Blurring the Line Between Work and Sick Time

There’s a new dance move we’re all trying to learn. It’s called the “sick-time slide." About three weeks after Kate Middleton, Princess of Wales, underwent her planned abdominal surgery, I went through something similar. Or at least I also had a planned abdominal surgery, although I am not sure our subjective experiences were very similar. Following surgery for two abdominal hernias, I spent one night in the hospital. Kate spent about 10 days. Given how hard she works for the monarchy I think she has earned some recovery time. But for those of us without a Royal support system, the experience of surgery often turns into an exercise in endurance.

My husband drove me to the hospital at 5:30 am. I like and respect my surgeon and received support from several caring hospital employees including nurses, therapists, and support staff. But, at the end of the four-hour surgery and subsequent recovery time, I was told they had to find a room and schedule a radiology test before I could eat or drink. I spent the night dozing, unplugging the cord to the IV behind the bed so I could make it to the bathroom in time, and waiting for the overworked nurses to bring my pain medications. By two days after my surgery, I had battled my way through the wrong discharge information, a night with no prescription pain medications because the pharmacy didn’t have the right drug in stock, and a lot of aggravation.

The icing on the cake (which is ironic for someone who has been eating soup and pudding for a few weeks) occurred on Day 5 of my recovery when I received two official-looking letters in the mail. The first informed me that my insurance company had finally decided to cover the surgery I had back in July. That was a relief since they had spent the last six months regularly notifying me that they had denied the claim, because I had an autoimmune issue, not cancer. In the meantime, the second letter was from a diagnostic company informing me that along with thousands of other people, my medical and billing records had been stolen from one of their storage sites. The sad part of this story is that I am one of the lucky ones. I have a stable job, and benefits with a reputable insurance company, in a city with multiple award-winning healthcare facilities. But clearly, there are still some big holes in the system.

Hospital stays have shortened dramatically in the past few decades. While this reflects changes in medical practice, it is also a function of insurance company cost-saving measures. This is particularly problematic for individuals who don’t have a stable living situation and the necessary support to go home too. In addition, rising co-pays for services and medications, and unanticipated charges for out-of-network treatments and medical transportation, can be devastating to people who are already ill and feeling miserable from the treatments they don’t know if they can pay for.

Even if you don’t end up in the hospital, the sick-time slide catches up to you. Many Americans don’t get paid sick leave; they go to work, contagious or not. Working parents use their leave to care for sick children; those who don’t have insurance delay or skip treatments increasing the severity of their illness.

The American work ethos doesn’t help either. In a culture that judges you by what you accomplish and own, working is the clearest path to success. Americans already leave much of their vacation time on the table and cite pressure to be a good employee as the reason. Realistically, they are right. In many jobs when you don’t show up to work, key things don’t get done, your return to work is overwhelming, and the co-workers you left behind are exhausted and angry about having had to add your duties to their own.

To cope, many employees offer to work from home although “hopping on a Zoom call” when you can barely get out of bed is often counterproductive. One of my Dad’s favorite phrases is that the only minor illness is one happening to someone else. Furthermore, working instead of resting can leave you in a limbo of depression and fatigue. As your body mobilizes resources to heal it leaves less energy for other activities and can diminish your ability to remember things, think clearly, and stay focused. The result is that it takes longer to work effectively or to recover.

What does this mean? The CDC just announced that they are looking into reducing the recommended isolation time for COVID. The most likely outcome is that people, while still ill, will feel obliged to work, further blurring the lines between sick time and work time. As individuals, it can be hard to change large systems. However, supporting laws that regulate healthcare costs, advocating for better leave policies and sick-child care options, and changing the expectations in our own work units can help. We should encourage people to use sick time when they are ill and support the people who are still working by prioritizing the things they are asked to work on, not asking them to do more with less.

If your job does include tasks that are both crucial and time-sensitive, then someone else in the organization should be your designated understudy so they can set aside their regular duties to pick up the slack when you cannot. The bottom line is that allowing the line between sick and work time to slide is hurting all of us, physically, mentally, and professionally. Trying to dance around that truth isn’t helping anyone.