I try not to get into it with patients. Mine are all adults. I was going to say "grown-ups", but thought better of it.
I got into it with a patient a few months ago because she told me that I had no idea how much pain she was in, and had no idea about her stress. She was a mom of 4 who had so much back pain that she "couldn't work", but was “considering having another baby”. She missed her psych appointment for her Xanax, but didn't have the time to go to the walk-in clinic, because she “didn't know how long she would have to wait”.
She didn't know that I work full time on knees that need replacement. I have an unemployed husband. One of my triplets has ADD. One of them has autism, asthma, Methylmalonic acidemia, developmental delays and orthopedic problems. The third one is in the genius program, but clumsy like his Mom. He broke his knee when he was 12. So, after major surgery on his knee, he already has issues with the joint.
I lost both my parents in two years after long battles with cancer. Been through two funerals, and two interments at Arlington National Cemetery. My autistic son doesn’t really like funerals, by the way. But that’s another story.
I'm not asking for pity. I live with this. And I get to write about it on this blog.
She was telling me that I HAD TO WRITE HER XANAX AND PAIN PILLS. She had specific ones she wanted. No options. She wasn’t willing to listen to anything else I had to say. She had absolutely no plans to do anything to reduce her pain except take narcotics and benzodiazepines. Walk in, pick something off the menu like at McDonalds, and walk out.
All this because her life was so miserable. And she did this the day after we interred my Mother's ashes at Arlington Cemetery.
I lost it. She got no prescriptions, got a lecture and got invited to find another doctor.
Never did that before or since. We all have our breaking points.
Sometimes it is easier to just let it go.