Here is the email I sent back after getting a second NO when asking for a refill of a script:  Okay...but please don't tell me to have a great day or great evening after an email like that.  I'm sure you mean well, but it comes across as flippant after you have delivered bad news.  Which this is, for me.  It is expensive, anxiety producing and time consuming to go find a new person who I have to explain all my sicknesses to.  Not to mention I have to suspend my best coping mechanism, denail, in order to do it.  For a sick person, repeating the litany of symptoms, drugs, chronologies of failured treatments...it is depressing every time we have to do it for a new person.  Reliving it all over again.  True that's not your problem...but I am your patient. I anticipate you might want to explain why you write "Have a great evening" and why I'm over reacting or in someway not being fair to you...but CUT ME SOME SLACK.  I didn't have to tell you how I felt.  I risk being misinterpreted myself.  The pro forma use of sign offs like "Best," or "Have a great day" is often considered good customer service...but in reality it can lack empathy for a customer/patient's emotional state.  Here I am not only sick  but mentally ill, you just sent me a message that you aren't going to help me with X...and then you say "Have a great evening."  My actual evening?  I cried and ended up taking a valium.  The cognitive behavior approach - I do have self discipline - was too late to catch the molecules of emotion than were already coursing through my bloodstream.  I feel alone already.   Also...if I sign my email as Annette and you call me Ms. Simmons - thats another distancing technique - makes me feel less of a person. Normally I'd delete this email and never sent it...but on the off chance you have a heart, here goes. I did make it through another day without vicodin...but not without valium.  I ended up taking two in order to sleep.  I'm still bummed.  but I have to give a speech and teach a course so I have distractions.  I'm getting concerned though.  I really don't have a reason to live...I keep trying to come up with one.  Write a new book on Integrity?  I get a bump of enthusiasm and then it fades.  I should see a therapist...but it is the same deal.  Bringing a stranger up to speech is agony.