That subtle dismissiveness left me feeling ashamed, and thus I was more likely to wait until I knew I had no choice. We do that, when the symptoms are vague and the lab results and imaging studies are normal, we believe the patient must have some other motivation, some secondary gain or emotional need that is placated by medical attention. It’s an uncomfortable position as a physician: to believe a patient wants to be sick when they are not. It’s difficult for us to conceive of desiring sickness when surrounded by so many patients desperate for a cure.
