To help explain systemic infections such as neurological Lyme disease, Dr. Richard Horowitz uses an image of a patient with 16 nails in his or her foot. Even if a physician can diagnose and effectively remove four of the “nails” the patient is still left with 12 nails in their foot. These “nails” include parasitic infection, immune dysfunction, inflammation, insomnia, vitamin deficiency, food allergies, and more. I propose a “17th nail” which is the psychosocial effects of having a chronic illness in our society. Identity change, loss of employment, stress, anger, and social isolation can all affect the well-being of patients and their families.