‘Dissent’ would be the wrong word for eg patient saying ‘No, I haven’t got those symptoms. The symptoms I have are not like that at all’ This is clarification Can be clarification urgently needed but is still clarification And too often captured as dissent

Applies to pain and its nature also and what its nature in no way like But both pain and symptoms overall are happening to the patient

‘Over 20 years of medicine, I learned to listen and trust the patient. For years I have trusted that they know their body best’ As per previous posts my experience is healthcare can be at its very best where ‘trust the experts’ and ‘you know your own body’ (are allowed to) meet

On balance would say the second can be the worst But the first is its own kind of hell and it’s a terrible combination

This was not my experience at all of my care at time which tended to be mixture of clinicians re-explaining what they meant even where understood it first time and telling me what I meant to say when it was not what I meant to say I have come across opposite since but not then

Please remember when you don’t believe a patient you are not doing nothing You are very much doing something Am not talking about eg questioning stated no of alcohol units per week Am talking about eg not believing actual symptoms, nature of patient’s normal, and not normal

'we can only see what we think is possible...' Indeed And this can put patients at a disadvantage more than it does clinicians The patient can have the symptom before clinicians see it, before clinicians believe it, and before the right test done to reveal it

Tickbox systems, particularly in isolation, can have a lot to answer for Can be worth asking/remembering: What are they for? Who are they 'protecting'?

Know have said it many times but not just NHS In eg an environment taught to be overly defensive tick box can be just as prevalent, and just as meaningless in terms of actual symptoms or context, in private care

And I stay emphatic about this because otherwise it risks being treated as if issue is either confined to NHS or to do with finances Patients not being believed, even about what usual for them and what really isn't, isn't to do with finances or 'the technology'

As patient would agree Covid and the pandemic have not brought this about, but rather that they have shone light on it As always, not all clinicians, and not all care As always in these instances, not a matter of sector

And sometimes think that as much as issue of thinking laterally can be simpler matter of how seriously 'the patient' is permitted to be taken 'Clueless patient' syndrome can be deeply embedded I imagine it to feature, even if indirectly, in some of ways in which medicine taught

I wasn't trying to be a clinician But I was trying to ensure didn't need to spend yet another appt saying "I mean tooth. I mean more teeth. I mean necrotic. I mean changed blood supply I don't mean grief, atypical facial pain, sinuses, headache, jaw, burning mouth syndrome"

They were my symptoms It seemed impossible I be left to describe them, or to describe what was usual for me and what really wasn't Even as worsened, which wasn't believed or heeded then either I know am broken record about it but it was not at just one appt or one clinician

And am equally a broken record on how completely traumatic it can become (and I mean traumatic) once you are simultaneously worsening and not being believed about symptoms to have to start over with a new clinician Not to mention those in depts nothing to do with your symptoms

Equally broken record about fact it not being just 1 appt or 1 clinician does not make it (therefore) better/more understandable It made it much worse Patient passed on Patient not believed passed on For symptoms patient doesn't have Patient not passed forwards just passed on

The thing about ‘stumped’ and ‘mystery’ is they can operate as if the live patient who is more than able to describe symptoms is not present And ‘mystery’ can be shorthand ‘psychosomatic’

Patients can't 'fit' symptoms to what clinicians are most comfortable with the symptoms being (and which they are definitely not) This is not their job If patients have a job it can be to try as best they can to describe and convey the symptoms they are experiencing

The tooth then more teeth, as have posted many times, had by this stage gone from increasing stages of pain to increasing stages of lost sensation Eventually I could put ice cubes against them and feel nothing at all

As per so many posts also, the loss of sensation was even more scary than the preceding pain But nothing was as scary as to have these symptoms and not be believed about them (pain suppressants, CBT and night-guards were none of them belief, or 'hearing')