But You Don’t Look Sick: An Open Letter (Updated)
So, I've been sick a few more months than when I originally wrote this post. Every single day, I learn more about what it's like to be chronically ill and live with all of the ups and downs related to my conditions, as they take turns flaring and receding. I wonder if the conditions use some sort of lottery system, but I digress. Anyway, I've put some more thought into this post and updated it, hopefully for the benefit of all the sick and healthy people everywhere. As I talk to more people with chronic conditions and see that the perception of what being sick looks like has an impact on more people than just me. It affects so many areas of life for every chronically ill person.

You Don't Look Sick: An Open Letter- I originally published my open letter back in October. Since then, I have thought more about how invisible illness affects more people than just me. So, I've rewritten the original post to talk more about how the assumption of what illness looks like has a broad reaching effect in the areas of support (both emotional and financial), treatment with dignity, and access to medical care. Check out my new thoughts on how the phrase "you don't look sick" can hurt someone and generally does a disservice to everyone who suffers from an invisible illness. It is time to reassess what chronic pain and chronic illness looks like in our society, so that people can receive the necessary medical attention. #spoonie #chronicpain #chronicillness #invisibleilness #fibromyalgia #POTS #CFS #depression #ptsd #dystonia #dystoniaawareness #notalone

Hi there,

You may have just met me. You might be my good friend. You might even be my family member. I just wanted to take a moment to talk to you about the phrase "you don't look sick." You know what, you've never seen me at home alone. So, yeah, I don't look sick right at this second. To borrow a phrase from the ever wonderful writer Ariane, my pants should not have to match my pain level. Sometimes, putting on a dress helps my mood, even if it doesn't help my pain. I'm sorry if that messes up your idea of looking sick.

I don't mean to sound ungrateful for what you mean as a compliment, but it is kind of insulting. The phrase you don't look sick minimizes and dismisses my pain. So, if we just met, and I opened up to you about my painful neurological condition (and I didn't even mention the other conditions with which I live), please don't think you're complimenting me. If you follow it up with "but you're so beautiful," you are implying that being sick should make me ugly. Maybe you think I'm exaggerating my pain because you perceive me as beautiful. Beauty fades, but my pain won't.

This letter is not about only me, either. By telling me that I don’t look sick and that I’m beautiful, you are reinforcing the idea that if anyone wants his or her medical conditions taken seriously she should look a certain way. Maybe I should not take any pride in my appearance if I am sick, so your conceptions of illness and my illness will fit together. The preconceived notions of what being chronically ill looks like is what prevents people from seeking the medical attention that they need, receiving the benefits that they deserve, and being treated with dignity. There are people who cannot even get the much needed family support during their illnesses because their families do not understand that being sick can present in many different ways. Sick looks different for different people on different days.

I would like you to know that it probably took me twice as long to look passable for public viewing than it did before I got sick. Instead of wearing contacts, styling my hair, putting on make up, and wearing an outfit that isn't entirely from the "active wear" department absolutely every day, like I did in the past, I only do that once or twice a month. [Side note: We can talk about the irony of wearing active wear in my condition later.] You don't see me at home. You don't see me the way my family does. My situation is so excruciatingly embarrassing that even my doctors do not see all of the pain. My mask is reinforced by years of negative experiences with showing vulnerability. I dread necessary doctors’ appointments because I know that it will mean that I have to take a shower with energy that I do not have.

I only let you see what I want you to see because you would be uncomfortable with the truth. Plus, I do not want to be humiliated. I want to be treated with dignity. So, I only leave my house when I can be presentable, which is not often. Therefore, I become isolated and lonely because I don’t have energy to make myself look like my former self. There should not be any stigma when I can’t wash my hair because I am that sick, but there is judgement because you can’t see my whole story in a glance. That’s why you only see me when I don’t look sick.

If you are another person with Dystonia, I feel really bad for you. We share a common bond, which I thought you would appreciate. But when you tell me that I don't look like I have Dystonia, just because Botox helps me to hold my head straight for 8 out of every 12 weeks, you are insulting me, too. I am sorry if Botox doesn't help you hold your head straight, but I experience life altering pain, just like you.

I also want to take a minute to address a few more problems with the phrase you don't look sick. You may know about my illness from my blog or from me telling you about it. Either way, neither on my blog or in conversation, do I lay out my entire medical history. I can't even explain it all to a single doctor during an hour long visit, even if I bring notes and timeline. I don't tell you about the hours and money that have gone into biofeedback and neurofeedback, the tests that I've had run, and all the extra things that I require to maintain a manageable pain level. I'll never tell you how many doctor visits that I average a week or how many pills that I've tried and had horrible side effects or allergic reactions. I won't tell you about the pain of when the doctors don't know what to do with you -- yes, I have been turned away by primary care doctors because I'm too complicated -- they either throw a lot of pills at me or they take their frustrations out on me by yelling at me. It may sound crazy to you, but you probably only see the doctor when you have a sinus infection. So, in addition to dealing with pain and being sick, I deal with more frustrations than you could ever imagine. When I first got sick and didn't understand why the doctors were yelling at me, it felt like I was slowly losing my sanity. That makes me feel even worse. So maybe I brush my hair and try to look ok when I leave the house, but I carry so much pain behind the facade.

When I hold my head straight really quickly, so someone can take a picture, because I'm wearing makeup and plucked my eyebrows for the first time in two months, don't think that's my everyday experience. I go out of my way to document the moments that I can enjoy life, so when everyone else is living life, and I am alone in the recliner, I can see some evidence of that one time I enjoyed playing with my dogs at my grandparents' house.

So, I if you're a close friend or family member, I appreciate it when you tell me that my voice sounds strong or notice an improvement in my symptoms. But, if I don't know you or you don't think I look sick, you aren't complimenting me.

Thanks,

Sarah

Related Posts:
Rethinking Hospitality (for the Chronically Ill)
Cervical Dystonia
Managing Cervical Dystonia Pain
Invisible Illness



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