I work at the front desk of a dental office, and if a patient needs a large variety or a long stretch of work, we create “treatment plans” to let them know the scope and cost. These plans can be a hard sell if the patient has a small budget and, for that reason, poor insurance. The following conversation occurs over the course of several days, via both phone and email.

Patient: “This is a lot of money. Do I have to do all of it?”

Me: “If you truly desire, we can simply pull the affected teeth and not replace them. You’ll be, well, short a couple of teeth, but it’d save you a lot of money in the long run.”

Patient: “That’s fine, I’m turning seventy soon, I don’t have much time left. Okay, I want the teeth pulled only. What is this stuff about bone grafts? I’m not having the artificial implants.”

Me: “They are to promote healing in your jaw.”

Patient: “That seems like a waste of money. What’s wrong with me just having a hole in my jaw?”

Me: “Well…” *Explanation.*

Patient: “Okay, I will do that. Please schedule me for the extraction and the bone graft.”

Me: “Oh dear, it turns out we also want to apply a treatment to help your gums heal over the gap as well. I apologize for missing this. The treatment plan isn’t very well organized in terms of phases. I say this not to excuse myself but to explain myself. The gum treatment will cost you some more.”

Patient: “That seems like a waste of money. What’s wrong with me just having a hole in my gum where the tooth used to be?”

Me: “Well…” *Explanation.*

Patient: “That is a waste of money. Schedule me for the extraction ONLY, no healing afterwards.”

At this point, I stop to talk to my boss, the dentist. This doesn’t seem safe to me… but I have literally no formal dental training, so there could be important details I’m not aware of. Well, it turns out my instincts are accurate.

Dentist: “Tell her we don’t feel comfortable with the treatment as she wants it done. If she had PPO insurance, she could go basically anywhere, but she has HMO insurance and must be assigned to an in-network dentist like me; tell her that she should transfer to a different one.”

Me: “And if she disagrees? I’ve only been here for a year and a half, but I’ve already faced patients who intend to bully us into doing things their way, and I’m sure you’ve seen more like them.”

Dentist: “I have indeed. You’re doing a great job integrating all the exposition, by the way. The HMO network lets us decline patients. If you can’t reach an understanding with her, I authorize you to fill out the forms and have her transferred elsewhere. If the patient doesn’t trust us, there’s no future in the relationship.”

Me: *On the phone.* “[Patient], this is your dentist. I wanted to call you and let you know that we cannot schedule you as asked, and believe you should seek treatment elsewhere.”

Patient: “I can’t believe this! Why would you say such a thing?”

Me: “Well, without the grafts and the gum treatment, you’re essentially asking us to cut you open and then not sew you up afterwards.”

Patient: “This is America! I have that right!”

Me: *Doubting this is true.* “Regardless, WE do not feel comfortable performing such a procedure on you. That’s why we suggest you seek treatment elsewhere.”

Patient: “Why won’t you do it?”

Me: “The—”

Patient: “I don’t understand why you won’t do it. Why won’t you do it?”

Me: “The—”

Patient: “I don’t understand why you won’t do it. Why won’t you do it?”

Me: “The—”

Patient: “I don’t understand why you won’t do it. Why won’t you do it?”

Me: “Would you like me to tell you? I’ve been interrupted every single time.”

Patient: “Okay, why?”

Me: “Because we don’t feel comfortable opening you up and then not–”

Patient: “The other stuff makes the price 6 times higher! You’re just trying to get more money from me!”

Every for-profit business exists to make money, and we’re especially concerned about HMO patients like this one, as we’re contractually obligated to lose money on some of them. That said, I know whether someone is ready to have a logical conversation. Besides, I have better ways to spin it.

Me: “Our primary concern is your health. To repeat, we don’t feel comfortable performing surgery on you and then not applying the necessary measures to help you recover. If that is what you want, you should seek another dentist. We are not the kind of office that does a cut-rate job just to save money.”

Patient: “You only care about money! Those other offices will let me save the money, but you won’t?”

Me: “Well, if that’s the case, I think we’re in agreement that you’d be happier at one of those other offices.”

Patient: “No, they only care about money!”

My boss, the dentist, has taken a seat next to me. The patient’s volume is such that he can hear them clearly. I know he has come to offer back-up if I need it; but I can also see the self-congratulatory grin for having me on hand to tackle it for him.

Me: “That’s correct. WE care about your health. Which is why we have proposed additional measures that–”

Patient: “I don’t want those! Those are a waste of money!”

Me: “I’m sorry, but I think it’s time to bring this conversation to a close. It’s clear we cannot come to an agreement on the best way to move forward. To repeat, I think everyone will be more satisfied if you seek treatment elsewhere. I’m going to have you unassigned from our practice, and I wish you great fortune in finding a dentist that is more to your satisfaction.”

The patient is still going when I hang up. I then get an email from her claiming that she doesn’t consent to being reassigned. Alas, the paperwork was filed within five minutes of the end of the call.

I’m driving a regional transit bus. I pull up to a stop, and a mother and her kids get on, with the youngest in front. She’s maybe five or six, with a very serious look on her face.

The child steps up to the fare box, which is significantly taller than she, and holds up a transfer card. It’s expired and beaten up and clearly trash.

Mom: “Oh, she grabbed that off the bench, go ahead and ignore that.”

I take her transfer and stick it in the machine. The machine gives the beep that means it can’t read the card. I give her a thumbs up and say:

Me: “You did it!”

The child solemnly nods and walks to a seat.

The mom thanked me for humoring her, but what was I gonna do? Refuse? No way!

A young-ish guy walks over holding a wilting basil plant.

Customer: “Hi, I bought this last week and now it looks… well…”

Me: “Hmm, it’s probably getting too much sun and not enough water.”

Customer: “Oh. I thought herbs liked the sun.”

Me: “They do, but in moderation.”

The customer’s boyfriend walks over and gestures at the plant.

Customer’s Boyfriend: “So did you figure it out?”

Customer: “The plant is throwing shade because I didn’t give it any.”

I stifled a laugh, and gave a simple explanation on how best to maintain the plant going forward.

For context, I work in a landscape materials yard, which means a lot of heavy equipment is used and big piles of rock and sand.

A woman comes in with her child, and my manager is outside speaking to the mother about her project, and I am in my office, which has a pretty clear view of the yard. I happen to look up from my computer and see this woman’s child on top of one of the material piles! I get up and step outside to get the kid down from up there, but she is already coming down. I sit back down at my desk and continue to work, thinking that’s the end of it.

A few minutes later, I see the kid up on another material pile! The material pile she is on is a 3” rock that can get slippery, and if the kid falls, she could get seriously hurt. I hop up again but see one of my yard boys talking to the kid already, telling her to get down so he can take her to the mom, who at this point is on the other side of the yard, not even noticing her kid is gone. The kid is brought to her mom by my coworker, and I sit back down, thinking that now it’s over

If you are thinking by now that the kid climbs on the material piles again, you are absolutely correct, except this time, the mother is in front of the material pile, taking PHOTOS of her kid on top of the pile. At this point, I am concerned for the kid’s safety and walk out to the yard to tell the kid to get down and to talk to the mother.

Me: *Talking to the kid.* “Excuse me, sweetie, but can you get down from there?”

Mother: “Excuse you, I am right here and I am the parent! You do not talk to the child, you talk to the parent!”

Me: “Ma’am, what your child is doing is extremely unsafe, and I do not want her to get hurt. She needs to stay by you while you are in the yard.”

Mother: “I was watching her! A manager was showing me around and talking to me, and I was keeping an eye on her!”

Me: “Ma’am, I need you to tell your child that it is not safe to do this. I don’t want her to get hurt.”

Mother: “I don’t want her to get hurt either, that’s why I was watching her!”

During this entire conversation, she is talking down to me like I’m a little kid. I am a grown woman, so her treating me like I am a child does not go well with me. However, since I am at work, I cannot tell this woman what I really think. I just remind her again to keep an eye on her child and go back to my office.

She finishes up with my manager outside, and my manager asks me what the confrontation was about, and I tell him. He agrees with me that she was being very careless with her child.

Manager: “Wow. Well, she seems like one of those people who we will never see again.”

Me: “Don’t threaten me with a good time.”

It was back in 1990, and we were moving about five thousand people from the old corporate campus to the new one. Everybody knew that there was a new campus, and that the old one would be closing. Each weekend, we’d notify a suitable number of people that they were going to be moved that weekend. The facilities people had distributed labels, boxes, and printed instructions.

Then, on Friday night, we’d come around to everybody’s cubicle, break down the computer, bag the cables, and tie the whole mess together with plastic wrap. We’d make sure that everything was tagged as well. 

On Saturday morning, the movers would pick everything up and deliver each person’s stuff to their new cubicle. We’d then run around and hook everything up so that on Monday morning, everybody would be ready to work. 

So, Friday night. I go into the cubicle of a graphic designer. He had a giant monitor attached to a high-end Macintosh (very odd for 1990). He had packed nothing, and he was busy working away (at 10 PM on Friday night).

I asked him why he wasn’t packed up, and he replied:

Designer: “For what?”

Me: “For the move. You are supposed to have all your things in boxes, and we are to bag and tag your computer equipment.”

He replied, and I swear that this is the truth:

Designer: “Nobody told me this was going to happen!”