It's everyone's favorite time of year: cold and flu season! I dutifully got my flu shot in October, so when my throat started to tickle a few weeks ago, I dismissed it as a passing bug. Bad idea: It turned into an epic cold that nearly shut me down. (I may have also shared this cold with some of the people nearest and dearest to me. I'm sorry, guys. Really.) But from the sounds of the coughing, sniffling, sneezing, and wheezing around me—all around me—I'm not the only one to have grappled with an illness recently.
We all know the basics of cold and flu etiquette: cover your mouth when you cough or sneeze (with the inside of your sleeve, please), wash your hands often, avoid touching your eyes and mouth, and minimize contact with others. Sharing your germs is frowned upon, though it becomes a bit challenging when you're in close contact on the subway or the bus or the commuter rails. It's no secret that New Yorkers are masters of navigating close spaces, but when confronted with a phlegm-y neighbor, we're suddenly aware of how close we actually are.
The Sick Role
The state of being sick means that the individual is incapable of performing her social roles and tasks. And largely that's okay because she can't just decide to get well—the illness beyond her control and it's understood that she'll need help. This idea is known as the "sick role," a concept created by sociologist Talcott Parsons that tells us what types of behaviors we should associate with and expect from sick people, and how others should respond.
When a person assumes the sick role, there is a general understanding that the individual is exempt from regular social duties, and that the exemption varies in accordance with the degree of illness: people who are less sick, or people who are less visibly sick, are accorded shorter periods of exemption than more severely sick people. Not only are the sick exempted, but they're also accorded special privilege within their networks—people care about them. However, there is a condition for the exemption: the sick person is required to take the necessary steps to make herself better:
The basic condition for the temporary exemption for the sick individual from his or her task and role obligations is rooted in the recognition that being sick is an undesirable state of affairs, and because it is so undesirable, the sick individual is obligated to try to get well. To get well, the sick individual must cooperate with others, because recovery is not possible through his or her efforts alone. Thus, while the sick person has the opportunity to enjoy the temporary but legitimate exemption from normal task and role obligations, he or she has the new obligation of trying to get well as soon as possible (1).
The obligation to try to get well soon reflects an understanding about the care requirement placed on those in our immediate network who will obtain medicines, and provide company, sympathy, and support, even with the risk of possibly contracting the illness themselves in the end.
Time Is Money
Being sick is not an isolated event—it ripples through the networks and social spaces that the unwell person occupies, and requires both the sick and the well to acknowledge the experience. That doesn't mean that you can't be sick otherwise—after all, there are clear physiological signs of being ill—but that in terms of modifying our place within our networks, there needs to be an agreement between all parties. Acknowledgment is vital to the ways in which the sick role unfolds. For example, it becomes the basis for using a sick day or asking and receiving the assistance required to get well.
However, in meeting the various obligations in our lives, we have little time for being sick—or for others to be sick when it might impede our productivity. Plus, economic and employment concerns also mean that people may feel pressured to go to work when they're unwell or have no or little time off available to spend on a recovery day. Time is a scarce resource, after all, and its use must be optimized, particularly the time we are paid for. So we find ourselves impatient with short-term illnesses that we know we're bound to recover from, and sometimes impatient with those around us who are unwell and may be taking a longer period to recover than anticipated. In short, the sick role has become a maligned position within the network because it's costly in terms of time and, ultimately, wages. The sick role may be viewed as a sign of weakness, of needing assistance at what might be the detriment of others. So we insist we aren't sick when we might be to distance ourselves from this potentially damaging label.
A Medicated Facade
To manage sickness and try to maintain a veneer of normalcy, we medicate ourselves with over-the-counter remedies. In short, we bypass or minimize our participation in the sick role as the primary participant, the caregiver, or even just a casual observer. We also send the message that the illness is less severe than it might actually be, warranting less attention than we might otherwise get from those within our network.
Medicines become a mask for how we might really feel, as well as a preventative means for warding off sickness. Though we might be exempt socially from duties if sick, realistically, this isn't necessarily an option. Medicines help us present competency and reduces the caregiving obligations of those closest to us:
Medicines provide a means of coping with a situation that is out of control because they eliminate the need to devote time to sickness or healing activities, or to the down time ill health necessitates. Medicines have become commodities that make the consumer more efficient and in doing so have joined the ranks of other time management products (2).
The question, "Are you taking anything?" can be more than a polite inquiry. It can provide confirmation that the sick person is indeed fulfilling her obligation to get better as quickly as possible, and may excuse certain members of the network from having to invest care and concern to more attentive degrees. An affirmative answer reduces the perceived dependence of the sick person. So by self medicating, we control the sick role and its requirements for care and attention, and we minimize our need for assistance, which might be linked to weakness.
"I'm not sick" becomes a mantra, a refusal to be removed—even temporarily—from the normal functioning of the network. It is an assertion of membership in a culture that values productivity and performance at all times. And it's supported by a variety of medications designed to minimize the symptoms of illness. "I'm not sick" may not be the truth, but it seems to be important that we convince others it is.
Managing snow removal is really culturally specific to where you live. Comments have been disabled on Anthropology in Practice, but you can always join the community on Facebook. Come tell us all about it.
Segall, A. (1976). The Sick Role Concept: Understanding Illness Behavior Journal of Health and Social Behavior, 17 (2) DOI: 10.2307/2136342
Vuckovic N (1999). Fast relief: buying time with medications. Medical Anthropology Quarterly, 13 (1), 51-68 PMID: 10322601
Wolinsky, F., & Wolinsky, S. (1981). Expecting Sick-Role Legitimation and Getting It Journal of Health and Social Behavior, 22 (3) DOI: 10.2307/2136518
1. Wolinsky and Wolinsky (1981): 230. | 2. Vuckovic (1999): 62.
Image Credit: William Brawley