i'll pass on that, thank you.

did you ever walk by someone on the street or in the mall and they hold something out to you and you automatically take it - a flyer or a sample or something?  you take it reflexively, partly because you are being polite and partly because it's easier to just take it and throw it away then to refuse.  this happens in the exam room too.

sometimes when i hold the ophthalmoscope up to shine the light in my patients' eyes, they will reach for it like i am offfering them a microphone, and it always makes me laugh.  i ask them if they are going to sing some karaoke for me.

but sometimes in the exam room, someone holds something out to me that i refuse to accept.  now i'm not squeamish about too many things, but this just really grosses me out.  the patient will reach into his or her pocket or purse and hold out to me a greasy looking used up tube of some unidentified ointment and say something like  'my other doctor used to prescribe this for my hemorrhoids, can you refill it?'  i'll gladly refill it, but i'm not touching it!