The night an OB/GYN diagnosed a rare neurological condition—and proved that gut instinct matters
Every doctor has at least one case that replays in their mind—the one that arrives at 3 am when your brain is running on cafeteria coffee and autopilot, and still you manage to pull off something extraordinary.
In a recent TikTok video, board-certified OB/GYN Fatima Daoud, MD, FACOG, shares hers: the night she diagnosed cauda equina syndrome in a trauma patient in her third trimester of pregnancy.
The case that started like any other trauma admission
Dr. Daoud was a resident on nights when a pregnant patient arrived after a motor-vehicle collision. Third trimester, direct abdominal trauma—the kind of case that instantly activates your mental checklist: fetal monitoring, labs, looking for abruption, ruling out labor, serial exams.
She moved through the admission, wrapping things up before realizing she’d forgotten one routine but essential piece: the cervical exam. The patient wasn't contracting on the monitor, but Dr. Daoud still headed back in.
As soon as Dr. Daoud started the exam, the patient said she didn't feel anything.
That’s the moment Dr. Daoud’s instinct kicked in. She started checking sensation in the perineum, and the patient repeatedly responded: “I can’t feel that you’re checking me.” So Dr. Daoud immediately called neuro.
"I have a patient, and I think she has cauda equina syndrome. And they're like, 'What are you talking about?' … I tell them the whole story, and I could tell that I was on speaker because I could hear people listening in the background … The second I said 'cauda equina syndrome,' the guy in the background was like, 'UGH.' I guess they get a lot of consults for things [people think] are cauda equina that are not cauda equina syndrome," Dr. Daoud recalled.
But she stuck to her guns and insisted that because her patient was in a car accident and had saddle anesthesia, it was a real possibility. Neuro agreed to assess the patient.
"I’m going back to my desk, and I'm feeling really insecure about myself. And I was like, 'Wait, what if I was wrong?' … When I tell you that this lady was on their operating room table within the hour, it went from … consult to on the operating room table within an hour," she said.
[I] successfully diagnosed cauda equina syndrome. And the only reason I knew what it was was because it had a cool name in medical school. I never forgot it.
—Fatima Daoud, MD, FACOG
Condition refresher: Cauda equina syndrome
Cauda equina syndrome is a serious medical condition that happens when the cauda equina nerves become compressed or damaged. This compression disrupts the normal nerve signaling and can lead to severe symptoms, including back pain, weakness, sensory loss, and problems with bladder or bowel function.[]
It's considered a surgical emergency because timely intervention often determines long-term outcomes. []
Cauda equina syndrome is rare. Estimates suggest about 1–3 cases per 100,000 people per year. [] Adults are most often affected, especially middle-aged individuals (40–60 years), mainly due to disc problems. []Trauma-related CES can occur at any age but is still rare overall. []
People with the following may be at higher risk: a history of lumbar spine problems; previous spine surgery; infections, tumors, or inflammatory spine conditions. [][]
Your takeaway
Dr. Daoud's story isn't just of a nice memory from her training—it's a case study in the power of listening, examining, and not dismissing clues that don’t fit the box you’re working in.
The best diagnoses aren’t always made when you're at the top of your game, fresh from a good night's sleep—they can happen in the bleary hours when a patient says something easy to dismiss but you still decide to follow the thread.
Dr. Daoud joked that she’ll never reach “Dr. House” levels again. But the real takeaway is less about brilliance and more about presence—showing up, paying attention, and following the details through, even in the middle of the night.
Related: Patients suffer when these rare neurological conditions are misdiagnosed