You can't always get what you want

Ick. Last night's call was by far the worst of the month. We only took 3 admissions, which isn't bad; however, some not-so friendly debate arose regarding the validity of various purported VA "policies." Read between the lines: Nursing staff told me I couldn't and they wouldn't do certain things, which led to a long and painful night for me (not to mention my poor intern). Next time you find yourself thinking that maybe the government should be in charge of health care, ask me for more details about life at the VA. The irritations and inefficiencies, including having my skinny cinnamon dolce latte with which Maggie so kindly surprised me this morning taken away because I was standing too far away from the "hydration station." No, I'm not making that up. (Hey, OSHA? Guess what? Doctors get thirsty, too? You let the patients have drinks!) But I need to move on or else I'll get worked up all over again. Let's have a good laugh instead, shall we? Alright, let's do.
Let's pretend you're a primary care doctor in Anywheresville, America, in Friday afternoon clinic. Your patient has just a few questions for you. Pick something from column A and something from column B. They don't necessary have to correlate; in fact, it's more awesomely bad if they don't.

Column A (But doc, my___ is so well-controlled!)
hypertension
diabetes
pain
weight
heart failure
cholesterol

Column B (Can't I just ____?)
stop taking my blood pressure pills?
stop taking my insulin?
have some extra pills, just in case?
quit exercising?
quit my fluid restriction?
eat french fries every day?

You: Riiiiiiiigghhht. Umm, you see, the reason your Column A is so well-controlled is because you don't Column B.
Patient: So, doc, you're saying I can't Column B for the rest of my life?!
You: Pretty muccchhhhhh, yeah.
Patient: So why have I been takin' all these bleepity-bleep pills!
You: Well, to control your Column A.
Patient: But if I'd known I'd never be able to Column B...
You: Hmm, yes. (Rise slowly from chair and back away towards the door.) Don't you need your tetanus shot updated? (Hand turns the doorknob slowly, surreptitiously.) I'll just have the nurse (Your body is halfway out the door.) comeinhereandgiveitthenyou'refreetogobyehaveagoodweekend.

And you're out!