In 2025 I put the white coat aside and went round the clinics as an ordinary patient. What I learned in that year was not about headaches. It was about the distance between what a doctor sees and what a patient feels — a distance I had spent years on one side of without noticing. This is about when a doctor becomes a patient.
In Summary
- A doctor assesses using pain reports, test results, range of motion — a range of circumstances and data. They are looking at the whole forest of a long treatment course.
- A patient does not experience pain as data. They are the one undergoing it, and the centre of their world is the pain itself.
- So a doctor can say “this is going well” while the patient hears something that does not match their morning.
- I am about 80 percent through my own treatment course. Objectively that is substantial improvement.
- But the area that remains hurts at much the same intensity — so what I feel is impatience about the twenty rather than gratitude for the eighty.
- Doctors need to understand the patient’s difficulty more deeply. Someone in continuing pain is unwell in mind as well as body, and perfectly rational judgement should not be expected of them.
- Patients need to find the clinician who fits them. Not every doctor suits every person, and rapport is not a luxury — it is what lets a patient set the anxiety down.
- Diagnoses differed between the places I went. That is not a reason to give up; it means the right key has not been found yet.
- Constitutional diet is not a formula either. Environment, current health and habits all change what the same constitution should eat.
The Doctor Sees the Forest, the Patient Is Stuck at a Tree
Doctors try to maintain a reasonably fair and objective view. They analyse the intensity and character of the pain a patient reports, test results, range of motion — a range of circumstances and data taken together.
So even where the patient’s suffering has not much decreased, if the other objective markers are improving, the doctor can reasonably conclude that treatment is progressing. The doctor is looking at the whole forest of a long journey.
The patient is somewhere else entirely. A patient does not feel pain as data; they undergo it with their whole body. The centre of their world is their own pain. If today hurts even 0.1 more than yesterday, it can feel as though everything is collapsing, and the anxiety that last night’s sleepless pain might return is its own affliction.
However kindly a doctor shows the chart and says look here, you are clearly improving, the patient agrees in the moment. Then they walk out of the consulting room, the ache returns, and every explanation fades against the subjective reality of I am still in pain.
What I Could Only See From the Other Side
I began treatment for headaches from neuralgia and sympathetic overactivity. The uncomfortable area has narrowed considerably from where it started, and I would say I am about 80 percent through the whole course.
Objectively, that is a remarkable improvement. Had I been the clinician looking at a patient in this state, I would have said with confidence: you have got a great deal better.
But as the patient, I do not experience it that way. The area may have shrunk, and yet the pain in what remains feels about as strong as it did. That, I think, is the largest gap between what a patient feels and what a doctor sees. Rather than gratitude that 80 percent has healed, there is impatience and regret about why it has not all healed. People are, unavoidably, creatures of appetite.
Going Round the Clinics
Until 2025 I had a strong conviction that I would fix my own illness. As a KTM physician I was accustomed to diagnosing and treating myself.
My headaches had improved considerably from their worst in 2022 and 2023, but through 2024 they stalled with no real change. Self-treatment, self-management and exercise had run into a wall. And headache being what it is, ordinary hospital investigations struggled to produce a clear answer.
The diagnosis differed slightly at each place I went. What the trustworthy ones had in common was reading it as headache from cervical nerve involvement rather than a disc problem. I found one that suited me and had acupuncture and manual treatment consistently for about eight months. It helped a great deal.
Then a heavy second semester overlapped, I could not keep up the treatment, things worsened, and another plateau arrived. Now I am trying another approach. I ordered a decoction I have never taken before, today.
There were stretches hard enough that the thought it might be faster to be born again crossed my mind, not entirely as a joke. But passing through that long tunnel as a patient rather than a physician taught me things.
Three Things I Want to Say
To patients
There are many correct answers in the world, and many kinds of clinician. The famous place may not suit you; an unexpectedly small one may be where the thread comes loose.
I know as well as anyone the frustration of different diagnoses and slow progress. But please do not give up. If your current treatment has hit a limit, that does not mean treatment is impossible. It means the key that fits you has not been found yet, and finding it takes persistence.
I want to be careful here: differing diagnoses are not evidence that medicine is arbitrary. Complex problems genuinely look different from different angles, and the working diagnosis narrows as evidence accumulates. Keep going through the process rather than around it.
To those who arrived searching for constitutional diet
As with my own treatment, there is no single correct answer in constitutional eating either.
As I have written elsewhere on this site, mechanically dividing foods into harmful and beneficial is not the answer. Even within the same constitution, the diet should change according to the person’s environment, their current state of health, and their habits.
Constitutional diet is not a mathematical formula. It is a flexible process of coming to know your own body.
To junior colleagues
Clinical practice contains a great many treatment methods, and every one of them can be the right answer for a different patient. Health and treatment are not multiple-choice questions with one answer; they are written questions admitting many combinations.
You cannot be excellent at every method, and there is no need to be. Sharpen the one you genuinely do well and enjoy as your main instrument. Then accumulate secondary ones, one at a time, for the situations your main instrument does not resolve.
It is the clinician with flexible thinking who can open a patient’s closed door.
What Both Sides Owe Each Other
First, doctors must understand the patient’s difficulty more deeply.
A patient in continuing pain, or one who has been through a serious accident, is unwell in mind as well as body. Perfectly rational, normal judgement should not be expected of such a person. Rather than the data has improved, so you are fine, what is needed is warmth: it is hard, still being in pain — but look how far we have come, let us push on a little more.
It is worth remembering that coming to see a doctor is not easy in itself, and that during the consultation the patient is often working to appear more well than they are.
Second, patients need to meet the clinician who is right for them.
Not every doctor suits every person. What matters is finding one who listens properly, understands your anxiety, and at the same time explains the treatment course persuasively enough to create belief. When that positive relationship of trust — rapport — is established, the patient can believe what they are told, set the anxiety down, and concentrate on getting better.
I believe there is, for everyone, a clinician who will be the right one for them.
Summary
My own 2026 is still in the middle of looking for an answer. That is an odd thing for a professor of pathology to write, and it is also the most useful thing I know.
May your own health journey hold hope without giving up.
Related: Cold Hands in Pancreotonia
