Second Shift for the Sick

I love language. One of the benefits of reading blogs is that I’ve learned words and phrases that have opened up my world and helped me understand my own life. I’ve learned how language can be empowering or disempowering. One such empowering phrase: The second shift for the sick.

This phrase refers to all the work one does when one has a chronic illness. Self-care can be a full time job; this applies whether one works a traditional job or not.

Some examples of things that take up time and energy in this second shift:
Multiple trips to doctor’s appointments, including specialists and physical therapy, and any alternative therapies such as acupuncture.
Trips to the pharmacy.
Filling up pill keepers and setting pill alarms.
Phone calls to arrange appointments and transportation.
All the waiting in reception rooms, on hold, and in line.

Resting. This is its own category. You might be saying, what is so hard about resting? Isn’t that a good thing? Well, for me anyway, resting so much is inconvenient. Sometimes the need for sleep or the need to sit down hits me like a brick, I need to do it now, even if I’m in the middle of a work day or out running errands. The need for rest can lead to frequently cancelled social plans. Rest can also be boring, especially when one is laid low by pain, because concentration is difficult.

Each chronically ill person probably has their own example of other “second shift” work. If you are on a restricted diet, that diet most likely involves a massive amount of work to plan and prepare, for instance. Keeping a journal of symptoms, something which is recommended for people with migraines, IBS, and other chronic illnesses, is often daily work.  You might need to do specific physical therapy exercises, maintain a CPAP machine, or check your blood sugar.

All of this work takes time and energy, and for the chronically ill, energy is often in extremely limited supply.

Amandadaw at FWD described it this way:

Resistance — truly the best word for it — it is as though “normal,” “healthy” folk are able to move throughout the world uninhibited, like pushing your hand into thin air — but sick people, disabled people must move through a world which is set up to prohibit their full participation — like pushing your hand into a thick heavy bog.

All of this logistical work is uncompensated; indeed, it is expensive. While chronic illness may reduce one’s earning power due to pain, fatigue, and other impairments, the financial costs of being ill are sometimes hidden. In addition to co-pays for medical expenses, chronically ill people may have to pay for things such as:
-transportation to and from appointments
-over the counter medications
-assistive technology such as braces, canes, mouth guards, special shoes, etc
-ice packs
-Special foods such as gluten-free items

Some will say that it’s only fair that those who are using medical services more should be paying the increased cost in the form of co-pays, etc. But it seems to me that this is a disability tax, a fee for being ill.

Discovering the phrase “second shift for the sick” was empowering for me because it gave me a way to recognize all the little things I’m doing as work, work that other people don’t have to do, work that is costing me money and energy.  Learning about women’s work and emotional work were similar processes.  I have high expectations for myself, many of which are expectations I had for myself as an able-bodied person.  Adjusting my expectations as an ill person has been a difficult process, and something that has helped has been learning about the value of different kinds of work.