“Emergency rooms are dangerous places for people with Long COVID,” says David Putrino, who studies and treats the condition as director of rehabilitation innovation for the Mount Sinai Health System in New York.

“Imagine you go to an emergency department, you wait 13 or 14 hours, your condition actually deteriorates, and then you’re told, ‘Hey, good news, everything is normal and we’re sending you home,’” Putrino says. “Going home doesn’t sound like a survivable outcome. So at that point you might break down…and often that gets reinterpreted as ‘Let’s put this person on a psych hold.’”

Such experiences fit into a long, troubling tradition in medicine. Because there often aren’t conclusive tests for these types of complex chronic conditions, and because many patients do not outwardly appear unwell, they’re frequently told that they aren’t physically sick at all—that symptoms are all in their heads. “Mainstream medicine really isn’t geared toward treating conditions and diseases that it cannot see under a microscope,” says Larry Au, an assistant professor of sociology at the City College of New York who has studied one of the consequences of that disconnect: medical gaslighting of Long COVID patients.