I have always been proud of my ability to calm injured children so that I can sew them up without medeval restraints. I raised 5 children myself as a single father. I had to sew them all up at one time or another. Everything from chain-saw accidents to a soft-ball line drive right into the nose!  Two wound up upside down in a car! I do have the severe restraints and the drugs to put really uncooperative children into a compliant semi-sleep, but that is rarely necessary and I prefer to talk them into cooperation rather then strong-arm them into submission. Two year olds are the greatest challenge. They already have a strong mind of their own. You can't fool them. You had better be honest and tell them in advance when it is going to hurt a little bit. If you do, most will put up with a temporary ouch if they believe you that it won't happen again. This particular two year old was the youngest of 4 siblings. Sometimes the youngest is the most spoiled. Spoiled not just by the parents by by the older siblings as well. But this was the youngest child of a doctor mom. Doctors know quite a bit more than the average parents about successful parenting, and how to not spoil the kids while trying to raise them safely. This was not a spoiled two year old. He was used to getting a straight answer to his quesions and used to being able to trust those answers. Thanks mom.  I had the dad sit in my exam chair and hold the child in his lap. This gave the child a feeling of security. I reclined the chair and raised it to my comfortable operating level. After expalining that we needed to put the ouwie to sleep with a little novocaine, I placed a gauze soaked with novocaine on his forehead laceration. This started the numbing process but still didn't decrease the sharp short pain of injecting more novocaine. Daddy held his arms and I injected the necessary novocaine by placing the needle into the laceration and not through the skin where it hurts a lot more. He cried but held still enough for me to not stick the needle anywhere I didn't want  it to go. After I washed the laceration with betadine without any pain, he reluctantly agreed to hold still while I sewed it up. The tiny sutures were as small as a human hair and had to be 2 mm apart. Earlier in the day I had a lot of coffee. I don't drink coffee before exacting tiny procedures like this if I know in advance I'm going to be doing such tiny and exacting work. No plastic surgeon can drink coffee before micro-surgery. Well as luck would have it, I was exhausted enough at the end of a long day that the coffee tremor was gone. Good thing because the surgeon mom was hovering over the operative field almost as close as I was to the surgical field. The operation was a success and the young man will grow up without a noticeable scar on his face. The three other siblings in the room were well behaved and didn't make any unhelpful comments. For younger less cooperative children, I have the mom hold them over her shoulder while I pull the diapers down and quickly inject a very safe dissociative anesthetic into the buttock. In less than 3 minutes the eyes roll back and the child is safely out for the count. But the count is only 15 or 20 minutes. I have to get with it and inject the novocaine, prep wirth Betadine and repair the wound before it wears off. It always works out just perfect. This particular drug is not allowed in hospital emergency rooms for liability reasons that have nothing to do with what's best for the patient,  just what's best for the hospital. But now I've opened a whole new can of worms I'll talk about in another blog later.   Dr Foster