8:00 A.M.

I knock on the door of my first clinic appointment. He is a longtime patient with opioid use disorder who is here for a buprenorphine/naloxone refill. My nurse tells me he does not seem well. Looking at his vital signs, I notice a heart rate of 133 beats per minute. I walk into the room and see that he is alert but appears ill and pale with a rattling cough. I ask him to go to the emergency department and my nurse calls transport to take him there immediately.

10:00 A.M.

I am seeing a patient to discuss her anxiety. Her symptoms are well controlled on sertraline. She excitedly shares with me that she is pregnant, and we celebrate the news. We had discussed safe medications during pregnancy at her past several visits, but she is still wondering if she can use propranolol for her occasional situational anxiety. I reassure her that it is safe.