When can a doctor call in sick?

I struggle every time I’m ill. This week, it’s not so much my own illness that’s been the major problem. It’s the kids. Because they can’t sleep. And if they can’t sleep, we can’t sleep.

It started last week with this upper respiratory bug that’s going around. Cold viruses mutate just enough over time that every few years, I get hit hard. I call it the “three year cold.” This one was really bad as it hit me on top of my undertreated seasonal allergies and having a 9 month old who doesn’t sleep through the night. (I’m just not getting to the Neti pot.)

So no surprise that after a week of this virus, I started to get an earache. Within an hour the earache went from kind of annoying to consistently throbbing. I had a colleague look at my ear to confirm that there was a dull, red, bulging TM there. By the time I got to the pharmacy to pick up my antibiotics, it was screaming, pulsing, popping. I kept putting my hand to the canal expecting to feel pus and blood.

This is on top of a toddler and a 9-month old with copious nasal discharge and coughing. The baby hates having her nose aspirated, but is used to sucking her binky as she falls asleep. With all the green mucous, she can’t suck the binky and breathe at the same time. Thus, misery, for her and us. It’s been over a week with this struggle to clear her little nasal passages so she can soothe to sleep.

Our toddler is a bit better off, but still cranky, clingy, picking at meals, whining. And waking up during the night coughing. A cup of juice and some quiet rocking lulls him back to dreams, but meantime, either me or hubby is up, again.

Night before last, it was midnight, and neither child had been able to fall asleep yet for more than a few minutes. Stuffy snotty noses, coughing, diarrhea, fevers … we had spent hours trying all the tricks. Steamy shower, nasal aspirator, saline wipes, Tylenol, juice, singing, reading, cuddling, cartoons.

And I had to be up at 5:15am for a 7:40am start time in clinic.

I admit that I kind of lost it. I was personally miserable with my own symptoms, exhausted from several nights in a row of this sort of shenanigans, and I knew I would have only a few hours’ poor sleep before I had to truck it to the city and take care of people.

“You have to call in sick,” insisted my husband.

“I can’t,” I insisted.

And I didn’t. The kids eventually drifted into snoring/coughing but sustained slumber. My alarm went off at dawn. I hauled my sorry drugged-up ass into the shower, and made it to work alive. I popped phenylephrine, chugged dextromethorphan, snorted Afrin, gulped a whole lot of coffee, and tucked a full bag of Ricola into my white coat pocket. I saw my full panel of patients. I got some looks from people, colleagues and patients alike, for my red, swollen, flaky nose, and this wet cough. I kept assuring people, “I’m at the tail end of a cold, I doubt I’m contagious. It’s my own misery.”

I’ve commiserated with colleagues. Everyone’s been through this before. But we all agree. You should call in sick for this stuff. But we all feel like we can’t call in sick for this stuff.

So when can the doctor call in sick?

I remember as an intern on a busy overnight call, one of the senior residents started the evening with GI bug symptoms. It was severe, coming out both ends. By 1am, he was laid out in the call room, and the nurses hooked him up to IVs. Still, we interns were coming to him for all the usual overnight precepting: running admits by him, reviewing labs, discussing cases. There was no question of, “Could he go home sick?”

We knew that he was febrile and dehydrated and not thinking straight, but there was no choice. And in the morning, the attendings heralded him as a hero for sucking it up and holding down the fort, despite having active nausea, vomiting and diarrhea … that was contagious. That left a strong impression on me. Today, I think that was insane.

More recently, I had to fight with a patient of mine who also happened to be a surgeon. She had developed flu symptoms and wanted Tamiflu, but didn’t want me to test and confirm flu, so she wouldn’t have to call out sick, as is mandated by occupational health.

“I’m on the schedule, I have to operate,” she explained.

Those are extremes. More common, I think, is our family’s situation. We’re all miserable, but can’t justify calling out.

What would you do?

“Genmedmom” is an internal medicine physician who blogs at Mothers in Medicine.

Comments are moderated before they are published. Please read the comment policy.

  • http://briarcroft.wordpress.com/ Emily Gibson

    I’ve worked in clinic wearing a mask so my nose doesn’t drip on patients and my cough is covered, loaded with antipyretics to keep my fever down. I’m not proud of it and don’t consider it a red badge of courage. When there is no replacement available and there is a never ending stream of patients in a high volume clinic, someone needs to see them and a sick doctor is better than no doctor.

    I did have to take a week off after an appendectomy as I felt mentally foggy from an allergic reaction to the general anesthesia. Otherwise, sick leave is rare for me. My criteria is whether I’m sicker than the patients who need to be seen. Thankfully the answer is almost always no.

  • http://www.facebook.com/profile.php?id=36408878 Jeff Midgley

    Personal Responsibility – we tell our patients this all the time. If you’re sick, stay home.

    The only difference is the lack of a system of backup and catch-up in medicine for doctors to call in sick.

    So what do you do when you can’t? You go to work sick, tired, and potentially spread your germs to the general population.

  • Dale Coy

    I’ve missed work twice in 18 years. Once when my wife gave birth early delivery with twins, and once when I broke my finger and had to see a doc myself. Both times I heard how angry and mean patients were to my covering doctor. Better to work when you’re sick.

  • jleong

    No matter how tough and how smart, it’s really hard being a mom and a doctor. It gets better though once they become teenagers, and the time goes by pretty fast – in retrospect. I lost my sight while rounding on patients on a Sunday afternoon. I could only see in my peripheral vision, it had never happened to me before, so I didn’t know it was ocular migraine. I finished all my notes with a sideways glance and then took the bus to the eye hospital and had an MRI of my brain. We are insane, I think we have to be.

  • Molly_Rn

    Definitly call in sick if you are sick, especially if you are febrile and contagious. As a nurse, I always thought if I could make someone else sick by my going into work than stay home.

Most Popular