Kate Middleton is doing it… but should we really be working through illness?

The Princess of Wales may currently be recovering from abdominal surgery, but that isn’t stopping her from working from her hospital bed. The claim, reported in The Times this week, was met with both praise and concern. Some lauded Kate’s apparently relentless work ethic. Others suggested it set an unhealthy precedent. Wherever you stand on the matter, it typifies a wider trend: a social tendency to work through illness… even at its most severe.

For some, the reluctance to call in sick is a result of ambient workplace pressure: an unspoken rule, disseminated through disapproving glances and examples set by colleagues. For others it’s out of necessity, a response to work insecurity and a lack of sick pay. But for many of us it is entirely self-imposed, tied to the glorification of hustle culture and a widespread “suck it up” mentality enforced by neoliberalist attitudes to work. It has transformed “the sick day” into a luxury rather than a necessity, particularly in the UK.

A 2019 UK study found that 79 per cent of those surveyed go to work despite being physically or mentally unwell. Some 67 per cent reported experiencing guilt over taking time off work, even when they have health-related issues. The paradigm is so ingrained it has its own appellation, “presenteeism”, and has been found to cause depression and exhaustion. It also cuts into workplace productivity. “You’ll make errors and the work you do will be sloppy because you’re not well,” warns Dr Clark Gaither, a New York-based physician who’s written extensively about burnout culture.

There was a brief period in which we seemed set for change, that Covid would liberate us from the herculean, under-the-weather trek into work. All of a sudden a contagious and potentially fatal illness was everywhere, and our responsibility to keep each other safe took on new weight. How had we been heedlessly passing on illnesses for decades, we asked ourselves. But four years on, we may have metamorphosed work culture through the boom in hybrid working and working from home, but powering through illness has, for many, retained its status as a noble sacrifice. It’s especially true for baby boomers and Generation X. (There’s a spate of Reddit threads, for instance, dedicated to unpacking why boomers are so against sick days). According to Dr Gaither, this is largely down to a sense of “inertia” – a “we did it so you can too” attitude towards younger employees.

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In some ways, the expectation to toil through illness has been compounded by the prevalence of at-home work. Instead of simply taking the day off, sick employees tend to work from home, or are expected to do so. It’s a compromise that may not offer the recuperation needed to recover, not to mention the fact that, even from the comfort of the couch, it can be near impossible to operate through discomfort and pain.

Those with jobs that require in-person attendance don’t, it should be said, even have that option. Leslie* is the general manager at a pub and restaurant in central London, and often has no choice but to go in when she’s sick. “The reality of my job is that if I can’t go to work, there’s a strong likelihood that the business won’t be able to open, or at least open on time,” she says. “Ultimately, I don’t feel comfortable calling in sick because it’s likely to cause more issues in the long run.”

She maintains that she’d never coerce someone into coming into work if they’re unwell. But she admits that she can’t always mask her frustration if she suspects they’re calling in sick due to a late night or social engagement. “It’s always difficult to get cover last minute, so the team ends up struggling or staying late, or I do unpaid overtime,” she says. “It creates a tense and sometimes toxic working environment.” She puts the crux of the problem down to those at the very top of the working food chain, who tend not to understand the ripple effect of absences and effectively plan for them.

Dr Gaither says that many of his patients tell him they avoid sick days due to financial uncertainty. “When they say ‘I can’t afford to take time off from work,’ what they’re saying is, ‘I can’t take the drop in income if I don’t go in,’” he explains. “People are having trouble meeting their obligations and paying their bills. What that means is they may have to take an extra job.” Unlike in the US, sick pay is mandatory in the UK, but it is low and often subject to caveats. Employees on zero-hour contracts, for example, are only entitled to sick pay if they’ve been unwell for four consecutive days. 

The pressure to power through illness can be particularly pertinent for women and people who menstruate. A study by Bloody Good Employers, a subsect of the menstrual equality charity Bloody Good Period, found that 25 per cent of people felt as though their career progression had been affected by taking time off work for their menstrual health.

“We had somebody report that colleagues who take regular sick leave in their workplace are seen as unreliable,” says Elysha Paige, Bloody Good Period’s commercial and development director. “They don’t want to talk to their manager about their ongoing period pain because they worry about appearing weak or because that support isn’t in place. They just suffer in silence and get on with it. In the workplace – and especially in corporate spaces – we’re still seeing that women are able to be successful by essentially masking and being like a man.” The goal of Bloody Good Period, she adds, is to educate employers on the menstrual cycle and advise them on revising their core absentee policies – measures which, when done right, benefit everyone.

For younger generations, though, a departure from Western society’s long-standing work-first ideology is gaining traction, spearheaded by millennials and accelerated by Gen Z. TikTok has emerged as a hub for expressions work fatigue, with young people sharing videos on their workplace regrets, their frustrations with low wages, rejections of hustle culture and the importance of self-care when it comes to productivity. There’s also been a boom in more controversial trends, among them “quiet quitting”, or the practice of doing the bare minimum in the office, but enough to remain employed.

Although this has caused a schism between older and younger generations in the workforce (boomers and Gen X’s complaints about young people’s work ethic often make headlines) it could signal a positive shift in our sick leave philosophy. A study by Health Shield Friendly Society found that Gen Z take more sick days than their older peers. It means that while Kate may not be a fan of taking time off from work, it may at last be routine by the time Prince George, Princess Charlotte and Prince Louis are grown up.