What to do when you get sick in medical school...

Let me start by saying that I have never missed a day of medical school from being sick. Until yesterday.

Most medical students and residents will tell you that it is practically unthinkable to call in sick. It's sort of an unspoken rule that to stay home sick is weak, slacker-ish, unprofessional, and just not something a doctor or future doctor would do. I'm not sure where this attitude came from, since as caregivers for the sick you would never think that we would be the worst possible people to take care of ourselves. But regardless, we always think that we need to keep on pushing ourselves, and when we're ill or tired we just need to push harder.

Mine started with a seriously painful earache (later discovered as probably referred pain from my tonsils, interesting), continued with my asthma getting worse, and culminated in a sore throat which led to me looking at the back of my throat in the mirror with a flashlight. Bad idea, since what I saw was (sorry if this is too graphic) pus dripping off both tonsils and the back of my throat. I kind of freaked out at this unpleasant and called to make a doctor's appointment. I was able to get into one of the family medicine residents who proclaimed when he saw me "Yeah, you know that something's wrong if a medical student or resident goes to the doctor." He proceeded to look in the back of my throat and got pretty excited "Wow, that's exudative pharyngitis if I ever saw it!" (a.k.a. probably strep throat).

I got my antibiotic prescription and then asked the million dollar question: should I go in to the hospital tomorrow? I was scheduled for a 24 hour shift: operating room until 5 p.m. for ob-gyn surgeries and then OB call from 5 p.m. until the next morning. I was pretty confident that my aggressive hand scrubbing and mask/sterile gear would protect the OR patients but I was worried about exposing a new baby to possible strep throat. The resident, just as we've been trained, told me to go to my rotation in the morning and mention to the attending that I was sick but had started an antibiotic. He didn't seem to think it would be a problem for me to go to clinical. Pretty typical, since most attendings will tell you that they can count the days they've missed in years of practice on one hand (or one finger).

I got to my rotation early, my throat was painful and I was wheezing up a storm, but I've felt a lot sicker and was fairly confident I could get through the day. My attending walked up: "How are you?" to which I replied "Well, a little sick but I started an antibiotic..." My attending's affect immediately changed: "Then why are you here?" He proceeded to give me a harsh talking to about coming in sick, exposing other's to being sick, etc. (not the reaction I was expecting). Needless to say, I went home.

I was a little shocked by my attending's "counter-cultural" reaction. Part of me felt defensive, "but my doctor told me to go in," "but I'm a medical student, we can't miss a day of our rotations." But part of me learned a valuable lesson: we should always have our patient's best interest at heart. It takes humility to go against the grain and call in sick, but if we are truly ill, we shouldn't hesitate to do so and protect our patients.