Sarah Rose // Features Editor
The water concentration inside a fish is higher than in the ocean itself. A frilled shark thrives underneath enough pressure to crush a car. There are many kinds of habitats, and some are less tangible than others. Adaptation is the only rule for denizens of a hostile ecosystem thousands of feet below the surface. Humans are not omitted from the need for a suitable habitat. In a way, these feel like rules.
If you break down the arbitrary border between what we think of as nature and what is subjectively categorized as human space, a lot of the rules fall apart. Why should those who get sick be left behind, or why do we have such banal and pervasive policies around sick notes?
Remember: Just because you can’t see the predators—the bosses—doesn’t mean they aren’t there. And if they are, they’re probably exploiting you. That is in fact the rule of natural selection. In the gig economy under capitalism, that is.
The knowledge economy is the fastest growing segment of the freelance world as reported by McKinsey. According to a study of 65 gig workers by the Harvard Business Review, it takes an equilibrium of four separate rules to cobble together a relatively suitable habitat for the 60 percent of millennials and Gen-Z’s occupying this market. Those rules being: environment, routine, purpose and community.
The knowledge economy is oft freighted with so much risk that it could be a scene lifted directly from No Country for Old Men. Gig workers, independent consultants and artists ride a precarious coin toss of produce or perish. Not just financially and physically, but also existentially in the agonizing weight attached to the price tag of “freedom.” Grinding the roulette wheel alone means there’s no managers, reliable income from an employer on a payroll or corporate health benefits—leaving many to simply drown.
“There’s no arriving, that’s a myth,” one anonymous artist wrote, “you become your work.”
DoorDash recently showed what this looks like when they took a page directly from classic restaurant parlance by paying workers in tipped wages. DoorDash drivers never saw those tips, they got a static flat rate until the recent outrage prompted a shift. All tipped wage ecosystems mean is the harder someone works, the less predatory bosses have to worry about paying workers themselves.
In gig work, productivity is seen as a kind of antidote to instability. Gig platforms promised to flip everything we knew about work on its head. What it really meant was that in altering the definition of employee, they could get away with not paying for anyone’s healthcare or sick days. For those floundering in the gig network, a few sick days can cost more than just rent or food, but their job itself. There’s no incentive to hire a sick temp worker when there’s a cache of other healthier ones in the primordial soup to fill the spot. Even employees who aren’t temp or gig workers face an offensive lack of security. “I would be crucified for calling into work sick,” said Jessica Jeanson, an employee at a local grocery store where the laissez-faire rules of her environment act more like a noose. “There’s no official policy on anything. They just make it up as they go along and write you up if they feel like it,” she said. “I’m a wreck at this place and it’s been the best job I’ve had up to this point.”
Like cities and economies, habitats are built over time by responding and incorporating the implicit messages received from the community. It often begins in the classroom, where the message is repeated year after year that perfect attendance is something to achieve, and not just a shared delusion.
Getting sick isn’t a matter of personal constitution, it’s something we have virtually no control over. These attitudes reward people for being healthy and punish those who do get sick or have disabilities, which begets the evolution into an ideological position that school and work come before ones’ own physical and mental wellbeing. It creates a disparate environment, as if we should all be able to perform under the kind of pressure of a frilled shark at five-thousand feet below the sea. Congruent with the Harvard Business Review’s finding that the most successful environments were those designed like shelters to protect workers from outside pressures and distractions. One freelance writer in the study describes the necessity of environment as: “people fail because they don’t create the space and time to do whatever it is they need to do.”
For those with chronic conditions and disabilities, those kinds of expectations will ubiquitously be beyond reach no matter how dedicated they are. The kind of delusional meritocracy surrounding perfect attendance also neglects those who are forced to live in hostile or even desolate environments such as lacking fixed residency or facing economic hardship.
Doctors such as Dr. Anton Rabien often resent being asked to write doctors notes at all. “Many employers demand sick notes indiscriminately—basically using them as a blunt instrument to combat absenteeism,” said Rabien. His sentiment is echoed by the Canadian Medical Association, where form-filling including sick notes represents “significant administrative burden” on doctors. “Asking employees with self-limited viral illnesses (particularly colds and flus) to go to the doctor for sick notes is a terrible policy,” Rabien said. “It unnecessarily exposes others to potentially contagious illnesses.”
In post-secondary institutions, the prevalence of fake doctors’ notes is shockingly high. Those faking doctors’ notes are (on a surface level Reddit browse) not simply slackers looking to scam the system. They’re students who are severely ill, those who can’t pay a fee of anywhere between $20 to $50 for a note, or those who don’t believe their malady—especially mental health concerns—are valid enough for a note. One Reddit user and former call center employee writes, “I was once told I needed to get a doctor’s note if I spent more than 12 minutes a month in the bathroom.”
The physical price of a note is how convincingly one can produce the receipts for illness, but the intangible cost is far greater. An anonymous Dr. W describes that his office (and most general practices) don’t charge fixed rates for notes since there is no official policy on the matter. “I don’t generalize,” he said, “those I think that are scamming, I charge more for.”
The inherent problem in asking doctors to act as gatekeepers of behaviour is it creates a climate rife for bias. If you’re a woman, you’re more likely to be perceived as faking it regardless. Nowhere is this more evident than when it comes to gynecological conditions such as endometriosis. One it ten women suffer from the extraordinarily painful chronic disease, but it takes an average of seven years to be diagnosed. Many citing a primary reason being the doctor’s refusal to believe that they were really in pain, not simply faking it. A study published in The New England Journal of Medicine found that women are seven times more likely to be misdiagnosed and discharged in the middle of having a heart attack.
Yet even at institutions with no-note policies such as the University of Alberta, the use of sick notes continues. When, even according to the NLMA, doctors’ notes serve no purpose except to inconvenience the student as well as the doctor.
Dr. Rabien echoed this sentiment, “if educational institutions are going to have sick note policies, then they also have the obligation to ensure that their students have timely access to medical services. You can’t pack thousands of young people into shared accommodations, schedule exams during flu season, and expect them all to remain healthy,” said Rabien.
There’s also an inverse relationship to the burden being placed on doctors. A 2016 study published in Annals of Internal Medicine found that for every hour physicians were seeing patients, they were spending nearly two additional hours on paperwork such as filling out doctors’ notes. This is particularly evident for mental health concerns, where recent studies by the NHS implicate issues like stress, anxiety and depression as the number one reason for notes. It’s not surprising when depression is the leading cause of disability worldwide according to the World Health Organization.
Dr. W explains how languishing it can be to see mental health cases in general practice, “it takes up all your time, multiple facets have to be explored,” he says, although his tone jarringly shifts to add: “people want everything for nothing, they don’t work as hard.” Which sounds half nonsense, half banality from the previous sentiment. It runs contradictory to the fact that while methods of exploitation have changed, the predatory determination to cut costs and increase performance at the cost of worker wellbeing has not. Most worryingly, he believes what he’s saying. In this climate that sort of authenticity carries weight, even if what’s being said is misguided.
“I do not trust medical notes,” Professor Frances Woolley wrote for The Globe and Mail. “When I see one, I do not know if the student is ill, or simply ill-prepared. I do not trust medical notes because I do not trust physicians to act as gatekeepers,” said Woolley.
There are plenty of creatures with eyes powerful enough to see colours that don’t exist to the human eye. Good luck asking them to survive anywhere that we do, because they migrate (as all things do) when the habitat is no longer survivable. A human is just a coral reef shaped extension of microscopic marvels, teeming with enough biodiversity that there are fewer human cells than those of the creatures who create the habitat we call ‘you’. What’s the point in naming them, or saying they don’t work hard enough when they’re perfectly adapted to an environment as deadly to humans as the surface of the sun? The bottom line is those rules just make it easier for someone else—that someone rarely ever being the student or employee.
In post-secondary institutions Woolley suggested more frequent, lower-stakes assignments and tracking deferrals. Asking for doctors’ notes should be reserved as a last resort and for those chronically taking time off. “Educational institutions need to stop asking doctors to police student behaviour,” Woolley wrote.
The UK has already taken strides to combat the rampant predation of the gig economy in a review by Theresa May for paid time off and sick leave. The reality is as much as a third of workers find themselves doing gig work. Not just for smaller startups like DoorDash and Uber, but companies like Google where 50 percent of the workforce is comprised of temporary and contract workers.
The Justice for Foodora Couriers group is currently seeking to unionize to bargain for things like basic employee benefits, such as sick days, better pay and employment insurance. It’s a landmark decision that would shift the definition from independent contractor to dependent contractor, the middle ground between full-time employee providing the environmental protections while maintaining the flexibility of gig work.
The truth is there is always an adaptation to be made, or an alternative to the status quo. It begins with honoring others’ happiness before our comfort, respecting the value of truth, and recognizing not everything is there for your convenience.