Physician, Heal Thyself

Thomas Robey -- How many colds have you had this season? I'm working on number two. This is from a man who can count on one hand the number of times he missed school in grades K-12 because of illness. Okay, maybe two hands, or a polydactalied hand. Whatever. I've been sick in the third and fourth years of medical school more than any other time in my life. For example, the only time I remember vomiting (ever!) was on my medicine clerkship in Spokane. And I even drink from mountain streams. So what gives?

1. Stress. Lots of it. Long hours. Wanting to learn EVERYTHING, like memorizing the eMedicine article about hepatic encephalopathy.

2. Not eating well. Granted, hospital food is great, especially when it's free. Wait a minute... “Hospital food is great?” I am sick.

3. Not exercising as much. Taking the stairs helps, and that 20 pounds I lost on my emergency medicine rotation wasn't only because I forgot to eat twice during the 12 hour shifts, but being on your feet doesn't cut it for getting the heart rate above 120.

4. Vectors, fomites, sick contacts... we get them all.

5. Sympathy for your patients.

6. Sleep? We don't need no stinkin' sleep.

7. “But I got the influenza vaccine...”

You get a medal if you get through these two years without a viral URI, the flu (stomach or real), strep throat, sinus infection or scabies. For those of you without a medal around your neck, the next test is what you did after you got sick.

The sick doctor has an obligation not to infect her patients. “First, do no harm.” How do you draw the line about deciding to come to work? Stay home with active vomiting? Sure. Is it okay to have a runny nose on pediatrics because everyone else does? In the OR, you'll get you no sympathy from the scrub techs. “Aw, the medical student is spotting his mask...” is as uncomfortable as if I were spotting somewhere else. Lower GI problems? No one wants you around. Don't even think about it! But I'm sure some of us do. After all, not only are we students part of the provider team, we are learning and being evaluated. Missed work equals missed opportunity, right? I don't think so. If you are sick, you're not going to learn. Instead, stay home. Yes, students help the team. But remember your first month on the wards? The team got on without you. They can get by one more day, but be sure to call in. They'll probably thank you for staying home, too.

So what can you do to get back ASAP? There's a lot of stuff that people say works. Many swear by that effervescent pill Gas-Birth. (Names were changed to protect the clinically disproven.) There's something special about chicken soup -– especially if someone else makes it. Drink fluids when you're down. Stay healthy with fruit, exercise, sleep. You know the drill: you've told patients hundreds of times. The CDC promises us the flu vaccine is going to work this year -– get that not for yourself, but for your immunocompromised patients. And you probably know you should be washing your hands AND using hand gel more than you think you need to. Cover your nose. Wipe down your workstation. In the end, the best advice I've received is simply to stay home. You'll be back to your eager medical student self faster that way.