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"But you don't LOOK sick..."

September 21st, 2012 |
Awareness & Education, Emotional Support, Survivorship

by emilinaMPN | Fighter: Myelodysplastic/Myeloproliferative Diseases    Connect


Cancer doesn't look the same on everyone. For some, thinning hair and weight loss is the norm but for others, there are no outwardly signs of suffering. If you're a supporter who is wondering what to say to someone who doesn't necessarily look sick, read more to find out why Lina says to never tell someone that they don't look sick.

If you didn't know I was sick, you would not know.
That's because I have something called myeloproliferative neoplasm. More commonly known as an MPN. If we break down the words they give a pretty good working definition.

Myeloproliferative Neoplasm:

Myelo - From the Greek Muelos which means marrow
Proliferative/Proliferation - to grow or multiply by rapidly producing new tissue
Neoplasm - an abnormal growth of body tissue

So basically, the bone marrow produces lots and lots of cells that do not belong there. That is my basic working definition of a myeloproliferative neoplasm. MPNs are invisible illnesses. There really are not many outward signs that show that those of us who live with it are sick. But boy, do we feel it! I don't know about the rest of you, but no matter how I look, sometimes I feel like I've been run over by a truck.

"But you don't LOOK sick..."

However well-intended the phrase may be, telling a sick person that they don't look sick can be pretty insulting. There's an implication that we are faking it or that it's not real. What should sick look like? Should we all be emaciated, bruised, or limping? What does it take to be acceptably sick? This may surprise some, but not all sick people look alike.

We all have good days and bad, but for the invisibly ill, including those with myeloproliferative neoplasm, the bad days often outnumber the good. Most of us, though, are obliged to put on the happy face and get on with things. If we didn't do this, we wouldn't be able get much done.

I learned to put on the happy face real quick when I got my first "Grown-Up Job." I started at my office as the receptionist, so putting on the perky, bubbly personality-however fake it may have been- became a part of my daily life. Fatigued, sick, or suffering with a headache? It didn't matter, that smile was plastered on.

Inside I might have been cursing the phone for ringing, but I'd still thank you for calling and inquire how I could help. I often feel like I am two completely different people; the one on the outside, who looks just fine and deceives everyone around her; and the one on the inside who is exhausted, battered, and miserable.

So, what should you say?

There are days now, though, when I just can't fake it anymore. My fatigue catches up with me and knocks me out. On those days, I tend to hear that dreaded "but you don’t LOOK sick..." Also, on those days my sarcastic side will often think (or sometimes say, depending on the audience) "And you don't LOOK like a jerk, but I guess appearances can be deceiving, can't they?"

I've been asked in the past what a better response might be. Why not just "I'm sorry you're not feeling well today." Or "Is there anything I can do to help you?", or even "That sucks!" But there is never a reason to tell someone they don't look sick. To me that just screams "Suck it up, and stop exaggerating!"

Believe me, I am neither wanting nor expecting sympathy. Understanding would be wonderful though. Yes, it's true that we don't fit the picture in most people's heads of what sick should look like, but trust me - while these illnesses may be invisible, we and our pain certainly are not.

Please, just think twice before telling us we don't fit your image.


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Lina is a 25-year-old who has been living with Essential Thrombocytosis since she was 18. She works full time, and volunteers where she's able. She recently married her best friend who really takes the vows "in sickness and in health" to heart. Follow her on twitter @linampn or subscribe to her blog - linampn.wordpress. You can also find her on I Had Cancer under the user name EmilinaMPN!

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