The Ethics of Staying Home While Sick

I get sick frequently. This has been true about me since childhood, when it seemed like I had a runny nose or hacking cough at least once a month. Having been sick so frequently as a kid, I've learned to go to school even while ill. Because when you're sick several times a semester, and you're trying not to rack up a huge list of absences, ain't nobody got time to stay home when you have a little runny nose.
I've carried this general attitude of work-through-the-illness into adulthood. This presents a unique conundrum, when my "work" is interacting with hospitalized patients on a daily basis, some of whom are immunocompromised (ie, their immune systems are less capable of fending off illness than the immune systems of typical people). I've also learned that the more rest I allow myself during illnesses, the better. After all, when I have muscle aches and a fuzzy head and a fever, I'm not a very useful member of a patient care team.
So this Monday, when I began to feel a little fuzzy-headed and muscle-achey, I decided to go to my assigned night shift, since a part of me wasn't sure if my symptoms were due to sleep deprivation or a true illness--though a couple of sneezes from earlier that morning should have told me it was clearly the latter. Of course, I got to work and scrubbed into a surgery, only to find myself getting uncomfortably light-headed and feeling my bowels go into disarray. I ended up scrubbed out, on a stool in a corner of the OR, with my head between my knees and a juice cup in my hand. Since this week's rotation involves delivering babies, my resident and my attending decided I should stay away from newborns with whatever virus was afflicting me, and I was sent home early, with assurances that no one would fault me for doing so, and that I should take the next night off too, if I was still feeling bad.
I was really grateful for my team's incredibly healthy attitude toward illness. As one of my residents said, as a medical student, I should take advantage of being able to take time off when I'm sick, because most residents have precious little opportunity to do that. Since Monday night, I've also ended up staying home from work on Tuesday and Wednesday night, because my symptoms have steadily worsened into a garden-variety upper respiratory illness (URI)--one that rendered me unsafe to practice any kind of medicine, especially medicine involving newborns who would literally be entering the world into my germ-ridden hands.
The frustrating thing is that, in the time since I was sent home by my team on Monday night, I've gotten steadily more and more signs that people seem to think I'm stretching my sick leave a little longer than I should be. My residents have asked whether I've told the clerkship director about my absences. My dad keeps talking about how I should be sure not to miss too many "credits," and is expressing concern that I'll never learn how to deliver a baby (a skill that, while important for any physician to know, likely won't be of great use to me as a pediatric geneticist).
And this brings me to the point I'm trying to make with this post: When is it okay to prioritize my health above other factors? Granted, I'm not suffering from Yellow Fever or something, and this URI certainly isn't going to kill me. But it will make me uncomfortable and inefficient at work, and it will make me a hazard to the patients I encounter. Isn't it right to take off as much time as I need to get over this illness, or at the very least to get over the phase of the illness during which I feel like I'm actively shedding germs from every pore of my body? Or is it more important to fulfill my duties as a student? If I still don't feel 100% tomorrow, should I go to work anyway, lest I exceed the allowed number of days off from my rotation, and end up having to do makeup days?
Perhaps a more pressing line of questioning is, How will all of this play out when I'm a resident, and later an attending physician? When my contribution to the medical care team is no longer negligible, when my notes in the medical record carry actual legal weight, when my patients won't have a doctor if I don't come to work? I'm not sure what the right answer is. I suppose it's something I'll have to wrestle with in the future. For now, I will content myself with being grateful that, as a student, I can still take time off when my body needs me to.

Irresistible Radio Men

I was listening to an old episode of Snap Judgment today (if you don't listen to it, you should), and there was a man on the show, telling the story of the time he got catfished. In short: a mysterious woman started calling him, out of the blue, and having racy chats with him. These chats slowly evolved into real talks, about their lives and backgrounds, and they ended up cultivating a sort of relationship over the phone. All of this happened while the protagonist was on a cross-country road trip with his brother, and he often felt lonely on those long nights out on the road. Eventually, the protagonist returned home, where he started to spend time with real live girls, and his relationship with the Girl on the Phone (let's call her Nicole) melted away.

Fast forward a few years, and the protagonist finds himself stranded on the side of another highway, his car engine failed, and all alone with his thoughts. He eventually begins to think about Nicole, and wonders why he never tried to make something real out of the relationship he had with her. He calls her, and says, "Let's meet in person." Nicole agrees, but says, "I hope you're ready to meet the real me."

Our protagonist (Davy Rothbart is his name) flies to Austin, heart in his throat, and enters an Applebee's on the north side of I-35. In he walks, and the first woman he sees is ancient. That must be Nicole, he thinks, and walks right up to her and introduces himself. The old lady tells him "There's no radishes in my soup! I asked for radishes!" So, that wasn't Nicole. The next woman is sitting at the bar, beautiful, wearing a red skirt, and he feels a rush of vindication. But she isn't Nicole either. Confused and frustrated, he rushes out into the Texas night, running straight into a man on his way out. The man turns and gives him a tiny, cautious wave. And suddenly, Davy knows: this is Nicole.

So he walks over, and shakes the man's hand. "Nicole?" "You can call me Aaron," the man tells him. And instead of punching Aaron, instead of running away screaming, instead of accusing Aaron of being selfish and cruel and immature, Davy has a drink with him. And talks to him for several hours. And keeps in touch with him. For 8 years now.

I have mad respect for this guy's maturity and presence of mind and kindness to this gay guy who had deceived him for months, and kind of made a fool of him. I won't lie--I'm listening to Davy say the last few bits of his story, and I'm thinking "Where you at, Davy? Let's talk. You seem like a nice dude." AND THEN the host of Snap Judgment says, "You can read all about Davy and Nicole in Davy's latest book of personal essays." And then I went crazy. This man sounds awesome. Where can I meet him? Davy, can you hear me? (Note, this is an allusion to Rosie O'Donnell's infamous "Tommy can you hear me?" running joke.)

Alas, radio men are out of my reach. Still, I'm hoping he'll read this and come at me, bro.

On Doing Things That Scare Us

I feel like there's no point in life during which people like to tell you how to live, more than during your twenties. It seems like every time I open up Facebook, someone else has posted yet another Buzzfeed or Jezebel "list" of things one must do in one's twenties: places to travel, cities in which to live, things to do, books to read, movies to watch, things about which to be nostalgic. I suppose the digital era magnifies society's desire to tell us twenty-somethings what to do, but it still seems as if this urge to guide the lives of young adults has always been there.

"Do something every day that scares you" is an urging that makes an appearance in all of these "lists" in various forms. Either it's written verbatim as one of the items, it's reworded in some clever, themed way, or it underscores the entire list itself ("7 war-torn regions worth visiting in your twenties." I'm kidding. Or am I?). 

Now, most of the items on such lists kind of confound and mildly annoy me. I think it's up to me to decide how I'm going to live my twenties, and more often than not, reading about how others wish they had lived theirs doesn't really change my behavior or ideas. As John Mayer sings, "Is there anyone who really recalls ever breaking rank at all for something someone yelled real loud one time?" And to be perfectly honest, I think people who tout traveling at a young age sometimes just sound really entitled--not everyone has that kind of money to spend, or the freedom (literally or figuratively) to just drop their lives and go gallivanting across the world.

However, I've always liked the idea of doing something every day that scares you. It's a simple concept, it doesn't have to cost anything, and it leaves a lot of room for interpretation. Different things scare different people. Hell, I'm scared of birds and fish, and doing something that scares me could be as silly as staring at a fish tank for a while. [I've done it. It's unpleasant.]

But the truth is, I'm a pretty fearful person. I am terrified of rollercoasters. I am so entrenched in my fear and aversion that when I went to Universal Studios earlier this year, I literally brought a book to read while my friends went on their joyrides. When I was in dance performances in college and the choreographers wanted us to do flips, I point-blank refused to participate in such shenanigans, cause I just didn't like being upside-down, suspended in the air and at the mercy of both gravity and some random guy who was just as frightened of dropping me as I was. I have tried a rollercoaster once or twice. I even tried a flip a couple times. After the rollercoaster, I promptly decided that the fear and knee-knocking and trembling and anticipation weren't worth the 10-second euphoric high afterward. When I tried flips, I ended up dropped on my head. On more than one occasion. So, that was a no as well. 

And so trying to do things that scare me, things that REALLY scare me, often hasn't yielded the best results. Or at least, not the sort of results those lists would have me believe I'd get. Doing something that scares you should lead you to unexpected places, both literally and figuratively. It should expose you to unexpected vistas, set up that perfect photograph for your Facebook cover photo. So far, doing something that REALLY scares me has only shown me that I had good reason to be afraid, and I'll continue to live in fearfulness, thank you very much. 

Still, I guess fear is unavoidable. After all, the unknown is at the heart of life. No one knows what will happen tomorrow, or a year from now. No one knows how we'll look or who we'll be or where we'll work when we're in our thirties, giving advice to those twenty-something whippersnappers. And let's be real: that's scary, whether we feel like it is, or not. Because not all of it is in our control. And perhaps that's the real reason we are afraid. There's no way to mend that. There's no way to control it all. So we keep living. And we keep scaring ourselves. And we keep learning which fears are worth holding onto, and which we can let go. That's what I'm trying to do, anyway.

The Pros of a Con

Fact: I'm often at my most productive when I'm also at my most dejected. During medical school, all the new projects and initiatives I've taken on have been in the wake of a break-up. Indeed, these projects might never have gotten off the ground without the catalyst of my heartbreaks. When all I want to do is curl up in bed and cry, I instead end up seeking out challenges and pushing myself to the brink in strictly unemotional realms. How organized can I be? How many things can I juggle at once? What things can I focus my energies upon, and exhaust myself with, so that I'm left with as little time and emotion as possible in which to brood upon the state of my personal affairs?
People often tell me I'm a perfectionist, a Type A personality, and I always disagree with them pretty heartily. But I suppose this impulse of mine is as good evidence as any of what is perhaps my true nature. When things suck for me, I just try to keep myself busy so that I don't have time to wallow.
Not that it really works, exactly. Like most people, (I assume so, anyway; I suppose I have no idea what other people have in their heads) I have a lively inner dialogue, a tempestuous sea, if you will, that is constantly running, whatever I'm doing on the outside. So I still find time to wallow. Time to come up with new iterations of my pain, new metaphors and catchphrases and mental images and sounds. I guess you can't really run away from your problems, no matter how hard you try.
But at least I'm doing useful things in the meantime. I've found that when one is in a crummy place emotionally, (and, incidentally, when one is in general not where one wants to be) the idea of "fake it till you make it" is a pretty useful one to apply. Eventually, the person you're trying to be becomes the person you are. 

Way Too Spicy

Today I went to a Thai restaurant and experienced a most unpleasant convergence of sensations. My family foolishly ordered "hot" food and ended up with an entire meal that was so spicy it had us all blowing our noses, sweating, and coughing. My nose was running, my bowels were going crazy, my eyes were watering, my tongue was burning, and to top things off it was so freaking cold in the restaurant that I was shivering the entire while. Not an experience I'm likely to want to relive any time soon.

Wifehood, Motherhood, Doctorhood, Womanhood

Tonight I met two bright, female high school teachers who love science. They were closer to my mother's age than to mine. Both told me that when they were in college, they wanted to be doctors. But both of them decided to forego that career path and chose teaching instead. Both said they made that decision because, as one of them put it, "I realized I couldn't be the wife and mother and doctor I wanted to be" all at the same time. They don't regret their decision one bit, both of them said. They don't make a lot of money, but they're happy and love what they do. Now, normally my English major mentality would leap forth at a moment like that and scream "Methinks she doth protest too much!" But I really don't think those women meant anything negative by what they said. I really do think they're happy, and they love what they do, and they don't regret their decisions at all. 

I reassured the AP biology teacher that as a medical geneticist, I won't be making a fortune either, not compared to people in business and certainly not compared to physicians in many other subspecialties of medicine. And then I stopped to think.

For most of my early childhood, my mother was a stay-at-home mom. Though she started working outside the home after my sister and I got a bit older, and continues to work outside the home, she and my father demonstrate very traditional gender roles. My mom does all the cooking. My dad cleans up after dinner. He pays the bills and drives the family around and is the family's primary breadwinner. She tries to teach my sister and me to cook, say Hindu prayers, and generally gain other skills that will make us suitable wives someday. It surprises me a little that I didn't give motherhood even a moment's thought when I decided to become a physician. Believe me when I say I wasn't one of those kids who dreamed of being a doctor all her life. I resisted the idea of going to medical school for quite some time, but by the time I was in college, I knew it was a field in which I would excel, and a career that would give me deep satisfaction. And that's where my thought process more or less stopped. Sure, I wondered if I'd ever have time for anything outside of medicine, but my focus was more on a vague sense of a personal life, and not caring for a family the way my mother always did. 

I suspect that more than a little of the hesitation of the women I mentioned earlier, and my lack thereof, has to do with the fact that those women likely had boyfriends or husbands with whom they were planning a future while they were considering medical school, and I simply didn't have that pull then, and don't really have it now. Because I don't have one person to mentally Photoshop into my imagined scenes of domestic bliss, I'm not very attached to that vision of the future. Here's what I know: I'm going to make a good physician, and my career will make me happy. Maybe someday I'll find myself in a domestic situation that causes me to change my tune and become a stay-at-home mother and wife. Maybe I just won't like the idea of someone other than me being at home with my children. Maybe none of those things will happen. Whatever the situation, I'm glad I decided to go to medical school, gender roles be damned. I think I can find a way to make doctorhood live in harmony with motherhood, wifehood, and womanhood, or whatever -hood life throws at me.

On Traveling with People Who Travel

A couple weeks ago, I visited Orlando with some of my friends from college, for pretty much the sole purpose of visiting Harry Potter World. It didn't disappoint, but that's not the point of this post.
All three of the girls I traveled with are in the working world, as opposed to the twilight that is professional school. Two out of the three travel extensively for work, have a formidable collection of hotel points and airline miles, and can jump into the express line at airport security with ease. The third doesn't travel for work, but she is a seasoned world traveler. Aside from my experiences traveling to India, I am none of the above.
In traveling with these girls, I realized a few things about such an experience. Traveling with those who travel (especially for work) is kind of like trying to hang out with the cool kids in middle school. They all own carry-on luggage that is mildly, but boldly oversized. Their suitcases all have not two, but four wheels, the better to transport them vertically. For every one of them who has perfectly arrayed liquids and semi-liquids in the regulation 3 oz size in clear Ziploc bags, there's another who blatantly brings aboard full-size bottles of shampoo, citing all the previous times they've done so and not been penalized. These girls are the type who know ahead of time what kind of plane you'll be boarding, and whether said plane will have DirecTv that you'll have to pay for, or if free movies will abound. They know that it's always better to carry on a suitcase than to check in--and they know that their carry-ons can be a little fatter, a little heavier, than the stated upper limits, because they've never had trouble with such luggage in the past. When taking an early-morning flight, they'd unanimously rather get another precious half-hour of sleep and park in the more expensive garages near the terminal, than wake up a bit earlier and pay less to park in a satellite lot and take a shuttle to the airport. In short, these girls are travel experts. I'm not.
For the most part, I found the tips and know-how of my friends to be helpful and illuminating. But I have to admit that I thought some of the things they did were a little, well, dumb. For instance, they always wheel their carry-on luggage around on four wheels, even though rolling it along on two wheels, at an incline, is often a much more efficient (not to mention ergonomic) way to transport it. The craziest thing about this all is that I found myself imitating them, lest I somehow throw a kink in the well-oiled machine that is Traveling Like a Consultant. And though I think it's kind of great to be able to sneak perfectly harmless liquids over 3 ounces past airport security (I get a sort of secret thrill when I realize I've inadvertently done so), I think it's bordering on entitled for people to knowingly flout the rules set in place by airport security. This isn't to say that my friends mean any harm by doing so: they don't. They just know they can get away with it, and so they do it.
I suppose this kind of knowledgeable handling of situations that all people encounter at various frequencies happens in all fields of work. I mean, if I'm ever admitted to the hospital, I'll surely have an advantage over my consultant friends, simply because I know how things work at a hospital; I know when to expect to see my doctor, when to ask why the team isn't running specific tests on me. When I wait forever in my primary care physician's waiting room, I understand the most likely reasons why that wait happened. (You'd be surprised how busy a primary care physician is all day long, from seeing patients to answering phone calls to approving medication requests from pharmacies, to checking on patients admitted to the hospital, and much more.)
At any rate, I guess since people in most fields of work/study can use their knowledge to their advantage, knowledge most other people don't have and thus can't leverage for their own advantage, it's not necessarily wrong to do so. More than anything, I found the whole situation somewhat amusing, and a little disconcerting, because I found myself imitating my well-traveled friends, even when I didn't understand why they were doing what they were doing. In a move that nearly hearkened back to clumsy attempts to get accepted by the cool kids in middle school, I even brought my VA hospital badge with me on the trip, because I knew it could get me into a short security line at the airport. I hoped I'd be able to provide some advantage to the group, since I was benefiting so much from the influence and smarts of my friends. Fortunately or unfortunately, we were never delayed enough that I had to use my badge. Perhaps more ruefully, I'm fairly certain my badge wouldn't have gotten us through security any faster than my consultant friends' "elite" statuses with their airlines. So it goes.

Small Pleasures

In the new year so far, I've been spending nearly all my time studying for Step 1, my first medical licensing exam. I've also [finally] moved into my own place, which is shaping up quite nicely. Living on my own feels good. What with all this upheaval in my day-to-day life, I've developed new routines and rituals as I go through the week. One of my favorites is doing Bollywood dancing with a friend on Sunday mornings. Another is working out at the gym near my parents's house (my membership doesn't expire till the end of January) on Sunday evenings, while listening to "Snap Judgment" on my NPR Player app. I listen to about half the show during my workout, and I have the pleasure of listening to the other half as I drive back to my apartment after having dinner with the family later in the evening. I really love "Snap Judgment." And listening to it weekly recharges my spirit.