'You're the eighth rheumatologist that I've seen,' the patient told me. She ticked off her symptoms'pain, fatigue, and what she described as a sense of brain fog'which she'd lived with for years. Some doctors had no answers for her; others had said that she likely had fibromyalgia, a poorly understood pain-processing condition, and that they could do little to help. She began to cry, and I began to sweat. My medical training had prepared me for seemingly everything'diagnosing heart attacks, treating life-threatening infections'but not for this kind of problem. I knew the technical definition of fibromyalgia, but my confidence in making the diagnosis correctly was exceedingly low: The disease can cause the symptoms my patient described but cannot be proven by lab or imaging studies. And even if fibromyalgia was the cause of her suffering, I had few concrete solutions to offer her. Modern medicine is excellent at delivering treatments that precisely target the biological cause of a...
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