When They Can't See It, They Don't Believe It
Article breakdown: Why invisible symptoms are often dismissed in healthcare - and what you can do about it.
The Article
“Invisible Illness and Measurability in Modern Medicine”
Published in the AMA Journal of Ethics, this piece explores how modern healthcare often privileges measurable data — labs, imaging, and test results — over a patient’s lived experience.
AMA J Ethics. 2021;23(7):E512-513. doi: 10.1001/amajethics.2021.512.
Conclusion:
“When a patient’s pain can’t be proven, it’s often invalidated.”
This disproportionately affects people living with conditions like ME/CFS, fibromyalgia, multiple sclerosis, endometriosis, and long COVID — illnesses where symptoms may not always show up on tests. Too often, patients are told it’s “all in their head.”
Key Highlights
“Patients with hard-to-recognize symptoms frequently receive insufficient, inequitable support.”
Disbelief or dismissal from clinicians leaves patients feeling misunderstood, isolated, and sometimes blamed.
When doctors can’t see or measure symptoms, frustration can shift onto the patient, who is labeled as “difficult” or psychosomatic.
Why This Matters
The article shares the story of a woman who appeared healthy, endured years of doubt and dismissal, and was ultimately diagnosed with lupus.
This isn’t rare — it’s a pattern. And it comes with real consequences:
Disease progression and permanent damage that limit treatment options.
More severe symptoms and complications that might have been prevented.
Reduced quality of life, including limitations in work, relationships, and daily functioning.
Financial strain from missed work and higher healthcare costs.
Delays in diagnosis don’t just postpone treatment — they can fundamentally alter a person’s prognosis, independence, and emotional wellbeing, sometimes for life.
A Thought from Me
I didn’t understand this kind of dismissal until I lived it.
My symptoms didn’t show up “on paper.”
But I felt them — deeply, daily, undeniably.
This article offers hope. Written by Jennifer Dobson, MD, it shows that there are physicians who see this problem and want to change it. Change is slow and progress isn’t linear — but the louder our collective voices, patients together with these clinicians, the more we can push the system toward real empathy and reform.
Takeaway Tips
If your symptoms are invisible — but real:
Document everything — your patterns matter, even if they aren’t yet recognized.
Keep advocating — invisible does not mean imaginary.
Seek providers who listen — not just those who only test.
Validate yourself — especially when the system doesn’t. Your symptoms matter because you say they do.
Final Words
Trust yourself and what you feel. Ignore dismissive voices.
And keep advocating — until you are impossible to ignore.