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The Challenge of Chronic Illness

I. Barry Pless, MD; T. BARRY PLESS, MD
Am J Dis Child. 1973;126(6):741-742. doi:10.1001/archpedi.1973.02110190593001.
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The one feature that permits us to consider disorders as biologically diverse as diabetes, asthma, epilepsy, and hemophilia in the same light is the simple fact of their chronicity. Because most chronic illnesses are not curable and few will improve spontaneously, the care of children with these disorders is frustrating and complex. For many of these children the assistance of co-professionals is required, and the pediatrician's job becomes as much that of manager as active therapist. Because these disorders will persist for long periods if not indefinitely, there is a distinct risk that some children will begin to regard themselves as "sick" and "defective," rather than as persons with a sickness or defect. The evidence suggests, when this occurs, that secondary psychological and social disabilities follow, so that eventually the original disability may be compounded by secondary handicaps that will have further adverse effects on the child's future.1 The


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