I can't write you a note.

I'd say a solid 20% of my clinic patients ask me for some sort of note at the end of their visit, that they need to show their boss to prove they went to the doctor and didn't just flake out on work. And of that 20%, maybe half want an actual note that reflects the reality of their visit and what their medical limitations are, and the other half want, well, something else.

"Can you say that I can't work until Thursday? I wanted to go to the casino tomorrow."

"Can you write that I need a break every hour, for my health?"

"Can you say I need to be allowed to eat on the job?"

"Can you write that I won't be better until the middle of June?"

"Can you say I can't walk distances."
"Distances of how far?"
"Any distances at all."

"Will you say I should have extra time on my exam?"
"You have a rash."
"So? Scratching it takes time."

"Can you write that I need to have a more comfortable chair?"

"I need you to say I saw you yesterday, okay? Because I didn't go to work yesterday either."

"Tell them the medication is going to make me sleepy."
"It's not."
"But this way I can take a nap and no one will care."

"Write that I can't lift heavy things."
"You work as a nanny."
"But the kid is really fat."

"You need to tell them I was in the waiting room all day."
"It's 10:30 in the morning."
"But you need to tell them that."

It's actually really hard to say no sometimes.