Work-Sick Divide?

There is always a grey area when judging how miserable you must be, to be "ill enough" to stay off work.

When I was still teaching, I once had 3 weeks off work with a severe flu.  I was very miserable for most of that time, yet the last day of that absence period I remember thinking that I felt okay-ish, and I felt quite guilty for still being off work.

In those days I tended to return to work as soon as I could stagger in, confident that my body would heal itself in due course.

So now that I've become long-term sick I wonder about where the "well enough" boundary should lie?

Does this well-ill boundary fall in the same place on the way down as it does when going back up?

And does sickness duration affect your approach to returning to work?

I like to visualise things, so I created this graph, to show how I think most people regard a period of work absence due to illness. (Click on image to make it bigger):

Let's assume our "normal person" has reasonable health, but they get the odd cold, so they are not adverse to sometimes pushing on into work feeling a bit below par.  Yet their basic health is good, so dips in well-being might not much change their ability to work.

Then if our normal person gets flu - well that can happen quite quickly, so although they may "struggle on" for a bit in what I have called the "grey zone", it will soon become clear that they need to take to their bed and rest.

Yet on their return to work, they are unlikely to go back whilst feeling as miserable as they did on the last day before their absence period.  There is a general understanding that people should stay off work long enough to recover sufficiently to properly function once more.

So the work-sick boundary is not the same on the way down as it is on the way back up.  We tend to stay either "working" or "not working" long enough to see what direction things are really going. We neither rush to take time off, nor rush to return until we are sure. 

All the same, it seems clear to me that time in the "grey zone" for a healthy person, can be a short transit between two extremes.

Absolute full health can, of course, still take a bit longer to return, so for a time our normal person might cut out a few after-work social activities until they feel fully back on their feet.

When I was in normal health, that "return to wellness" was an assumption that I never doubted.

So what about the Chronically Ill person?

I've assumed this person is still working, and that their health is such that they are really only just "well enough" to work.  For this person each cold is a serious problem, and they might regularly dip into that "grey zone".

 Now assuming this person gets the same 'flu as our normally healthy person, let's look at what might happen.

Like the "normal person" flu acts quickly to knock the chronically ill person off their feet, but sadly recovery is likely to be slower - simply because there is less wellness to draw on.

This chronically ill person is also likely to be incredibly aware of the time they take off work.   So what do they do?  Do they try to go back as soon as vaguely possible, and risk a relapse and another period of absence? Or do they wait until they are really "well enough" to work, and in doing so take an extended absence?

It is a hard choice for others to understand, because although "normal" folk may have some experience of attempting to work whilst in that "grey zone", their transit through this zone is short-lived and their experience very temporary.  Bluster from the healthy, about how "I just pushed on through..." sounds shallow to an individual having to cope with long term ill-health.

Sadly I have no answers to provide, but I think the concept of ill health lingering for long periods in this insufferable "grey zone" is a useful one to consider.

Going back to the 'flu I mentioned earlier - because I was generally healthy at the time, my transit through the grey zone back to "well enough" was so rapid, that I ended up feeling "better" sooner than I had expected.  A day later I was back in work and functioning normally.

A chronically ill person has a much slower transit through that "grey zone" and consequently much more difficult choices to make about when to attempt a return to work.