Most pediatricians treat Children who are well or who, at worst, have an acute but Curable illness. Children with chronic illnesses don't fit. Our appointment schedules aren't structured to deal with them and they clash with our "health and normality" mind-set. Chronic diseases, incurable and possibly lethal, conflict with our need to heal, and the obvious pain and dismay of the parents is painful and dismaying to us as well. Practice might be more comfortable without them. Yet no group of patients can benefit more from the understanding of healthy development and knowledge of management of disease that are combined in today's pediatrician. The child with chronic illness is not just a case of a specific medical condition; he or she is also a child, with all of the development, psychosocial, and physical needs that are characteristic of children in general. This discussion will focus on the ways in which a child and his or her family may be affected by chronic disease, and what the responses of each to chronic disease are likely to be. The physician's responses will also be examined, as well as how the physician caring for a child with chronic illness can facilitate the adjustments and adaptations that will allow the child and his or her family to attain their greatest potential for a normal and fulfilling life.