As recently as six years ago, the National Center for Health Statistics, a division of the Centers for Disease Control, estimated that 90 million Americans lived with at least one chronic illness. Some argue that literally half the population — roughly 150 million of us — deals with some sort of chronic condition.  How do we account for such rampant growth? The most obvious explanation is that the vast cohort of baby boomers — those born between 1946 and 1964 — is aging, with the first boomers turning 65 this year. Eighty percent of all people over 65 have a chronic condition. 

Another factor is that more illnesses, including some cancers, used to be killers. But extraordinary advances in medicine allow doctors to treat them, and now they are considered chronic. Chronic illnesses by definition are incurable, but often they can be treated, with symptoms kept in check. 

As a result, vast numbers of us live with chronic illnesses, and our needs are too little understood. Often, our illnesses or disabilities are invisible to the world around us.  That may be why some people do not really believe we are really sick. But you look so good, becomes our inside joke. Our warm smiles and rosy cheeks belie the seriousness of whatever ails us.  People want to believe we are healthy, and if we look the part, then how bad can things be?

Sarah Levin Weiss, who was profiled in my book Strong at the Broken Places, is a case in point.  Sarah has Crohn’s disease, a ghastly degenerative condition that can ravage the digestive tract.  Sarah has been on regular oral steroids for much of her life. “But my cheeks are rosy and my face round, and others think I am the picture of health,” she once told me, long ago. 

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