where stoicism was valued and doctors were avoided:

“Going to the doctor was never really seen as...you just get over it. Out of sight, out of mind.” —Zoe [03:03]
Isolation in early teens triggers depression, anxiety, and self-harm; first migraines also emerge.

2. The Onset of Medical Mysteries

[07:03] Zoe develops chronic migraines with persistent visual aura (never losing peripheral vision but seeing “stars and stuff”).
[07:01] For the first time, a doctor links her migraines with mental health—“If you don't let these feelings out, your body will figure out a way to push it out.”

3. Tingling, Numbness, and A Dismissive System

[09:00-14:00] In 2015, Zoe develops insidious tingling in hands and feet, which worsens. When she begins losing sensation while driving, she seeks medical attention.
PCP suspects MS; neurologist dismisses concerns, floats brain/spinal tumor before running inconclusive tests—EMG and muscle biopsies.

“He was like, we can’t really find what’s causing this, but I think you just need to accept that you have the nerves of a 60 year old diabetic...you just have polyneuropathy. You’re just one of the lucky people.” —Zoe [14:30]

Dr. Nance Interjects:

[16:09] “That term, stocking and glove neuropathy, is used for people who are pretty significantly diabetic who lose the sensation to their fingers and their toes...No, not a 20 something year old. No.”

4. Unexpected and Dismissed GI Symptoms

[17:16] Zoe’s digestion collapses—fibrous foods induce vomiting or diarrhea, and she can’t process salads. A doctor’s advice:

“Well then just stop eating salads.” —Zoe, quoting physician [18:00]
Loss of bowel control becomes an embarrassing, normalized part of life:

“Well, I didn’t shit my pants today, so we're gonna count that as a win.” —Zoe [18:48]

5. Years of Pain, Mobility Issues, and Medical "Girl Math"

[19:26-31:30] Zoe bounces between providers, receiving a degenerative disc disease diagnosis at 32, told nothing can be done. Pain worsens, mobility declines, and heavy drinking becomes a pain management strategy.
Zoe tries interventions—chiropractors, physical therapy, podiatrist—but continues to decline. Providers repeatedly assume issues are psychiatric or due to weight/drinking.

6. Increasing Disability & Systemic Barriers

[33:00-41:00] By 2022, daily life is functionally limited. Zoe describes her shrinking world—choosing between food, showering, or walking the dog; legs fall asleep after mere minutes.
Attempts to advocate in residency clinics fail; care is fragmented, and concerns are consistently dismissed: “They felt that I was just being dramatic or crazy.” [33:54]

7. Red Flags, New Symptoms, Continued Dismissals

[40:07] A chiropractor is first to mention “saddle anesthesia” (numbness in groin area) — a classic emergency sign.
Zoe asks for MRI, is told to lose weight and lessen drinking first. Insurance and provider stonewalling continues.
[41:25] Dr. Nance (heated): “This is just gross negligence from the physicians and providers. I can’t even think—”

8. The Final Days Before Paralysis

[47:00+] Zoe’s symptoms escalate—saddle anesthesia comes and goes; can walk only minutes; unable to urinate normally. Makes a plan to go to ER as soon as she can leave pet-care duties.
[53:45] “...as soon as this house gig is up, I'm gonna go to the ER in Seattle. Something's wrong."
Collapses at home, relies on a friend to get to the ER.

9. The ER Visit: Diagnosis at Last

[55:00] ER nurse quickly recognizes seriousness, finally gives pain medication—a dramatic relief (“I just started bawling because I didn't even know I could ask for it…” [56:13])
MRI performed; immediate surgical emergency declared. Diagnosed with cauda equina syndrome:

“You have had cauda equina syndrome for months, possibly even years. I've never heard of someone having cauda equina syndrome going on that long without someone diagnosing it. It is so ridiculous...” —Dr. Nance [59:09]
Zoe’s surgical findings: herniated disc, compressed spinal cord, thecal sac fused to cord.

10. Emergency Surgery & Aftermath

[61:39] Zoe undergoes surgery; pain is immediately and markedly reduced, though with complications (CSF leak, temporary inability to void bowels/bladder).
[64:31] Dr. Nance: “It’s really upsetting to me because it's in my own field...That was a delay in diagnosis that led to developing true cauda equina. Full blown cauda equina.”

11. Systemic Bias & Gaslighting

Discussion highlights repeated errors: over-focus on mental health history, weight, substance use, and gender bias as obstacles to care.
The team's outrage is palpable.

“I think she’s suggesting that there are money in them hills for this. Ridiculous. Not to be an opportunist, but... you basically couldn't have a life for many years in which you also gaslit yourself.” —Anna [65:04]

12. Looking Forward: Lessons & Recovery

Zoe describes new gratitude for being able to walk, yet ongoing numbness and medical trauma.
Dr. Nance theorizes underlying connective tissue disorder as the possible root:

“...This seems more of a failure of your connective tissue. All of the tissues that are supposed to help keep your body in line...” [68:31]
Zoe's message: with the right vocabulary, support, and team, self-advocacy becomes possible, though trust remains hard to rebuild.

Notable Quotes & Memorable Moments

On gaslighting and internalized doubt:

“You were so gaslighting yourself because you'd been gaslit by others—that your legs are doing, I don't know what dance down below you can't control, and in your mind you go, that's my fault.” —Anna [46:09]

On systemic failure:

“This is just gross negligence from the physicians and providers.” —Dr. Nance [41:25]

On gender and stigma in medicine:

“You should get to fight someone who says [‘it’s your cycle’] to you. Like, I'm sorry, sir. You said the fight words. And then fight club should commence.” —Anna [42:13]

On bringing data, but not being believed:

“I have an entire page of, like, punch words that I thought would get attention...I was like, say these words, someone will listen to you. And they weren’t.” —Zoe [49:29]

On the emotional toll:

“Zoe felt like at times she was punished for being honest with her doctor. And that is, I think, the crux of this lesson.” —Anna [75:28]

Thematic Takeaways

Biases kill: Mental health history, substance use, and obesity led to dismissals and catastrophically delayed care.
Self-Advocacy: Zoe’s experience demonstrates the necessity and burden of relentless self-advocacy, even in the face of repeated dismissal.
Clinical Red Flags Ignored: Classic signs of cauda equina syndrome and progressive neurological deficit went unrecognized for months, nearly costing Zoe her mobility and life.
Systemic Barriers: Populating residency clinics, insurance gatekeeping, and lack of continuity in care deprive vulnerable patients of timely, accurate diagnoses.
Burden of Proof: Zoe’s “notebook of punch words” symbolizes how patients must “perform” sickness to be heard rather than simply believed.

Final Reflections

Dr. Nance and Anna issue a call for providers to recognize and challenge biases in diagnosis and documentation, and to appreciate that clinical complexity is not “psychosomatic” simply because it is poorly understood.
Dr. Nance:

"There are only three orthopedic surgery emergencies. …Cauda Equina Syndrome...This is a red, red, red flag. Do not pass go." [60:02]
Anna closes by emphasizing the need for empathy and inquisitiveness in medicine, not moral judgment:

“When a person comes in and says, ‘I've gained weight’, the first thing a doctor should do is...ask what's happened to cause their previous behavior to change. …That should be the discussion point, not the weight.” [78:12]

If you liked Zoe’s story or have a mystery of your own, The Medical Detectives encourages you to share your experience. This episode is available wherever you get your podcasts, and the conversation is ongoing.

Key Timestamps:

[03:03] Zoe’s medical upbringing
[07:03] Visual aura / migraines explained
[14:30] Neurologist dismisses findings
[16:09] Dr. Nance calls out misdiagnosis
[18:00] GI dismissal (“Just stop eating salads”)
[41:25] Dr. Nance labels provider response as negligence
[49:29] “Punch words” and the notebook
[59:09] Dr. Nance explains cauda equina emergency
[62:20] Post-surgery experience
[75:28] Anna on being punished for honesty

For medical professionals and patients alike, Zoe’s story is a stark reminder: listen, believe, and never judge a patient’s distress—the cost of being wrong can be everything.

Zoe's Story: 24 Hours from Paralysis

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Summary

The Medical Detectives: Zoe's Story – "24 Hours from Paralysis"

Episode Overview

Key Discussion Points & Timeline

1. Zoe’s Upbringing and Early Health Experiences

2. The Onset of Medical Mysteries

3. Tingling, Numbness, and A Dismissive System

Dr. Nance Interjects:

4. Unexpected and Dismissed GI Symptoms

5. Years of Pain, Mobility Issues, and Medical "Girl Math"

6. Increasing Disability & Systemic Barriers

7. Red Flags, New Symptoms, Continued Dismissals

8. The Final Days Before Paralysis

9. The ER Visit: Diagnosis at Last

10. Emergency Surgery & Aftermath

11. Systemic Bias & Gaslighting

12. Looking Forward: Lessons & Recovery

Notable Quotes & Memorable Moments

Thematic Takeaways

Final Reflections

If you liked Zoe’s story or have a mystery of your own, The Medical Detectives encourages you to share your experience. This episode is available wherever you get your podcasts, and the conversation is ongoing.

Summary

The Medical Detectives: Zoe's Story – "24 Hours from Paralysis"

Episode Overview

Key Discussion Points & Timeline

1. Zoe’s Upbringing and Early Health Experiences

2. The Onset of Medical Mysteries

3. Tingling, Numbness, and A Dismissive System

Dr. Nance Interjects:

4. Unexpected and Dismissed GI Symptoms

5. Years of Pain, Mobility Issues, and Medical "Girl Math"

6. Increasing Disability & Systemic Barriers

7. Red Flags, New Symptoms, Continued Dismissals

8. The Final Days Before Paralysis

9. The ER Visit: Diagnosis at Last

10. Emergency Surgery & Aftermath

11. Systemic Bias & Gaslighting

12. Looking Forward: Lessons & Recovery

Notable Quotes & Memorable Moments

Thematic Takeaways

Final Reflections

If you liked Zoe’s story or have a mystery of your own, The Medical Detectives encourages you to share your experience. This episode is available wherever you get your podcasts, and the conversation is ongoing.