He claims to have had increasing difficulty driving his lorry recently, and says the task has now become impossible. Weakness in his right leg, which was affected by polio in childhood, is stopping him from operating the pedals, although this has never been a problem before.
Examination reveals profound weakness and wasting of the calf musculature.
Despite considerable scepticism, the GP issues a sick note. A flurry of letters follow from the patient's insurers, all asking why he has only just developed this problem when the polio attack occurred 30 years ago. It is only after recourse to the literature that the question can be answered. The patient is suffering from postpolio syndrome. The weakness and muscle pain they endured as children revisits them after 30-40 years of stability, only this time in a more chronic, insidious and deceptive fashion.