How to Talk to Someone with a Chronic Illness

I don’t typically pen do-and-don’t lists, but in writing Chronic, I thought a lot about how we talk to sick people, particularly the blame and biases encoded in our words. That reflection inspired this list.


Don’t rush to tell her, “You lost so much weight! You look great!” If the person lost that weight due to serious illness, this compliment, while well-intentioned, sounds weird. Also, equating beauty with extreme thinness is always a bit perilous, no?

Don’t ask, “What did you do to get X disease?” That question sounds like you’re blaming the victim. “Do researchers know what causes it?” might work better.

Please don’t give ludicrous dietary advice or promise miracles if your friend changes her eating habits. You know, “I cut out gluten, and if you do it too, I bet your X will go away.” This one’s a particular pet peeve of mine.

Don’t ask, “Are you better yet?” There is no “yet” with a chronic disease. A more constructive formulation: “How do you feel now?” or “Is your disease currently under control?”

“You don’t look sick” is a double-edged sword. On the one hand, most people enjoy hearing that they look healthy, as our beauty ideals are tied up with “looking healthy.” But if you say this in the wrong tone, it can sound accusatory. Especially in the work place, where it might seem like you’re leveling a charge of malingering, please use with caution.

Don’t say, “At least you don’t have terminal cancer/other horrible disease.” Your friend already understands that in theory, things could be worse. Things could always be worse. But your friend doesn’t need to feel guilty for her concerns or anxieties.

Above all, though, don’t avoid your friend or loved one for fear of not saying the right thing. It’s better to try and stumble than to shun someone at the moment she needs you most.


If you know someone with the same disease who is thriving, please share the story. It can give your friend a lot of hope.

Do tell your friend she’s beautiful if she’s undergoing cosmetic changes like hair loss due to a disease. Focus on the positive. If she asks for advice, feel free to give it, but I wouldn’t start off with, “Wow, you’ve lost a lot of hair. Why don’t you get a wig or scarf?”

Do ask, if you’re inviting her over to your house or out for dinner, “Is there anything you can’t eat?”

Do help her to face the future with optimism. Comments like “Your life will be really hard” are never productive. It’s more generous to say something like, “You’re a really strong person, and I admire how you face your illness.”

Do understand that many chronic diseases have periods of remission and flares. If your friend enjoys a long period of remission, you may be surprised if she eventually gets sick again. You may even feel a sense of frustration—at life, the disease, or even her. And that’s fine as long as you keep it to yourself.

Do express love, support, and empathy—always. This is the best way to make your friend feel better.

Copyright © Cynthia Gralla, 2019