Zebras Underground Medical Glossary

Because medical records shape your care. Know what they're saying secretly in your chart.

Decode the Diagnosis. Rewrite the Record. Reclaim the Sass.

Why This Glossary Exists

Medical records shape your care. Period.

The language written about you in your chart—especially if you live with complex, invisible conditions like EDS, POTS, MCAS, or chronic pain—can impact how every future doctor treats you. Or doesn’t.

This glossary is for patients who've been labeled before they were listened to. Who’ve seen “noncompliant” or “anxious” in their chart and felt the care shift. Who show up with binders of medical history and still get reduced to “vague symptoms.”

We're here to take the language back. This isn’t just about decoding dismissive terms—it’s about reclaiming your right to be heard. Each term includes what they wrote, what it really means, what you can say back, and a little sass to say it like it is (or at least to whisper under your breath on the way out).

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What They Say – What It Means – What You Can Say – Sassy Reframe

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Malingering

What they say: “Patient may be malingering.”
What it means: They think you’re faking your illness to gain something—time off, meds, disability.
The subtext: You’re lying.
What you could say:
“I’m here because I want help managing my condition, not because I benefit from being sick.”
Sassy reframe:
“Oh right, I fake being sick so I can spend my weekends at the pharmacy instead of the beach. Living the dream.”

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Noncompliant

What they say: “Patient is noncompliant with treatment plan.”
What it means: You didn’t follow their orders to the letter.
The subtext: You’re difficult.
What you could say:
“I made choices based on how I responded and what was sustainable. I’m open to revisiting the plan together.”
Sassy reframe:
“Sorry I didn’t follow your plan blindly. I must’ve missed the part where my body became your science project.”

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Functional Neurological Disorder (FND)

What they say: “Findings consistent with FND.”
What it means: Real symptoms, no structural brain issue.
The subtext: It’s all in your wiring, not your structure.
What you could say:
“I’d like a referral to someone experienced in treating FND so we can move forward.”
Sassy reframe:
“So my nervous system's throwing a tantrum—but sure, let’s not do anything about it.”

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Functional Overlay

What they say: “Functional overlay suspected.”
What it means: Emotions might be making the physical symptoms worse.
The subtext: Your stress is showing.
What you could say:
“I’m open to exploring psychological factors, but I’d like physical causes ruled out first.”
Sassy reframe:
“I didn’t realize needing medical care was a vibe check.”

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Subjective Complaints

What they say: “Patient reports subjective symptoms.”
What it means: Symptoms like pain or fatigue that aren’t measurable.
The subtext: We can’t prove it, so we’ll question it.
What you could say:
“Subjective doesn’t mean unimportant. My symptoms are impacting my life and need to be addressed.”
Sassy reframe:
“Oh, it’s just ‘subjective’? So is your bedside manner.”

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Somatic Symptom Disorder

What they say: “Somatic features present.”
What it means: They believe your physical complaints are rooted in anxiety or stress.
The subtext: This is probably mental.
What you could say:
“I’d like to ensure that any physical diagnoses are ruled out before we assume psychological causes.”
Sassy reframe:
“Glad to know years of joint dislocations can be cured with a journal and a hot bath.”

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Conversion Disorder

What they say: “Symptoms suggest conversion disorder.”
What it means: Neurologic symptoms with no neurological disease—often linked to trauma.
The subtext: We’re done investigating.
What you could say:
“I’m open to integrative care, but I want to ensure nothing neurological has been missed.”
Sassy reframe:
“So now I’m a case study from a 1903 psychology textbook?”

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Secondary Gain

What they say: “Possible secondary gain noted.”
What it means: Your illness might be giving you unintended rewards—sympathy, attention, time off.
The subtext: You’re not just sick—you’re benefitting.
What you could say:
“I’ve lost far more than I’ve gained from this illness. I’m here to improve my health, not to escape responsibility.”
Sassy reframe:
“If this is my ‘gain,’ I’d like to speak to the manager.”

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Anxious-Appearing

What they say: “Patient appears anxious.”
What it means: You seemed nervous, fidgety, or emotionally charged.
The subtext: That explains everything, doesn’t it?
What you could say:
“I may seem anxious because I’ve had a long journey trying to get care. I’m showing up because I want answers.”
Sassy reframe:
“Apparently showing emotion in a vulnerable moment is a clinical red flag now.”

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Fibromyalgia-Like Symptoms

What they say: “Reports fibromyalgia-like symptoms.”
What it means: Pain, fatigue, sensory issues—without formal diagnosis.
The subtext: We don’t know, so we’ll say fibromyalgia-ish.
What you could say:
“If that’s on the table, I’d like to understand the diagnostic criteria and treatment options.”
Sassy reframe:
“So… you’re calling it fibromyalgia-adjacent and hoping I leave quietly?”

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Pain Disproportionate to Exam

What they say: “Pain appears disproportionate to findings.”
What it means: The pain you describe doesn’t match the test results.
The subtext: You’re exaggerating.
What you could say:
“I understand there’s no clear cause showing, but the pain is real and I’d like to address it.”
Sassy reframe:
“Just because the X-ray doesn’t scream doesn’t mean I’m not in agony.”

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Vague Symptoms

What they say: “Presents with vague or nonspecific complaints.”
What it means: Your symptoms don’t fit a clean box.
The subtext: Too much work.
What you could say:
“I understand the pattern isn’t obvious. That’s why I need someone to help me dig deeper.”
Sassy reframe:
“Sorry I didn’t arrive with a prepackaged diagnosis and a bow.”

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Chronic Pain Syndrome

What they say: “Likely chronic pain syndrome.”
What it means: You have long-term pain and we don’t know what’s causing it.
The subtext: You’ll probably stay this way, so we’ll stop asking why.
What you could say:
“I’d like support managing the pain, but I’m still interested in investigating root causes.”
Sassy reframe:
“Ah yes, the ‘we gave up’ diagnosis.”

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No Abnormalities Noted

What they say: “Imaging unremarkable.”
What it means: Tests didn’t show obvious issues.
The subtext: You must be fine.
What you could say:
“I’m glad there’s nothing critical, but the symptoms remain and I’d like to explore them further.”
Sassy reframe:
“My scans are boring, but my symptoms are not.”

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Exaggerated Response to Stimuli

What they say: “Tenderness appears disproportionate.”
What it means: You reacted strongly to touch.
The subtext: Maybe you’re overreacting.
What you could say:
“My pain sensitivity is high, which could suggest central sensitization. Can we explore that?”
Sassy reframe:
“I’m not dramatic, I’m in pain. Learn the difference.”

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Overly Focused on Symptoms

What they say: “Appears preoccupied with somatic concerns.”
What it means: You talked about your symptoms too much.
The subtext: Stop being so invested in your own body.
What you could say:
“I’m trying to give you the full picture so we don’t miss anything. My goal is function, not fixation.”
Sassy reframe:
“Didn’t realize talking about symptoms at a doctor’s office was frowned upon.”

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Difficult Historian

What they say: “Patient is a difficult historian.”
What it means: Your history is complex or hard to follow.
The subtext: You’re overwhelming us.
What you could say:
“I know there’s a lot. I’m happy to provide a written summary or timeline to help clarify.”
Sassy reframe:
“It’s not that I’m difficult—it’s that your chart can’t handle this plot.”

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Complex Case

What they say: “This is a complex presentation.”
What it means: Your case doesn’t follow simple rules or pathways.
The subtext: Too hard. Too time-consuming.
What you could say:
“I know this isn’t easy, but I’m looking for a provider who’s open to long-term collaboration.”
Sassy reframe:
“Sorry I’m not a textbook—turns out real people are messy.”

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We Don’t Treat EDS Here

What they say: “We’re not equipped to manage EDS.”
What it means: They’re not trained in connective tissue disorders.
The subtext: Good luck out there.
What you could say:
“Thank you for being honest. Can you refer me to someone who does have EDS experience?”
Sassy reframe:
“Do I need a referral, or just a magic wand?”

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Words Matter, Know the Terms to Take Note Of

Your chart is a permanent record—but it shouldn’t be a permanent misrepresentation.

This glossary is your decoder ring. Use it to spot gaslighting. Use it to respond with clarity. Use it to advocate like the fierce, flexible, fire-breathing zebra you are.

If you know other words to be added, pop them in the comments and we will look up the real-deal on their meaning.