The difficulty of saying "no"

Saying “no” to a patient in the emergency room can provoke a spectrum of responses, including some bizarre ones:

She escalated; I explained my thought process. She yelled, she wept, and she begged. I held firm, and she was discharged. On her way out she stopped by the charting station and said, with a vicious spite in her voice, “I hate you. You are a terrible, terrible person, and I hope you suffer, and I hope your children suffer. In fact, I am going to make sure of it. I am going to go home and make a voodoo doll of you and all of your children and I am going to stick pins in all of them!”

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