Really good article
Medicine demands physicians be invulnerable, trained to push through exhaustion, to be helpers, never helped. But Long COVID shattered that illusion for
a significant number of healthcare workers worldwide. The system lacks mechanisms to accommodate chronically ill physicians, without flexible scheduling, clear disclosure pathways, a framework for disabled doctors.
We face a choice: hide our limitations and risk our health, or disclose and risk our careers. If medicine cannot accommodate physicians disabled by the pandemic they fought, it will never truly serve disabled patients.
The choice isn't just 'hide our limitations and risk our health' or 'disclose and risk our careers'. As Mustafa Talat makes clear, if you don't provide suitable accommodations for health professionals with ME/CFS-type illness, it's the patients' health as well as their own that is risked if they continue working. A brain-fogged doctor whose main thought is how they need to lie down is not going to be the caring alert doctor that we all want. And making it so hard that the doctor with mild ME/CFS can't continue isn't going to help patients either, when the supply of highly trained health professionals is, as it always is, scarce.
I suspect I’m not alone, though silence makes this isolating. I observe colleagues exhibiting patterns I recognize: leaning against walls during rounds, taking frequent breaks, avoiding stairs, and declining responsibilities. I cannot presume their health status. But what strikes me is how common these quiet adaptations appear, and how systematically we avoid discussing them.
I was interested to see the 'leaning against walls' comment. I do that too, leaning against a wall, a doorway, a table, if I ca't sit down.
This education must extend across all levels: integrating post-viral conditions into medical school curricula and training all staff to recognize accommodation needs. This should be mandatory, delivered through
grand rounds, department meetings, and communications explicitly naming Long COVID as an
occupational risk. The silence will break when institutions make it professionally safe to acknowledge COVID-19’s ongoing impact.
I thought that last sentence about explicitly naming Long COVID a an occupational risk was a powerful thought. Imagine if Long COVID was named as an occupational risk, imagine if doctors had to acknowledge in writing that if they get it, they are pretty much on their own (as they so often are).
It reminds me when I was spending a lot of time in hospital observing the terribly bad infection control. It turns out my relative had an antibiotic-resistant infection, and sometimes she would have a sign on her curtains calling for extra hygiene measures. Sometimes she wouldn't. Even if she had a sign on her curtain, the cleaning staff did not know what that meant for them, did not realise that even urine could spread the infection. Briefly, my relative had a room to herself, mostly she was in a mixed ward. All the time, she used shared toilets, and hygiene in those toilets was frequently poor. I could go on, but the point of my story is that I asked a doctor what was going on, and he said 'oh, it (having the antibiotic resistant bacteria) is 'not a big deal, probably all the staff in the hospital have it'. And that's fine while they are young and immune-competent. But, a time may come when the antibiotic resistant bacteria in their digestive tract is actually not a big deal.
I think avoidant thinking on the part of health professionals is actually part of the problem with acknowledgement of ME/CFS. If infections can leave you disabled, it becomes a whole lot less comfortable to be working in an environment where repeated infections are 'just part of the job'.
Medical systems must create flexible scheduling to accommodate chronic illness, allowing start time adjustments and workload modifications following symptom flares rather than expecting consistent performance. Financial protection is equally critical. We need extended paid sick leave for chronic conditions, disability insurance that recognizes Long COVID, and income protection that doesn’t force all-or-nothing choices between full capacity and departure.
Infection prevention, including improved ventilation, high-quality masks, and policies protecting healthcare workers, remains critical. COVID-19 continues to circulate, and
reinfections worsen Long COVID. If medicine can’t retain healthcare workers disabled by the virus, what does that say about our commitment to those whom we serve?
We’re here, we’re still practicing, and we deserve better than silence and self-management. Medicine asked for our bodies. It’s time medicine made space for what became of them.
I do think this issue of 'how are you going to get and keep new doctors once they really understand the risks they are running' is quite an interesting one from an advocacy perspective.
Thanks to Mustafa Talat for the interesting points.
