It's About Time

Taking Time to be Sick by Suzanne M. Schweikert M.D. Copyright 2003 All Rights Reserved Comments, thoughts, and personal experiences on time related topics are welcome. Email: Dr.Schweikert@WritersMonthly.com

Almost everyone I know is sick with a summer flu bug right now. Except me. So, I've been getting the usual run of queries from friends, family, patients, and office staff. It goes something like this: "Hey Doc, can you give me something to make this cold go away? I can't afford to be sick." I smile, and I remember.

I used to feel the same way about being sick: What a waste of time. Two years into my residency, when I had been coughing and sniffling for what seemed like months, I asked my doctor if there was anything wrong with me. Perhaps I was immunocompromised or had been infected with some terrible disease. Her answer surprised me. First of all, she pointed out, I hadn’t missed a day of work, and therefore had exposed all my colleagues and patients to the same bug. Furthermore, her lecture continued, I had not taken time to be sick, and had not given my immune system the respect it deserved. I must have looked doubtful, because she went on to explain that my body was begging me for rest, and had gone to great lengths to convince me of this need. But still, I wasn't seeing the signs.

Finally, she took pity on me. Go home and get some sleep, she said. You have driven your body to its limit, and you are paying for it. Don’t let it happen again. But I didn't listen to her. I failed to get some rest, and I still didn’t miss a day of work. The culture that I belonged to (medical residents) did not accept being sick as an excuse. Eventually, I did recover (although it was sort of hard to tell, as I remained in a permanent state of exhaustion). However, my doctor’s words survived somewhere in the recesses of my tired brain, and so the next year, when I developed another cold, I took a day off.

By this time, I was a chief resident, and I realized that I couldn’t run an entire labor and delivery unit with a fever and chills. My down time was in the best interest of everyone. Then the most amazing thing happened. I took two days off, during which I laid in bed, slept, drank fluids, and did nothing to exert myself. Although I was very ill, I had almost no traces of a cold when I went back to work. In fact, I had to dramatize a little, just to convince my co-workers that I had really been sick. My friends who also got sick that summer seemed to have colds that dragged on for weeks, while I bounced back quickly. I also didn’t get the virus again when it came back for round two.

This experience gave me a bit of insight into why we get sick, and why we stay sick. It should be apparent to anyone visiting their doctor for a cold or flu, that medical school did not provide us with any weapons against such ailments. We were left with bigger dragons to slay, like cystic fibrosis, bacterial pneumonia, and HIV. We were admonished not to prescribe antibiotics to every miserable, runny nosed person who comes walking into our office, as this would create worldwide multi-bacterial drug resistance, not to mention untold deaths from allergic reactions. Instead, we would send these souls back into the world, pitting them against modern day snake oil peddlers and the hugely profitable business of over-the-counter cold remedies (quackery at its most capitalistic).

As physicians in training, we were not reminded to observe and listen to our own internal signals, to take "down-time" for sickness, and to expect less of ourselves in these periods of healing. We were never taught that sickness is as much a part of being alive as wellness (just as being sad is as much a part of life as being happy). It is possible that this was considered common sense by previous generations of physicians, and therefore never written down in medical textbooks. Or, it may have simply been too contradictory to the image of doctors as powerful healers, above the level of mere mortals. Much like certain religious leaders’ special ability to communicate with God, only doctors were presumed able to read the "signs" of an illness, and so the rest of us just stopped trying.

I think it is fittingly ironic that our strongest weapons against the yearly onslaught of colds and flus are our own observing and listening abilities, something that doctors and patients can practice in equal measure. Nowadays, when someone asks for advice for a nagging cold, I ask them to pay attention to the clues their body is sending. In medicine, we call these the "signs" of a patient, rather than the symptoms. These signs can be obvious, as in an X-ray showing pneumonia. Or they can be subtle, as in someone who looks visibly fatigued, but does not know why. It is often impossible for a physician to know which diagnosis is most likely (without a battery of lab tests), unless the patient is tuned in to their physical self, and is willing to listen and respond to the messages, or signs, being sent.

Our body’s message is not a hard language to read, but once read, it demands to be heard.

Its most important message is this: getting sick is not a luxury. It is a necessity. It gives the immune system time to swell its coffers of antibodies, and to shout to the world how potent it is. The antibody reaction to a common virus becomes a show of arms against other would be invaders, many of whom are repelled by a previously well-stocked arsenal. Replenishing this arsenal takes time — sick time or down time - whatever you want to call it. When we force our T-cells and B-cells to compete with e-mails, stress, and work obligations, we end up with a weakened army, and then seem to fight a losing battle.

But what does all this have to do with writing? Paying attention to signs is as much a part of writing as is, well, writing them down. None of us has the time to accomplish everything we wish in life, and most writers have pesky little day jobs, not to mention responsibilities to family, friends, and landlords. But first things are first. When you are sick, you must find time to heal. And likewise, when you have something to say, you must find time to write. You will suffer less in the long run, if you follow the signs your body and mind are telling you. These two are mirrors of one another, and those who excel at listening to both are perhaps the best writers of all.

So, get into your sickness. Savor it, relish it, and even wallow in it. It might just be the closest you will ever get to a near death experience, and it could provide the fodder for your next novel. While nobody likes to hear a writer whine about not getting paid — the opposite is true for sickness. The public eats up stories of malarial fevers, snakebites, and wheezing children. Just think about Albert Camus' The Plague, John Irving's The Cider House Rules, or (my own favorite account of suffering) Alexander Solzhenitsyn's One Day in the Life of Ivan Denisovich. Such stories of pain and illness hook us, tug on our morbid curiosity, and lead us into temptation. We can't put them down.

But how will you ever write convincingly of suffering if you don’t take the time to really suffer? While lying there in bed, you can pretend you've been trekking through the jungle and have come down with sleeping sickness after a bite from a tsetse fly. Or you might envision yourself as the hero of an international intrigue novel, coping with the fact that you were just exposed to a biological weapon. Knowing you have 24 hours to live might make you write things you wouldn't have otherwise. And by all means, whine to your loved ones and coworkers about how terrible you feel, so they will beg you not to go to work. Then sit back and do absolutely nothing. You don’t have the stamina, remember, you're sick.

Just return to your job and your writing when you are recovering at long last, and recount for others your harrowing journey back to life. Your body will be stronger. You might even realize that you've been taking your health for granted and use this as the starting point for a new diet, or a plan to quit smoking (since the severe difficulty you had with breathing during your cold made you wonder what emphysema feels like). You will find that your obligations don’t change a whole lot while you’re away, and your writing doesn’t evaporate on the page.

Given all these benefits, you might even be looking forward to getting sick. If so, just touch the doorknob at your local Starbucks, then place your fingers on your nose and mouth. A few rounds of this and you should be infected. However, if you are one of those reclusive writers who has had so little contact with humanity that you haven't had a virus in ten years, beware. You won’t have any natural immunity, so you might actually come close to dying. Get a telephone with brail symbols on the number pad and place it next to your bed, just in case you need to call 911 when the rampant encephalitis in your head knocks out your vision. You might also want a tape recorder to document your feverish ramblings, as the post encephalitic amnesia will wipe out any traces of just how horrible it all was. Good luck, and go get sick.

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