To mark Disability Pride Month this July, Lyrical Muse presents our personal essay collection ” Before you assume, let me tell you…”. The first essay comes from award-winning aesthetics doctor Dr. Heather Wilkins who shares her story as a medical professional who has dealt with multiple invisible disabilities of her own.
Before you assume, let me tell you… “People like you could never understand.” I hear those words more often than you might think. Usually at work. Usually from someone who has no idea they’re talking to someone who understands far more than they realise.
I’m a doctor. I’m also disabled. I live with multiple invisible physical health conditions, neurodivergence, chronic pain and mental health conditions.
Every day starts and ends with medication. Every day involves weighing up what my body is capable of and what it will make me pay for later. Most people don’t see any of that. I’ve become very good at making sure they don’t. Masking isn’t something I chose; it’s something I learnt. It helped me survive medical school, hospital corridors and busy clinics. It helped me keep going when stopping wasn’t an option. It’s also exhausting. Only now, in my forties, am I beginning to let some of those carefully built walls come down. Brick by brick.
These days when a new doctor asks me, “Any medical history?” I usually smile and ask, “Would you like it chronologically, top to toe or by body system?” Humour has become one of my coping strategies. Apparently I “look better than my medical notes.” They’re not wrong. My notes tell a story that most people would never guess from looking at me.
Ten years ago, I underwent a six hour operation to remove a liver tumour the size of a tennis ball. Before surgery I was told I had a 60% chance of surviving just the operation. The tumour had been found completely by accident. I had walked into hospital expecting reassurance about one problem and after driving home received a devastating call that I had another. I still remember asking the hepatology surgeon whether it would be keyhole surgery and whether I’d be home the same day. The specialist nurse gently took my hand. “No, love,” she said. “This is serious, this is big.”
“Invisible doesn’t mean insignificant. It doesn’t mean easy. And it certainly doesn’t mean imagined.”
In intensive care afterwards I noticed one eyelid had started to droop whenever I sat upright. I mentioned this to the nurse and was seen by the on-call neurologist. My suspicion that I’d developed positional Horner’s syndrome was correct. I had.
Doctors aren’t supposed to diagnose themselves. Sometimes, though, years of training become impossible to switch off. That wasn’t the last time my own medical knowledge helped me recognise something unusual. Nor was it the last time an incredible consultant took the time to listen, look again and see the answer. I’m grateful for every clinician who saw beyond the obvious, behind my smile, behind the mask. Because not all of them did.
One of my invisible conditions is Ehlers-Danlos syndrome (EDS). It took years. Five dislocated knees. Reconstructive surgery. More tests, more referrals. And finally someone recognising that, sometimes, when you hear hoofbeats… …it really is a zebra. Looking back, I wonder how much also changed after being a passenger in a major road traffic collision in 2011. Just ten days after recovering from emergency surgery for a burst appendix, my husband, another junior doctor friend and I found ourselves treating casualties and decreased at the roadside before being assessed ourselves.
“The hardest parts of having a hidden disability is often the part nobody witnesses.”
Trauma doesn’t leave just visible scars. Sometimes it changes you. For years afterwards, I became an expert at looking well. Because patients needed their doctor. Friends needed the version of me who always said yes. Family needed reassurance. And somewhere along the way, I convinced myself that if nobody could see my disabilities, perhaps they didn’t really count. Maybe they weren’t ‘that bad’. I know now how wrong that was. Invisible doesn’t mean insignificant. It doesn’t mean easy. And it certainly doesn’t mean imagined.
The hardest parts of having a hidden disability is often the part nobody witnesses. The cancelled plans because your body simply says no. The crash and recovery after smiling through an event. The pain that arrives after everyone else has gone home. The endless appointments. The medication alarms. The mental calculations before agreeing to do something that other people never have to think twice about. Part of my work now involves asking patients about body dysmorphic disorder. It’s a conversation I approach carefully, because I know how complex and deeply personal it can be. What most people don’t know is that it’s something I’ve lived with too. In my twenties I underwent surgery in the hope it would help. It didn’t. Long before that, I was the girl at school who was badly bullied for her skin, labelled and dismissed in ways that stay with you far longer than people realise.
Life has a strange way of coming full circle. Now I work in aesthetics part time, helping others feel more comfortable in their own skin, and I’ve been fortunate enough to be recognised for that work. But none of that erases where I started. If anything, it’s what allows me to sit with patients and understand what they’re really asking for.
“Don’t judge someone’s health by how they look on their best day. Don’t mistake composure for the absence of struggle.”
Today I’m still a doctor. I’m also proud to be a disability advocate. Not because I’ve got everything figured out. But because I’ve sat on both sides of the consultation room. I’ve cared for people whose lives were turned upside down. And I’ve been the person hoping someone would believe me.
So when someone tells me, “People like you could never understand,” I usually just smile. Not because they’re right. Because they couldn’t possibly know.
Before you assume, let me tell you this. Some of us have become experts at looking okay. Some of us have learnt to hide our pain so well that even those closest to us forget it’s there. So please… Don’t judge someone’s health by how they look on their best day. Don’t mistake composure for the absence of struggle. And don’t assume that the person standing in front of you has lived an easy life simply because you can’t see their scars. I understand. I always did. You just couldn’t see why.
Written by Dr. Heather Wilkins
Dr. Heather Wilkins, 41 is a doctor and businesswoman, based in the UK. Currently the owner of multi-award winning aesthetics clinic Angel Aesthetics ( Instagram). Heather has earned accolades such as the Inclusive Business of the year 2025 at the SOS Beauty Awards and National Aesthetician of the year 2024 & 2025 at GB Beauty Awards.
Keep up with our Disability Pride essay series on Lyrical Muse.
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