Your Tests Are Normal. Your Life Isn’t.

For millions of patients in the U.S., managing to even get a doctor’s appointment isn’t the hardest part of healthcare. It’s what happens next: the medical limbo that follows when nothing shows up on standard imaging or labs. Common chronic conditions—from fibromyalgia and chronic fatigue syndrome (ME/CFS) to Long Lyme and Long COVID—are invisible, complex, and often misunderstood. Conditions like arthritis and endometriosis, though well known by name, can follow a similar path: years of symptoms that evade what conventional tests can detect.

When scans or labs don’t explain symptoms, delays in diagnosis and care can begin. Many patients are told everything looks normal, while their lives are anything but. Because their conditions lack clear biomarkers, they are likely to be minimized, disbelieved, or dismissed altogether. Although doctors are trained to listen and look beyond test results, that is not what many patients experience.

Despite leaps forward in medical science, bias from the past can hold doctors back. When visible evidence is absent, they may question and even stigmatize patients’ lived experience. And when “normal” tests are misinterpreted as evidence that nothing is wrong, patients are burdened with proving their pain and other symptoms before they can be treated. They’re caught in a systemic blind spot—one that interferes with medicine’s capacity to recognize and treat pain and other symptoms that are difficult to measure.

When symptoms are dismissed, people get sicker.

Medicine still prioritizes what can be measured over patient-reported symptoms. Yet many painful conditions not readily detected are now linked to nociplastic pain—driven by altered processing in the brain rather than tissue damage. The problem: this science has not been fully integrated into clinical practice. It exposes a consequential disconnect between patients’ lived experience and the long, uncertain path to diagnosis—let alone effective care. This is what happens when doctors treat lab results instead of the patient in front of them.

Marginalized without clear answers and sometimes told “it’s all in your head,” patients can spend years in diagnostic limbo. Fibromyalgia alone takes more than six years on average to diagnose, and patients with ME/CFS and Long COVID also face delays linked to worse outcomes. As patients wait for care and cycle through providers seeking someone to take them seriously, their symptoms become more entrenched. Altogether, this reality raises the stakes of doctors getting it right sooner.

There are signs of progress at the federal level, but it has yet to reach everyday care. A recent NAS report called for closing research gaps for conditions such as ME/CFS and Long COVID, and FDA guidance supports streamlined development pathways for non-opioid pain therapies. While these are important steps, they have not yet changed what patients encounter in exam rooms. The costs extend beyond health, robbing people of their most important life roles.

The answers begin with believing patients.

To close the diagnosis-treatment divide, medical education, clinical practice, and policy must catch up with current pain science. Diagnostic frameworks already recognize symptom patterns, but this must be consistently reflected in practice. Patients’ voices must be heard over test results so they can receive timely diagnoses and access to effective, FDA-approved treatments.

Federal research priorities should continue expanding to focus on conditions without clear biomarkers. The NIH HEAL Initiative could deepen understanding of complex, invisible symptoms and ARPA-H is well positioned to accelerate next-generation treatments for chronic pain. The Centers for Medicare & Medicaid Services also has a role to play by ensuring access to safe, nonaddictive treatment options.

It’s time for patients to have a seat at the table. Science has finally bridged the gap between their suffering and the care they receive. The opportunity is within reach: a future where patients are met with belief instead of bias, diagnosis instead of delay, and care that helps them get better. Done right, it will change the lives of millions.

About the Author

Seth Lederman is co-founder, CEO and chairman of Tonix Pharmaceuticals Holding Corp., a biotech company dedicated to developing novel medicines for central nervous system disorders.