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For the last two decades, model, actress, and former MTV VJ Karen Duffy has been grappling with sarcoidosis, an inflammatory disease that causes her constant pain. In this excerpt from her new book Backbone, she explains the best way you can support a sick friend.

The book of Ecclesiastes contains the proverb, “a faithful friend is the medicine of life.” Good friends are good for your health. No doctor can write a prescription for friendship, love, and laughs. The power of friendship cannot be overestimated. It’s up to us to be good friends to our friends. But some of your friends or even family members may be acting like jackasses, and making your tough row even harder to hoe.

People want the world to make sense. When a great person like you gets sick, it’s not fair, it doesn’t make any sense. You’re a swell pal, why’d it happen to you? It can’t be random, because that’s too scary. If it’s random it might happen to them. So these jackasses have to tell themselves a story, that you got sick because you ate non-organic gluten, or you work too hard, or you grew up in New Jersey. And you’re staying sick because you’re not doing what they bray. These stories soothe the fears your condition provokes in them. The healthy jackasses imagine themselves in the sick person’s situation, and in their mind, they would be sick so much better.

This isn’t just my theory. I often consult with a brilliant psychologist who studies the psychology of illness in women. She said that healthy people have difficulty conceiving what it’s like to live with a chronic illness. They just can’t face the truth that bad things do happen to good people, and sometimes it’s random chance. If you get a chronic illness, then it could be possible that they could get sick too. And that manifests in jackassery (note: not a medical or clinical term).

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