Too sick to work?

By yesterday at lunch time, you knew you were sick. The sniffly nose and scratchy throat of the previous 2 days were maturing into a full-blown cold or worse. You woke this morning feeling achy and a bit feverish. The only thermometer in the house is a scary looking thing in the cutlery drawer next to the kitchen stove. There have been no cases of influenza reported in the country or even the state.

It is Thursday, and it is your partner’s traditional day off. You think you remember him saying that he was planning on driving out of state to visit his daughter who was struggling in her freshman year in college. Your new associate is in St. Louis taking her boards. The questions that need to be answered by 7:30 this morning are: Do I see if I can reach my partner before he leaves town and ask him if can work for me? If he is already on the road, do I call the office and tell them to cancel the day’s schedule because I am too sick to work?

This is the kind of scenario that most have us have faced more than once in our working lives. Who will I be putting at risk by going to work when I am sick? Of course, there are my patients. Is my patient population particularly fragile because of their age or immunological vulnerabilities? And there are my coworkers. Last of all, will going to work make me even sicker so that I will miss more work?

Where do you go for help in answering the question of whether you are too sick to go to work? Should you try to find a thermometer at an all-night convenience store? If you find one, exactly what temperature is the threshold that will prompt you to call in sick? How many sneezes per hour will render you too contagious to work? How many coughs? If your illness is primarily gastrointestinal, are you still a threat to your patients if your trips to the bathroom are spaced far enough apart to allow you to spend 15 minutes trapped in an examining room?

Would wearing a mask be of any benefit? My sense is that it wouldn’t help and may make you more of a threat if you keeping fiddling with it to readjust it for comfort. And a mask will certainly alarm some parents.

There are situations in which you look or sound worse than you are. I seem to develop laryngitis several days after the worst of my cold has passed. Unfortunately, this scenario is not one of those situations. If you show up in the office, you are going to sound and maybe look like you are as sick as you feel.

What are you going to do? I am embarrassed to admit that I was one of those masochists who would have gone to work regardless of my state of health. You would have had to tether me to an IV bottle to keep me at home. As a recovering workaholic, I have had to accept the fact that I may have jeopardized the health of some of my patients by my pigheaded and at times selfish devotion to showing up in the office come hell or high fever. But, on days when I was the only show in town, it was easy to fall into the trap of believing that I was indispensable. Although full-time emergency room physicians and hospitalists hadn’t been invented yet, there were a few other primary care physicians. I guess it was pride that prevented me from admitting that I could have called on them for help, even though they weren’t board certified pediatricians.

On the other hand, I still wonder how much harm I did by dragging myself to work when I was sick. Because Brunswick is a small town, I know my overly intense devotion to work didn’t result in any deaths. But how great was the collateral damage in the form of lost days from school and work for my patients, their parents, and my coworkers? There is no way to know, but I am sure there was some.

It is unreasonable to say, “I won’t ever go to work if I am ill.” I may have set the bar too high, but I am interested to hear how you decide when you are too sick to go to work.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “Coping with a Picky Eater.” E-mail him at [email protected].

By yesterday at lunch time, you knew you were sick. The sniffly nose and scratchy throat of the previous 2 days were maturing into a full-blown cold or worse. You woke this morning feeling achy and a bit feverish. The only thermometer in the house is a scary looking thing in the cutlery drawer next to the kitchen stove. There have been no cases of influenza reported in the country or even the state.

It is Thursday, and it is your partner’s traditional day off. You think you remember him saying that he was planning on driving out of state to visit his daughter who was struggling in her freshman year in college. Your new associate is in St. Louis taking her boards. The questions that need to be answered by 7:30 this morning are: Do I see if I can reach my partner before he leaves town and ask him if can work for me? If he is already on the road, do I call the office and tell them to cancel the day’s schedule because I am too sick to work?

This is the kind of scenario that most have us have faced more than once in our working lives. Who will I be putting at risk by going to work when I am sick? Of course, there are my patients. Is my patient population particularly fragile because of their age or immunological vulnerabilities? And there are my coworkers. Last of all, will going to work make me even sicker so that I will miss more work?

Where do you go for help in answering the question of whether you are too sick to go to work? Should you try to find a thermometer at an all-night convenience store? If you find one, exactly what temperature is the threshold that will prompt you to call in sick? How many sneezes per hour will render you too contagious to work? How many coughs? If your illness is primarily gastrointestinal, are you still a threat to your patients if your trips to the bathroom are spaced far enough apart to allow you to spend 15 minutes trapped in an examining room?

Would wearing a mask be of any benefit? My sense is that it wouldn’t help and may make you more of a threat if you keeping fiddling with it to readjust it for comfort. And a mask will certainly alarm some parents.

There are situations in which you look or sound worse than you are. I seem to develop laryngitis several days after the worst of my cold has passed. Unfortunately, this scenario is not one of those situations. If you show up in the office, you are going to sound and maybe look like you are as sick as you feel.

What are you going to do? I am embarrassed to admit that I was one of those masochists who would have gone to work regardless of my state of health. You would have had to tether me to an IV bottle to keep me at home. As a recovering workaholic, I have had to accept the fact that I may have jeopardized the health of some of my patients by my pigheaded and at times selfish devotion to showing up in the office come hell or high fever. But, on days when I was the only show in town, it was easy to fall into the trap of believing that I was indispensable. Although full-time emergency room physicians and hospitalists hadn’t been invented yet, there were a few other primary care physicians. I guess it was pride that prevented me from admitting that I could have called on them for help, even though they weren’t board certified pediatricians.

On the other hand, I still wonder how much harm I did by dragging myself to work when I was sick. Because Brunswick is a small town, I know my overly intense devotion to work didn’t result in any deaths. But how great was the collateral damage in the form of lost days from school and work for my patients, their parents, and my coworkers? There is no way to know, but I am sure there was some.

It is unreasonable to say, “I won’t ever go to work if I am ill.” I may have set the bar too high, but I am interested to hear how you decide when you are too sick to go to work.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “Coping with a Picky Eater.” E-mail him at [email protected].

By yesterday at lunch time, you knew you were sick. The sniffly nose and scratchy throat of the previous 2 days were maturing into a full-blown cold or worse. You woke this morning feeling achy and a bit feverish. The only thermometer in the house is a scary looking thing in the cutlery drawer next to the kitchen stove. There have been no cases of influenza reported in the country or even the state.

It is Thursday, and it is your partner’s traditional day off. You think you remember him saying that he was planning on driving out of state to visit his daughter who was struggling in her freshman year in college. Your new associate is in St. Louis taking her boards. The questions that need to be answered by 7:30 this morning are: Do I see if I can reach my partner before he leaves town and ask him if can work for me? If he is already on the road, do I call the office and tell them to cancel the day’s schedule because I am too sick to work?

This is the kind of scenario that most have us have faced more than once in our working lives. Who will I be putting at risk by going to work when I am sick? Of course, there are my patients. Is my patient population particularly fragile because of their age or immunological vulnerabilities? And there are my coworkers. Last of all, will going to work make me even sicker so that I will miss more work?

Where do you go for help in answering the question of whether you are too sick to go to work? Should you try to find a thermometer at an all-night convenience store? If you find one, exactly what temperature is the threshold that will prompt you to call in sick? How many sneezes per hour will render you too contagious to work? How many coughs? If your illness is primarily gastrointestinal, are you still a threat to your patients if your trips to the bathroom are spaced far enough apart to allow you to spend 15 minutes trapped in an examining room?

Would wearing a mask be of any benefit? My sense is that it wouldn’t help and may make you more of a threat if you keeping fiddling with it to readjust it for comfort. And a mask will certainly alarm some parents.

There are situations in which you look or sound worse than you are. I seem to develop laryngitis several days after the worst of my cold has passed. Unfortunately, this scenario is not one of those situations. If you show up in the office, you are going to sound and maybe look like you are as sick as you feel.

What are you going to do? I am embarrassed to admit that I was one of those masochists who would have gone to work regardless of my state of health. You would have had to tether me to an IV bottle to keep me at home. As a recovering workaholic, I have had to accept the fact that I may have jeopardized the health of some of my patients by my pigheaded and at times selfish devotion to showing up in the office come hell or high fever. But, on days when I was the only show in town, it was easy to fall into the trap of believing that I was indispensable. Although full-time emergency room physicians and hospitalists hadn’t been invented yet, there were a few other primary care physicians. I guess it was pride that prevented me from admitting that I could have called on them for help, even though they weren’t board certified pediatricians.

On the other hand, I still wonder how much harm I did by dragging myself to work when I was sick. Because Brunswick is a small town, I know my overly intense devotion to work didn’t result in any deaths. But how great was the collateral damage in the form of lost days from school and work for my patients, their parents, and my coworkers? There is no way to know, but I am sure there was some.

It is unreasonable to say, “I won’t ever go to work if I am ill.” I may have set the bar too high, but I am interested to hear how you decide when you are too sick to go to work.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “Coping with a Picky Eater.” E-mail him at [email protected].