I’ve noticed a weird pattern. I’m extremely hesitant every time I feel the need to take a sick day, or even sick hours.

I could have a migraine and be squinting out the light from my phone’s dimmest setting, but I’d still wonder if my boss would believe me for calling in sick. I could be throwing up as the sun rises and I’d wonder if I should try to go in that afternoon. Even if I don’t have pressing deadlines or major projects underway, I struggle to accept my need to take sick time.

I can know I’m on the precipice between feeling poorly and being actually ill, but taking a day to rest and recover feels like an indulgence. As do the monthly massages that significantly reduce the frequency of my migraines. When I’m depressed or need to leave work early for therapy or something else that helps my brain manage its chemical equilibrium, I never take sick time. Even though I know my brain needs care the way the rest of me does, I am ruled by the stigma associated with mental illness, the idea that productivity equals worth, and my own anxiety about being seen as dedicated to my job.

In “Missing Hope: A Trio of Miscarriages, and What Happened After,” Laura Turner writes, “Sick is a feeling as much as a state of being, and it makes you feel Victorian in the worst way, like a woman sent to bed for being weak, which is an especially tough blow in a culture where your value is predicated on your professional productivity.”

And there’s the idea that you must be productive—constantly productive—to be valuable in any way. Yes, we’re paid to work, and so rightly must work to be paid, but there’s also the sense that taking sick time demonstrates a lack of devotion. Or worse, indicates weakness. I’m much less likely to take a sick day on a Monday or Friday because I don’t want people to think I’m lying about being sick. And whenever I must email in sick, I over explain and over justify, trying to make sure my boss knows I’m devoted to my work and to being on a team, but also too ill to be a good employee that morning, or that day.

Last Monday was a day like that. I’d struggled with headaches all day Sunday and medicine made little to no difference. After a wonderful day Saturday with my mom and grandmother and two of my three bridesmaids, and a beautiful bridal shower thrown by Tyler’s family, I thought at first that I was just drained. I’m an introvert who’d spent a lot of time in others’ company the day before. For all the good of that day, I’d need some time to recover. And I probably didn’t drink enough water the day before, and that could account for my headache. I’d mostly muscled and drowned it into subservience by Sunday night, but when I woke around 4 Monday morning, I had a full-blown migraine.

I took medicine immediately and rubbed a special blend of peppermint and eucalyptus oils on my forehead to try to take the edge off. I curled up on my side in the dark room and waited. Nearly an hour later, the pain had lessened enough that I thought I could sleep. But I also knew I wouldn’t be recovered enough in two hours to go to work. I flinched at the light of my screen as I emailed my boss and turned off my alarms. Then I turned the screen off and finally fell back asleep.

In the morning, as expected, the remains of my migraine remained. Maybe by 9, I thought. Then, I’ll aim for 10. Probably by noon or 1. None of which came to pass. I snacked when I felt up to walking around. I wrote a few thank you notes while I sipped Gatorade.

Around noon, head still pounding, I lay down on the sofa. When I next woke, it was 2pm. I felt much better! I got up and walked upstairs, calculating how fast I could get ready and by what time I’d reach the office. The sunshine filtering through the slits in the blinds was uncomfortably bright. I took another sip of Gatorade as my forehead began to hum. I decided I’d try to read, to make sure I’d be okay doing the same activity at work. Ten minutes later, book abandoned, laying down with more peppermint oil on my temples, I finally gave up on making it to work that day.

I am so grateful that I had felt so well on Saturday for the shower and all the fun we had together. I’m grateful I have paid sick time. I’m annoyed with myself for feeling guilty for using it. I’m annoyed that I struggled to admit to myself that I just wasn’t well enough to go, even when there were only a few hours left in the day. I frustrated that the demands of productivity are so closely tied to the idea of worthiness. And I’m aware that the ones who most suffer this are disabled.

Thank you to all the disabled rights advocates, past and present, whose work betters the world for everyone, every day.

For those interested in exploring these themes in fiction, I recommend On the Edge of Gone by Corinne Duyvis.

For those interested in learning more about the social work of disabled people, try A Disability History of the United States and Enabling Acts.