I think it comes down to shallow reasons . Obama was a nerd , but still charismatic . Trimp is a douchebag , but a TV star . <| sep |> Shield K 1 ? <| sep |> As a physician , abdominal pain has to be one of the most frustrating things to treat . So often people get put through too many tests to establish a physical cause of their pain , only to turn up nothing . Then , when we come up with nothing , too often we don ' t have the mental health resources to help people with their depression or anxiety . Or , when we suggest that there may be a large anxiety or depression component , people often can be offended . I always try to explain to patients , that yes , pain can be real and ' in your head ' at the same time . Just because there is a large emotional component , does not mean it ' s made up . EDIT A lot of commenters are expressing frustration with not getting a diagnosis when they go to the emergency room . Unfortunately , this is not what an emergency room is for . Emergency medicine is primarily directed at ruling out immediate , lifethreatening illnesses . People with chronic abdominal pain are best treated by a primary care provider . Unless of course , they have new symptoms which warrant evaluation by an emergency physician . EDIT 2 A lot of people have brought up good points about current incomplete medical knowledge . I ' m sure there are lots of people with chronic abdominal pain who simply have a disease which we don ' t understand or have the ability diagnose . Nonetheless , mental health is an often ignored cause which physicians don ' t approach effectively .