US VS THEM:

A 2005 outbreak of the norovirus stomach bug in a nursing home highlighted the role of medical personnel in spreading communicable disease. The most disturbing aspect of the case was that medical staff members continued to come to work while ill, well into the outbreak, despite strenuous and public exhortations to stay home. This may have prolonged the outbreak and led to more patients' falling ill.

A survey of British doctors back in the '90s found that 87 percent of G.P.'s said they would not call in sick for a severe cold (compared to 32 percent of office workers who were asked the same question). In Norway, a 2001 survey revealed that 80 percent of doctors had reported to work while sick with illnesses for which they would have advised their own patients to stay home. Two-thirds of these illnesses were considered contagious.

What explains this toxic brew of denial, ignorance and bravado? Part of it is a professional but often exaggerated sense of responsibility to colleagues and patients. Even if you are sick enough to have an IV running in your arm, you keep doing your job.

But another part is how we see ourselves. Illness is what we do, not who we are. We define ourselves by vanquishing illness, not succumbing to it.

As much as we empathize with our patients, part of protecting our inner core may require drawing an unconscious demarcation between "us" and "them." I can recall, as a resident, the palpable relief of leaving the hospital at the end of a long night, something I generally thought about in physical terms -- getting out of grubby scrubs, the promise of a hot shower and edible food. But it was more than that: There was also the awkward relief of leaving behind the graphic reminder of what could befall my own body. Somewhere, deep down, I needed to convince myself that we doctors were a different species from our patients.

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