Illness might be the most isolating and alienating experience a person can know. Lots of well people simply have no clue how to relate to someone with a chronic and catastrophic illness. That sort of thing is scary even just to witness. They hope (or assume) you’ll get better, and then they won’t have to deal with whatever you’re going through – but when that takes too long, they drift away.

I can’t even count how many friends I’ve lost to my disease. Granted, many of them obviously weren’t great friends in the first place. But a few of them I wish I’d kept around for a while. And now that I’ve had a few sick friends of my own, I realize it’s hard for a well person to be a good friend to a sick person. It’s tough to know what to do and when to do it, even though it ought to be instinctive for me.

To that end, here are a few tips to help you help your friends deal with your illness:

Tell them you are sick. If you keep something a secret from people, you can’t blame them for avoiding that subject. From their point of view, they’re doing you a favor. So if someone is a friend, and your illness is likely to affect that friendship, let them know – as concisely as possible – what’s going on. Do not – DO NOT – suggest they Google your disease to learn more; I  made that mistake, and it was very stupid of me. In fact, you should probably tell them not to.

Give your friends the chance to opt-in. It’s really tricky for well people (can I call them wellbeings?) to navigate the whole “how are you?” conversation; they often don’t want to ask for fear of embarrassing you (or themselves). But if you give them a way to stay up-dated without prying, it saves trouble all around.

The last time I had surgery, I sent an e-mail to my friends informing them that my mother would be sending out updates, and they should email her to get added to the list. To this day, I don’t know what names were on that list, but I know many people appreciated the mechanism. Blogs and websites are also good for this sort of “passive” attention.

Pay attention to people who pay attention to you. When I was in the hospital, a not-very-close acquaintance sent me a “get well” card, even though lots of my “friends” didn’t email. I’m still not bestest buddies with this friend, but I would walk through fire to help him, if he asked. This is especially true of friends who have stuck with me through a few transitions – e.g. a bad flare, or a round of surgery, or a move to a different city. I’ve come to view those transitions as the litmus test for a true friend – and I make damn certain to stay a true friend to anyone who passes.

Email is never enough. There’s this idea out there that email and Facebook and chat have made it easier to be friends with people. Yes and no – we trade depth for breadth, and most online friendships just aren’t deep enough to accommodate serious illness. I make sure I keep in regular analog contact with the friends that matter to me – by telephone for some, but also by handwritten note or by personal contact. At the minimum, every one of them gets a Christmas or holiday card (not everyone shares my beliefs) with a note, just so they know I’m still alive.

Don’t waste your time. If you’re sick, you know that time (and energy, and money, and life) is not infinite. Conserve your time and energy so that you can be a real friend to the people who matter to you. As a trivial example, I keep my Facebook friends list down to 100 or so people who really matter to me; anything else, I’d be diluting my attention and energies and slighting the people I really do care about. (Also, this lets me be super obnoxious occasionally, since all those people know me well enough to give my sense of humor some latitude).

The general principle applies more broadly: to parties, happy hours, et cetera. I still allot time in my life to make new friends (every now and then), or for charity, or for career-related social activities – where I’ve learned that being “friendly” with someone does not make or oblige you to be their friend – but I save some energy and time for the people who matter to me.

Age and experience have made me more sympathetic towards my friends – even if they aren’t great friends in the first place – and how they deal with my illness. I now realize something important: I can help them to be better friends.

I hope this helps you, too.

Duncan Cross blogs from the perspective of a chronic patient at his self-titled site, Duncan Cross.

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