Cultural Insights: I’m Sick, What Do I Do?

A simple thing.  My daughter is sick.  She of course should stay home until she is better.  Or should she?

It’s a dilemma that we have, in part because our lives cross two significantly different cultures:  Sweden and the United States.

It used to be an easy question for me.  I grew up in the United States, a country that awards students for perfect attendance at school and at the extreme, fires people for being sick.  With that type of reward and incentivising, one can guess the answer what to do.

Suck it up and deal.

Go to school.  Go to work.  Take the best over-the-counter (OTC) medicine you can find, even if it’s questionable what it’s doing to you (and should you be operating machinery or an automobile while on it).  

No one ever gets anywhere in life by lying in bed sick.  Get up, get out there, earn your keep.

With no thought what-so-ever about transmission and others.  It might seem cold and callous.  It definitely did to one of my team members in Sweden who called me out on it once.

I was at work, probably with a fever suppressed by Day-Quil, despite feeling awful.  Because I was important.  I was needed.  And damn it, I wasn’t going to let a little cold hold me down.

I was sucking it up and dealing, commending myself on being stronger than the latest flu strain, when one of my team members came into my office.

  • You look like hell (the meaning, if not the exact wording).  Why are you here? 
  • Important stuff to do, due tomorrow.  Besides, I’m tougher than this.
  • Yeah, but what about us?
  • What do you mean, us?
  • Our team, all of us.  Our kids, our spouse, everyone who will now be sick because you came to work sick.

Hmmm.   I felt like a total jerk.  How could I be so thoughtless?  So inconsiderate of my team, their families, the entire society of people I had possibly contaminated.

It definitely had not occurred to me that morning when I got up, despite a strong force pulling me to stay in bed.  I was raised to overcome sickness, not just in my family, but in the society I grew up in.  Although I never made it, I knew that perfect attendance was important.  It was valued.  It was necessary.  It was a measure of one’s grit, perseverance, and toughness.


But not everywhere.

After having lived most of the last twenty years in Sweden, I’ve learned now to stay home when I have something I could spread to someone else.  Even if I could mask the symptoms by spiriting Day-Quil over in my suitcase, I wasn’t eliminating the sickness that could spread to others (and nothing spreads sickness like Swedish kids in daycare).  

And more than that, if my daughter was sick, I was protected by VAB – vård av barn, a permission for parents of young children to miss work when their child needs to miss school.  With pay.  But especially never having to worry about being fired or disciplined.  VAB was important, noble, sacred as a reason to miss work.

But now that we are back in the US, even temporarily, we are a bit in a quandary what to do when sick.  And it was also a recent chance for a lecture in cultural differences at our dinner table, where my daughter was expressing frustration with a classmate who came to school sick (and thus made my daughter sick).

  • How can she be so thoughtless?  So inconsiderate?  Didn’t she think about making the rest of us sick?
  • No, she didn’t.
  • What?
  • Well, it might seem completely apparent to you, a child who was raised in Swedish schools and society that when one is sick, one stays home to avoid spreading it to others.  But did you know when Mommy was little (or even, not so long ago), I would go to work or school sick.  
  • Mommy, that’s awful.  How could you do that?
  • Well, if we look at Hofstede’s scales for culture, the US is a very individualistic society, as well as rather masculine (or tough).  So, in the US, you are rewarded for being tough, for not letting your sickness hold you back or down, and you think about yourself, not others.  In fact, they even give rewards to kids for not missing a day of school.  Sweden is, however, more of a collective society (relative to the US), meaning you think of other people and the society as a whole.  Plus, it is more feminine (caring for others, cooperative) which means it’s ok and good to say one needs to rest and get better, and not risk spreading to others.  So, Mommy wasn’t doing it to be evil, I just didn’t think about it until I learned the Swedish perspective.
  • Oh, so my classmate didn’t mean to make me and others sick.  
  • No, she probably didn’t think about it at all.  Because she hasn’t learned to.  Plus, she might not have been able to stay home, because then her parent could be fired for not coming to work.  That would be really bad, right?
  • Yeah, it’s not the same.
  • No, honey, it’s not.

So, if you move to another country and live somewhere for a while, you might consider how you act, and also how you judge others who don’t act as you do.

Or if you have a colleague who just arrived from somewhere else, sniffling and sneezing in misery at their desk as you gaze on them aghast at their audacity for daring to make you and others sick, take mercy on them, as my colleague did, and explain the different expectations where you are.

Often there are all kinds of values and unwritten rules, as well as structural support systems (or lack thereof) that drive behaviour.  

Now, what do you do when you are sick?

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