In this article, the author reports on a small-scale ethnographic study of illness behavior in a residential work setting, a large merchant cargo ship with a multinational crew. Although parallels with previous observational work on illness behavior in residential settings (where illnesses result in treatment only if there is a break in accommodation to symptoms) exist, it is clear that type of setting is pivotal in shaping illness careers. Here, accommodation to symptoms was overlain by the economic imperative to keep the ship functioning: Management feared that the right to the sick role would allow "malingering," whereas workers feared adoption of the sick role would exclude them from employment. In the latter case, the worker might experience illness or disability in a manner parallel to a Marxist analysis of the product of workers'labor: as an alien object of control and oppression, grounds for his or her removal from the workforce.