I was half way through residency.  Pre 80 hour work week regulations, 2001.  Here is what my schedule looked like:  Monday morning, arrive at hospital to round by 5.  Leave hospital Tuesday evening around 6.  Work out.  Eat a bagel and cream cheese and some carrots for dinner.  Prepare for presentation on esoteric knee fractures while falling asleep.  Repeat.  An easy week was 90 hours.  Most were 100 or more.  And my body had the audacity to fail me.  Fever, chills, vomiting.  I did the unthinkable.  I called in sick.  I paged my attending.  The actual words I heard, “I’ve never heard of a resident calling in sick.  Are you sure?”  I was sure.  In fact, I had barfed again while waiting for the page to be returned.

Times I had slogged through work sick…  pink eye, scabies picked up in the call room, I even passed a kidney stone on call, Not once, but twice, I had a nurse give me a bag of IV fluid mid stomach flu so that I could get through the surgery day.  It was not uncommon to quietly step away from the operating room table to quickly vomit, then scrub back into surgery. Of course this was always accompanied by the question all women residents are used to, “Are you pregnant?”  I was not.  Just sick.

On this day that I was sure I was too sick to work, my nausea was exacerbated by my shame.  I had done the taboo.  I admitted weakness.  There was no system to backfill or cover for sickness.  Because it never happened.  My attending would have to round and see the patients with the medical student.  My work would be done by my superior.  I was terrified of the implications.  I truly thought I might get fired.  I am still ashamed, 17 years later, when I see this surgeon.  I actually am afraid that I am still in trouble.

When I practiced at an academic hospital from 2004-2011, it was still rare for residents to stay home sick and rarer for attending surgeons to miss work for sickness.    I came to work with fevers, runny nose, flu.  I operated the day before I gave birth.  Of these things I am actually no longer proud.

We understand that impaired doctors should not take care of patients.  We understand that doctors cannot be intoxicated.  No drugs.  No alcohol.  Yet even in 2018, doctors work through sleep deprivation and illness.  So many reasons, some good and some awful.  Pride.  Finances.  Patient expectations.  Administrative expectations.  Nursing expectations.

So this year, when I got shingles at the age of 46, I struggled with all of this.  The pain was unreal.  But this is not what kept me home for 4 days.  Actually, I have 2 surgeon friends who took no time off for shingles this year.  What kept me home was the fact that my rash was on my neck and I could not hide it.  And I was contagious.  I take care of young people, babies, and sometimes even older people who do not have the best immune systems.  The guilt was huge.  I am a trumpeter of physician wellness, staying fit and staying sane, doctors are people too…  yet to stay away from work as a sick doctor remains foreign and shameful even to me.

We must work to change this culture.  To promote wellness.  To be brave enough not to go to work when we are sick.



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