I would like to begin by putting forward the idea that there is much to be gained from a more generic as opposed to a medical model in working with chronically sick children. I would like to consider the potential advantages of this generic approach, and then go on to consider more specifically what can be learned, firstly, from the specific example of childhood cancer and, secondly, from chronic illness more generally. Whether we work with children with cancer, cystic fibrosis or any other chronic condition, we have to be impressed by the child's capacity to ‘survive against the odds’. While early work described the problems or deficits shown by sick children, it is now clear that there is huge variability in outcomes. Many children show extraordinary resilience and coping. We are increasingly concerned about quality of life (QOL) as well as quantity of survival. In expanding on the thesis that much can be learned from other diseases, I am going to use QOL as an example.
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