four updates from letter-writers

Here are four updates from people who recently had their letters answered here.

1. I think our employee lied about having cancer

We continued to have problems with the employee in question. She would stonewall me (ignoring me completely, including when asked about work tasts) but was continuing to tell other employees she had cancer. I started going back through records and schedules and found that she had called out 18 times in 4 months (in addition to additional time off requests that were granted!)

So, I wrote her a performance improvement plan regarding calling out because it places undue strain on the rest of the hospital to not be able to count on her attendance at scheduled shifts. Part of the plan was not calling out. We went over the plan, she signed it, then told me and our HR manager that she wouldn’t be coming in the following day. We told her, per the document we had literally just signed, this was unacceptable. She said “well, I have a working interview.” I told her she had been scheduled for this shift for 3 weeks, so she could either have traded it to someone else earlier or scheduled her interview for another day. She had tried to trade but nobody would trade with her. I told her I wouldn’t force someone to trade shifts with her. She then decided she quit.

Morale in the hospital has improved significantly.

2. What are the ethics of keeping money left over from a travel per diem?

Just to follow up, I discussed and got resounding “okay” for myself and my reports to just keep the per diem and handle expenses personally. It’s a win-win, we get to keep a little cash and avoid expense reports, and the organization doesn’t have to deal with administrative side.

3. Should I bring up my disability at my year-end review? (#3 at the link)

I sent an email to my superiors per your suggestion and using much of your language (thanks!) and they responded so kindly! They said they had suspicions that I might be having a hard time hearing and look forward to talking about increased accessibility soon (they both are not in the office every day). They were also thankful I brought it up, understanding it was likely difficult for me to do so, and that they want to help me succeed here professionally and at the same time break down these barriers.


Thank you again and for all the helpful advice from your readers!

4. I got the job, but I’m sure I gave a bad interview and I can’t stop ruminating about it

Thank you so much for answering my letter. I was so grateful for all the kind and wise advice from you and the readers rightly pointing out that I was way, way too hung up on the interview.

I’m pleased to say this is a happy update. Another new hire joined a couple of weeks after I started – we were both employed from the same hiring round but the logistics worked out differently as they were relocating. We compared notes on our interview experiences and they also thought it had gone badly, which kind of neutralised things for me. I helped talk them through some aspects of the role which made me realise how quickly I’d picked things up and that, yes, I really am capable and I do have the expertise and skills I was hired for so the interview was really just a means to an end and doesn’t need to loom so large in my mind. Having a good manager and nice colleagues has also really helped me to move past my worries about the interview.

My feeling now is that it really doesn’t matter how I got here. I’m just happy I did and am going to get on with enjoying my career. Thanks again to you and all the commenters for helping me see sense!

{ 98 comments… read them below }

    1. Captain Radish*

      Updates are my favorite letters! I do so wish we could solicit more. I want a few writers from this year to come back! You know who you are.

  1. Lil Lamb*


    This one stuck with me! I guess we never will know if she really was lying about having cancer. As a side note, someone who works at the cafeteria at the college where I work lied about being pregnant. When she started entering the second trimester we asked her how her baby was developing and she had an entire story about the baby was developing in her Fallopian Tube. We had no idea what to say to her about this as it’s completely medically impossible. She recently went on maternity leave too…

      1. Lil Lamb*

        She might have had an ectopic pregnancy, but she continued to tell people she was having a baby and went on leave. We had no idea what to say or do about the situation so we stopped asking questions because we thought she might be processing the loss of the baby this way. She doesn’t work directly in our office so we figured it wasn’t our business.

    1. OhBehave*

      That would be an ectopic pregnancy. The embryo can develop for a period of time, but then it will rupture the fallopian tube. EP’s are always removed because it’s just not viable. It’s also quite dangerous for the mom.
      She actually went on maternity leave? WOW!

      1. Lil Lamb*

        The thing is she never too leave to have the surgery to remove the EP. She just told us that the baby was developing in her Fallopian Tube and that her doctors advised her to keep it there and carry it to term. We knew that was impossible because it would burst and she could die from it. Fast forward to now months later, she went on leave for several weeks. It’s just a bizarre and uncomfortable situation so we stopped asking about it.

          1. OhBehave*

            I feel sorry for her whether it was true or not. It’s hard to believe her doc told her to carry it to term if it was in the fallopian tube. She may have just been in shock or denial. I’m sure the time she took off was much needed for her physical and mental health.

            1. Anion*

              It’s not “hard to believe,” lol, it’s impossible to believe. Telling a woman to carry an ectopic pregnancy to term is malpractice and, potentially, negligent homicide (if not outright homicide) on the doctor’s part. That would be like telling your doctor you sliced your carotid artery and her/his reply is “Well, give it time, your body heals on its own,” or him/her sending you home when you have appendicitis because maybe it’ll be okay if you just get some rest.

              (BTW, not “correcting” you, just conversing/expanding on your point.)

              1. SimontheGreyWarden*

                I do know someone who was sent home during early symptoms of appendicitis because the ER thought it was malingering, and she was rushed back later when it actually did rupture.

    2. Bumblebee*

      You know, you say that, but my mom actually had a pregnancy wherein the fertilized egg implanted itself outside of the reproductive system altogether – no idea how. Anyway, she went to the doctor repeatedly because something just felt really off (she was pretty much always breastfeeding or pregnant for 15 years, so she wasn’t having what you would call ‘normal’ periods just in general, but she also knew what pregnancy feels like), but they didn’t find anything. Months went by – like 3-4 months. Long enough for a sizable fetus to have developed. One day she woke up in excruciating abdominal pain and went to the ER. The ER doc was skeptical that it could be anything, because she just didn’t seem to have anything wrong with her, and despite her pain, she was functioning really well. The ER doc calls my mom’s OB/GYN who immediately orders emergency surgery because my mom’s threshold for pain is unbelievably high (7 natural births with no painkiller, no problem). So, pregnancies can be carried for a long time in unexpected and horrifying places.

      But my husband did have a coworker who faked a pregnancy and then a miscarriage (when she wasn’t showing by ~4 month) once. She also said one of the other (married) employees had gotten her pregnant – they’d never even had sex. So… yeah. People suck.

      1. OhBehave*

        I’ve heard of this as well. The fallopian tubes are not ‘roomy’ enough for a fetus to develop. I can totally see how a baby would develop outside of the reproductive system only because there would be room to grow. The body is a mysterious thing. My ob/gyn told me that having a healthy baby is truly a miracle. If you think about everything that has to go just right in those 9 months, it is a miracle!

      2. Rusty Shackelford*

        Yes, it *is* possible to have an ectopic pregnancy implant someplace other than in the Fallopian tube (ectopic simply means not in the uterus). And I believe there are even cases of these pregnancies being carried to term. But I don’t think that’s what happened here.

        1. Honeybee*

          Yes, there are four cases of ectopic pregnancies being carried to term (that I could find), but none of them were within the Fallopian tubes.

        2. JoAnna*

          You can find one such story if you Google “Miracle baby was carried outside mother’s womb” (won’t put link here so it doesn’t go into moderation).

      3. Honeybee*

        Yes, but that was because the doctor didn’t find anything at initial visits. If the doctor DID find and knew about an ectopic pregnancy – especially one in a Fallopian tube – dollars to donuts they’d recommend terminating it.

          1. AcademiaNut*

            Even most Catholic doctors would recommend terminating a pregnancy when the alternative is a guarantee that the mother and baby will die in horrible agony – see the recent news coverage of the government’s attempt to put a total abortion ban in place in Poland for example. I have heard of people whose non medically trained families and friends, though, urged that the mother continue the pregnancy and pray for a miracle.

            1. irritable vowel*

              You should watch this week’s episode of Samantha Bee’s show – she has a segment about how Catholic hospitals do exactly the opposite of what you’ve said, including an interview with someone who basically says, “yeah, sometimes the woman is just going to die.”

              1. Anion*

                Oh, well if some partisan “comedian” who hosts a “We’re a news show, but feel no responsibility to be accurate or objective because we pretend to be satire! We’re not responsible, la la la!” show on basic cable found some guy to say something on camera, it *must* be true in every single case!

                Did she produce an anecdote, too? Because an anecdote would definitely prove that AcademiaNut is absolutely wrong about what “even most Catholic doctors” would do, and that every single Catholic hospital on the planet, without exception, just lies to women about its policies in order to trick them into walking through the door.

                1. Mookie*

                  it *must* be true in every single case!

                  No one said that. I’m going to follow up this comment with some links that demonstrate examples of what irritable vowel is talking about.

                2. Anion*

                  I don’t need examples. I’m aware of them. But when someone says “Most do this” and another person follows up to say “No, those places do exactly the opposite of that,” it sure sounds to me like “You’re wrong, and I know better.”

                  It was rude and uncalled for, IMO.

            2. Cactus*

              Officially the Catholic position would be to condone a salpingectomy, but not a termination, in the case of ectopic pregnancy. In these instances, the pregnancy would still be terminated, but only as a side effect of the removal of the entire fallopian tube.

            3. The Strand*

              Funny you mention this because, there was a NYM piece *today* about a Catholic affiliated hospital refusing to tie a woman’s tubes during her C-section, despite the fact that she has a brain tumor that makes additional pregnancies extremely dangerous. She’s not even asking to terminate, just prevent!

              And from that I discovered the website MergerWatch – apparently this is happening with a lot of religious-affiliated hospitals around the country, who are merging with secular hospitals.

              Pretty awful cases there, e.g. one woman who was miscarrying – the baby was not viable – was forced to carry an additional 5 weeks, rather than offered even the knowledge that she could abort.

          2. sunny-dee*

            I believe ectopic pregnancies aren’t considered the same as routine pregnancies, more like a condition. Kind of similar, I had a missed miscarriage last year, which meant my baby died but I didn’t lose it, so I had to schedule a D&C. My OB doesn’t perform elective abortions, but there was no “loss of life” in that case — it was medically necessary to me and couldn’t hurt my child anymore.

      4. Candi*

        As I remember the diagrams, the Fallopian tubes aren’t attached thoroughly enough to the ovaries to keep an ovum from wandering once in a while. An unfertilized egg will just get cleaned up by the immune system. (Unless something very rare happens.)* A fertilized egg… Ectopic pregnancies can occur in the ovaries as well.

        *That something being a teratoma -DO NOT Google that while eating!

      1. Lil Lamb*

        We didn’t ask anything invasive. My coworker and I are very friendly with her and just asked “how are you feeling.” She had been joking with us previously about how she’d been putting olives on everyone’s salads because she’d been craving them. She then told us this we didn’t anticipate her getting so detailed

        1. sunny-dee*

          FWIW, it doesn’t seem overly personal, since she’d already told you she was pregnant. It’d be like asking about an upcoming wedding or house renovations or something.

    3. Rusty Shackelford*

      You know, it’s even possible that she didn’t understand what was happening to her. I’ve met some people who wouldn’t understand and wouldn’t ask questions, and when they had surgery to remove the ectopic pregnancy, would assume the doctor was putting it back into the uterus where it belongs. And might even sign up for “maternity leave” on the due date they were given when they first took a pregnancy test.

      A million years ago, I remember someone on a Usenet group with an unplanned pregnancy who wanted to find out how to put the embryo up for adoption, since she’d heard of “embryo adoption” and assumed that meant you took an embryo out of one uterus and put it in another. So yeah, people don’t always get it.

      1. michelenyc*

        This lack of understanding/education of human reproduction to me is really sad. This really should not be happening.

        1. Elizabeth West*

          Just another reason we really NEED reproductive education in schools because clearly some people aren’t getting it at home. And their parents probably didn’t either. It is really sad. :(

          1. Candi*

            (Waves) I gave my kids their maps!

            (Okay, I’m bragging.)

            Funnily enough, all the talks about sex and relationships and STDs and emotional/mental involvement and pregnancy (and also drugs and alcohol) led to them both deciding on just not having sex until they’re good and ready, because they just don’t want to deal with the whole thing while they’re teenagers (and my daughter doesn’t want to deal with it until she’s definitely in a long-term relationship).

            Funny how education works.

    4. AMT*

      The original post had an addendum in the comments. Apparently, she admitted to OP that she didn’t have cancer:

      “She then told [my administrator and HR director that] she had never told me she had cancer, but that she had H. pylori being treated with antibiotics and that she had lied to me about the doxorubicin because I was asking too many questions. So, basically, I know she is lying but our HR referral service told us not to fire her for this because of ADA concerns.”

    5. INTP*

      The OP updated in the comments to the first post and said the employee admitted that she did not have cancer. The employee admitted that she had an H. Pylori infection and was on antibiotics, not chemotherapy, and lied to the OP because the OP was asking too many questions. (Not that it makes any more sense this way! I still don’t quite get the reasons or endgame here and clearly she wasn’t being earnest with her employer in general. But no one was falsely accused of not having cancer, in any case.)

    6. Leah the designer*

      I would like to point out that it could be an ectopic pregnancy. The fallopian tubes are the most common locations for an ectopic pregnancy. Its my understanding that these types pf pregnancies are very dangerous and almost always means the pregnancy isn’t viable. There’s been a handful of cases with successful ectopic pregnancies but they are incredibly rare.

    1. Pwyll*

      It’s entirely possible that her employer had too few employees to be covered under FMLA (50 employees within 75 miles). But even if FMLA applied, the employer can request medical verification, which would be difficult because the employee already admitted to OP that she didn’t actually have cancer.

    2. Moonsaults*

      It depends on the length of employment as well. You have to be with a company for a year and worked at least 1250 hours.

      The hoops my mom had to jump through when my dad was going through his extensive cancer treatments weren’t that bad but it gave me an insight into that side of FLMA at least. It’s not as cut and dry as “I have a medical emergency, you have to let me miss as much work as necessary, no questions or follow up required just a doctors note.”

      1. Retail HR Guy*

        It’s almost that cut and dry. The Certification of Health Care Provider form isn’t exactly onerous to complete.

      2. Temperance*

        So that’s what it was for me, but my firm has an amazing HR department and I had built up goodwill. Also, I called from the ER, so they started the paperwork early.

    3. INTP*

      She probably wanted to minimize the paperwork and HR/administration involvement since she was lying about the whole thing. It sounds like the only point was to make people more sympathetic to her frequent calling out (which may or may not have had anything to do with an H Pylori infection or other documented illness).

  2. EddieSherbert*

    #1: that situation was so bizarre; I’m glad it worked out! I hope the employee learned something from all this.

    On another note, OP #1, I’m incredibly curious about where you work since you mentioned the employee worked in “dog kennels” before and mentioned the “hospital” now :)

    1. Two-Time College Dropout*

      Maybe she changed some identifying details in one or both letters, but didn’t think to make them uniform?

  3. TMA*


    I’m a little concerned that she quit. When she refused to comply with the PIP, she should have been fired, right? Or at least moved to the next steps in discipline. If there weren’t consequences for failure listed in the PIP, I worry your PIP isn’t sufficient.

    1. Newby*

      She decided that she would not comply with the PIP and quit. I don’t understand why that would be a bad outcome.

      1. Not the Droid You Are Looking For*

        In the few times I’ve seen managers use PIPs, I’ve seen people quit (some on the spot, some part way through).

        The update made this sound like this was a very, very quick turnaround, if not all in the same meeting. Employee signed, said “oh but wait..”, OP and HR stood firm, Employee quit.

        I hate to say it, but having the employee quit before going through the PIP is an easier outcome for everyone. And if they are anything like my company, I just ask HR to check the box in the system that says, “employee not eligible for rehire.”

        1. INTP*

          I’ve done that, quit on a PIP. In my case I did make a genuine attempt to fulfill the PIP, but it became clear that even though I was improving I was just not going to be able to meet their expectations fully with the amount of support they were willing to give, so I quit mid-PIP because it was humiliating to be at work every day. I have some misgivings about the way it went down, but I think it worked out well for both sides. They didn’t have to fire me, and they promised that they would give a good reference if I needed an employment check for another kind of job.

          1. neverjaunty*

            That does sound like a good outcome… especially since you, unlike the employee in the letter, were self-aware!

    2. hbc*

      It’s not a race. Someone getting their act together and continuing in the job, quitting because they realize it won’t work, or being fired because the manager thinks it won’t work are all reasonable outcomes of a PIP. And as far as unemployment benefits go and all that jazz, most employers would be grateful that a problem employee beat them to the decision.

      1. MegaMoose, Esq*

        Also, when it comes to unemployment benefits, quitting under circumstances like this would probably have the same outcome as being fired – the employee would not be eligible.

      2. Crazy Canuck*

        This is especially true in Canada, where the burden of proof is on the employer to prove a firing is for cause. (A firing without cause requires severance pay.) There is a perception that the court tends to side with employees, so most employers are quite happy when a problem employee on a PIP quits.

  4. Pen and Pencil*

    I don’t understand #1, in the comments of the first post she updated saying the woman worked in dog kennels, but here she is saying she works at a hospital? I get that both would be issues with immunocompromised individuals, but why did the story change so drastically? Why would she continue to tell people she has cancer after you already called him on her lie?

    1. Anna*

      Mentioned above, the hospital might be connected to the kennels at a vet’s office or even a shelter.

    2. Mack*

      I think the OP may have meant Animal Hospital/Veterinary Hospital, which would include the woman working in the kennels.

    3. the_scientist*

      It could be a couple of things- as others have mentioned, “hospital” could mean veterinary hospital. Otherwise, research hospitals (for people) do have animal facilities and employ vet techs to work in those facilities, including monitoring the welfare of the animals and administering experimental treatments as needed. Experimental animals do get exposed to a lot of nasty things so facility managers need to be extra careful about immunocompromised employees–for example, women who are pregnant often actually end up disclosing as soon as they know, way before you’d typically tell your employer, because their job duties may need to change.

    4. Dankar*

      I was poking around in the original post (I’d never seen this one!) and saw that OP commented that they work in veterinary medicine and the (ex-)employee in question work(ed) in the kennel portion of the practice.

  5. H.C.*

    Actually, the original #1 post reminded me of a HIPAA quandary at OldJob a while back: is it a HIPAA violation to disclose that a person is NOT a patient at your facility?

    On one hand, the HIPAA privacy rule is about what a facility can or cannot disclose about their patients, so someone who’s not a patient there wouldn’t be bound to those restrictions. On the other hand, would saying “no, she’s not a patient here” indirectly violating it by implicating where else she could be treated (esp in smaller communities where there are, say, 3 hospitals in the area – with 2 out of 3 hospitals saying “no, she’s not a patient here” and 3rd hospital going “no comment”, making it pretty easy to figure out.)

    Ultimately, at OldJob we went with the “no comment” though non-patient was blatantly lying to the media about being a patient there (and was only able to refute it later when non-patient produced faked invoices that look nothing like ours, asides from the lifted logo.)

    1. Julia*

      I really hope this is a reference to the recent Real Housewives of the OC scandal. If not, I will pretend it is.

    2. ArtK*

      “It is the policy of the United States Navy to neither confirm nor deny the presence of nuclear weapons on any of our vessels.”

    3. Rusty Shackelford*

      I don’t think that’s a HIPAA violation, but it would make me happy if *every* facility’s policy was to say “no comment.” Unless, of course, the person was fraudulently claiming to be a patient there, in which case I’d say they’ve given up their right to privacy and you should feel free to call shenanigans.

    4. Red Reader*

      Technically speaking no, because a patient at a hospital can request that their presence be kept secret, in which case the operator says (or should say) “No, I don’t have any information about a patient by that name” whether they do or not.

    5. INTP*

      I don’t know if it is a violation but it’s a very poor practice against the spirit of HIPPA if they are saying “no.” That would make that aspect of the law pretty pointless, because then a “no, Jane Smith is not a patient,” would mean just that, but “we are not able to tell you if Jane Smith is a patient here” would mean “Yes, she is a patient.”

      1. H.C.*

        That’s also a very good point. Per the OldJob scenario in my original comment, this arose when a non-patient repeatedly claimed they’re being treated here – and we continued with the “no comment” line until the non-patient produced a falsified document.

      2. Honeybee*

        HIPAA does not prevent covered entities from confirming whether or not someone is a patient. Anyone can ask for a patient by name and the hospital can confirm, or deny, that that person is a patient at the facility. A journalist could call and ask “Is Beyonce Knowles currently at your hosptal?”, the hospital could say “Yes” and not be in violation of HIPAA. They could also say “No, she was treated here and released” and still not be in violation of HIPAA.

        See more here.

        1. smthing*

          The hospital can also put in place a policy stricter than HIPAA, and simply decline to answer if Beyonce is a patient or not.

      1. Honeybee*

        In the U.S., I’m not sure that’s the case federally. As far as I know, psychotherapists and other mental health providers don’t have different privacy restrictions under HIPAA, so a psychotherapist could say someone was not their client (or was their client) and not violate HIPAA. The only difference is the treatment of psychotherapy notes.

        State laws and laws in other countries may be different.

        1. Cat Steals Keyboard*

          Nope. You can’t say if they are, so you also shouldn’t confirm that they aren’t.

        2. Cat Steals Keyboard*

          May be a therapy thing and not a HIPAA thing, but it is absolutely NOT okay to confirm that someone has ever been your client unless you have their consent, and sometimes not even then.

        3. The Cosmic Avenger*

          IIRC, that is a matter of professional ethics (and possibly APA membership), not law. So one’s licensure could be threatened, but there are no criminal or civil penalties, as opposed to HIPAA violations.

    6. Adam V*

      Alison said this in the original letter:

      > it would also be smart to have the doctor’s office verify that the note from them is real. HIPAA does allow them to confirm or deny that they wrote this sort of note, so you could fax it to them with a request for that confirmation.

    7. Honeybee*

      It’s not a HIPAA violation to say that someone is not a patient at your facility. Even in small communities where you might be giving a person more clues as to where that person might be treated, that’s still not a HIPAA violation. HIPAA is about protecting your patients’ personal health information; if a person is not a patient of your facility.

      In fact, I found out some time ago that it is not even a violation of HIPAA to say that a person is being treated at your facility. If you ask for someone by name, the hospital is legally allowed to tell you that person is being treated there, their condition (in one word) and where in the hospital they are located unless the person has specifically forbidden it. Hospitals can opt to make a policy that refuses to give this information out, though.

      I learned this when I worked as a residence hall director in graduate school; part of my job was going to the hospital if students were transported there via ambulance. We would get the notification from Public Safety that the student was being transported, but often there’d be a lag time between the time the ambulance was called and the student actually got to and was checked into a room in the hospital. So I often called nearby hospitals’ main line and asked for specific students and what room they were in to check and see if they were there before I made my way there, because it sucked to get out of my bed at 4 am, make my way to the hospital and then have to wait 30-60 minutes for the student to actually get assigned a room. They would also tell me if the student was admitted, as that set in motion a chain of other events and reporting and waking up deans and such.

      1. Rusty Shackelford*

        And that’s why doctor’s offices are still allowed to have sign-in sheets at the front where other patients can see your name. It’s not a violation of the law (though it might be a violation of a facility’s policy) to reveal that someone is a patient. You just can’t reveal details of their condition, treatment, medical history, etc.

    1. OP #4*

      Thank you! I’ve basically never been happier at work. People keep telling me I seem like a new person.

  6. ali*

    #3 – as a fellow hard of hearing person, I am so glad to hear this! I have been “out” at work for a long time and it has made all the difference in the world for me.

    1. CM*

      #3 makes me really happy! It’s such a relief when you’re worried about bringing something up, and it’s met with kindness and understanding.

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