Now, there are few people in the world who can make the claim: “I called in sick for what would certainly have been the single most challenging and consequential shift of my career.” I, however, am now one of them.

I believe that even the Northern Tasmanian News carried the reports of another of the sickening repeats of American violence – the shooting in a theater of 70 people with 12 immediate fatalities, and many other severe injuries. Being the closest hospital, University [of Colorado] Hospital received 23 of the victims. On my shift. And I was home sick. Thanks to an Australian who shared his influenza with me. Ouch. And Dr. Sasson, now my hero, took one for the team. Thanks, Comilla!

It’s something that we as ER docs face periodically: Should we be tough and do the job? Or call for help? Many of us have spent shifts working while getting Zofran and intravenous hydration so that we wouldn’t have to appear untough. (Probably a few of our patients later missed work when they were ill for a few days with [norovirus] or salmonella – but we were tough.) But sometimes it is wise to recognize our own morbidity. In this event, I did work one shift with chills and myalgias. But if, as I got worse, I had tried to tough out another, I fear that a 65-year-old, partly demented ER doc like me, further hampered by chills and bouts of racking cough, would not have had anywhere near the energy level required for a disaster of this magnitude. I might note that the temptation to be a tough guy may be greater in the U.S. than in Australia where I did have paid sick time available, whereas in the U.S. if you miss a shift – tough luck, dude. We pay the guy who worked for you.

A few other differences between the U.S. and Australia:

In Australia, the hospital wouldn’t have to wonder how big a financial hit they would take in caring for these folks, as they would all have insurance. A trivial concern in the midst of the crisis, but a not insubstantial one for the hospital and for the surviving victims and families who may be uninsured but try to pay their bills.

In Australia this might not have any way of happening. I suspect that all of the military-grade armaments that this guy had would be impossible to buy in Oz. Perhaps buying a 100-round magazine for a semi-automatic rifle would require a “Genuine Need” certificate for something like self-protection from vicious wallabies or attacking box jellies.