I think my opinion on this matter is well-known.

But, quite a few discussions I had with my neurologist about this made me (and I think also him) see it in a somewhat different way.

This is one example:

A patient with stroke requires treatment with thrombolysis-an agent that can (at least to some extent) dissolve the clot. This has to be given within a very short window of 4 or at the most 6 hours. This treatment is not without risk as it can cause intracranial bleeding.
My neuorlogist told me about a patient he saw which was given thrombolysis because she presented with one sided paralysis, she developed a serious complication of this treatment, but repeat CT scans did not show a stroke.

The argument between me and him is that he thinks it was non-organic (what ever that means) and I think it was not vascular, but could have been caused by a metabolic abnormality or another process he can not assess or see.

But, we both agree that it was a mistake to give thrombolysis to this patient.

Cardiologist who have to make similar decisions do not have this problem. Even if the ECG is non-diagnostic (which is relatively rare) they can do a coronary angiography.

Neither do hematologists, who can look at the blood smear under the microscope or if this is not informative enough, they can quite easily obtain a bone marrow sample.

About half of the patients an average neurologist sees present with symptoms he/she can't confirm with any test available to them. Yet, they have to make management decisions, just like other physicians.

Modern medicine is very unforgiving to mistakes. Neurologists are expected by themselves and society to reach an accurate diagnosis and give proper treatment just like any other field. Yet, they don't have similar tools, at least not yet.

Such unrealistic expectations lead to mutual frustration. Frustration leads to anger and even hostility. Giving a "diagnosis" solves this very well for the physician...

But, I think what my neurologist realized from discussions with me is the price of this convenient solution for the patient and also the long-term price his field pays by not recognizing and learning more about possible environmental toxins and other causes of not yet described diseases.

The problem is that most neurologists I have met are not ready for such a sincere dialogue with "patients",( mostly patients who dare to not fit their book !), and trying to create such a dialogue with them leads to a very hostile reaction.

Many neurologists who treated me with such disrespect, also told me that I have to understand that their field of practice is not as accurate as mine. I refused to understand their inferiority complex as justifying hostility and disrespect towards me. Nor did I think it justified their repeatedly endangering my life and well-being.

My neurologist does not have such an inferiority complex regarding his field of practice. On the contrary he is very proud of his profession and through his eyes I can see the beauty of neurology.

That is why, he is not intimidated by my criticism and sees it as constructive. That is why we can learn from each other.

But, unfortunately, most neurologists (at least those I had the "pleasure" to encounter) are not like him-they use ill defined made-up seemingly psychiatric diagnoses to cover their own ignorance and the lack of knowledge and understanding of their entire field. They treat with hostility patients who refuse to accept those ridiculous and non-substantiated explanations for their disabling and even life endangering symptoms. They expect their patients (whom they don't trust) to fully trust them. In my opinion they do not deserve the respect of their patients nor their colleagues in other fields.

There is no doubt in my mind, that honestly admitting the true virtues and limitations of their field to themselves, their colleagues and their patients (as my neurologist does) would have made them earn the true respect of their patients and colleagues and enabled them to help many more people even if they do not yet fully understand the mechanism of their illness. I am sure it would have also led to much more research and better understanding of those diseases they currently lump under "unexplained" (as if it were an explanation) instead of condemning them and the patients suffering from them to remain unexplained forever.