When my brother Matt was just a few years into his restaurant career, still working as a line cook, he got salmonella on the job. It was the restaurant’s opening night, and he was one of just three cooks, including the chef. The situation was, obviously, precarious: “There was no wiggle room.” He was asked to stay, and sat out prep before getting back on the line for service. “I couldn’t stand up,” he recalls, adding that he threw up several times and was aching. Instead, the chef placed a chair on the line, “so I could sit down between pickups.”

My brother’s story is actually not particularly extraordinary in the restaurant world, where, according to one former bartender, “basically every single person who has ever worked in the service industry” has been asked at one point or another to work while sick or injured. “I’ve been asked to come back to work with a fever — I’ve been asked to come back to work with a second-degree oil burn on 75 percent of my arm,” says Greta Herrin, who cooked in high-end kitchens before leaving the industry a few months ago. “The injury was very much a by-product of the working conditions. It was a Saturday night. We were all in the weeds and I moved the pan too quickly because I was being pressured to move faster, and to produce faster.”

For as long as there have been restaurants, or at least for as long as anyone can remember, it was simply understood that an employee would not stop working simply because she or he was sick or hurt. Cooks cauterize wounds and share stories of cutting off the tips of their fingers, only to put them back on with glue so they can keep working. A particularly gruesome injury might require a trip to the hospital for stitches before the worker returns that same night to finish a shift. People work through physical disabilities, visible and invisible, in an industry that doesn’t prioritize health. A cold, the flu, or a fever are simply ailments that workers are expected to push through. In a 2015 survey of food-industry workers — including those in restaurants, dairies, slaughterhouses, and other businesses — 51 percent of respondents said they “always” or “frequently” work when they are sick; only 5.6 percent said they “never” do.

As Herrin puts it, working through impediments is “treated like a competitive sport” — or at least it was until COVID-19. In the words of another cook, “this was the first time illness was treated as anything besides an inconvenience.” When Omicron arrived, the highly contagious strain of COVID spread rapidly around restaurants and changed the calculation for many operators. Many operators announced temporary closing so that employees could get tested for or recover from the illness. Many tried to push through with thinner staff, and others didn’t disclose outbreaks. In some cases, management was not so forthcoming with staff. While it appears many people have been staying away from restaurants because of Omicron, employees keep working while making less money. There was nothing surprising, really, about hearing that people were asked to keep working while sick or felt they’ve had to — that they’ve had to return to work before they felt well — because they always have.

A former pastry chef, who asked to be identified only by his last name, Lima, remembers the time a few years ago he called out of work with a 101-degree fever. “My boss at the time said, ‘How about we just have you come in for the first half of the day? We need you,’” he explains. A few hours later, Lima’s temperature hit 104, and he said he couldn’t come in. His boss pleaded for him to come in the next day, so he woke up before dawn and went into the restaurant. But he couldn’t do it. He wrote out a prep list of what needed to be done, then went back home. “I passed out and I got three phone calls from my boss later that day being like, ‘Why’d you do that? Why’d you come in if you weren’t going to stay? Why didn’t you set up this, why didn’t you set up that?’”

The push to work no matter what is as much a result of toxic kitchen culture as it is about the economic reality of working in an industry where some of the workforce still earns the federal subminimum wage, $2.13, which hasn’t changed since 1991. Some cities and states have a higher tipped minimum wage, including New York City, where it is $10 an hour for food-service workers. Americans have an unhealthy relationship with work generally, but the people who bear the brunt of that are the working class and people of color, and those employed in blue-collar industries like food service.

And employees say they often feel like they have no choice, because if they don’t work, they don’t make money, and they can’t afford the time away. According to a report by the nonprofit worker center ROC United, the poverty rate among restaurant workers is 16.6 percent, compared to 6.6 percent of the workforce overall. While New York is one state where employers are required to offer paid sick leave, the law does not require employers to pay out lost tips, and workers say the policy is often not discussed.

As Herrin described fine-dining kitchens, “there’s this expectation that sick leave is a personal favor, both implicitly and explicitly.” (One chef told me that it’s up to employees to educate themselves about paid sick leave.) The attitude that rest is a privilege is deeply ingrained and difficult to shake. “Everywhere I’ve worked, the prevailing attitude was that it existed but wasn’t available,” Katherine Hill, who works in craft beer, says of paid sick leave. One Friday in December 2019, Hill says she was hit by a car. She didn’t suffer any broken bones, and she went into work the next day. It was, after all, the holiday season. “I cried for half of my shift because one of the customers yelled at me and called me lazy,” she says. “I tell myself if that happens to me again, I probably wouldn’t come into work,” she says. “But I would probably still talk myself into it.”

And there is no such thing as paid sick leave — or unemployment — when you’re, say, a self-employed street vendor. Hulya Sevendik and her husband Mustafa have run a seasonal vegetable-and-fruit stand on 14th Street for a couple decades. In 2003, Sevendik was diagnosed with multiple sclerosis, and a few years later her husband was diagnosed with lymphoma. They are both high-risk because of their treatments, which has posed problems for their health, especially during the pandemic. (Sevendik gets infusion therapy to treat her MS, which has weakened her immune system, according to her doctor.) While she gets social security benefits (around $700 a month) and her husband now does, too (around $440 a month), that wouldn’t be enough to support them. “We kept working, because we have to,” she says. “Otherwise, who is going to pay our rent and how are we going to live?”

In states with no paid sick leave at all, cooks and other workers are put in an even worse position. Greg DeFranco moved from New York to South Carolina last year. He says that he and his girlfriend, whom he works with, both got sick recently. DeFranco began to feel ill after work last Saturday night and took off Sunday, then rested on Monday and Tuesday, which he already had off. But he said he struggled to find an appointment for a COVID test until the following week, and couldn’t find at-home tests anywhere he looked. Besides, there’s no mandatory paid sick leave in South Carolina, and people working these jobs who do get positive tests now have to quarantine at their own cost. “What do I do? Do I not go to work and risk not making money for an entire week?” he said on that Tuesday. Three days later, he told me he’d gotten an extra day off paid and was back at work. “If there’s one week for me that I’m out five to seven days, it’s going to put me in a really bad spot as far as paying my rent.”

Recovery is another issue, as employees often aren’t able to take time off to recuperate after an injury. Dalia, a former server, tells me she still experiences pain from a torn tendon she suffered in 2010. “I couldn’t afford to not work,” she says. After a few days off, she had to return. “And every single day, after my 12-hour shift, my foot would be so swollen that I would cry myself to sleep.”

Riley Redfern left the industry last year after more than a decade cooking in professional kitchens. She anticipates the effects of working through injury will last for a long time. “I have carpal tunnel from working as a pastry chef — all the days when I worked through that, which is pretty simple, pretty low-key pain,” she explains. “I look back and I have a lot of resentment and anger about that because of all the pressure I felt to not go to the doctor, to not get rest that I needed. It took a huge toll on my mental health.”