In primary care, you have to keep your wits about you. Often medicine is the easy part; identifying, understanding, and dealing with secondary motivations that patients have can be tough. You hope that your Spidey-Sense is about you, most of the time.
But sometimes it isn't.
Like when you are writing chronic narcotics for patients with well-documented and legitimate pain issues, but when you check a random drug screen it's negative for narcs and positive for cocaine.
Or when the patient you put on disability for oh-my-aching-back can't call you back since he's out hunting for the week.
I got worked today. The perpetrator: 3 years old.
He was nervous for his well child check. Cute kid, I don't really know him that well, and don't at all blame him for being nervous. But we had a good time, played a little, used my favorite trick of looking for the belly button on his foot (always gets a laugh from a 3 year old). The exam was over, he was roaming the room while I talked car seats and sunscreen with mom.
He approached me, tugging on my arm. "Dodder. Dodder. DODDER!"
"Dodder, I wub you."
So cute. So innocent. So sweet.
"May I have a kiss please, right on my cheek?"
But whilst he was planting a big wet one on my cheek, his hand was slipping into the pocket of my lab coat, and pilfering my prescription pad.
Smooth operator, that one.