Bobby is a little boy, 9 years old. He has herpangina, a mouth full of blisters, and so his oral intake is really poor due to a sore mouth. He becomes dehydrated, is admitted, and the resident decides he needs IV fluids. Father agrees.

When the time comes for Bobby to get his cannula, Bobby (understandably) freaks out and starts crying. His dad asks if Bobby can just 'give breakfast a try and if it doesn't work, he'll get his cannula then.'

I mean, it's not an unreasonable request -- if he'd only discussed this with the resident during the ward round rather than try to bargain with me, an intern doctor, because I'm not the one who makes the decisions. And also if not for the fact that Bobby's poor oral intake is the very reason he was hospitalised to begin with. So I'm in a tough spot: the resident is in clinic and shouldn't be interrupted. Do I risk Dad's wrath by insisting on a cannula right now? Or can this wait until Bobby is too dehydrated and I fail the cannulation then? I decide to let him try breakfast.

To nobody's surprise, Bobby couldn't do breakfast. He has to get his cannula.

Bobby freaks out again. Father refuses the cannula. I sigh. It's not like I have tons of work to do already without trying to fit this cannulation around everything. Fine. We'll wait until afternoon ward round.

Afternoon ward round. Resident sees Bobby still doesn't have a cannula and has only managed two mouthfuls of juice all day. She tells the father Bobby has to get a cannula and IV fluids or he'll become very sick (not to mention a child is hard enough to cannulate as it is, nevermind a dehydrated child). Father agrees.

Bobby freaks out for a third time and is taken, kicking and screaming, to the clinical room to get his cannula. No amount of assuring works; he's already worked himself into a state. We ask dad to leave the room -- the clinical room has as few people there as possible to reduce infection risk and also because kids tend to act up when the parents are in the room.

Dad leaves the room. Surprise, surprise, Bobby quietens down, gets his cannula without so much as a whimper. We praise him and give him a sticker.

Guess we know who runs the household.