I was just reading the column by The Washington Post’s agony aunt, Carolyn Hax, which today centered on a couple’s upset over another couple’s last-minute cancelling of plans to dine out. In this case the offending couple’s cancellation was so last-minute that the hosting couple would not have been able to cancel their restaurant reservations. One member of the hosting couple was seeking Carolyn’s opinion or whether or not she had mishandled the situation by labeling the offending couple’s wedding-registry-matters excuse as “lame.”

Reading this made me feel just a bit like a Martian. My spouse and I are both disabled by chronic illnesses, and we no longer have to worry about cancelling plans with friends at the last minute. We used to have to do that — given the inconsiderate vagaries of our illnesses — but in our culture, cancelling plans with friends is a highly effective way to end up having no friends at all. It’s possible that we could have held onto our friends if we had negotiated the pitfalls of our conditions better, but based on conversations with others disabled by chronic illness, it’s not all that uncommon an occurrence.

I don’t think that healthy people intend to dissassociate themselves from anyone who’s chronically ill, but many serious chronic illnesses don’t announce themselves as such all at once. They can come on gradually, which lulls the sick person into making unrealistic plans that they hope that “this time” they’ll be able to handle. And for the healthy friends, having someone, repeatedly, make plans and then cancel them, feels like a rejection.

I had one person in my life who I thought was a potential friend who remarked, after I yet again cancelled a planned get-together, “I don’t understand why you’re only willing to associate with chronically ill people.” At the time I was flabbergasted by the remark. To me it felt as though it came out of left field, but I wonder if perhaps she assumed that I was playing by rules that would be acceptable to chronically ill people? Dunno, since she never contacted me again, and at the time I was stung enough that I didn’t contact her.

I wish that there were some recognized set of social rules for friendship between healthy and chronically ill people. Among the healthy, cancelling plans at the last minute is a sign that one does not value the friendship. It needs to be better understood that that’s just not how it works with sick people. We want and need friends of all kinds, but going through with plans to go out and do something is an iffy enterprise for us. Perhaps we wake up sicker than we’ve been of late. Perhaps we look into the bathroom mirror to see one side of our face drooping horribly or swollen up and unrecognizable. Perhaps our bowels are suddenly raising hell with us and we are terrified of being more than ten steps away from a restroom. Perhaps it’s been so long since we’ve been out of the house that we end up having a disabling anxiety attack at the thought of going out into the world. There are all kinds of perfectly good — and rather embarrassing — reasons why we might have to cancel plans at the last minute.

Here’s my advice to you if you are a relatively healthy person whose sick friend bails on you at the last minute: Try to be gracious. Don’t act like it’s all that big a deal. And end the conversation by offering to drop by to visit the sick friend in a couple of days, “just to see how you’re doing.” Once there, don’t bother saying, “Listen, if there’s anything you need help with let me know.” We’re often much too embarrassed to follow up on such good-hearted offers. Instead, think of something specific, like, “I’m going to go shopping tomorrow, could you give me a list of things I could pick up for you?”

If you keep your eyes and ears open, you might discover other things your friend needs but is embarrassed to ask for help with, and the act of helping your friend might give you a chance to gain a better understanding of what it is she or he struggles with. It’s hard enough being chronically ill without feeling like a social pariah as well.

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