Last time I had a surgery, I accidentally insulted the lead nurse and instantly felt like I made the biggest mistake of my life, even though she said she thought it was funny.
We were having a friendly chat before the surgery and I guess I was too relaxed, and at one point, she said that if she makes a funny face, it was just her normal behavior and not something bad had happened, and I jokingly said, "How would I know?" and instantly died inside.
It's like an automatic joke I'd say with my friends, but I barely knew this lady. I hadn't even really noted what she looked like. And when I actually looked, she had a very alternative look. I think she had a lot of tattoos and green hair.
She thought it was funny, but I started sweating.