It’s a call I’ve made only once before in my medical career, and I’m dreading it.
She answers on the third ring. I can hear the background hustle of the ward and the unmistakeable fatigue in her voice.
‘I’m sorry, I’m not well, I can’t work today,’ I say. I hold my breath. I’m not sure what I am expecting. Perhaps a ‘pull yourself together’ or a ‘do you know how understaffed we are?’.
But she is nice, and I am relieved.
Although my illness will be only transient, I cannot shake the feeling that I have let people down. Have I been weak where others might have persevered?
But it is not the patients for whom I feel guilty - they will be well looked after whether I am there or not.
My guilt is for the burden I have placed upon my colleagues. The colleagues already working well beyond their hours, missing their children’s bedtime or partner’s birthday, one of whom will have to arrange childcare, placate their partner and cover my absence.
The medical take will continue, but only because of the sacrifices made by those around me.
Upon my return the following morning I am greeted by an email. In keeping with any good bureaucracy, there are two forms that I need to complete to justify my absence or my pay ‘may be deducted’.
In the first form I am required to disclose the nature of my illness. Of course, there’s always the option not to do so, in which case my line manager will ‘clarify the details of my illness at a later date’.
It seems the confidentiality I provide for my patients is not applicable to me.
The second form must be completed by my consultant, proving we have met and agreed a plan to avoid future time off work.
Overall, I am left feeling mistrusted and even more guilty.
It is well known that doctors take far fewer sick days that any other group of professionals. In a system where even ‘fully staffed’ is synonymous with ‘overstretched’, concerns for placing additional pressure upon colleagues and fears for negative impact upon career mean the decision to take sick leave is extremely difficult.
I have colleagues who are proud never to have taken a day off sick. And yet on the occasions I have worked whilst unwell, I know my propensity for empathy is significantly limited and capacity for error greatly increased.
Sickness may be part of our everyday working lives, but to relinquish the role of doctor and care for oneself before patients and colleagues goes against many instincts and is a decision which I suspect will never be guilt-free.
Our second Secret Doctor has bidden farewell and written a final blog. Until we appoint a successor, other junior doctors will be writing guest contributions for the blog, and this is the first we have selected
Read more of the Secret Doctor blog
Exactly. It should be simple. You are too sick to work, you don’t go to work. But in medicine it really isn’t that simple, for the many reasons you express so well. Thanks for writing this.
I used to go to work sick. Now I know if I make a mistake I’ll be thrown to the wolves I don’t.
If one is genuinely sick, a leave has to be taken. The problem starts when people take sick leaves when they are well. That is a bigger problem.
Many employers will ask for more information about what was wrong with you, via the management chain.
As an LNC chair I had battles over the having-to-declare-what's-wrong bit. You do not have to provide any more information than is in the Med 3 form; and most doctors will leave that very vague if there are issues you don't want to raise.
If management require further information, then you can insist on providing it to occupational health.
That said, management may be better able to help you work around any health issues if you are open about them; and knowing what people are getting ill with might help them address issues better.
People looking after themselves at the expense of colleagues. It’s like work life balance and needing to arrange childcare. Only works if some other poor sod does the work.
It’s so true. I am terrified ringing in sick - who will be answering the phone, how are they going to react to my reasoning of being unwell and being too sick to come into work. I genuinely feel I’ve let me colleagues down and the fear of going back into work the following day(s) - what will they think of me, will they believe me that I’ve been genuinely ill and off for a good reason. When you are off, the whole department knows why you’ve been off sick, as you say your illness should be confidential and respected, but it’s not. Even if you do go into work sick, you don’t get any phrase, you just suffer and pass on your illness to everyone else around you.
Excellent article, thank you.
I know the feeling exactly. It's even worse as a GP or consultant when there is no-one to take your place. But unless we take care of ourselves, how can we presume to care for others? Next time you are sick, try asking yourself, 'What would I say to a patient in my position?' and then do just that.
Its ironic I'm reading this, as my partner keeps telling me for last two days that I should not be going to work, but there ia nothing more terrifying than feeling that you've somehow let down others, or worse, increased their burden by being 'weak'
It's never that simple. I went to work with pneumonia. I didn't think it was that bad, but I was struggling. I'm embarrassed to admit that this was as a Consultant. My Registrar told me off and sent me home...
Do not come in to work if you do not feel well enough/safe enough to work. By coming in to work when unwell we are a risk to patients, ourselves and our colleagues (if infectious). In the short term we are supporting colleagues but in the longer term we are supporting the view that the NHS can continue without more funding.
Excellent article and what I have done for rest of the off-day is trying to reason to myself or rephrase how I'm going to start a conversation when back at work. I need to break that chain of thought and your article has given a good platform to reflect. Well done
When I had cancer I thought it had taught me there is more to life than work, and to look after myself. Similarly after bereavement. However, I still feel guilty for taking time off for legitimate illness, and for necessary treatments. Sometimes you are made to feel that you are really putting people out, or are “punished” by being given the unpopular jobs for a few weeks, which I feel unfair when such things cannot be helped.
Dunno what’s all this bellyaching about taking time off if you’re unwell. Guilt? Why indulge in such a useless emotion! Even if you’re unwell through your own most grievous fault, ie, hungover, you’re still unfit to work, so take the time off to get better. The NHS doesn’t need you the way you imagine. Things go merrily on without you . No one will thank you for martyring yourself and , in the aftermath of Dr Bawa-Garba’s experience, you can be sure you’ll be blamed if anything goes awry.
Perpetuating this culture doesn’t help. We are human too, we don’t get sick for the fun of it. Being off sick and riddled with guilt is not going to hasten recovery. As a colleague says below, we should think about what advice we give our patients.
It’s rather ironic that we, the people who choose to treat the sick, are harshest on ourselves and our colleagues when ill.
I have taken a lot of time off sick during years of cancer treatment, I have needed allowances made for me. I would ask my fellow medics if I should focus on recovery or guilt?
This bureaucracy is necessary to be able to deal with the few people who take sick leave when they aren't sick. The procedure of evidence gathering has to be applied to everyone or they immediately claim victimisation and bullying. We all know they exist.