Disclosing illness to your colleagues

I remember sitting at the 2019 USIU-Africa graduation ceremony immediately after I learned of my diagnosis with the deadly malignant melanoma form of cancer and that I would have aggressive surgery the next week. I could not even concentrate, I could not even hear the names of my students being called, and I could certainly not interact with the joyous members of the community enjoying the day and their important milestone.

I could only focus on three things: what will my family do without me if I die from the disease, how long and painful would my life be, and whether I should tell my employer. The uncertainty consumed me. I had to leave the ceremony and run into the adjoining library to allow tears to silently roll down my cheeks. A fellow faculty member came over to talk with me about a different matter, but I could not hold a conversation. I put my fears aside, chose authenticity, and told her everything. I then proceeded the next week to inform all my colleagues.

Thousands of Kenyans face this same dilemma every year. Disclose personal health crises to employers and colleagues or instead suffer in silence? I chose openness. Alternatively, should we instead create a dystopian sub-community of cancer patients and survivors while psychologically walling ourselves off from our workmates? Everyone's decision, work situation, employer policies in practice versus reality, and goodness of colleagues are different. Full openness does not and cannot work for everyone.

Sidney Chahonyo, the Board Chair for Hope for Cancer Kids in Kenya says “I do not think that organisations are sensitive enough to the needs of cancer patients or the long-term consequences that come after treatment. Patients and survivors fear being discriminated against, isolated or even fired due to changes that affect their performance. These can be physical or stress related. Human resources needs to be more sensitive to and let employees feel comfortable that they can speak to them and know that they will not be negatively affected by declaring their medical status.”

Thankfully, my extensive surgery in 2019 was successful. Unfortunately, I face the same quandary once again. Last week as the world celebrated the New Year 2021, I had a PET scan at the Aga Khan University Hospital in Nairobi and received two pieces of bad news. This week as I write, I have further tests and a biopsy. So, the social science research surrounding employee to employer disclosure becomes practical as well as theoretical for me on a personal level. Here are pertinent outcomes that could occur from disclosing private deeply personal health information to colleagues and bosses.

First, logistical benefits could occur upon disclosure. Joanna Pryce, Fehmidah Munir, Cheryl Haslam found that workplace flexibility around treatment appointments and work hours as the largest correlation with a cancer patient’s ability to continue to work and work effectively and productively. A logistically supportive workplace, desire for openness with coworkers, requests for employer support, and managing expectations were the biggest reasons that cancer patients chose to disclose or not disclose their health condition to their employers.

Personally, I had a colleague fly off the handle this week because I took two business days to respond to an email received last week during my PET scan, the bad news, and medical planning. Then, upon explaining that I was off work for important health procedures and therefore expecting logistical grace, that colleague did not extend grace and leaked my health status to another individual. While such occurrences are usually rare in workplaces, one must not let individual outlier events prevent them from looking at the big picture of one’s organisation and their colleagues as a whole. In the deeply individually and daunting disclosure decision, concentrate on the average, not on one-off occurrences.

Second, the employer could fail to help in any tangible way leaving the employee feeling ostracised. Michiel Greidanus and a large team of researchers found that an employers' willingness to support a cancer patient after disclosure is based on the employer’s previous perceptions of that staff member, the goals that the employer has towards their workforce, and national or organisational policies. Therefore, workers should gauge these factors before disclosing health information to colleagues or superiors.

Third, research highlights workplace discrimination that can accompany cancer disclosure. Mary Stergiou-Kita, Cheryl Pritlove, and Bonnie Kirsh found that while employers claim on surveys that they do not discriminate against cancer patients and survivors, the patients and survivors themselves feel that their diagnosis heavily stigmatises them in their workplaces. The biggest misconceptions held by organisations involves misconstructions associating cancer with death as well as misunderstanding about the impacts on the workplace including the worker’s abilities, reliability, productivity, and extra costs for that employee.

Fourth, colleagues could avoid the individual to escape what they perceive as uncomfortable conversations, not knowing the right thing to say, stigmatisation, or fearing a request for support. Fifth, the perceived authenticity that comes with higher perceptions of honesty and integrity after being open with colleagues and supervisors can bolster someone in the office. Colleagues appreciate honesty and seeing a coworker working hard and knowing that they told the truth about a personal life event can increase team cohesion.

Sixth, termination can ensue due to the above-mentioned incorrect perceptions. Researcher Nicole Gillespie places staff decisions about workplace disclosure of personal information down to the levels of trust that employees feel in their workmates and bosses.

Seventh, research by this author on disclosure in East and Southern Africa shows that the more employees disclose to colleagues and employers, then the more they feel vulnerable and desire to leave the organisation. This stands in contrast to other parts of the world that hold a higher desire to stay with a firm commensurate with the more they share.

Thankfully, I have a tremendously supportive employer and fantastic caring colleagues. In the above choices that I personally face in 2021, I began telling colleagues yesterday of my new negative health development. What personal health disclosure choices might you also make in difficult circumstances? What would you recommend to your own teammates if they faced similar dilemmas? Disclosure boils down to the trustworthiness of coworkers and employers.

Dr Scott may be reached on [email protected] or on Twitter: @ScottProfessor