Women at Work - When You Need Time Off for Health Reasons

0:01You're listening to Women at Work from Harvard Business Review. I'm Amy Bernstein. I'm Amy Gallo. And I'm Emily Coffield. With the endless video calls that COVID has forced upon us, our personal lives have become visible to the people we work with. We've gotten used to colleagues seeing inside our homes, what we look like dressed down, family members and pets, and in my case with a pile of clothes in the background. If at first this visibility left women feeling exposed, For many, it's come to relieve the pressure to appear so put together. A public health crisis created healthier expectations. But our private health, what's happening inside our minds and bodies, is in many cases still invisible to colleagues. And when an acute or chronic health issue disrupts our work life, how do we let our bosses and coworkers know? How vulnerable should we be? And as managers, how do we best support an employee who discloses a diagnosis?

1:00These questions hit home for our show team recently. When Maureen Hoek, the editor of hbr.org and our boss, colleague and friend, told us she was scheduled for surgery to remove a mass on her uterus. She had endometriosis and her doctor needed to check for cancer. Maureen wasn't just dealing with the uncertainty of what was ahead. She was also struggling with what and how to tell people at work about her health.

1:26The surgery went well, no cancer, and she's recovering. Now that she's been back at work for a few weeks, she and I talked about what the experience was like, particularly the interpersonal stuff. Maureen, when your doctor told you you were gonna need to have surgery and that you'd have to take two weeks afterward to recover, what was going through your mind? I think the first thing that I thought was denial, despite the fact that I am most definitely...

1:56middle age now. There was a part of me that's like, two weeks now. That's not, it's not going to take that long. Were you denying like, oh, it's not going to be that bad or was it more like I don't want to be out of work that long? I think it was both. Thinking about it, I kind of realized how important work to me is to feeling normal and feeling like myself. And I felt this way after I had a baby too.

2:20Like I really miss that part of myself and I remember returning from maternity leave sitting in the office and feeling this huge wave of relief like something felt normal to me. You know? Yeah. I think it was just really hard to have to admit in a professional context to tell people, especially people more senior to me, that I was going to need some time off. It felt different from having a baby. It felt different even from if I needed to have knee surgery or something, it just felt different. It felt uncertain. There was a lot of uncertainty and I was very fortunate to have supportive managers, supportive people all around me. Like I was sort of in the best possible position. Yeah. Tell me a little bit more about the uncertainty, like how that played a role. Having to kind of say to people, I'm gonna have...

3:13surgery, I don't really know exactly what the outcome of that is going to be. The place where my mind went was this fear that people would hear that and say, well, I don't know that she's going to be able to do her job now. You know, even though no one had that reaction, nobody questioned my fitness for my job. Like, it's weird that like in my thought process when I first heard.

3:38You're probably going to have to go see a specialist. You're most likely going to need surgery. You're most likely going to need a hysterectomy. Of course, my first thoughts were to my family and to me, but work was really high up there. Yeah. And honestly, one of my first reactions, too, was like, do I need to tell anyone about this? Like maybe I should just, and here I am talking on a podcast about it, but just even to have the right language to talk about it.

4:05I felt that was hard. And I did some searching on our site and elsewhere to try to come up with what are the right words to use. And I do remember talking to a couple of people. Amy, you were probably one of them actually. Just to say, how do I frame this? How do I think about communicating this in a way that doesn't make other people uncomfortable, but signals to them this is a place where we can talk about those things.

4:35I wanted people to know something was going on. I didn't want it to sound scary, but I didn't want it to be a burden for other people either. Yeah. Yeah. I remember that conversation you and I had about it. And I remember thinking, well, let's not worry about what other people think or the level of comfort. But yet as a manager that you have to think about that, even when it's about you personally. Yeah. I know, for example, Amanda, our producer cried.

5:04sort of reflexively when you told her. Did you think about those kinds of reactions and how you would handle them? I did not expect people to have some of, yeah, some of those like personal reactions because I'm very focused on like what people mean from me or like how this will affect their work or who has to cover for me i really didn't think about it in the context of like you know these are people that i have a relationship with some of them for many years now and it's not just going to be like well who's going to approve my copy.

5:38for the blurb because that's where my mind goes and then I think I was reminded these are human people like we rely on each other for a lot of different things and your reaction to hearing that you know somebody's got a health issue isn't just about the transactional work. Right, yeah.

5:57I think with Amanda, my first reaction, which is always my reaction, is I just wanted to be like, oh, don't cry, don't cry. It was like something very awkward, which like, why am I telling her not to cry? That's also the opposite of what I'm supposed to do. I didn't want to cause anybody any distress, you know, for people that I did want to tell myself just to let them know, so they weren't totally caught off guard. Everyone had reactions of like, it was a mix of concern and just sort of, what do you need from me?

6:26Right. Which is exactly the kind of thing I would want to be able to provide for somebody else in this situation. Yeah. So what did you end up saying to most people? I think when it came to sort of one-on-one conversations, what I said was, I have a health issue.

6:44learned about over the last couple of months. It will require me to have abdominal surgery. And then in some cases, you know, I would say it's related to, you know, I was recently diagnosed with endometriosis. I didn't always use the word hysterectomy, though. Like that was that was a word that was hard for some reason. And I wish I could understand this about myself that it just felt so personal to share that with people. When I talked to Amanda, our producer. I also use the words that I had a mass, which I learned from that conversation with Amanda that telling people you have an abdominal mass is scary, you know. So while I didn't want to, you know, I didn't want to sugarcoat it, but I also just didn't want to use words that were going to just unnecessarily freak people out. So, you know, I think when it came time to kind of telling a wider group of people, I did some thinking about it. And I said, I have a

7:41a health issue that's going to require abdominal surgery. I'm going to be out for this amount of time. So just trying to stick to the facts. I'm going to have to go through this and hopefully everything will be fine and I'll just keep you posted. If anybody wants to know more about it, please reach out to me. I remember being in that team meeting where you told people and we had already talked. So I knew the information, but I did think the way you handled it, which was very matter of fact, also open. You weren't shutting down the conversation, which was really helpful. And you also didn't dismiss it as like, this isn't a big deal. You didn't over promise like, I'll be fine. Like you were really clear. This was going to happen. We'll see what we'll see what the outcome is. And I certainly felt reassured by that.

8:32I'm so happy to hear that. Looking back on the whole situation from having to tell your colleagues to talking with your boss and taking that time off, is there anything you wish you had done differently? I think I probably wouldn't have spent so much time being afraid to talk about it. Maybe not so much time just even kind of beating myself up.

8:58This is gonna sound a bit illogical but for the fact that it was happening at all like I of course I logically know it's not my fault But there is this moment where you're like wise is happening now, right? And I've also come to terms with sometimes things happen that you don't want to happen and they Suck in their heart and you just have to go through them, you know, right? I think what I realize and I have this whole new level of just respect for women and anyone with a chronic illness of like how do you handle that and still have all the confidence and guts that you need to say, like, this is true. And it's also true that I can be really good at my job at the same time. Yeah. You know, as your colleague and your friend, to hear you say that you spent time beating yourself up for this is, I mean, I know you, so I know, I know you tend toward that. But I also, it breaks my heart a little because you didn't choose any of this. And I mean, I feel the same when I like,

9:58I've had a stomach bug and I've had to miss two days of work. My husband sometimes has to say, this is not a moral issue. You are sick. Right. And I think sometimes we do overlay this sense of agency on it that we somehow chose. Yeah. Hearing it from your mouth, I'm like, that's not right. That is so far from the truth. No one thinks Maureen didn't do her job by having to have surgery, right? And yet I also know that mental space of getting there.

10:27and thinking, could I have done this differently? Right. So you were worried going in to these two weeks about people not seeing you as committed or not capable of doing your job. How were the two weeks? Were you able to disconnect? Surprisingly, yes. And I obviously put some work in to try to plan things and make sure that things were covered and people knew what was going on. So it's not like I just sort of like signed off without doing any preparation. But it was one of the first times for me where I really had to sit and not do anything. My job was to literally sit and watch Netflix. That's my actual job right now. I think I kind of realized coming out of that, it shouldn't really take a major surgical procedure to be able to take some of that time.

11:26I just felt more rested. I felt less underwater after that time. I just felt, I felt better. Right. Maureen, thank you so much for talking with me today. It's always nice to have you on the show. Thanks, Amy. I'm glad I could talk about this with you. Maureen came away from that series of delicate conversations about her health with even more respect for women with chronic illnesses. Women who may need to have those sorts of conversations with colleagues regularly throughout their careers.

11:56Lori Edwards is one of those women. She's a writer with multiple chronic illnesses, including a rare genetic lung disease. In her articles and books, she describes the challenges she and others living with chronic illnesses come up against. Among the challenges is disclosure. Lori spoke with me and Amy B. about how she approaches it. Lori, thank you so much for being here with us today. Thank you for having me. I'm happy to be here.

12:22all the fears and uncertainties that Maureen shared. Was there one that you related to particularly and that you feel that you've made peace with or figured out for yourself? The point that really jumped out at me was the idea of not wanting to share information or disclose because she was fearful that maybe people would think that she wasn't competent or wasn't going to be able to do the work or that she was somehow not being there for her team or sort of that that whole idea of will you think of me the same way if you know this about me and that's absolutely something that I can relate to it's an ongoing struggle when you live with chronic illness and so sometimes I think I handle that with more grace and more experience but it's definitely still something that I struggle with and I think it really speaks to the nature of

13:20either invisible or chronic or serious illness because those illnesses and those symptoms wax and wane and flare and then get a little better. And they're so unpredictable that it's sort of this ongoing tension. Absolutely. What advice could you share with our listeners who are dealing with that same kind of fear and anxiety? Anything you've picked up along the way that helps you cope?

13:46The big question is, when do you disclose illness, right? For me, the rule of thumb has always been, and it's information I got from a wonderful collaborator, Rosalind Joff, who's written about work and chronic illness quite a bit, is when you're no longer able to do the job as it stands, then it's time to have a conversation. Yeah, so Laurie, as someone who's dealt with chronic illnesses and who's worked with other people with chronic illnesses, What advice would you give someone who actually has to tell their manager or tell their direct reports about a chronic illness or about a health issue at work? That's probably one of the most difficult decisions. And I will offer the caveat that, of course, there's no one size fits all answer really will depend on the patient, the symptoms, the relationships, all of that. But with that said, I think the big

14:41overarching rule that that I follow and that I recommend is when you're not able to do the job as it stands, then you have that conversation. And when you have that conversation to be clear and specific about what your needs are. So someone that you're trying to discuss and collaborate with, you know, doesn't necessarily need all of the details. But what they really need to help you be the best employee is, okay, so how is this illness specifically impacting this aspect of a job and what is the plan? What is the potential proposal, right, for addressing that? Right, so there's no obligation to share the specifics of the illness if you don't feel comfortable doing that? No, no, I really encourage people to think in very concrete actionable and specific terms of, you know, what is the job? What is the obstacle?

15:36to me as the employee doing their job as it stands and doing it well the way I would want to. And then what are the specific things we can discuss to try to alleviate that? So Maureen described her discomfort in talking about her medical situation with her manager and other senior leaders. And I'm wondering if you have any counsel to offer managers who want to be supportive when their folks come to them in similar straits? Absolutely. And you know, I've sort of had this interesting experience in my own career where for periods of time I have been in a more supervisory or manager position. And so I've been on the other side of that question. And so I've really, my own experiences have really helped me sort of

16:29respond both to students who might be coming to me or when I have overseen instructors in my job who have personal health problems the conversation flips to how can I support you or hopefully you know that's the ideal is to respond from a point of view so what what do you need in order to continue to do what you're doing often so often the accommodations are requests are fairly simple. That's not always the case, of course, but a little bit of flexibility and a little bit of collaboration can often make a really, really big difference. Right. So Amy, I know you have a lot of experience as a supervisor and in a more management role. In my experience, I have found as an employee that, for example, I have really needed flexibility with course scheduling, that there are certain times a day where it's really hard

17:22for me to be on campus because I need to fit in physical therapy five days a week for my lung condition. So for me, the ability to not have courses very early or very late or to teach some of them online has been a huge life-changing accommodation that also speaks to my skill set. And so I've been able to have a conversation with my employer and just say, you know, these are my scheduling needs.

17:47Let's talk about it. What can we do? And I've been very lucky and unfortunate that I've been able to work those things out It's not always that easy and the needs aren't maybe always that sort of low hanging fruit that it we can we can adjust that we can adjust your core schedule So what kinds of advice would you offer as someone with a lot of management experience for how those conversations could go or what would you say to employees who are approaching you with potential problems and needs Well, let me start with the first question, which is that I really do think that you have to respect the individual's need for privacy. And engaging that is sort of one of the first things I try to do. And it's not a direct question how much privacy you want. It's more sort of listening to the words they've used and looking at their body language. I mean, of course, the first reaction is I just want to hug people who

18:46are in a situation that frightens them or where they feel imperiled. But then from my perspective, trying to think together about a path forward to make the next six weeks or six months viable and comfortable for the person. Yeah, I really, really appreciate what you were saying about what can we do to work together for the next, you know, whether it's six weeks, six months, because I think from my own perspective of being in that vulnerable position myself, feeling like your employer is invested in working with not against makes such a big difference and can really ease some of that anxiety and that fear because it's really hard to be vulnerable. Even if you're disclosing the absolute minimum amount of medical information, it's a really hard place to be.

19:46So I want to bring in a question from one of our listeners. She's going to need to take six weeks or more off from work to deal with a health condition that she describes as sensitive. And she's worried that when she comes back, I mean, she's really anxious about it. And what worries her is that she's going to be judged as weak and incompetent.

20:13by her manager and she'll be denied future promotions and other opportunities. Any thoughts for her to help her through this? Yeah, I think that that is such a real and understandable and human fear and it's something that really stood out to me when I was listening to Maureen's segment as well. At the end of the day, whether you have been sick with things your whole life, whether you have a sort of acute temporary health condition that you need to recover from and there is a finite recovery period or do you have something chronic? People get sick, things happen and I think that it's easy to say that from the outside and much harder when you're the one with with the health problem and the fear and the anxiety about it if we can try to extend to ourselves.

21:04a little bit of understanding and from the outside, if it were happening to somebody else, our reaction would most likely be of concern and wanting to be supportive. And you know, not everyone is going to be in an environment where that's the reaction they get. But I think if we can just focus on what we do know and what we can control and make a plan and be very communicative, here's how long I'm going to be out.

21:33Here's how I'm going to delegate the work. I think that hopefully the stigma won't be as present and realize it might feel in those moments of fear and vulnerability. So Lori, you have a really busy work life. You're writing, you're teaching, you're an advocate, and your daughter is also doing remote school from home right now. How have the challenges of managing your illness changed the way that you're managing your career in this moment?

22:00That's a great question. I have had to, in a way that is very uncomfortable for me, I've had to really work on boundaries. I have said no to opportunities that I normally would still say yes to over the course of this pandemic. Absolutely. I think we're all doing that, whether we have chronic illness or not. I have had to make some tough choices. I have had to sort of say, Today this is going to be my best and give myself more slack than I'm ever used to giving. I think that it's easier for a lot of us and for myself it is to give other people that slack than it is to to do that for ourselves and I think

22:43For me, I have, you know, 40 years of trying to negotiate the whole, I'm not going to let illness define me or stop me from doing what I wanna do, mentality that I continue to negotiate. But yeah, you know, I think at the same time that women have had a crushing impact from the pandemic on our work and in the workforce, a silver lining that I hope can come out of all of this is that, employers can see the possibilities of flexibility and I think for women with chronic illness and serious illness that that is going to be even more important. Just the notion that work doesn't have to look the way we assume it should for us to be productive and viable members of the workforce. Definitely. Laurie, thank you so much for talking with us. Oh, thank you. Thank you so much for reaching out. I am absolutely thrilled to

23:43have this conversation. It's an important one and one that continues to evolve, thankfully. Laurie, listening to Laurie's conversation with Emily and Amy B, was there anything that you heard that was particularly helpful to you in the situation you went through? Yes, I liked what Laurie said about when you are talking to...

24:13a manager or even just other people at work if you have a health issue you need to discuss, try to be clear and specific about what it is that you need in the context of doing your job. Of course, I probably thought I was doing that, but I could have said, you know, I have this going on. I'm going to take this time off and been like sort of thought through what I what I really need from you is this or, you know, these are the specific things that I think somebody is going to have to step in on. I get that it's sometimes hard to put all of those pieces together, especially if you are trying to process a

24:42diagnosis, but even to say that you're working on those things, even if you haven't figured all of them out, that gives also your manager some room to react and say, ask questions or feel like there's forward motion to it. Yeah. I mean, I think about it, what I was hearing from Lori and even what Amy B was talking about, how as a manager, she's handled some of these things. If you think of it as.

25:05a partnership between you and your manager trying to solve a problem together. So it is a disclosure, of course, right? I'm dealing with this health issue, but there's a business problem that you're trying to solve together. And I think that can help, especially if you don't want to have an emotional conversation with your manager, you don't have that sort of relationship. Right. And I think there's also, there's always value to in, in just in general, I think in saying I'm going to think about other questions I have if you do the same and let's talk about this again in a couple of days, you know, just to kind of give people a little bit of time to process, because sometimes if you are coming to someone with something very unexpected, they also need their own time to react. Yeah, that's a good point. And I like that this might be a series of conversations. This is not one and done and that you need to leave room for everyone to have their emotional responses. Right.

25:59Another thing I learned from that conversation just as a manager is I liked what Amy and Emily and Lori were talking about, where even being able to say to someone in the context of that conversation, if it's someone that you manage, really being direct about what do they prefer when it comes to their privacy.

26:15you know, like what are the boundaries that they want to set? Again, they might not have every single answer in that first conversation, but that is something that, you know, when people have talked to me about issues like this in the past, I could have asked that earlier on, you know, just to be very clear about it. I'm comfortable, you know, sharing this with the team, or I'm not.

26:35Right. You have a right to privacy, and also your HR department can be helpful to you in figuring out what some of those boundaries are. I don't want to overlook that resource that's within a lot of companies for helping you sort that out. Yeah, and I think what sort of levels of privacy, how much do you want to disclose to people? And then also how can I help with that? Because I think also sometimes you may not want to have the conversation with 20 different people, and it may be helpful for your manager to send a discrete note. Exactly. And Sugar, who's a cancer survivor and an executive coach, has written a couple articles for us. And she gave an example of an email that a manager could send when an employee's diagnosed with cancer. And in that email, the sample email, it said,

27:21the employee asked me to tell you this. So it was clear. I'm not revealing information that your colleague doesn't want you to have. I'm doing what they've asked me to do. The other thing she wrote in the article, what to do when your employee is diagnosed with cancer, was about the importance of having a plan B. And that was you and your employee will come up with a plan for how to handle their leave, any accommodations you need to make, but you need to consider the fact that that plan may not work. You know, they may be sicker than they anticipate or something urgent might come up. So what's the plan be? And to really outline what's absolutely necessary that needs to be done and what can be delayed or delegated. A lot of people tend to be optimistic when talking with their managers or about their own health issues. They want to return to work. They want to feel healthy soon.

28:13So helping maybe Plan B, maybe even a Plan C would be helpful for both you and the person. Right, and I did that too with even with the time that I took that I was sort of making an estimation of how much time I would need.

28:27I might have needed more time for the procedure I had. Some women take as many as six weeks off. It kind of depends on the kind of procedure you have and a bunch of other details. But it did help to be like, OK, I think I'm going to need this amount of time. But if I don't, if I decide I need more, then these are the things that we'll do. That is something that's worth spending time on when you're in that situation. Also, you eased back in. You didn't come back full time right after.

28:54the two weeks. That's right. And I was tempted to, very tempted to, but I decided to take on that my third week back. I came back for half days and I'm really glad that I did that because it sort of allowed me to get my mind back sort of in the place of work to start to catch up on things. I didn't feel that pressure day one to be just 100% back at full capacity.

29:17I think I would really recommend that if at all possible for anybody who's still going through a process of healing, that that's really helpful. And I would recommend for anybody who's looking for more advice on some of these topics. We do have articles on how to talk about a cancer diagnosis. We have an article from earlier this year on what to do if your employee tests positive for COVID-19. And we'll drop those in our show notes.

29:46Maureen, I have to say I'm really glad that your procedure went well and that you're feeling good, and it's really nice to have you back. Thank you. I'm so grateful for that, too, and I'm really glad we could talk about these issues on the show. That's our show. I'm Amy Bernstein. I'm Amy Gallo. And I'm Emily Caulfield. Our editorial and production team is Amanda Curse, Maureen Hoek, Adam Buckoltz, Rob Eckart, and Tina Tobi-Mac.

30:19If you enjoyed this episode, please share it with others who could benefit from the insight and advice. And leave a review on the app where you're listening. That'll help more women find out about the show. Thanks for listening and for spreading the word.