To my knowledge, nobody has ever been permanently disabled by one of my awkward first impressions … OK, OK, but they never planned to use that horse to haul anything heavy anyway.

By this point in your career, you’ve made a boatload of first impressions. One would think that so much practice would help making a first impression a snap. But that’s not the case. Far from it.

So, I would like to share, for the first time anywhere, my finest optometric first impressions after 31 years of uncomfortable opening lines—all true.

Me: “Hi! I’m Dr. Vickers.”
Patient: “Dr. Vickers, your fly is unzipped.”

Me: “Congratulations! When are you due?”
Patient: “Oh, I’m not pregnant. I’m just fat.”

Assistant in hallway: “Dr. Vickers, the patient has a deformed ear—just a little warning.”
Me to patient: “OK, let’s go. Take this paddle and cover your left ear.”

Me: “How’s life?”
Patient: “Other than my sister got murdered, not bad.”

Me: “Hello. How’s your mother?”
Patient: “You were at her funeral three weeks ago, remember?”

Me: “Hello. What’s wrong with your eyes?”
Patient: “See, Mom! I told you everyone could tell!”

Me: “How can I help you?”
Patient: “I could use a beer.”

Me: “Hi! Can you see?”
Patient: “You a comedian?”

Me: “So nice to meet you!”
Patient: “We dated for a year in high school.”

Me: “Hi! Ready to go?”
Patient: “Good idea. Where’s the ladies room?”

Me: “Did you break your glasses?”
Patient: “Dad punched me in the face.”

Me: “What seems to be the problem?”
Patient: “When I get excited, my penis bends.”
(OK, this conversation actually happened to one of my mentors when I was a student extern—but I heard the whole thing and I had to mention it! I also wrote it up as a case study for school and received a grade of “Average.” Average? By the way, the doctor’s response was perfectly professional: “Do you think this is related to your vision?”)

Me: “Is this your Mom?”
Patient: “Parole officer.”

Me: “OK, I see here on your chart that you have diabetes and cataracts.”
Patient, age 12, starts crying. Whoops, wrong chart.

Me (to teen patient): “Hey, Lee, been staying away from the girls at school?”
Patient: “I am a girl.”

Me: “Afternoon, Samuel, how’s the garden this year?”
Patient: “The birds ate the tomatoes, but the weed is growing like crazy.”
(By the way, Samuel will probably never have glaucoma.)

My best advice is always to be yourself. Unfortunately, this means you will likely say some amazingly stupid things in your lifetime. If you want to avoid making a crappy first impression, just enter the room and say “Hello.”

(By the way, did you know “hello” means “your sister is a mongoose” in certain cultures? You cannot win.)