This week I became too cynical and the patients are starting to notice. For some reason, I walked in to appointments thinking that people were always going to ask me for something I didn't want to give them. Or that there was going to be a confrontation. Or that I wasn't going to know what to do. It made me a worse doctor. I need to consciously get back to giving people the benefit of the doubt. I think a lot of it revolves around the patient population. Lots of people with narcotic problems, lots of people who've been given narcotics by the doctor who I'm filling in for that I wouldn't have necessarily given narcotics to, lots of chronic pain that I feel helpless to treat. I think narcotics are one of the things I feel most uncomfortable about and thus I end up leaving people unsatisfied. I give people other things for pain, of course, but often what they're looking for and what I'm giving are different. Unfortunately, this makes it very difficult to have a trusting and pleasant relationship. I need to check my head next week.