Very few people choose to be sick or injured. Significant aspects of American cultural behavior can make these individuals feel guilty or ashamed. This can inhibit them from healing and seeking appropriate healthcare, often resulting in suboptimal and sometimes catastrophic outcomes. Individuals attempting to heal from illness or injury will do best to approach their healing with dignity and strength. They benefit from the support of their friends, family members, and providers in the form of compassion and encouragement.
The sources of shame and guilt toward the sick and injured are too numerous to fully describe here, but following are some very common sources.
Family Members and Friends
Those closest to the unwell often bear the burden of taking care of them and often have to make significant sacrifices. For example, they may have to forgo important or pleasurable activities to be available to their ailing loved one. There may be significant loss of income if the loved one is employed and does not have sick leave as a benefit.
Sustained illness or injury is often associated with feelings of resentment as the sacrifices continue. In some cases, caretaker burnout results. Even the most compassionate caretakers struggle to suppress these feelings over time. Most unwell individuals already feel inadequate and burdensome to others and are stung by these expressions.
Workplace
Many employment arrangements do not offer paid sick time. This encourages employees to work even when they are not well. It discourages them from seeking medical care if it interferes with their work schedule, which for 9-to-5 employees, is almost always. These employees are effectively fined for resting or seeking medical care, which is necessary for healing and recuperation.
Many workplaces reward employees for not taking sick time. They often pay them for unused days at the end of the year. This leaves those who need to take those days feeling guilty and ashamed for being ill.
Co-workers often are charged with “covering” for those out sick. They often feel like they are doing their job as well as someone else’s without additional compensation. This can be expressed actively by complaining about the burden, or passively by not doing the job adequately or completely. Unwell employees are then punished when they return to work by having to remedy problems created in their absence.
Doctors
The demand for physicians is greater than the supply. Doctors are often overworked. They are required to see as many patients as they can and often have to be on call when they are not seeing patients. This results in doctors often making their patients wait for scheduled appointments. It is common for patients to wait in doctors' waiting rooms or hospitals for over an hour, and sometimes for several hours, for scheduled and emergency visits.
Often, when the doctor finally does show up, they are often rushed and exhausted, making patients feel like they are burdensome. The lack of enough doctors often means that those requiring expedient care must see "physician extenders" (i.e., physician's assistants or nurse practitioners) rather than their doctor, also adding to the sense of being a burden or unworthy due to their unwellness.
These very common experiences leave the sick and injured feeling like they have to beg for standard medical care. In some cases, they are humiliated for feeling so needy.
Medical Insurance
When presenting for medical care, most sick and injured patients are required to sign documents promising to pay for medical care if their insurance company does not. Many sick and injured people cannot afford to pay for uncovered medical services. Some cannot afford the “copays” that many insurers levy on their subscribers. Feelings of humiliation are common when individuals suffering medically are turned away for lack of funds.
It is very common for medical insurers to seem to discourage medical care and encourage feelings of guilt and shame when they deny claims. This is often done with an audit or “utilization review,” after which patients are notified that they are not sick enough for the care they seek. This is tantamount to accusing them of committing fraud for seeking medical care.
Shame Essential Reads
General Population
Most individuals are uncomfortable with the idea that people can get sick or injured through no fault of their own. For example, they want to believe that if they never smoke cigarettes, they will never get lung cancer. If they maintain a healthy body weight, they will not get heart disease. These are good life choices, but to support this ideology they often ask questions that are hurtful to the unwell. Here are a few examples.
When people are diagnosed with lung cancer, they are asked, “Did you smoke?”
When people are diagnosed with skin cancer, they are asked, “Do you tan?”
When people are infected with a virus, they are asked, “Are you run down?”
When people are in automobile accidents, they are asked, “Were you drinking?”
In each of these common examples, it is implied that the person who is sick or injured might have avoided the pain if they were more diligent. While this might be an unintended consequence, it makes the unwell feel worse.
Self-Induced Guilt and Shame
With all of the above influences suggesting directly or indirectly that unwell individuals are that way by choice or weakness, it is not surprising that many individuals get angry with themselves when they get sick or injured. They go to work when they are sick. They avoid seeking medical care as long as possible. This can make them sicker.
Social and systemic reform is highly desirable. Unwell individuals should be treated with compassion by all. Everyone eventually gets sick or injured.
You cannot control what others think and say, but you can control how you cope with unwellness. Your healing and recovery will benefit from self-compassion. When you are sick or injured, your wellness becomes the number one priority in your life. Pursuing rest and treatment when you are unwell is championing your survival. This is strong and honorable and nothing that anyone should feel guilty or ashamed about.