I saw two positive lines on the home test kit. My body felt like I had been beaten with a jackhammer and the buzzing in my head reminded me of a hangover, the likes of which I had not seen for at least 20 years. Somehow, I organized my thoughts enough to call employee health and then updated the primary care clinic where I work as a physician. Clinic staff members were given the task of rescheduling my frustrated patients. Throughout this process, several staff commented, “Well, at least you still get paid time off from the COVID sick bank before that ends on 12/01/22.”
Yes, it is true. COVID is becoming endemic – as in widespread or consistently present within a geographic area – and the institutional safety net intended to cover the paid time off for affected health care workers is ending. I am not going to argue the ethics of whether or not employers should cover paid leave for mandated time off due to illness, however, I do want to speak to the influence mandated COVID time-off has had on me personally.
This was my second COVID infection since the start of the pandemic. For the first infection, the CDC recommended seven days off for health care workers and five for my current infection. As I lay curled up on the couch wearing the same sweatpants three days in a row because I couldn’t quite muster up the energy to shower, I contemplated the ethics of self-care. Despite how terrible I felt, I knew, without a doubt, that I would be working if there were no COVID mandates to stay home. I knew this because the last time I left work for illness (excluding pregnancy and the care of my children) was during the H1N1 pandemic when my employer forced me to stay home for 48 hours because I had a fever of 101. I knew this because, during both of my experiences with COVID, I contemplated lying about the dates or even my COVID status so that I could keep working and minimize the impact it would have on others. I would rather work sick than disappoint my patients. I would rather work sick than ask my overworked colleagues to do more work. I would rather work sick than face my own judgments regarding whether I needed and deserved rest.
For many people, illness triggers a survival instinct that demands slowing down. Contrary to this, many physicians are committed to distancing themselves from their own bodily needs. This distance is an unspoken measure of our strength, our commitment. If we didn’t come to medical school with this ethic, we learned it in residency, “Eat when you can, sleep when you can, and don’t mess with the pancreas,” right?
Forced COVID leave has opened me up to the examination of the guilt and, possibly, even the shame attached to my need for rest. As if somehow my knowledge about medicine and the human body should elevate me above the physical realities associated with the experience of illness. I shouldn’t have needs, I can’t have needs. As a physician and a mother, I excel at caretaking. I am also coming to appreciate that in the past, I have erroneously viewed self-care as a scheduled commodity, a reward, or something I might earn in exchange for working hard, maybe a yoga class or a massage. I have to say that from my viewpoint right now on the couch, self-care looks very different, and scheduled relaxation seems like a misplaced solution to my body’s desire for rest. Whether for illness or overwhelm, I now believe that there are times when even a physician deserves to stop and seek renewal – as much as for survival than anything which would feel luxurious.
Jacqueline Redmer is a family physician.