I have friends and colleagues that naturally grew up with the mindset of giving everyone the benefit of the doubt.  I’m not sure why I didn’t, but I used to often assume the worst about others.  I didn’t even see it as a problem until I was in training. 

Thankfully, I began to learn to give patients the benefit of the doubt during training. By way of example, I experienced my fair share of narcotic seekers and manipulating who wanted to either abuse medications or divert prescriptions for money. Cynicism reared its head early; however, I had key faculty, colleagues and patients that taught me some important concepts. 

One lesson was that some patients do a bit of over-acting as a preemptive tactic.  They fear they won’t be believed and will be dismissed so they exaggerate.  I particularly remember this in a few patients of our large population of patients with sickle cell disease needing admission for severe acute...