Is it the who or the what that lingers long after someone comments on your health without thinking how it might land. I’ve been asking myself this question lately as I tell more people about living with heart disease. I admit, it’s exhausting, to share the backstory.  I was diagnosed nearly 50 years ago so suddenly it sounds as if I’ve hidden the fact far too long and downplayed the relationship by keeping the news to myself.

Sometimes, it’s “what” is said that lands wrong if it’s wrapped in a kind of casual certainty that makes you question your own body. Other times, it’s not the phrasing at all, but the implication underneath: you don’t look sick, no one would ever guess, have you tried, why didn’t you tell me sooner—as if your lived experience could be solved with a quick fix.

Sadly, when a clinician rushes past your complaints, it can feel like a systemic failure, perhaps even expected. I worked with an elder lady just last evening who finds her new cardiologist distant and unresponsive to her concerns on MyChart when she is dizzy. She recanted when I suggested she speak to someone about changing doctors, “Oh, no, I can’t do that,” she said.  “I wouldn’t know how to ask.”

There are moments when the exact same words land differently depending on who says them. A stranger’s comment might roll off your back, while someone close to you—someone you hoped would understand—can leave a bruise that lasts for days.

That’s because the “who” comes with a history. It holds old stories, misopportunities, hurt feelings, and expectations.  It relies on trust and familiarity, a pattern that may have been in place for years.  Disclosing a chronic health condition can feel like inviting a third person into the conversation that no one expects.  Now what do I say?  The closer the relationship the more likely the moment creates a shift in who they see you to be.

What if, instead of trying to control every comment that comes our way (an impossible task), we became more curious about our own reactions? Not to dismiss them, but to understand them. To notice: Was it the words? The implication? The person? What it simply a bad hair day? That awareness creates a small but meaningful space where we can remind ourselves that our health is our business and others will never have the full story of what we are experiencing.

It’s best to safeguard our strength, reassess who knows what and take in the words that encourage you and leave the rest behind.  It doesn’t mean becoming stoic or immune to the “who” and “what” but rather discerning so the world sees and knows you for the real person you are.