Sometimes the role of the family doctor is to play the bad guy. Sometimes I really don't mind this such is the case with drug seeking patients or people that believe they are entitled to every test and treatment under the sun at no cost to them. I generally don't mind telling them no and occasionally I look forward to it.
Then there was the seven year old that came to see me today for his sports physical. He wanted to play football. His older brother was there too and he got signed off without a problem. This little guy was unfortunately born with a chest wall defect where he has an absent pectoral muscle and notable rib deformities. I felt this placed him at undue risk for not only a collapsed lung, or pneumothorax , but sudden cardiac death from a blow to the chest wall called comodocordis . Mom knew the answer that I was going to give and did not fight me or try to guilt me into allowing him to participate in any contact sports. I think she probably even agreed with me. Both her and her son just needed to hear it from the doctor.
Climbing off the exam table with his head hung low, the little boy crawled up into his mother's arms to protect him from the big bad man who told him he couldn't be like his big brother and play football. Sometimes I hate being the bad guy.