Three out of every ten patients who walk into hospitals are told their tests are normal while they continue to suffer. That sentence alone should make us pause. This essay is about those people. It is about symptoms that feel undeniable when machines say otherwise. It is about the brain, the nervous system, the doctor–patient relationship, and the old wisdom that still has a place in modern care.

When normal tests do not mean normal health

You know something is wrong. The scans are clean. The blood work is perfect. You go home with advice to reduce stress. Doubt creeps in. Am I imagining this. This is not a fringe experience. It is common, costly, and emotionally draining.
I met Mrs A with a cluster of unexplained problems. A relentless appetite. Bowels that set the schedule for her day. Pain and fatigue. Weight gain. Many consultations later she still had no answer. Her story mirrors thousands. Appetite that swings, bowel habits that dominate social life, exhaustion that ages you before time. Endless tests. No clarity. The emotional toll is predictable. Isolation. Hopelessness. A willingness to try anything because nothing seems to help.
If unexplained symptoms were a country, it would be one of the most populated on earth. The issue is not difficult patients. The issue is a system that often struggles to interpret what it cannot easily measure.

Why this rift occurs

Patients feel unheard. Clinicians feel pressed for time and powerless. Labels such as neurotic or drug seeking appear. Advice becomes generic. Trust erodes on both sides. Healing stalls.

This is not a new problem. Historic reviews from leading neurology centers showed high rates of misdiagnosis when symptoms were dismissed as “hysteria.” Later studies with better technology still found that a significant minority had organic causes that were missed. The lesson is humility. What we cannot explain today may be clear tomorrow. Your symptoms are real even when our tools are not yet sensitive enough.

What sits beneath “unexplained”

There are several possibilities.

  1. A physical process we have not detected yet
     Early disease. Rare disorders. Technology lagging behind clinical reality. Autoimmune conditions that first appear as psychiatric or cognitive problems are one example we see often in neuropsychiatry.

     

  2. Conversion and somatization
     Psychological conflict can express itself through the body. Repressed emotion may translate into voice loss, pain, weakness, or sensory change. The suffering is real. The route is different.

     

  3. Health related anxiety and abnormal illness behavior
     Fear fuels bodily vigilance. Worry cycles amplify symptoms and medical seeking.

     

  4. Factitious presentations
     A complex, usually unconscious need for the patient role. Rare, but important to recognise compassionately.

     

  5. Malingering
     Conscious exaggeration for gain. Uncommon, yet necessary to rule out.

     

  6. Functional Neurological Disorder
     Hardware normal. Software misfiring. Real neurological symptoms without structural damage. Weakness, nonepileptic attacks, tremor, speech problems, sensory loss. FND is common in neurology clinics and now recognised in ICD-11. Awareness opens doors to treatment rather than dismissal.

The autonomic piece: the vagus nerve

Many with functional symptoms also have dysautonomia. The autonomic nervous system runs the heart, gut, sweat glands, and much more. When it falters you see fatigue, palpitations, gut trouble, dizziness, sweating. The vagus nerve is the master regulator. When it is out of tune, many systems sound off-key.

Long COVID brought this to public attention. Viral inflammation can involve the vagus nerve and produce a wide spread of symptoms. Simple bedside tests such as lying to standing pulse and blood pressure changes can identify patterns like postural tachycardia or orthostatic hypotension.
The good news. The vagus nerve can be retrained.

Resetting the system: noninvasive vagus nerve stimulation

Transcutaneous auricular vagus nerve stimulation delivers gentle impulses through the ear. No surgery. Outpatient use. Evidence is growing. In practice we see improvements in autonomic balance, stress physiology, mood regulation, heart rate variability, and inflammatory tone. Sessions last about 20 to 30 minutes. Most people need several weeks to a few months. TAVNS can sit alongside medication, psychotherapy, nutrition, and mind–body work.

How integration helps

At Buddhi Clinic and Neurokrish we use a comprehensive model.
  • Modern medicine for diagnosis and disease control

  • Advanced neurological assessment for dysautonomia

  • Brain stimulation including TAVNS and other modalities for selected indications

  • Psychological care such as CBT, trauma-informed work, stress skills

  • Nutrition with an anti-inflammatory focus and gut–brain support

  • Traditional practices such as yoga, Ayurveda, and naturopathy for regulation and recovery

  • Rehabilitation for speech, occupation, and social function
The aim is simple. Reduce suffering. Improve function. Restore participation.

Mrs A’s outcome

We identified autonomic dysregulation and significant health related anxiety. We treated the physiology and the psychology. Medication stabilised autonomic tone. CBT addressed worry loops. Nutrition steadied energy and appetite. TAVNS, yoga, and allied therapies supported regulation. Eight weeks later she ate normal portions, travelled without fear of her bowels dictating the day, and felt like herself again. Her words mattered most. For the first time in years, I felt heard and there was a plan.

Tools are vital. Relationship is decisive.

Hans Berger, who recorded brainwaves for the first time, reminded us that a machine cannot replace common sense or intelligence. It also cannot replace time, attention, and trust. Pattern recognition and experience still matter. Good medicine listens. It connects dots across biology, psychology, family and culture. It asks how you are living, not only what your scan shows.

Hope for the unexplained

  • Your symptoms are valid.

  • Science is catching up through the recognition of functional disorders and the study of network dysfunction.

  • New tools such as noninvasive vagus nerve stimulation add options.

  • Integrative care offers multiple paths to recovery with quality of life as the outcome that counts.

Please remember. You are not alone. Effective treatments exist. Hope is realistic.

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