‘MUS’ or ‘DEN’?

All letters are subject to editing and may be shortened. General letters can be sent to bjgpdisc@rcgp.org.uk (please include your postal address for publication), and letters responding directly to BJGP articles can be submitted online via eLetters. We regret we cannot notify authors regarding publication.

For submission instructions visit: bjgp.org/letters

I have long despaired at the focus on the ‘consultation’ and the psychological approach to patients whose symptoms have not yet acquired a diagnostic label.¹ Since learning the latest about the linked conditions of mast cell activation syndrome, postural orthostatic tachycardia syndrome, dysautonomia, and the hypermobility syndromes (including Ehlers–Danlos), I have yet to find anyone with ‘MUS’. I just find patients who have been failed by a lack of medical knowledge among their caring clinicians. Stop feeling that heartsink and stop giving patients the message that it’s all in their head. Instead, educate yourself about the manifold presentations of these newly recognised conditions and give your patients the validation they deserve.