Sawbones: A Marital Tour of Misguided Medicine - Doctoring While Sick

Episode Date: February 1, 2022

Work culture often lauds the idea that you should go to work even if you’re sick. This is true among a lot of occupations, but the self-declared worst offenders are doctors and other health professionals. Dr. Sydnee explains from her own experience and that of others why it is often the case that doctors are reluctant to become patients.Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk is about books. One, two, one, not a sense, the escalant macaque for the mouth. Wow, it's amazing. Hello everybody and welcome to SoBones.

Merrill Durvis, Guy to Medicine, I'm your co-host Justin. Macaroy. Macaroy. And I'm Sydney Macaroy. If you're going to cough like that. I'm not. I'm not going to say hydrated and bumped and no more coughing.

That's my last cough. Okay, it would help if you didn't do like chanting in our intro, if our intro didn't have to be a chance. I refuse to bring down the energy for our audience that relies on us to get hyped and to get pumped for their week. With a chant, like with a... It brings the energy out. Okay.

This is appropriate for our topic this week. This is actually why we're doing this this week. So we didn't have an episode last week, and I'm very sorry about that. It is primarily my fault, I guess it's partially your fault because you were also ill. We don't need to assign blame. But I was ill...

The illest. The illest. I was the I was this I was the I was iller The illest the list I was the hell in middle school in hurt Tasmanian devil sweatshirts the illest I did not have a Tasmanian devil sweatshirt. I had a Tasmanian devil baseball cap And it was just a big T. You know looking all cool Very cool. Yeah, the illest the illest the illest that this is a true story. I had that had Anyway, I'm not talking about illest. This is a true story. I had that had. Anyway, I'm not talking about ill in that sense. We were just sick. Like, you know, we had a sickness.

Y'all, we took some COVID tests. You have no idea. We, I was certain we had COVID. I'm trying to convince myself we definitely did not. We had, I mean, we had like home tests and PCRs. We did the whole thing. The whole mess. A lot of home tests. A lot of home tests. A lot of home tests. A lot of home tests. A lot The whole mess. A lot of hum tests.

A lot of several PCR, three PCRs. Three PCRs. We were, I was just, the symptoms fit. We of course, as you know, are fully, fully vaxed to the max. Quintuple Vax. Quintuple Vaxed in this household, like the two of us. Our kids are fine. Yeah.

Never got a symptom, both fine. No fine. So I don't know. I don't know what it was, but whoof, whoof. I will say this, if it was COVID and all those tests were wrong, which I'm not saying it was, but if that's true, this is testimony to the importance of vaccination. Yeah. Because we were both pretty sick.

I was, I am still, you can hear it. I was kind of inspirational, I felt like, in the way that I pushed through to take care of you and our family. So you don't give me, don't, you are playing into. Like Sid was still in bed, I really, I really, I'm like, I'm like, up making lunches,

bring home the bacon, fried up in a pan kind of deal. You know, it's like, come on, Sid, are you sure? This is sick, quite a fine. It could have also been the flu. We've also both got this sick, quite fine. It could have also been the flu. We've also both got flu shots, of course, but it could have still been the flu. Either way, we are both getting better and we will be fine. So if it was either of those, thank you vaccines. Yeah.

If it was some other virus, I'm mad at you. But it caught to mind the idea that generally when I am sick, I do not miss work. I know I did last week. We didn't do a solbons. And I also did not go. I work at Harmony House. I volunteer there to provide free medical care. And I did not go. Mainly at the request of the director,

our good friend Amanda, who said, please do not come. You are sick. You're not here. What is wrong with you? Why would you come to work when you're sick? You could make other people sick. And I'm thinking, well, I'll wear a mask.

I'll be very careful. But her other point was, shouldn't you rest? Like, shouldn't you get better? When you're sick, even if it's not about being contagious, shouldn't you rest and take care of yourself and get better. And this is an idea that had not ever really occurred to me for me. I preach it. I do not practice it. So I thought it would be interesting to talk about that compulsion to work when you're sick that is true for many people of many different professions, especially

in like a sort of a capitalist economy that really stresses the importance of going to work. I mean, our whole culture does, right? Like, that's why we have perfect attendance awards. I never got one of those. Never one, not a single one. But that's why we have those because we think it's important to show up no matter what. Especially cheer your doctors.

It would sort of be like, if I may, it would sort of be like if a mechanic called in and said, I can't come to mechanic work today because my car broke down. Yes. Then everybody would be like, just fix your car. Well, I do think there's a lot of reasons. I think that's part of it for sure. I think specifically if you look, and there's data to support this, healthcare workers, and the worst offenders being physicians come to work sick at rates that are higher than the general public. We do that. And that seems wild because we are also the people who tell you to stay

home when you're sick. So what's going on? So I thought it would be interesting to kind of look into that. And this has been a big topic of conversation because of the pandemic, because we are kind of compelling people, not kind of, we are compelling people to work sick now, especially when hospitals are at crisis standards.

The recommendations are basically, if you have COVID, but either you're asymptomatic or you're getting better, put on your mask and come to work in crisis standards, not regular standards, but that is the new dictate in a lot of hospitals that you will have people who might be working who have COVID, who would be contagious. But we are so short staffed, that is the new idea. But this predates the pandemic.

A lot of people went to work sick before COVID was ever concerned. Reasons for that, there's a whole range. And certainly there's some things that are more like practical. You don't have a sick day. You can't miss work because you get paid hourly for when you're there and you cannot miss out on that paycheck. People need the money to pay the bills, keep the lights on. Lack of coverage, if I'm not there, there's nobody there that's been my story, my whole life. If I'm not doing it, there's nobody to do it instead, so I better go. This is just to drill down this, and I think we've illustrated this before, but this

is not as simple as, Sydney isn't there today, so call in. There's an issue with continuity of care, right? Sydney is the one who is in charge of the patients, and it would not be, it's not as easy as you come in and watch them for a day. There is no, exactly. That happens in the hospital and in the office, if you are scheduled to see your family doctor

and your family doctor calls in sick, there is no backup plan to like, well, why can't we put these patients on other doctor's schedules so that they can still be seen today? Maybe that happens other places, but my experience is, no, they just cancel all the appointments. And that's very frustrating. If you've waited a while to go see your doctor and then your doctor isn't there and your appointment gets canceled and maybe you had an issue you want to talk about. So anyway, there's also like fear of repercussions from your boss for not showing up when they wanted you to cultural things like I just want to do it myself.

I don't want to let my colleagues down. This is who I am, professional identity. There are a lot of issues, right? It's mainly that one. And while all of this would clearly hold true for members of the medical profession, all of these things I just mentioned are concerns. But it's still shocking, I think, that this is called sick presentism is the term for this.

Presentism is showing up even when you maybe shouldn't or can't do your best. You know that term? Yeah. I didn't I never use that term. I know absenteeism. I had that with a lot of parties when I was in high school, just showing up when no one really wanted me to do. No, it's not. That's not true.

And that's not what it's. Presentism is when you show up. And this doesn't have to be because you're sick. This could be because you're going through some sort of stressor or family crisis or something like that. For some reason, you are not up to being at work that day, but you show up anyway. That's presentism. And specifically when it comes to sick presentism, doctors are among the worst. And there's a long history of this across cultures, by the way.

I know a lot of people would say, well, this has got to be like an American thing because that's Americans they're going to work. That's their thing. It's not just in America. It is a cross-cultural issue. It wasn't until, and I want to talk about a little bit about like the idea of doctors getting sick in general. Because obviously everybody gets sick. So doctors have always gotten sick, as long as we've had doctors, sometimes they've been sick. But that specific issue, sort of like you mentioned, the idea of the car mechanic who's car breaks down,

the doctor who gets sick, that sort of entered into the cultural imagination in the 19th century, and it was primarily based on a certain illness that was not solely a problem for physicians, but was highly linked to the medical profession, and that was addiction. That was the first medical condition that was sort of connected to the idea that doctors get sick, and it was because,

and we've done shows on this, with the invention of the hypodermic syringe and the ability to inject first morphine for pain control, we saw a lot of physicians develop addiction to morphine. And so for a while, there was this sort of linkage of like, well, doctors do get sick sometimes. They get addicted to morphine. And this was sort of the first writings you would see, people writing about hospitals where over half of the doctors there are using morphing on a regular basis and that kind of thing.

And the next accounts, again, are linked to particular illness. So first it was this concern for substance use disorder. And then it moved on to the classic doctor illness became angina. What's that for chest pain related to your heart, angina related to like lack of blood flow, meaning oxygen to a part of your heart muscle causing pain, angina. That became very closely linked to the medical profession. And there were some, again, there was some research that suggested that while anyone in a high stress job, you know, may experience angina, certainly, doctors did tend to get angina at a higher rate than other professions necessarily.

And so you began to connect like, well, that's the doctor disease. So that was the other way doctors got sick. They either could get addicted or they would get chest pain because they're in these high stress jobs that tax your cardiac health. And so they develop a heart attack would be the concern, right? But again, these were really accounts about doctors. These were people writing about this kind of doctor figure, the doctor figure who either, because they have access and are constantly around morphine and syrenges become addicted

to morphine. Or they were writing about the doctor figure who worked so hard so many long hours, denies themself all of the, you know, relaxations that the rest of us enjoy and maybe engages in high risk behaviors like smoking or whatever. And so they develop chest pain. Hard to text. This was not doctors writing about being sick. Doctors weren't doing that yet.

But by the 20th century, you start to see that change. You start to see doctors considering the idea that maybe being sick and having the knowledge they have could make them a useful conduit for what that experience is like. Do you know what I mean? Like I can filter my experience of having an illness through my medical knowledge and give you an account that might be more illuminating in some way.

You can send me to the bomb of the sea. I'm going to be like, dang, there's a lot of fishes down there and they're just wild and out. But if you get Jacques Cousteau down there, he's going to have some perspective that will probably be a little bit more useful. There you go. That was exactly, and that's exactly the first accounts that were put together, there's a collection that was put together in Germany in 1929 called Doctors as Patients.

And it was very much doctors giving accounts of their illnesses through their own medical lens. Jacques Hussot was like barely alive when I was alive. Like I don't know that the new generation has like what's like the comparable I mean Steve Zissu from the life of Quaudeck is fictional. Who's like the deep sea guy for this generation? Well honey I don't know.

Who's the deep sea guy that millennials turned to when they need a reference for a deep sea guy? I don't know. People will have to tell us, I guess. A person in general, so it doesn't have to be a guy. Yeah. It can be anybody. All on the gender spectrum can go down

the bottom of the ocean, walk around. It's just who's the deep sea person for this generation? Justin, I don't know the answer to that question. That was not part of this episode. Okay, go ahead. Maybe somebody can tell us. Yeah. Maybe somebody will help helpfully tweet to us.

We got it Barack Obama, and I'll just look for his pigeons. Who is the, who is the Jacques Cousteau of this generation? Just tell Barack Obama and call, you know, CCM on it. Barack will appreciate it too, I'm sure. Barack loves to hear, I, yeah, I tell peopleco appreciated it too, I'm sure. Barocco loves to hear. I, yeah, I tell people that it's a Barocco offer. No good reason.

So anyway, and these accounts were again, doctors writing about their annulances, and the idea was this could be helpful to other doctors. It could also be helpful to people who just want to know about an illness. Maybe they have it. Maybe they know somebody who has it. You know, this would be, This would be helpful for people. This was followed by in 1952,

the book When Doctors Are Patients, which was put together by Max Penner and Benjamin Miller. And again, it was the same idea. There are a lot of different disease processes sort of explained by doctors from their autobiographical perspective. Everything from typhus to manic depression is described. And they're written so that even they're not written for like a textbook audience.

It's so that non-medical people, if they are so inclined, can read them, gain an understanding of the disease, learn about it from a doctor. And the idea was, again, that like as a doctor, you may be able to prescribe this better. You may be able to give insights into it. So like, I'm experiencing it. And I know the anatomy and physiology so I can talk about it in a more robust way. And I'm not saying this is necessarily true,

but the experience of colors there, yeah. This was the thought process. Along with, like, aside from like this specific illness, like the anxieties and fears and concerns and all that stuff. And there is no thought in these anthologies and these stories. And I'm using these as sort of a window into the minds of physicians of the era. It's not an identity thing. It has nothing to do with who they are.

Oh, yeah, I had that. Let me tell you about it. It's that. It's that simple. And it's not a very convoluted idea to be sick as a doctor, because the idea is, well, yeah, I mean, of course, I'm a human. Of course I get sick. So here it is. Here's the experience. There. Did I help you? Good. Okay. Moving on. And that's really it. But then we see a shift. And I want to tell you about that shift. I'm any. But first we have to go to the building department. Let's go. The medicines, the medicines that I skilled at my car before the mouth. The Mouths. Yeah, completely. Our silly show is 15 years old. That makes it old enough to get its learners' permanent, and almost old enough to get the talk. Wow, I hope you got the talk before then. A lot of things have changed in 15 years.

Our show is not one of them. We're never changing and you can't make us. Jordan Jesse Go the same forever at MaximumFront.org or wherever you get your podcasts. Prepare yourself for the greatest pro wrestling podcast, spectacular known as Tarzan. Tarzan. A fact-drobbing audio showcase that helps you understand the world of pro wrestling with a lot of love and no toxic masculinity. Victory host, Danielle Radford.

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Tights and fights! Every Saturday, Saturday, Saturday, Saturday on Maximum Fun! Things were shifting, Sid. There are big things afoot. The medical profession has continued to change, especially in places where medicine has been more highly tied to business. And there's a lot of money to be made off of medicine,

by not just the people, like not just doctors, but everybody involved. And as the profession has shifted, the identity and attitudes of the people who work and it have also shifted. And that is true again, cross culturally, but especially in this collection of stories from 1987 called When Doctors Get Sick by Harvey Mandel and Howard Spiro, you see a very different tone Begin to develop and that's not that far apart. We're talking about the 50s to the 80s and the grand scheme of thing

That's not a huge chunk of time, but it's the same format. So again, these books are very similar in that you have Here is a chapter that's just this is who this doctor is, this is what they have, here's their story. And that doctor can write however they want to about it. Like, here is my experience with getting diagnosed, here is my experience with getting treated, whatever piece of that tale they want to tell is that's up to them. This again is the same idea and they have a wide range of illnesses that they have doctors talking about, everything from multiple sclerosis, Lyme disease, Parkinson's, alcoholism, depression,

Crohn's, lymphoma, all different manner of issues. Sometimes multiple chapters about one thing, you know, there are a couple different accounts of depression from different perspectives. But the interesting thing is that as you read these stories and I've been able to read, I would love to get a copy of this book, it's hard to find now. There aren't a lot out there, easily available and it's pretty expensive. I got you. But I found some. You found a way. I found one anyway. I would love to read this book in person because I found some excerpts. I was able to find some little free samples online so that I could read bits and pieces of it, but I do want to pay for this book because I want to read it. But the stories are so different in the way that they talk about being sick. It's clear that this isn't just, here's a story of an illness.

There's an underlying hint of sometimes shame, fear, frustration, there's anger sometimes, there's confusion not about what's happening. It's very clear and I haven't read every single story in the book obviously, but from the samples that I was able to read, it's very clear that there is this layer of an identity crisis that is happening for a lot of people, because they're able to intellectualize what's going on with their disease process. They know what that means. They know when the doctor tells them what it is. They even know before the doctor tells them. They know just from the sequence of events

that are occurring in the hospital. Right, them what it is. They even know before the doctor tells them. They know just from the sequence of events that are occurring in the hospital. Right, they get, yeah. I already know what this diagnosis is gonna be because you did that test and you said you were gonna do that one and then you canceled it. So that means it was this and they, like, they know this. You read the four row books and you see someone that has like a blow gun on the wall.

That's briefly mentioned, like, ah, I got you. I got my dude, that's it. So they're not confused about what's happening. Unlike for a lot of patients who go through these experiences, they have that knowledge that makes them sort of a step ahead in terms of knowing what comes next, but they don't know how to reconcile that with who they are. And I'm not saying that that is explicitly stated over and over again, but that feeling is definitely there.

I wanted to share a couple of examples from the book. So there was one doctor who is sharing her story of depression. And she talks about how she knew there was something wrong, but she refused to say anything to anyone. She tried to treat herself. She was terrified of admitting this to anyone around her. But she never stops working. She actually writes, in the autumn of 1982, I went on holiday, came back and thought, I can't face going to work. Of course, I did manage to work. There's the next sentence, because of course she still went to work. Right. Which I was reading this and I thought, oh man, I can identify with that so strongly. I know that feeling,

when you think that I cannot get out of bed and go to work, whatever the reason, because you've got a really bad respiratory illness or because of depression, whatever it is, I know that feeling, but then I know that simultaneous, well, but of course I will. There is no question as to if I will. I can't, but of course I will. There was another account of a heart attack. And the doctor, as he's describing this, as he's leading up to what's happening, he knows it. From the first twinge of chest pain, he knows what it is. And it is a textbook perfect account of someone experiencing a heart attack of angina.

We know that's what's happening. He knows that's what's happening. And he tries to convince himself otherwise. He tries to talk himself out of it. He tries to test himself. Well, if it's angina, it will get worse as I go upstairs or exert myself more and it'll get better when I rest. And he does it.

And that is true. But he's still not ready to admit. Well, but maybe it's just I pulled this muscle, but it's not sore there. Oh, and I mean, like he's talking himself through it. And then finally he gives in and says, okay, I know what this is. And it is. He's having a heart attack. He goes to the hospital.

He has the attempt stenting, you know, with a calf, but they end up having to do surgery, a bypass surgery on him. And he says, when he finally decides to go in, ultimately, I had to surrender to my greatest fear, not of death, which I considered without apprehension, not of disability, which I did not consider seriously enough, but fear of giving myself up to the doctors. It had to get very bad before I was willing to become a patient.

Which is a wild state, and he goes on to say, it's not that I didn't trust, I knew these doctors. It's not that I didn't trust them, it's not that I didn't think they knew what they were doing. It was nothing like that. It wasn't like a technical expertise thing. It was an identity issue. After his account, so he talks about going through the surgery and the recovery and everything like that. It wasn't like a technical expertise thing. It was an identity issue. After his account, so he talks about going through

the surgery and the recovery and everything like that and he's doing better. And he says, the thing is, even though he did all this, nothing changed. He returned to his, quote, lifestyle of overwork, deadlines, tensions and anxieties. And at the end, you think like, well, is he learned anything? And what he says is,

I will do almost anything to avoid being a patient. And... He said make the changes. It is life's sad. He said he'd be a bit of a mental. He says he jogs. But... Whoa! I'll be right. That'd be nice. I should be right. And these are really what you see here are people who can't... they can't be sick because if they are sick, then they can't be a doctor.

Is that because you have a just, like, is that a looking down on patients or is it just like that's not the identity that you have for yourself? I think it is very much, it is who you are. You are the person who stands to, you fix the problem. Right. You are the one outside of the illness who fights it off.

You are the one who protects people from sickness and death. You are not the person who succumbs to it. It's, I mean, I don't think it is a judgment. It's an identity. It's who you are. You don't have this in your notes, but I think that it is worth talking about the inverse of this that I have seen you do where you have seen things break weirdly bad so many times

that you have talked yourself into some truly heinous diseases that you are in possession of. Yes, this is true. Because you've seen the worst case scenario all the time. Like, you don't know how many times you got. You all, I'll look across the room and I'll see Sydney with a stethoscope on her chest. And just this morning, you're listening to your lungs

to see if you had pneumonia. And then you were like, I think I might have a heart murmur. And I was like, are you gonna go get it checked out? She's like, no, probably not. No, probably not. I was also becoming increasingly panicked as I was listening to myself and my heart was, my heart rate was going up and then I was having trouble

discerning that from the children yelling as they were playing row blocks and it was not, I need someone else to examine me. Which is why you shouldn't doctor yourself. You shouldn't doctor yourself. I will do it, I will do it. You don't do it. I will do it. You shouldn't doctor yourself. I will do it. I will do it. You shouldn't doctor yourself.

But I mean, part of it too is the idea of like letting people down. If you're sick, you can't take care of others. And that's so much a part of who you are that the inability to do it, you lose your entire purpose on earth. One man in one of his accounts of being diagnosed with a form of cancer, the first thing he does is sit down to call his staff and say, we're going to have to cancel patients. That's the first thought is we need to let the patients know. I don't want them to show up at the office and think they have an appointment with me and

then find out. I don't want them to be inconvenienced. We need to reschedule people. And it really is, I saw one person write that it comes from the perspective of, and I'm not saying that I feel this way, but this was one sort of sense of why would this be so. When you become a doctor, they felt like it's like you made a deal with God that as long as you took care of sick people, which he would like you to do, I suppose, in this feeling that he would not let you get sick. And that was one feeling, like that's the deal I made.

I've devoted my life to taking care of others. So you can't let me get sick, which of course is not. I mean, everybody gets sick. Doctors get sick, we all get sick. Is there any part of it? I would bet this is like more for surgeons, but like, is there any part of it that, you ever heard the old riddle, I guess it said,

if you go to a town with two barbers and one has a bad haircut and would want a good haircut, which one should you go to and just don't want the bad haircut because the other guy is cutting his hair. Is there anything of that with like doctors where they're like, if you didn't think you were the,

like everyone probably thinks on some level that they're the best at what they do, specifically, is it hard to like, oh, this guy, just don't let this guy work on me. Please, sky's a doofus. Like not trusting that your colleagues are like up to it. I won't either, um, confirm or deny that those conversations happen. Behind closed doors. Right. Of course, people are people.

Everyone has preferences. Everyone has. But I mean, that's not just true of doctors. That's true of everybody. You get recommendations. You have to go have a procedure done or go see a specialist. And what do you do? Yes, your friends.

Do you know anybody? And they tell you, oh, that person's a quack, don't go see them, but yeah, this person's great, go see them. I mean, everybody has that feeling. But anyway. I should mention, you're talking about this kind of clinically and we've joked about it,

but like if you're in a relationship with somebody for a long enough time, you have every permutation of every conversation there is, and you can disagree about stuff and argue about stuff and sometimes you run into these like roadblocks like logically, I think the probably everybody has these where it's like you know that I'm right like you've said that I'm right But you still can't get pat like this is that deep right where? Where it supersedes logic, it supersedes intent.

It's like, down deep inside. And I feel like that, it's worth noting, it's not like doctors need would hear this episode and be like, oh, okay, I won't be that way anymore. It's like, it's down deep. No, it's a hard thing because it's a perfect storm because I think that there is some idea, at least I know for me.

And I'd say a lot of my colleagues would say the same thing when you decide to become a physician, when you decide to go through that. There is some sort of sense of like, I am choosing to be like, I am health, I am wellness, that is me, that is who I can help you with that, that is what I have taken on. And so, even if, and that is, there's a lot of cognitive dissonance involved in that, because a lot of physicians engage in a lot of unhealthy behaviors, right? We're not all the best, you know, we don't all eat a healthy range of different foods

all the time. We don't all exercise regularly, you know, we, some of us stay up too late and drink beer, but Some of us. Well, I'm just saying like not all doctors are healthy, but for some reason There's this identity of like that is where I am in the spectrum. I am on the health end and then there's also like The external pressures because I think that's the other part So you already sort of have that kind of internal voice saying like Stay well take care of others you have to you have to you have to that's who you are But then there's this flip side of all of your training reinforces it

I Think that every residency probably has heard the story when you start of the mythological resident who rounded on patients while hooked to an IV I think that you have all heard it. I do not believe it is just at my program that you've heard the story of, well, so and so, had the flu or had diarrhea or whatever. And they were so dehydrated, but they hooked themselves up to an IV, a fluids, and then rounded on their patients with their IV poll. I guarantee you that myth is told in every residency program everywhere. I can't tell you how many of my colleagues would brag

about coming to work sick, working through an illness. I'm never taken a sick day. We would all talk about like, we've accumulated all these sick days. That's how I mean, that's how I took maternity leave. The only way I was able to take maternity leave is because I had accumulated enough sick days because I never took a sick day. So then I was able to use them to have a baby. I think that our training perpetuates that and there's tons of pressure from colleagues, from the people you're taking care of, from patients, from your administrators, from everybody

come to work, take care of others. That's who you are. That's your job. And we are also people, pleasers. We want to get A's. We want to get A's. We want to get gold stars. And so we do it. And it's not good.

I am not endorsing this, by the way. I'm saying this is true. And there are studies that support this. Not just in the US, they've done studies in the UK and Italy and Sweden and Norway and Hong Kong. All over the world, they've done studies that show that healthcare workers in general and specifically doctors are the worse.

They come to work sick. Some of the numbers were in the 60% range. Some of them were up in the 90% range of people admitting to coming to work sick. And these are people who are saying, I am coming to work with symptoms that if my patient told me they had, I would tell them to stay home. So they're admitting it. They're saying, yeah, I went to work and I probably shouldn't have. And the reasons are all the things we've already mentioned.

I mean, all those, all the, from practical fears of who else will take care of people. I mean, if I'm not there, there's literally no one else to do the job, which is sometimes true, too, I feel bad letting other people down. Just that sense of like, this is my job. And during COVID, I think the problem is that like, if you bring all this to the now, I would imagine that there has been a shift internally in a lot of physicians, recognizing seen in real time

that if you do go to work sick with something contagious, you're a threat to the people around you. You're a threat to your patients and you're a threat to your colleagues and your staff and everybody, you know, that is not okay. It's not okay to walk around out in the world with a contagious disease knowingly exposing other people to it. I mean, maybe legally it's okay, but it's not morally okay. And I think that there certainly must have been a shift in a lot of us. I know there

was for me because when I had the, when we first got sick and I thought there was a possibility that we had contracted COVID, there was no way I was leaving the house. Of course not. Of course not. I would never expose anybody to this, you know, there was no thought of that. So I imagine there has to be that kind of shift in medical professionals' mind. But what's going to be hard is reconciling that with a system that is telling us to go to work sick. Which is, and that's not happening, if your hospital is still on regular standards, I'm certain that's not happening. But I guarantee they're going to be hospitals working in crisis standards, all kinds of medical facilities,

where they are going to tell people, hey, listen, we have to have you. I know you tested positive, but you're asymptomatic. We got to get you back in here. There's nobody else. And when you go into healthcare, when they tell you, it's you and there's nobody else, and people need taken care of, I mean, you put on your scrubs and you go.

And... Podcasting is like the same way. Well, I mean, I'm podcasting right now. Inspirationally, yeah. Can I just make one last point? Of course you may, it's your show dear. It is hard not to, and even as I talk about it, I feel it in myself, so I wanna give it voice. It is hard not to romanticize the idea

that you are so tough, that you can work through anything. And I have had experiences where that has been reinforced, where I have gone to work with 101 degree fever and done my job and been literally applauded, not figuratively, literally applauded for doing so, for being so strong and so committed and so dedicated. So I know that because of those reinforcements, that is still in me. There is still a voice in my head that says, but you soldiered on no matter what. I also recognize

how dangerous that is and how it does also further stigmatize people who have chronic illness as like that is a bad thing. It is a bad thing to be sick that it is some sort of like moral failing or failure of your strength or will or weakness or something, when a disease state just is, it is morally neutral. You are sick, you are well, you are chronically ill, you are acutely ill. All of those things have nothing to do with your worth as a person, with your abilities, with how you should be perceived by others. None of that comes into play. It is just sickness. But that is a really hard thing, even as I talk about it, for me to constantly remind myself that I was sick, I stayed home, I didn't go to work.

I'm not worthless. I still matter, my contributions are still worthwhile. It is okay. It is okay to stay home when you're sick. It's okay to lay in bed, need soup, and watch mad men if that's what you want to do. Yeah. So if you're sick, please stay home.

Please stay home. Although I understand doing anything together, the house with our kids here, because I'm losing it over here sitting. Being in the house with our kids? Yeah, I mean, like, I think that that's really what this is about. It's like just in excuse to get out of the house. No, I love being home with that.

Charlie had a snow day today. I was so excited. We're all here together. I love it and they're still healthy. If you're worried. They're sitting in the room or actually they've been watching my mom, Papa, I'll podcast the entire time.

So like silent cherubs. If you're worried, they're still quite well. So thank goodness we managed to avoid infecting them with our germs. That is going to do it for us for this week. Thanks to the taxpayers for the use of their song medicines as the intro and outro of our program. I don't want to spoil it, but you should go to McAroyMarch.com come February 1st because I think there's going to be a new uh, Sabah and Spin that you're going to be delighted. But it'll be better if you see it in person. MacRomemerch.com.

And thanks for listening. We appreciate it. Stay safe. Get your vaccines, get your boosters, encourage others to do so, wear your masks, stay calm. Oh, there's gonna be a bumper sticker. A sobbing sort of bumper sticker. Oh yeah.

With Sydney's great quote, I'm not ashamed of my clown husband. So that's also a macro-emerge so you can And I remain unashamed of my clown husband. That is honestly said. It's so sweet. Thanks to Jacob Bailey for Designing that one and you'll be able to purchase that one too and that is gonna do it for us Until next time my name is Shade McRoy. Oh, what? Thank the taxpayers. I read it. I do it for us. Until next time, my name is Shaston McRoy. Oh, what? Thank the taxpayers. I already did. I did that as I think them first.

Oh, I'm sorry, I missed that. That was a great idea. Listen, you're out of your head. I'm cold medicine. You're all hopped up. I'm not on cold medicine. You're all hopped up on cool balls. I did. I took I be profiting in Musin X. Let's get into it for us. Until next time, my name is Justin McRoy.

I'm Sydney McRoy. And I always don't drill a hole in your head. Maximumfun.org Comedy and culture Artist-owned Audience supported