SICK WITH WORRY.(hypochondria)

Amanda was sure that she had contracted leukemia, developed a brain tumor, and had a stroke--all around the same time. She made this self-diagnosis while experiencing intermittent discomfort in her abdomen and feeling a persistent wooziness in her head. She often felt off balance, as if she were walking on a warped floor. "I was also really worried about my spleen,'' she told me in a recent conversation. (Amanda is not her real name.) For almost a year, she had sought explanations for her various complaints, discussing her symptoms with twenty physicians in her H.M.O. All of them told her that they could find nothing wrong. These doctors spent little time with her, and none offered a follow-up appointment, although they readily referred her to other physicians.

With growing frustration, Amanda visited more specialists, undergoing physical examinations, blood tests, and sonograms. Nothing abnormal was found, but with each test she became more convinced that she was seriously ill. She kept looking for a doctor who would tell her, unequivocally, that her symptoms could not possibly indicate a fatal sickness. When doctors couldn't give her absolute assurance, she concluded that something terrible must be wrong with her. I asked Amanda, a petite woman with a lightly freckled face, why she thought doctors kept referring her to others. She was perplexed by the question. "We live in a litigious society,'' she said. ''Maybe they were afraid of lawsuits, if they missed something.'' She paused. ''Maybe they were confused by what was wrong with me."

Amanda, who is thirty-three years old and teaches theatre arts at a West Coast college, has suffered from medical anxieties many times before. Several years ago, she was in a travelling theatrical group for children, and played a role that required her to wear an elephant costume for more than a hundred days in a row. After a long day spent in rehearsal and onstage, she often felt exhausted and queasy. Most people would attribute these feelings to stress, but she was convinced that her symptoms indicated a dire disease; one day, during a prolonged episode of abdominal pain, she thought she might be dying and, in a panic, asked a colleague to take her to a local hospital. The doctors there failed to detect anything out of order. The next night, she went again, and once more the E.R. physicians sent her home.

Amanda's fears about illness began when she was nine, after she heard that a schoolmate had almost died from a severe case of chicken pox. As a teen-ager, she was terrified each time she had to visit a doctor. "I remember when I was fourteen years old, and I was sitting in biology class and had a doctor's appointment later that day,'' she said. ''I was so scared, I couldn't think." She entered college at the peak of the aids epidemic. Though she told me that she ''wasn't strongly at risk for H.I.V.''--she had few sexual partners and regularly used protection--she became consumed by the idea that she was infected. ''I really thought I had the virus," she said. Shortly after graduation, Amanda moved to New York City, where she got a job in a bookstore. "Each day, I checked reference books in the store, and called people about aids,'' she said. ''It got so bad that my co-workers tried to keep me away from the health section."

She finally decided to be tested for H.I.V. and, one day, stood for more than an hour in a long line at a New York public-health facility. Part of the free testing procedure involved undergoing a pelvic exam. "I was up in the stirrups,'' she recalled. ''And this horrible doctor I didn't know said to me, 'Oh, my God! There is something definitely wrong with your cervix.' " Her heart started to race, and she asked the physician whether her condition could be related to cancer. He replied that her cervix was inflamed, and that some women with H.I.V. had a similar condition. "I began to cry hysterically," Amanda said. "The doctor looked at me and said I should learn to relax--listen to music or something." Amanda ended up getting two tests for H.I.V., in case one yielded a false result. Both were negative, and the inflammation was benign, but she was so traumatized that she didn't have another gynecological exam for three years.

People like Amanda populate every doctor's waiting room. Studies show that at least a quarter of all patients report symptoms that appear to have no physical basis, and that one in ten continues to believe that he has a terminal disease even after the doctor has found him to be healthy. Experts say that between three and six per cent of patients seen by primary-care physicians suffer from hypochondria, the irrational fear of illness. The number is likely growing, thanks to increased medical reporting in the media, which devotes particular attention to scary new diseases like sars, and to the Internet, which provides a wealth of clinical information (and misinformation) that can help turn a concerned patient into a neurotic one. Nevertheless, hypochondria is rarely discussed in the doctor's office. The ''worried well,'' as sufferers ...