The day my physician gave me the most powerful tool that doctors have—a diagnosis—marked the point when my journey living with coeliac disease began. For years I had had chronic abdominal pain and vague gastrointestinal symptoms. As a child, I never slept on my stomach because it was always sore. When I was a teenager, my symptoms worsened (possibly related to an increasing reliance on pizzas). I was generally unwell and developed a chronic iron deficiency anaemia that was refractory to oral iron supplements. My physicians—general practitioners and gastroenterologists—would take a history then prescribe a therapeutic dose of barium (to both ends) to reassure themselves that they had not missed a diagnosis of inflammatory bowel disease.

As the barium cycle was repeated, I realised that medicine is the art not of making a diagnosis but of ruling one out, with special attention to the rare and deadly (I was once screened for acute intermittent porphyria). Once all medical diagnoses had been ruled out, two areas remained—functional and psychiatric disorders. My insistence that my symptoms did not fit with a functional disorder only seemed to increase my physicians’ conviction that I had a psychiatric disorder. As my symptoms persisted, frustration was mutual, and I became a “heartsink patient.”