Ask any Indian doctor and they will know this patient.

They come in saying their heart races, their chest feels tight, their stomach has not settled in weeks, their sleep breaks at 3 AM, or some pain keeps shifting around the body just enough to keep them worried.

They have usually already seen the family doctor, then a cardiologist, then a gastroenterologist. 

The ECG is clean, the thyroid report is fine, the endoscopy shows nothing alarming, and the blood work is normal enough for someone to say, "nothing to worry about."

Except the person is still not fine.

By the fourth appointment, they have started doubting themselves. 

They start wondering if they are imagining the whole thing, or if it really is just acidity and everyone telling them to relax has been right all along.

In most Indian homes, someone eventually says gas, but no one can explain what's actually happening…

I want to talk about some Indian studies on this, starting with one from AIIMS Delhi.

It looked at new patients walking into the general medicine OPD. 

Not a psychiatry ward, not people already sent for counselling, just regular patients coming in with physical complaints.

Another study looked at 200 such patients more closely. 

The body is what gets people to a hospital. Almost none of them would have come in to say they were anxious.

One name for this is somatisation.

Not a pretty word, but a useful one. It means emotional distress can surface through the body. 

Not because the person is imagining things, but because the body is genuinely producing sensations that feel physical and frightening.

Nobody goes through four doctors and three waiting rooms for fun. The symptoms are real.

The mistake happens when a normal report is treated like proof that nothing is happening. A normal report only means that particular test did not find the cause.

Some people whose reports found nothing were functioning worse than people with diagnosed disease.

Listen to how we talk about emotions.

We rarely say, "I am anxious." We say, "Tension ho rahi hai."

That word does a lot for us. It is softer than anxiety, less embarrassing than depression, and less final than saying something is wrong with your mind.

Anthropologist Lesley Jo Weaver studied this word among women in North India and found that tension was not just casual slang. People used it for anger that came quickly, thoughts that would not stop, sleeplessness, restlessness, stomach trouble and family conflict. People who reported more tension also scored higher on measures of anxiety and depression.

So the body gives people a language that the house will accept..

This idea can go wrong very quickly.

The first mistake is dismissal. Real heart disease gets waved away as anxiety, thyroid issues get missed, and gut disorders, autoimmune problems or neurological symptoms can sit under vague complaints for months. Women know this better than anyone, because stress and hormones get thrown at them far too easily.

The second mistake comes after the reports are clean.

That is when the conversation usually ends. The doctor says stress, the family says gas, the patient gets antacids or vitamins or a sleeping pill, and everyone moves on.

Nobody asks what changed at home, what happened at work, when the symptom began, or what life looked like around that time.

In a crowded OPD, one more test is faster than one real question.

So people keep going from doctor to doctor, trying to get a physical answer for something that may need a different kind of listening. They are not avoiding help. They are asking for it in the only language they have.

If you are the person on the fourth doctor, hold both things together.

Your symptoms are real, and your reports may still be telling the truth.

Stress can show up as pain. Grief can sit in the stomach. Fear can feel like a heart problem. Long pressure can change sleep, appetite, digestion, breathing and the way pain is felt.

The hopeful thing is that this is not mysterious in medicine. It has names, it has treatment, and there is evidence that when care uses words people already understand, like tension, people are more willing to talk.

Sometimes the first sentence is not "I have depression."

Sometimes it is only this:

"I have been unwell, and the tests are not finding it."

For many people, that sentence takes years.

Hit reply and tell me: have you or someone close to you lived the clean-reports-but-not-fine experience, and did anyone ever name what was underneath?

I read every email.

Until next week,
Ritesh

P.S. If something feels acute or scary, chest pain, fainting, severe breathlessness, sudden weakness, do not intellectualise it. See a doctor. This note is not asking anyone to replace medicine with self-diagnosis. It is only saying that after the body has been checked properly, the mind deserves to be included in the investigation too.