How to Write About Characters in Permanent Physical Pain

Hey guys! So, today will be another Writing Tips post. I just have so much fun writing these! It’s fun for us writers to share the tips and tricks we use to make our books amazing.

Today’s Writing Tips are on characters in permanent physical pain. These include characters who are sick and/or injured. And not like a broken leg or a cold that will get better on its own, sooner or later. I’m talking about physical illnesses and disabilities that are ALWAYS there and will never go away or even get better on their own. I’m talking about permanent, lifelong, chronic.

I think these characters are very important and should show up in fiction much more often. Because thousands of readers will have chronic physical illnesses and disabilities, and to see characters in stories that are like them can be very inspiring. Many readers, even those without chronic pain, will be encouraged by a character who is strong, perseveres, and doesn’t let their condition define or control them. I feel like the main reason we don’t run into physically weak characters very often is because we don’t know how to write them. We don’t want to sound ignorant or offend people, or maybe we just have trouble imagining chronic pain, so we avoid those characters in our stories. And that’s wrong! If we learn to write these characters effectively, they can add something very special and powerful to our stories.

In The Apostle’s Sister, Paul is my character in permanent physical pain. He’s scarred, suffering from lameness and relentless pain in his back and limbs because of the physical abuse he endures. Countless floggings and other horrible stuff, needless to say, will affect your body in an awful way. Besides that, Paul also suffers from a relentless chronic illness: the fevers that recur each month for days at a time and leave him extremely weak, and the infection causes such damage to his eyes that he is sometimes unable to write his own letters.

Anyway, these are some tips I’ve learned from writing about Paul’s chronic pain. I hope my tips will help you if you want to write a chronically in-pain character but aren’t sure where to start. And if you have any tips I didn’t mention, feel absolutely free to share in the comments! The more wisdom, the better!

(During this post, I will call the ill character the “IC” just so I won’t have to keep repeating those long words. XD)

So how about we just begin?

1. Know your stuff!!

This is super important! You must do your research. Keep in mind that some of your readers will be very knowledgeable about the illness/disability your IC has. If your information is inaccurate, they will know, and they’ll let you know they know. (That sounded super weird. I hope y’all understood what I was trying to say!) Not to mention that inaccuracies can be offensive to people living with the illness/disability. And that’s the last thing you would want to do.

Any of y’all ever faked sick to get out of school? (I hope not. And for my part, this is one thing I never did XD.) Any informative YouTube video on the subject will tell you to know which illness you’re going to fake. You can’t claim to have chicken pox when there are no spots on you. You’re going to want to claim you have a flu, and prove it by making fake vomit and sticking the thermometer in hot water. (Which, let me say, sounds like a whole lot of work.) Writing about a chronic illness/disability is like that. You’ve got to know your stuff.

For example, you can’t just say your IC has cancer. You’ll need to specify which kind of cancer. You’ll need to know the symptoms, causes, treatment options, which group of people are at the greatest risk, etc. Read medical articles from reputable sources such as Mayo Clinic and Healthline. Talk to someone who has the illness/disability (but only if they offer, because it might be personal). Talk to a family member or friend who is a medical professional.

Another little example: For The Apostle’s Sister, I did a lot of research on how physicians from Biblical times would have treated Paul’s illness. His friend Luke, who treated his fevers, was a Greek physician, and I needed to know how Luke would have tried to make him better. During my research, I discovered that Greek physicians believed in four humors: black bile, yellow bile, blood, and phlegm. They thought fevers were caused by an excess of blood, and if they drained some blood, the fever would go away. That’s why Greek physicians did so much bloodletting. They thought that people with fevers got flushed because of too much blood, and that it was a good sign when the patient was pale and quiet after the bloodletting was done. (Obviously, today we know that to be untrue. Bloodletting caused horrible unnecessary pain and made you much worse instead of better.) Physicians also administered emetics, a kind of medicine that made you throw up until all the bad stuff was completely purged. (I know that’s not exactly lovely information, but I needed to know it, because that’s how Luke would have treated Paul!)

Anyways, all this to say that to make the IC realistic and believable, you’ve got to know your stuff! I can’t stress this enough. Do your research carefully.

2. Don’t make the IC use their illness/disability as a weapon.

Let me repeat this: Don’t make the IC use their illness/disability as a weapon! Trust me, this is probably the worst thing you could ever do. It’s highly offensive to people who live with chronic pain, because their pain is real and they do not use it as a weapon.

What I mean by “using the pain as a weapon” is basically the IC using their pain as an excuse to be mean, abusive, nasty, demanding, vengeful… you get the picture. And the other characters put up with their spoiled behavior because “Oh, so-and-so is sick. Poor thing, she’s not herself, it’s not her fault, et cetera et cetera.” Just. Don’t. Do. It. Being in pain is no reason to be cruel, and the chronically unwell are not like that. It’s just so offensive when chronically unwell people in fiction are portrayed that way. It’s not true, and it’s very hurtful.

I read a book this summer where the author made this horrible mistake. I’m not going to name the author or the book, because I really do love this author and her books. I just really don’t appreciate what she did here. In the book, the IC appeared kind and patient, even labeled “the angel” of the town. However, in the end we find out she was never ill. She faked the illness for years, in order to get revenge on her family and force them to care for her.

I just hated that portrayal. It really is hurtful. Please don’t do it.

3. The IC’s illness/disability should not define them.

Amen to this, am I right? The IC’s illness/disability should not define them. It just shouldn’t. I feel like too many ICs in fiction are established to the reader as “The Sick Person.” It’s just not right. A physical condition never defines a person. Their heart and their actions define them. Your IC should not have the illness slapped all over them like tattoos on their forehead. They should not lie in bed, calmly reflecting on their lost future and ignored in their chamber or hospital room while your “strong” characters get the amazing character arcs, adventures, love lives, etc. They should not serve as simply a tool for your theme of suffering. Of course, in TAS, Paul’s physical condition certainly plays a large role in the theme of suffering, but it never defines him. Your IC should not be a cardboard cutout with a big label slapped all over them.

In Little Women by Louisa May Alcott, Beth is sick with scarlet fever. But although she is sick, she continues to be generous and help others. She is active, extremely useful to her mother and sisters, and enjoys aiding the poor.

I know this isn’t a book, but one of the main reasons I really enjoy the Netflix sitcom Alexa & Katie is because Alexa, who has leukemia, is absolutely the strongest character on the show! She refuses to let others define her by the cancer. She wants her classmates to treat her the same as they always have. She wants her mother to discipline her just as her older brother is disciplined. She wants her guy friend to ask her out because he likes her, not because he wants to show her pity or charity. And when Spencer, another character with cancer, goes viral online for his basketball performance as “Cancer Guy” she is intensely upset. Alexa is totally right! An illness does not define who you are.

In TAS, Paul is sick and disabled, yes. But he doesn’t let that fact define him. Some people might laugh at a fevered and crippled apostle, calling him useless, weak, and too undignified to be listened to. But Paul doesn’t let that stop him. He isn’t defined by his physical condition. Quite the contrary!

I reveal the strength of my “weak” character by showing how Paul goes out and preaches and baptizes and performs miracles even when he’s suffering intensely from fever and the pain of his twisted body. He doesn’t stop his work for anything – he cares about the people whose souls are sick, not about himself who is physically sick but spiritually whole. He realizes that spiritual pain is much, much worse. He lives by Jesus’ declaration, “My Father worketh hitherto, and I work” (John 5:17). He heals other people’s physical conditions, and is not angry with God that it’s not His will that he heal his own.

This is not to say that your IC can never get the rest they need. Which brings me to our next tip!

4. Let your IC rest.

Sometimes we can get so caught up in portraying our ICs as the strong people they are that we forget they still have a physical condition. Reminding the reader that your IC is indeed physically unwell does not mean you’re labeling the IC as “the weak, sick one.” It’s simply acknowledging that the whole reason you’ve been following these tips is because your IC is sick. Their body might be weak, but that doesn’t mean their spirit is. My point is that it’s completely okay, and in fact completely necessary, to let your character rest.

Just don’t reduce them to a lifeless heap in bed.

Since I’m bad at explaining, how about another example from TAS!

I do have parts when Paul is absolutely unable to get up from his pallet. He’s overtired, feverish, in pain, and at times even delirious. He needs Temira’s reminders that God wants him to take care of himself as well. He needs her tender nursing, Luke’s medical advice and treatment (even if modern doctors would be horrified LOL), and just a time of rest and peace and quiet. A time when people aren’t crowding around him and knocking him around trying to touch his robes. And this absolutely DOES NOT mean Paul is spiritually weak or lazy. It means he’s a person with limited physical strength. He’s not a superhuman.

And as Paul lies resting and recovering, he’s still active. He instructs, comforts, and teaches his friends. He prays. He reads Scripture with Seth, and spends quality nap-time with him (which I think is really sweet XD). It’s an opportunity for Temira to have cherished alone time with him, without the noise of the crowds.

Basically, it’s the farthest thing from sin for Paul to take care of himself. If he didn’t, thousands would lose their beloved teacher. Sometimes he needs to be reminded to get some rest and not push himself into the tomb. This goes for all ICs. It DOES NOT mean they’re weak – it means they’re strong and wise to care for the body God gave them, which is His temple (1 Corinthians 6:19-20).

5. Don’t make your IC a whiner, but don’t make them perfectly angelic. Both are unrealistic.

I think we’ve all met these too-common IC stereotypes. There’s only two categories for ICs: One, either they’re a complete grump, full of self-pity for their excruciating lot in life and whining that people will be grateful when they’re gone; or two, they’re that perfect angel who never mentions their illness and pretends they’re not even in pain.

I’ll repeat that both these ICs are unrealistic. You want to find a median between the two.

But what is that median?

The fact is that although people are resilient with God’s help, they still feel pain they cannot ignore. Sometimes it will become too much. Sometimes you’ve got to get your feelings out, because keeping all those emotions bottled inside is not good and will only cause you harm. Sometimes you’ve got to cry or groan. And there’s no shame in that. Even Jesus wept. Being strong and patient does not require you to pretend you’re okay when you’re not. It doesn’t mean you’re a whiner. Creating an IC who bottles up their emotions just to be a “perfect angel” sends a very harmful message to readers.

Your IC just should not wallow in self-pity. And they should not complain incessantly and curse God or others.

Again, an example from TAS!

Three things Paul never once does is wallow in his self-pity, complain incessantly, and curse God or others. However, he DOES experience seasons of extreme discouragement and depression. Scars and fever take their emotional toll. There are times when he confesses privately to Temira that the pain has reached the point of unbearable. He’s an emotional human being. He’s not going to be unaffected by his painful physical condition.

6. Don’t forget their interaction with other characters and how the illness/disability affects that.

Don’t forget your other characters! The IC interacts with other characters, right? And their illness/disability will affect those relationships. In a novel, each factor should affect ALL characters, not only the protagonist and/or antagonist. The more characters that are affected, the more powerful the novel will be.

There are a couple rules for doing this efficiently. First, the IC’s relationships should NEVER revolve around the illness. Here are a couple things you will want to keep in mind:


– Create realistic reactions from your IC’s loved ones. It’s the worst to see someone you love in pain. Make sure to portray the worry, fear, and sadness that the loved ones feel. It’s not like they’ll be able to ignore their own feelings or pretend they’re not upset.

– Your IC’s enemies will likely be pleased by the weak physical condition and use it to their advantage. If you’re writing a novel with lots of swordplay, this might be literal, like when the antagonist attacks during a spell of faintness. But I’m talking mainly about your IC’s enemies mocking the physical condition and trying to convince the IC they’re “too weak” and to just give up.


– Turn your IC into a pity case among the other characters. Don’t make everyone be extra sweet and benevolent to them just because they’re sick. One thing that shows up WAY too often in novels and is super annoying is when one character is seen as a hero because they’re nice to the IC. Like the heroic kid hanging out with the IC at school who’s an outcast because they walk with an obvious limp. And everyone treats this “kind” character as a hero just because they show decent human respect to the IC. That’s just… no. Don’t do it.

– Make each interaction about the illness. The illness doesn’t have to come up in conversation whenever your IC is chatting with a friend. In fact, it shouldn’t. People with chronic pain are no different from those without. They enjoy chatting about movies, books, and funny memories from summer camp. You can certainly have another character ask them, “How are you feeling today?” or something like that, but don’t make every conversation about nothing but the illness.

Now for examples!

Keep in mind that each different person will have a different reaction to your IC’s illness, and that’s completely normal and okay. They won’t all react the same, even if they’re all loved ones, or even if they’re all casual acquaintances, or whatever. Some might react with confusion, some with fear, some with anger, some with sadness, etc. I’ll explain by using character examples from TAS:

1. Seth

Seth is not fully aware of the seriousness of his uncle’s feverish illness until he’s older. Being only a small child, he’s sometimes oblivious to things going on. Everyone conceals it from him, not wanting him to worry. In fact, sometimes they go to such measures that they manage to keep it from him completely. But they also underestimate him. He might be very young, but children are smart. They can sense things. Seth can feel the anxiety of his mother and older brother. He can tell by his uncle’s appearance and demeanor that Paul is not well. I have one scene where Seth catches Temira completely off guard by telling her he knows Paul is sick, and he’s upset no one told him, believing he’s too young to understand. Temira tries to quell him by saying that she will do all the worrying, and a few times she even tries to evade his questions or be outright dishonest with him. But Seth isn’t buying it. Temira might think she’s protecting her son by not telling him the truth, but in fact she is both patronizing him and frightening him. That negatively affects Seth’s trusting relationship with both her and Paul.

2. Temira

When Temira first finds out that Paul is sick from serious fevers, she reacts with anger, and the target of her anger is him. At first we might think her reaction is harsh, but it’s not. It’s completely justifiable. Paul hid his illness from her for a long time, and understandably that makes her angry because she’s his sister and she loves him. She deserved to know right away. He absolutely should have trusted her enough to tell her. Of course, he kept it from her in order not to frighten her and add something else for her to worry about, but he actually ended up hurting her and their relationship. (I just realized that, quite ironically, Temira does the same thing to Seth.) So that negatively affects Temira’s trusting bond with her brother.

Paul’s scars and lameness are excruciating cuts in Temira’s heart, because she’s his sister and feels his pain. Many times she wishes she could take the pain away from him and take it on herself, because she can’t stand to see him always in pain. Each time she looks at him, she sees that he can’t make the slightest movement without feeling the pain, and she is over and over again reminded of the horrible events that made him that way. She sees his blood on synagogue floors, pillars, and prison cells. She hears the laughter as he is tortured and whipped. It’s extremely traumatic for her, and she is reminded of it EVERY time she looks at Paul. She wishes she were the one tortured and whipped and starved and thrown in prison, not him. This creates a lot of tension and emotion during the story. Helping Paul deal with not only his physical pain, but also his own trauma, places a lot of strain on her and sometimes on their relationship. It’s hard to love someone who suffers, and it’s hard to keep on suffering with them.

3. Priscilla and Aquila

Priscilla and Aquila are two characters from TAS that I don’t believe I’ve mentioned yet in any of my posts. So now y’all get to hear about them for the first time. Yay! I haven’t mentioned them because they don’t play an especially huge role in the novel, and don’t have a lot of appearances. But I think they still add something very valuable to the story, and they’re my favorite minor/background characters from TAS.

Anyways, Priscilla and Aquila are an older married couple who are good friends to Paul. He first meets them while serving in the city of Corinth. They give him a comfortable place to stay in their home, and he teaches them about Christ. As a result, they both give their lives to Jesus.

Paul actually meets Priscilla and Aquila because they recently came to Corinth after being thrown out of their home in Rome (Emperor Claudius expelled all the Jews from Rome; Acts 18:2). Obviously, this is a terrible situation. Imagine being forced from your home just because you’re a Jew. To make matters worse, Priscilla and Aquila had to leave behind their son’s grave. He died while very young – from the same fevers Paul suffers from.

So when Priscilla and Aquila meet Paul, they’re still mourning their son’s death and the fact that now they’re unable to visit his grave. So when they see that Paul is sick from the very same illness that killed their son, it affects them in a deeply personal way. Their compassion doesn’t come from mere human pity, or even in reciprocation to the kindness Paul shows the people. It comes from their personal tragic experience, and brings back bittersweet memories of the suffering their son endured before he finally lost his battle.

Priscilla is especially affected because mothers have a unique kind of instinct about them. Aquila was only a father, so while he certainly loved his son deeply, he didn’t have the same kind of connection with him that Priscilla had. So Priscilla, with the motherly heart she naturally has, is touched with tenderness for Paul because he reminds her of her sick son. It’s like she has her son back, in a way, and caring for Paul comforts her because it’s like she’s caring for her son again. So she does everything she can for his comfort, and both she and Aquila treat Paul like a son. And when they meet Temira later, they treat her like a daughter. And obviously, their gentle treatment of Paul evokes Temira’s sincere love and gratitude to them before she even meets them.

It’s important to note that through all this, Priscilla and Aquila do not see Paul as a mere pity case, just as they didn’t see their son that way. In fact, when Priscilla meets Temira, the first thing she says is that the first time she saw Paul, the first thing she noticed about him was his strength in going out and speaking to the people in the synagogue although he was clearly ill. (Wow, that was a run-on sentence!)

4. Paul’s enemies

Since all three of the above examples were people on Paul’s side, I’ll talk a bit about his enemies. As I already mentioned, they used his physical condition as more reason to mock him and point out why he shouldn’t be listened to. Suffering and pain was seen as a curse brought down on someone from God, and if Paul was cursed by God, what was his business in preaching about God’s Son? They didn’t see, as we do, that it’s an honor to suffer alongside Christ (Philippians 3:10-11, 2 Corinthians 1:5, 2 Corinthians 4:10, Colossians 1:24, 2 Corinthians 12:9-10).

I’ll give a specific example regarding Paul’s enemies. Consider the false apostles who went to Corinth, seducing the people into believing that Paul was just some weak, feeble guy with no business teaching them. They boasted about their strength and the power of their teaching, while this is an example of the kinds of comments they made about Paul: “His letters are weighty and strong, but his bodily presence is weak, and his speech of no account” (2 Corinthians 10:10).

So that’s an example of how your IC’s enemies might use the physical condition to their evil advantage.

7. Above all, lovingly remind your readers that although pain is an inevitable part of this world, it will have no role in the next.

Let me repeat this:

Above all, lovingly remind your readers that although pain is an inevitable part of this world, it will have no role in the next.

In this world, there is illness and disability. And it’s sad. There’s nothing good or lovely about it. But the good news is that in heaven, there will be no pain of any kind.

Image Credit: Biblia Faithlife

Amen to this!!

Hope you guys enjoyed today’s post!

I hope these tips were helpful for you! Again, if you have any thoughts or any tips I didn’t mention, please share in the comments. I’d love to hear everything y’all have to say!

You know the drill – eat, pray, write, repeat!


9 thoughts on “How to Write About Characters in Permanent Physical Pain

Add yours

  1. Wow. Just wow. This was such a good post. I am thinking about creating a story with characters that go through this, and this really helped me! Your current WIP sounds great, too…something I’d really enjoy reading! Thanks for sharing.


  2. I’m FINALLY CATCHING UP ON ALL OF THESE POSTS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! *throws out party streamers* Yep!!! I COMPLETELY agree with EVERYTHING you said!!!!!!! There were some extra things I was thinking about that I wanted to say in the comments but by the end of the post I kind of forgot it sooooooooo I’m not quite sure what else to type. XD 🤣 My brain’s actually been running VERY slow after that past week of writing. 😂😂 (My stats came in today and I wrote a total of over 34K words for over 28 hours this past week. I don’t think I’m ever gonna do that again. XD) I don’t normally write about characters with illnesses ’cause I already know I’d mess it all up so I’m not even gonna try but I think it’s AWESOME for you to do this!!!!! And I do think we need some more stories out there with characters with illnesses leading the story!!!!!!!!!!!!!!!!! I liked you ending it with the seventh point!! A W E S O M E!!!!!!!!!! And sooooooooo true!!!!!!!!!


      1. I have absolutely no idea!!! I don’t even think half of the words I wrote even make any sense. XD But it was fun just pushing myself like that!!! I had started the week being like I’ll try to write 20K but I don’t think it’s gonna happen. And now too many words and late nights later my brain is ultimately shutting down. 😂😂😆 I think I’m gonna take a little break.


  3. Wow! I can’t believe I never thought about this before. Thank you so much for sharing these very helpful tips!!!!!!!!!!!!! I really like that you said the illness/disability does not define the character. It’s their heart that does. I loved all your points and the examples! And I also really liked how you wrapped up the ending with hope for a perfect life in Heaven with Jesus!!!!! 🙂


    1. Thanks, Katherine! It does get me really upset when I read about ill characters in books who have no lives beyond their physical condition. That’s why I liked Little Women because Beth still had a life like her sisters.


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