Please, could you turn off the air conditioning?” an elderly gentleman requested in Urdu, as he gingerly sat on the chair in front of me, his wife helping him make the final adjustments. I instantly obliged by switching it off and he acknowledged the act by placing his hand on his heart and nodding his head. He was in his 60s and adorned a white kurta. His eyes looked troubled and were brooding with grief that I wanted to know the source of. “I have an intense pain over the left side of my face,” he mumbled, keeping his mouth half closed. “If he opens his mouth more than this, he gets an electric shock down his jaw, sometimes his nose, and even his forehead,” his wife explained.

A few medical students interested in neurosurgery were sitting in my office, and I asked them to pay close attention to the patient’s history, as I had already made my diagnosis. “He can’t touch the left side of his face,” his wife continued. “He can touch his right forehead, can rub his right eye, dig his right nostril, but nothing on the left,” she narrated as her husband performed all these actions. It was like watching an elderly couple play dumb charades. “He hasn’t washed the left side of his face in a while,” she concluded. “I haven’t shaved in months,” he added, pointing to his long glistening silvery beard.