Hate is such a damaging word, isn’t it? Webster’s defines it as “intense hostility.” Do you have intense hostility toward something? Could it be the election … for chairman of deacons at the church? Perhaps free eye examination advertising? No shows? People who serve white wine with beef bourguignon? (OK, that’s one I understand.)

“Intense hostility” turns out to be the least important part of the definition. Webster’s goes on to say why hate occurs: because of “fear, anger and sense of injury.”


Fear produces a rush of adrenaline causing our heart rate to increase and our brain to get ready for fight or flight, or maybe explain why we charge extra for a contact lens fitting. Sometimes fear is immediate, like when a patient says, “Doctor, I have a complaint.” Sometimes it is subtle, slow and debilitating, like when your wife says, “Let’s talk about planning a trip tonight.” Or your son keeps asking for his Rx to buy glasses online.

But remember, the body’s response to fear is identical to its response to elation. It’s your choice how to handle it. For me, moping around the office all day seems to help. It means I am very, very happy, obviously.


Does getting angry work? Sure it does! Whoever you are angry with will no doubt get angry right back; and since the other person is angry at you now, you will feel vindicated for being angry in the first place. It’s a win-win.
I guess cussing out a no show will, nearly 100% of the time, solve the problem. They will never, ever schedule an appointment again, so you no longer have to fret they will no show. Problem solved.

Anger certainly has some advantages. If you get a dry eye patient mad enough, their eyes will water and they won’t need punctal occlusion. Raise enough Cain and your receptionist will stop chewing gum all day, or at least swallow it when you appear. I could go on and on. Get angry and watch your problems melt away. Maybe.

Sense of Injury

Hate doesn’t come from actual injury, but from sense of injury. If you put peroxide-based contact lens cleaning solution in a patient’s eye, it will cause actual injury. Pain, not hate, is the final outcome. There will be plenty of hate later when their eye isn’t killing them. By the way, I would not advise putting peroxide in anyone’s eye except in very rare cases of someone who totally deserves it, like a diabetic who is three months late for their yearly examination, for example.

Sense of injury means you probably see it coming in the first place, so you can clear it up ahead of time by turning them over to collections, for example (to prevent your hate) or giving them an official office t-shirt (to prevent their hate). Find a way to smell injury in the air before the actual injury occurs. That’s why we teach contact lens insertion and removal, check IOPs and ask about their vision plans before they show up all crazy and cocksure.

Hate is never really appropriate, although there are certainly exceptions. Why else would it be in Webster’s? OK, it can get confusing. I hate when that happens.