“I care about you” and other things to say to sick friends

by Carolyn Thomas  ♥  @HeartSisters

In honour of National Invisible Chronic Illness Awareness Week, I think I’ll snort some nitro spray. Oh, wait. Sorry. I mean, I think I’ll talk about what to say when somebody you care about is ill – rather than the well-meaning (but often annoying) greeting:You look great! 

When I’m having a really bad day, I’ve often thought that a lovely  neck brace or leg cast might come in handy. It would be like sporting a well-recognized outside sign that something is not quite right inside, because my cardiac symptoms are mostly invisible to others.

So instead of gushing “You look great!” – which may actually feel to the patient as if you’re somehow diminishing the seriousness of the diagnosis – you might consider just saying something like this example, courtesy of an Invisible Illness Week essay that I found recently:

“I don’t know what to say. I wish I could fix it all and take away your pain. I don’t know what you would like me to say, and I am so afraid of saying the wrong thing. But know this: I care about you.”

The essay went on to say that, although there is no shortage of friends or family who send patients newspaper clippings about the latest cure for their disease or fresh advice of ‘you should try. . . .’, the simple and precious words ‘I care about you. I am here for you’ are less common than most people would believe.  

If you’re a patient with an invisible illness like heart disease, how should you respond to that ubiquitous “But you look great!” greeting? When over 1,200 people took a survey back in 2008 on the Invisible Illness website, real live patients contributed many suggested replies we can try out on those who insist on that greeting.  Here is just a small sample of possible responses offered:

  • I am hangin’ in there . . .
  • Drugs are a wonderful thing.
  • I have my good days and I have my bad days.
  • I clean up well.
  • I have my ‘good’ days – but this isn’t one of them
  • That’s a perfect example of how you can never judge a book by its cover.
  • Well, I guess I did good job on my makeup!
  • “Powder and paint make you what you ain’t!”
  • It took a lot of work to look this fabulous!
  • If I can’t feel good, at least I am determined to look good!
  • I’m having a “good face” day.
  • Yeah, my kid thinks it’s cool that I’m an ill person working undercover as a healthy person

If you’re the friend or family member of a patient with an invisible illness, try offering something a tad more helpful than saying “You look great!” to that person.  Here’s what I wrote here previously:

   “Next time you approach a heart patient, a bereaved person grieving a loss, or those diagnosed with any chronic, progressive disease – what could you do or say instead of gushing over their appearance? One of the most helpful comments to me so far has been some variation of  the simple statement:

“It’s good to see you!”

… which is probably fairly accurate,  feels pretty fine to hear, and doesn’t elicit the ‘If you only knew…’ reply that we’re silently muttering.”

Screen Shot 2015-12-20 at 5.40.51 AM

Emily McDowell’s empathy cards*


  This post was also published as a guest post on the Prepared Patient Forum.

Q: Are you or somebody you know living with an invisible illness?


NOTE FROM CAROLYN:  I wrote more about what to say – or not say – to sick people in my book  A Woman’s Guide to Living with Heart Disease.  You can ask for it at bookstores (please support your local independent bookseller!) or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from my publisher Johns Hopkins University Press (use their code HTWN to save 30% off the list price).

See also:

Ten Helpful Things to Say to a Sick Friend

“Smile, Though Your Heart is Aching”:  Is Fake Smiling Unhealthy?

The New Country Called Heart Disease

When You’re Having a Terrible, Horrible, No Good, Very Bad Day

“But You Don’t Look Sick…”about Christine Miserandinos classic “Spoon Theory” – a must-read essay! 


*Emily McDowell’s empathy cards are wonderful and you should check them out!


9 thoughts on ““I care about you” and other things to say to sick friends

  1. NOTE FROM CAROLYN: This reader comment has been deleted because it was attempting to sell my readers a “miracle cure” that, if indeed it ever existed, would have already been patented and marketed by Big Pharma.

    For more info on how you too can get your comment deleted, please read my fascinating Disclaimer page.


  2. Yes, Carolyn, this so true. We are in a situation of being at the mercy of those caring for us and it is an awful and scary feeling.

    Have a Buddy, a Family Member, someone that will stand up for you, ask questions, demand attention and gets it. Choose this person wisely, Believe in this person so strongly that you would give power of attorney, if need be. I mean really, really, really , trust and love them. They have to be strong, they can’t fall apart at the sight of you lying there. This is the last thing you need in a crisis situation.

    Having read these few lines, someone probably, instantly, popped into your head. Make a plan with this person. Have a plan. While you are making that plan, give them a great big hug, thank them for being them. These kind of people are hard to find in life. Love them and tell them often.

    Liked by 1 person

  3. Wow! Carolyn, what a collection of comments! Thanks for sharing those. I hope it gives people knowledge and strength to speak loudly, demand respect and good service. I have been treated poorly in ER and I had my best friend with me. When he heard what they were saying he asked:

    “How long have you been a Doctor?” Then, before the Doctor could answer, He said “Wait! Don’t tell me, if you say more than an hour, I am going to be disappointed”.

    Liked by 1 person

    1. Trouble is, most patients feel so vulnerable in such situations that confronting a doctor’s rudeness/disrespect/bedside manner feels risky. At that point, we need them far more than they need us – hence our tendency to be compliant (and silent).

      Liked by 1 person

  4. My favorite reply to just about any of these – from “You look terrific!” to “How are you doing?” is a pleasant “Oh, one foot in front of the other.”

    Liked by 1 person

  5. Very well said! I am having a hard time with people, even Drs, saying to me “you’re too young, you don’t look sick, or this doesn’t look like you”, as they are staring at my EKG and me. Well what am I supposed to look like with dilated cardiomyopathy (with LV compaction). Love it when one recent Dr said “you look as if its all under control” when my echo just came back 5% deterioration since last echo last year. So not only do friends and family not know how to respond, sometimes other Drs don’t quite know either.

    Tough thing but we with invisible illnesses are tougher!!!

    Liked by 1 person

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