Carrie looking upward, hopeful, in contemplation, outdoors with fall foliage in the background

You can have more impact than you may realize in the lives of those living with a chronic illness.

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Dr. Caroline Niederman
Patient Care Advocate, Chronic Illness Educator, Veterinarian

Roughly 50% of individuals now live with chronic conditions and many of these are invisible.

Living with an invisible chronic illness for over 15 years, I’ve experienced deep loneliness, been misunderstood, and grieved the loss of my former athletic, able-bodied self.

Along the way, I’ve encountered a range of frustrating responses—from disbelief to dismissive comments like, “This sounds like anxiety,” or “It’s all in your head.” Even well-meaning advice, such as “Just rest,” “Exercise,” or “Have you tried eliminating X, Y, or Z from your diet?” reveals how often people—despite good intentions—fail to truly hear and understand what I’m saying. 

Living with an invisible chronic illness leaves me feeling unseen, as though my life has been relegated to the feeder road, running parallel to the fast lane of others’ predictable, linear lives.

Path to Understanding Timeline: Pre-Chronic Illness, Virus Hits, Viral Infection Becomes Chronic, Invisible Symptoms Affecting Daily Living, More Resilient with Support
Carrie pre-chronic illness, working as an Equine Veterinarian looking inside a white horse's mouth.
Carrie pushing her hands out, blocking her face demonstrating the feeling of living with uncertainty with invisible symptoms affecting her daily living, and experiencing friends and family having trouble believing her.
Carrie in her home, piecing together a puzzle.
The Midnight Effect Venn Diagram showing the 3 elements of The Midnight Effect, 1. Self-Reflection + Acceptance 2. Wellness + Coping Strategies 3. Communicate + Advocate

The Midnight Effect is my visual to bring about true understanding.

Self-Reflection + Acceptance: Reminds me that resets are now part of my daily life. I have not done anything wrong when my body signals it needs rest.
Communicate + Advocate: Serves as a tool for communicating the invisible and unpredictable nature of chronic conditions.
Wellness + Coping Strategies: Inspires pacing methods, energy conservation practices and self-care for navigating life with uncertainty.
Carrie's Message on Connection with Competence includes these 6 elements: Conversation, Learning Pathways, Backup Strategy, Pivot Signal, Conscious Listening, Understanding,

My Guiding Principle

The purpose of my work is to provide tools that foster deep connection and enhance competence when facing the impact of chronic illness within families and communities.

At the heart of this mission is the recognition that meaningful conversations are essential to understanding how chronic illness fundamentally reshapes life, where time becomes both unpredictable and nonlinear.

Through conscious listening and attention to even the subtlest physical cues, we can cultivate a deeper understanding. This intentional approach strengthens bonds, making our connections more resilient and meaningful.

Here’s how we can make an impact together!

This is the model that I use to illustrate the crucial pieces to increase competence in chronic illness care and increase the level of connection with your patient or loved one. Understanding and implementing this approach will support those living with a chronic condition to thrive.

Graph image demonstrating the elements that support increasing the Level of Connection with the Level of Competence in Chronic Illness Care

Conversation + Understanding is at the core of this work.