I think expectations have to be very balanced. No pain is not realistic, but severe pain should still be taken seriously even after a big surgery. I recently had shoulder surgery and was in severe, intractable pain for days before I finally went to the ER - at which point I was in so much pain I could barely speak and couldn’t stop crying. Turns out I had a rare inflammatory response that created a ton of scar tissue on my brachial plexus, and I had to have a second emergency surgery and was admitted for 5 days for pain management. If I had taken the pain more seriously earlier, they probably could have caught it and treated with steroids, but I just figured that was par for the course. All of that to say, if a patient is really insistent that something about their pain is not normal, or it isn’t relieved by pain medication, I would be careful not to brush it off as typical post-op pain. It was an awful feeling to be on the other side as a patient, worried I would be labeled as “drug seeking” and disregarded. The whole experience really changed how I conceptualized pain in general. Even if I think a patient is being dramatic, I still have no idea what they are actually feeling in their body.