Yesterday's post suggested that employers should try to build jobs around three-dimensional human beings, with their various needs. I should be careful what I wish for.
At both of my colleges, I've had to deal with extended faculty absences driven by medical issues. (Given the steadily-advancing median age of the full-time faculty, I expect this to become more common over time.) From an administrative perspective, these situations can get remarkably complicated and vexing.
Some medical issues are relatively well-defined, in terms of absence from work. Somebody taking a day or two for a stomach bug, or a week for the flu, is not a big deal. Somebody taking some time for childbirth, or for a relatively discrete procedure, requires more planning, but still isn't that hard, since you can be pretty confident about duration, date of return, and ability to work upon return. The tricky ones are the medical issues that involve long duration, episodic and extended absences, and uncertain prognoses.
Under those conditions, it's incredibly hard to get the rules right. I've had multiple cases in which expected return dates are set, then pushed back a week or two, then pushed back two weeks, then pushed back a week or two again. Given that semesters have relatively fixed starting and ending dates, it's difficult to extend the kind of flexibility to a professor that a given medical condition might demand. Say the semester starts in September and ends in December. Professor Doe notifies you in August that he'll be out for the first two weeks of September to deal with a medical condition. Okay, you work with the department chair to find subs to cover the classes. Two weeks into September, the leave is extended for a week. More subs. Now it's extended again, this time for two weeks.
Now you have to be the bad guy.
Given advances in medical treatments, people can be in ambiguous health for years at a time. Given the ADA, union rules, and medical privacy rules, it can be very, very difficult to get someone in that situation to make a decision, or even to get a clear sense of whether a decision needs to be made. At any given point, the seemingly prudent and emotionally-easy thing to do is to wait. But waiting is a decision, too.
Now it's Thanksgiving, and Professor Doe is happy to report that he's ready for work. Putting him back in him Fall classes at this point would be silly, so your job is to find other work for him to do until the end of the semester. Now you're paying him for makework, and paying his replacement(s) to cover his classes. (The replacement(s) are almost certainly making less than he does.) Meanwhile, you short other parts of the budget to make up the difference.
Repeat this cycle a few times, and it's hard to avoid resentment on both sides. Professor Doe is fighting some serious medical issues, and doesn't need some paper-pusher to generate static. From my side of the desk, classes need to run when they need to run, and the professor is either there or not there. (The students usually feel bad for the professor at first, but over time, start to get justifiably cranky if there isn't a reliable presence.) Our medical leave policies are written on the assumption that medical conditions are like pregnancy – clearly defined, and of finite duration, so the returning worker returns good as new. When the condition fits those criteria, the rules are pretty clean. (Paid vs. unpaid leave is another issue. In this, as in so many things, I think the Swedes have it right.)
But some conditions – especially those that more commonly hit later in life – just aren't like that. Sometimes the employee returns not-entirely-better, or functional-but-not-the-same, or almost-functional, or mostly-functional-but-delicate. Sometimes there's an element of denial by the employee about just how sick s/he actually is – those conversations are no fun at all. It's nobody's fault, really, but when the cycle repeats a few times, that can be hard to remember. From the employer's standpoint, predictability of staffing – the single greatest benefit of paying full-time salaries – goes down the drain. From the employee's standpoint, a career is at stake, as are salary and benefits, a sense of belonging, and the ability not to admit defeat.
Going on disability is an option in some cases, but it's not easy, and it doesn't lend itself to certain conditions. I'm glad the program exists, but it's far from a full solution to these dilemmas. And even there, broaching the subject in the wrong way and/or at the wrong time is very dicey, legally.
I really don't have a great answer to this. It would be lovely if prognoses were always clear-cut, people were always honest, and illnesses only struck during semester breaks, but that's just not reality. I'm neither a physician nor a soothsayer, but semesters run when they run. Flexibility has its limits.