"This is not my first rodeo."

I've always wanted an excuse to use that expression, which I will forever attribute to Joan Crawford and not some country song. The decidedly unflattering and somewhat unreliable Mommie Dearest had Joan saying it to the Pepsi boardroom, "Don't fuck with me, fellas! This ain't my first time at the rodeo." But I prefer the version from the entirely trashy and unreliable Brando Unzipped, which has Joan reassuring a young Marlon about to get undressed in front of her: "Don't worry yourself about a little male nudity in front of me. This is not my first time at the rodeo."

Unlike my beloved Joan, I've never had the opportunity to face down a corporate boardroom or Marlon Brando's dressing room, so it never occurred to me that I would have this opportunity. But a rodeo is indeed an apt metaphor for the patient's experience of the diagnostic process.

"This is not my first rodeo," I found myself saying to the tech explaining to me the gadolinium they would injecting in my bloodstream as part of my MRI. Two days later I found myself involuntarily using it again when a neurologist was explaining to me how a spinal tap and an EMG worked. Before long, it was becoming profoundly annoying to all around me ("Yes, Dad, we know it's not you're first rodeo, but you still need to sign this permission form if I'm going to go on this field trip"). It was time to put that chestnut out to pasture.

A week or so ago, I had a followup appointment with my endocrinologist, the man who had first greeted me with the information that I had "the testosterone of a 5 year-old boy." I appreciate frank doctors, and I am grateful to him in particular for kicking me back into the gym to start fighting my way back to lower weight and lower blood sugar. For years, doctors had told me my gradually increasing weight, blood sugar, and alcohol intake were all within normal range. "You might want to keep an eye on it," was the sternest warning I ever received. The endocrinologist had none of that back-slapping American bedside manner. On our second visit together he showed me his computer screen and said it was 50/50 whether the liver disease or the diabetes would strike first. I got the message no other doctor had taken the time to deliver.

So, again, I am grateful for his honesty then, just as I was last week when he conveyed to me a very different truth—one I had been suspecting was in the air but which no other doctor had had the courage to state directly.

"Have you considered the possibility," he asked, smiling genially, "that all of this you have been going through is due to anxiety and stress? Maybe what you need, after all, is a good vacation—some time in the sun!"

And with that the genie was out of the bottle: my doctors—at least some of them—were running out of ideas, growing weary of my unfixed body in their examination rooms, a constant reminder of their failure to find answers to what was happening to me. At a certain point, all doctors must consider the possibility that the source of the ailments which resist identification through blood and urine and the slicing and dicing of medical imaging in fact resides in the patient's head.

Ten years ago, when I became sick for the first time, I would have fallen into a pit of self-doubt. Three years ago when I became sick again, I would have flown into a fit of rage at the lack of faith on the part of those I most need to believe me (rage exacerbated, at the time, by the kidney hormones flooding through my system). But this time, my third tour of duty in a decade, I smiled calmly (I like to imagine it was a wise, world-weary smile), and preceded to remind him that 10 years ago my doctors wrote me off for the loony-bin after 18 months of failure to explain my crippling pain before discovering that my appendix was the culprit after all, despite countless scans that revealed it to be "normal." 3 years ago my doctors told me my pain and blackouts were psychogenic in origin, before an adrenal adenoma was revealed to be playing havoc with my system. In both cases, if I had not continued to believe in my own experience of my own body's breakdown in the face of the doubts and even disparagement of my doctors, I might well have ended up in a very bad place indeed.

But, I assured him, I knew well that the body and the mind were interconnected—indeed, I suspect I knew it far better than did he and his colleagues. My struggle with anxiety disorder had begun a decade earlier during that extended first round on the medical merry-go-round, and I learned quickly how stress made my sicker and being sick made me more stressed—and how they could so quickly forge a vicious circle that was seemingly impossible to break.

For years I have been working on my mental health, with both medicine and weekly therapy. I am stronger, healthier than I have been in my adult life when it comes to my mental health. Which is good timing, given where my body is taking me. But don't take my word on it, I said. Feel free to consult my psychologist, with whom I have signed a release of information giving her permission to talk about me as much as she wants.

"This is not my first rodeo, doctor," I said.

I don't know if I convinced him. Honestly, I'm not entirely sure he was listening (since as always he was starting mostly at my electronic records on his screen). But I reminded myself where I am and how I got here, and in so doing I convinced myself to continue to believe in myself. And I had finally got to feel like Joan Crawford—even if I was staring down, not a corporate boardroom or Marlon Brando's genitalia, but a skeptical, tired doctor.

I will never use the phrase again.