I know this subject very well indeed from hard personal experience. I once fractured my right knee ice skating and went to the hospital. I told the doctor of my suspicion that my knee was broken and asked for an X-Ray. He refused me the X-Ray and refused to accept my diagnosis. I spent a whole week in excruciating pain and went back to the same hospital. When the same doctor saw how swollen and badly bruised my leg was he did an X-Ray “Oh, you have a fractured knee," he exclaimed. “I told you that a week ago you fool,” I replied. That was in the UK.

In 2020, I was living in Spain and suddenly felt the debilitating onset of pains all over my body, especially my hips and shoulders. The doctor told me it was old age and sent me off with a prescription for paracetamol painkillers. Eventually I had to seek treatment in Japan, where I have a residential visa. The doctors there immediately diagnosed PMR/GCA, plus evidence of a silent hearet attack and a mini stroke. A long course of steroids brought it all under control.

I also know it from the patients side. I had a younger brother, now deceased, who fooled everybody for years with all manner of health issues he really did not have. It was all to not have to work for a living and live off health benefits.

And of course, I was gaslighted by two nasty ex-wives. Anyway, what a great read even if I was familiar with the subject. Great that you covered all the bases.