Wednesday, March 25, 2009


I am sick.

Yesterday at work my eyes were so swollen and my cough so toxic-sounding that even the surgeons were sympathetic. My head hurt. My throat hurt. My joints ached. My nasal passages were so congested I had to breathe through my mouth all day. Sick, sick, sick.

What on earth was I doing at work?

The answer is simple. Doctors don't call in sick. Or, I should say, doctor rarely, rarely call in sick.

We are held to a very high (unspoken) standard of dedication to duty. We are expected to put the comfort of others before our own, our patients' needs before ourselves. If there's work to be done, we are simply expected to DO IT. No right to "go on break" at regular intervals, like some other health care professionals. No lunch if it's too busy. No sleep if there are cases to do at night. And yes, no sick days.

The week after I broke my arm during internship I was back at work, performing my duties with the other arm. No extra time off. No strong painkillers allowed. My boss once hobbled around with a walker after a foot fracture. I've put IVs into my colleagues at work so they could keep functioning. Patient care first, at almost all costs.

There's a stigma attached to calling in sick. You'd better be practically DYING if you do. Even if half your guts are on the floor, you still get a version of the snippy, skeptical, "Oh, OK, MAYBE that's true, so I GUESS we can find someone to cover for you" at many places - by "vibe" if not by verbal utterance.

There are other unspoken judgments that accompany sick calls. That's WEAK, Doctor. Can't you suck it up? Are you as dedicated to your patients as you pretend to be? And now you have to tax your colleagues to do YOUR work FOR you? Weak, weak, WEAK.

I am counting my blessings: I am on call tonight, which means at my current place of work that I don't have to be at work until 3 p.m. So I slept last night and slept in this morning and will rest in bed all day until I have to report for duty. My mother-in-law graciously came over to get my kids off to school.

"Can't you call in sick?" She asked.

"No," I replied, perhaps a little resentfully, blowing my nose.

"That's crazy. You look terrible. Won't your patients get sick too?"

"I can avoid breathing on them and touching them ungloved. One advantage of my particular specialty."

"It's still crazy. You're sick. You should be in bed resting."

"But I'm on CALL. The only thing worse than calling in sick for a regular work day is making someone else do your CALL for you. Doctors don't call in sick, Maman. It's just not DONE. There are patients to take care of, and with two docs out on vacation, we're a little overstretched as it is. "

Doctors don't call in sick because they feel they can't. It's not culturally acceptable - and that's a culture code that's very hard to break, or to change.

But maybe with enough orange juice, Tylenol, and a squirt of phenylephrine into my nasal passages, I'll be better by this afternoon. Fingers crossed.


Michael Leddy said...

What, no Airborne? : )

Get well soon, T.

Elaine Fine said...

I second that.

Jo said...

{hugs} Hope you get better soon.

It does seem a poor culture code, though - surely if you are sick, not only is there a risk of passing infection on to your patients (and surely you are dealing with the very sickest, who can't afford to have a cold on top of everything else!), but you aren't going to be performing at your best, which could be detrimental to patient care.

T said...

Thanks, all!

Jo - I agree it's poor, both for me and for the patients; but no one's come up with a good solution so far. Just have a look at the comment board here and you'll see what I mean:

Oh well - at least call is over, and I'm off this weekend!

kkkumar said...

Cool post....

Patty said...

I do hope you are feeling better!

Oboists don't call in sick either. Heck, I've been at a rehearsal where I've had to go throw up and then come back and finish up the rehearsal. I played as a family member lay dying. I've played and bled on the instrument. It's just what one-on-a-part people do. String players call in sick. (Uh-oh, I'm going to get in trouble now!)

And here YOU are, in medicine AND playing oboe. You are in big, big trouble there. Hmmm.

Anyway, heal quickly.

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diptesh said...

get well soon...
your writings are really good...very natural...

BigBeaconHiker said...

I have been there. I was sick one night before I was starting a locums at a hospital I had never worked at before. Up all night, fever and at times thinking about going to the ER(Hi, I'm the new doc and I am really sick). Made it through with my DOC(Excedrin). I did call in sick one time. Spinal cord contusion and temporary quadraplegia. I don't anyone snickered about that one.