Seeing that you've been "a practicing physician for 40 years", I get the impression that you prescribe to the belief that if a diagnosis can't be made with x-rays or through blood work then all symptoms are imaginary. Your statement that there is no direct link between how a person feels (fatigue, pains in body, etc) and an ailment or disease, makes absolutely no sense. Have you ever heard of the basic laws of physics; action to reaction, cause and effect? I've never heard of a cancer patient or diabetic or any other person that suffers from something as mild as a headache to as severe as flesh eating bacteria not having pains or symptoms that help their doctors discover what is wrong. That is what the word symptom was created for. Not everything is imaginary and for a doctor to not believe there is anything wrong because nothing is visible or apparent is a violation of the Hippocratic oath. I would have more belief if a doctor told me that maybe it is a physical reaction to stress (which would explain nothing more than the fatigue). Anxiety is part of fight or flight, and a by-product of stress, but unless there is a chemical imbalance, it is impossible to maintain a constant high state of anxiety. By now I would have already gone crazy; suicidal or died. I'm by no means a doctor and my common sense tells me anxiety is impossible to cause daily fatigue, hand shakes, etc. UNLESS it is a chemical imbalance, in which there is a physical problem and my body is reacting to this imbalance.
The reason I quoted in the 1st post about hyper/hypo glycemia is b/c of this website. When typing in the symptoms I have, it repeatedly listed them as a possible cause.
Also there are so many items on the list of foods that trigger GERD, it is impossible to eat anything fast food or with any spice or caffeine. I had a burger last night at 11pm b/c I worked til 10pm and by the time I got home it was so late all I could do was stop and get fast food.
It seems to me that anxiety and stress are the modern answers for the Victorian custom of using the terms "fit" or "decline", when doctors couldn't then & can't now find the cause for a patients illness and giving a verdict of a generalized problem with no real solution works easiest for the doctor. It easiest to give a random prescription, wait several weeks or months and if the patient still complains about the same ills or worse; then the doctor moves on to another pill until the patient does get cured or dies.