April 2026 - Vol. 23, Issue 2

Patients with undiagnosed illnesses will encounter various species of doctors in their typical healthcare habitats. This guide details the behavior, physical characteristics, and range of visits expected for these species when attempting to find an answer for an undiagnosed illness of a neurological nature. Such serious illnesses present with symptoms like seizures, headaches, aphasia, and extreme fatigue.

Emergency Room Doctor

Range: Multiple visits in the span of two weeks.

Physical Characteristics: Emergency room doctor does not rush into patient’s room or show great concern for a puzzling array of symptoms like TV show emergency room doctor (see entry for TV

show emergency room doctor, rarely seen in the real-world habitat). Instead, ER doctor keeps patient waiting for several hours, then saunters in while speed-reading chart. ER doctor leaves after quick 5-minute “exam.”

Behavior: Upon meeting ER doctor, patient will describe sudden onset of tremors, headaches, slurred speech, and other symptoms. If patient describes a history of depression or feeling that she is going to die, ER doctor will immediately jump to the conclusion that, because patient is female, all of her

symptoms are linked to depression or anxiety. Will quickly prescribe anti-anxiety medication or antidepressant. Will only order MRI or CT scan if patient’s male partner (who claims to be a doctor but is really just an optometrist) describes what he thinks the problem is. ER doctor will then order MRI, which will show no brain abnormalities, confirming their assumption that the cause of symptoms must be anxiety/depression.

Primary Care Doctor

Range: Will stay with patient until doctor changes jobs.

Physical Characteristics: Often wears a white lab coat over business attire. Sports a stethoscope hanging with reassurance around her neck. Vocalizations indicate let’s figure this thing out attitude.

Behavior: Primary care doctor will exhibit concern for patient’s neurological symptoms, take her seriously, and refer her to a neurologist. Primary care doctor will run labs, thoroughly ask about symptoms, and offer possible diagnoses. Will believe patient and not assume that problem is mood-related. Throughout multi-year relationship with patient, will send referrals to initial neurologist, sleep medicine doctor, endocrinologist, neuropsychologist, another neurologist, and another, and another.

Warning: Some primary care doctors lack the capacity to empathize with patients. When such primary

care doctor is sighted in primary care habitat, look for signs that this doctor is really a neurologist in

disguise.

Neurologist

Range: One worthless visit per neurologist, spanning eight years.

Physical characteristics: Neurologist will appear like any other doctor: white lab coat, stethoscope, brisk walk into the examination room, glancing up at patient sparingly while typing notes into the medical record. This typical appearance may mask an inability to relate to patient on a human level. Often exhibits cold demeanor and lack of bedside manner. Neurologist comes in various sizes, but will appear to loom over patient with their authority.

Behavior: Will ask questions about symptoms and cut patient off if elaborates or adds explanations not related to questions. Will expect answers to fit typical diagnostic presentation. Will scoff at atypical presentations and emit vocalizations that symptoms are “psychological” or “nonexistent.” Will shrug their shoulders at lack of medical diagnosis and refer patient back to primary care doctor. 

Note: Vocalizations of “psychological” become more pronounced if patient is female. When new neurologist finds out that patient’s boyfriend dumped her in the middle of undiagnosed illness, will assume that the break-up caused all symptoms.

Sleep Medicine Doctor

Range: Multiple visits over several years.

Physical characteristics: White lab coat, no stethoscope. Will limit vocalizations and instead listen to patient’s vocalizations.

Behavior: Will suggest sleep study to explore patient’s extreme fatigue, then diagnose patient with sleep apnea. Will agree that persistent seizures are part of undiagnosed illness. When hears of patient’s “strange smells,” will suggest new MRI, due to the possibility that these phantom smells are a type of seizure. MRI will reveal cavernomas, blood vessel malformations in the brain that bled and caused symptoms ignored by 13 neurologists.

Neurosurgeon

Range: Once a year.

Physical characteristics: Neurosurgeon appears like neurologist, yet will take patient seriously when sees MRI showing brain cavernomas. Patient will wonder if this is only because imaging evidence for symptoms exists.

Behavior: When asked why emergency room MRI showed no evidence of cavernomas, neurosurgeon will explain that older MRIs used different sequences and these malformations would not appear on an MRI from eight years ago. Neurosurgeon will explain that cavernomas can bleed slowly and cause

neurological symptoms. Patient will think WTF?!? while reliving each neurologist’s incorrect diagnosis of the psychological nature of her symptoms. Neurosurgeon will not recommend risky brain surgery. Patient will realize that this means that, although the eight-year saga to find a diagnosis has ended, she must live with her symptoms. She will not have a dramatic movie ending that shows her frolicking on the beach, hiking in the forest, or dancing the night away.