My four day long weekend has been spent largely in bed, sleeping. Nursing a sore throat and general fatigue, keeping hydrated and popping paracetamol. As a model employee I am keeping sick days to my free time. I’m hoping I’ll wake up tomorrow magically restored with new energy. Feeling physically well, in time for my set of 5 evening shifts. It made me want to write a post on it though, how as a doctor you’re pressured into working through illness. Let’s dive into the facts, the stigma, and why it is so hard to take a day off.

In an ideal world I would call in sick tomorrow if needed, spend the day resting up in bed again. My husband is urging me to do so, but in the back of my mind I know I can’t. This year, I have used 3 sick days already (when I had a really bad outer ear infection). I know that fellow workers do not take sick calls well. Many doubt the truth and speculate about it amongst themselves at work.

They’ll ask what is wrong with you, why you can’t come in, and then gossip about how so-and-so is making up a good excuse.

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Logically we know doctors can get sick

Your colleagues logically know that it is impossible to remain healthy for 365 days of the year, every year. It is even more tricky to keep well when you are surrounded by illness. You often catch the virus that has sent the coughing children into your emergency department in the first place. Or you may contract it from sick co-workers who are ‘working through it’.

The hospital is a veritable breeding ground for contagious disease. We can see it to an even larger scale now, with the pandemic. So many health care workers have been infected with COVID-19, with over 3000 dying from the virus.

Mix this environment of illness with long work hours, lack of sleep and stress. It is a recipe for getting sick, and feeling physically unwell. The mental wellbeing of medics is not even being considered in this argument, which is shamefully even harder to speak about in the medical profession.

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Why is there a stigma around doctors being sick?

There are many levels to this stigma around an ill doctor. For one, doctors are meant to be infallible. They’re sometimes imagined to be an almost ‘super human’ entity that is never mistaken, and never unwell.

Imagine, your doctor actually gets the flu too? Or that stomach bug? Even more difficult to understand is a doctor with mental illness. How would patients feel if they knew their doctor was clinically depressed?

In terms of your co-workers, who sometimes are the harshest judges of their fellow doctors, I think it all comes down to stress and workload.

If you see your shift looming and know that you are already short staffed, and a few doctors call up saying they’re sick, you get annoyed. You may not even care if they’re unwell, you are worried about yourself and how you’re going to cope.

A selfish reaction, but one that makes sense. You need those people there, and know the shift will be a mess without them. One doctor down is enough to make a difference between an okay shift and a shift from hell. We all know there will be no replacement. You have to absorb the work amongst yourselves and hope for the best.

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Working when you’re ‘sicker than your patients’

During my last night shift, one of the more senior doctors was bragging about how he went to work with a fever. He had just come home from a holiday overseas (pre-covid) and was feeling unwell. He had a shift in the emergency department and decided that there was no way in hell he would call in sick. The hero that he was, he showed up to work febrile. During the shift he collapsed, and his colleagues had to attend to him. They took blood tests, and helped him to a chair.

He boasted that his c-reactive protein was 100, his white cells elevated. “I was sicker than the patients,” he laughed proudly. Obviously he was sent home after that. The other doctor said something about him being impressive.

I wondered, am I the only one thinking that is messed up?

I don’t think it is anything to be proud of at all. If you’re that unwell, you should stay home. One for the protection of everyone else, and two he gave his colleagues more work in the end anyway.

Maybe amongst doctors they’re seen as a great medic, but there isn’t really a prize for being such a martyr. Shouldn’t we of all people be valuing health above bragging rights?

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We should normalise sick days and protect our health care workers

Ideally, we should get to the point where we normalise sick days. We shouldn’t be normalising and celebrating people who work while they’re on the verge of collapsing. I’ve seen it time and time again.

Pregnant surgeons about to faint in the operating theatre, hiding it to seem tough. Workers getting medication out of the treatment room, analgesia for their aches and pains, or ondansetron for their nausea.

I know there will never be a normalisation of sick days until we have adequate staffing in public hospitals.

Hospitals need sick cover. Ideally the cover shouldn’t be someone else who then has to pull an absurdly long work week. For example, a doctor felt sick after his second COVID-19 vaccine. He couldn’t come into work, I was on my 7th day of 12.5 hours, clocking up 87.5 hours that week. I had to stay for the 8th of 7 days, and work another 12.5 hour shift. Rounding me up to 100 hours worked that week.

Obviously this is not safe. It also means the sick cover is at risk of fatigue and illness. It can become an endless cycle, and it is no wonder I did not have much sympathy for the doctor at the time. In a selfish sentiment you’re annoyed that you have to keep working, and wonder how sick they can be. I also remembered that week of night shifts that I had showed up every night, with runny nose and cough. Not wanting to call in sick to protect the same person from working extra (pulling a day and night shift).

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Politely ignoring illness

Everyone politely ignored my cough and runny nose, no one sent me home or to get a COVID-19 test.

Every worker knows that if a doctor is sent home they have no one to replace them. So we all just ignore the ill worker, and pretend they’re fine, and it is business as usual. Who else could they get to work 7 nights straight at this point in time anyway? Only a poor soul who has just finished their own 7 days straight of working.

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Which is why I will be sick in my own time

I know doctors deserve better. But until we improve our public health system I’ll show up to work tomorrow and keep the sick days to my days off.

Feature Photo by Volodymyr Hryshchenko on Unsplash