A conversation I had over vacation brought to mind a patient I had a couple years ago. He told me, quite seriously, that he tended to throw punches when he got a shot.
"You won't this time" I said calmly.
"You don't understand!" he insisted. "It's like, this reaction I can't control. You gotta get a couple big guys to hold me down before you give me that shot!"
I went on filling the syringe (I can't recall what, exactly, I had to give him, but it was one of those drugs that requires a glute shot and a Z-track) and said, again, "You won't this time."
(Query: Why is it always young, healthy guys in the military who tell me this? Dude, you spend your days *getting shot at by bad men with big guns*.)
He looked at me. I said, "Roll over onto your stomach."
He did. I said, "Okay, now grab your crotch with both hands."
A sidelong glance over the shoulder. "Why?"
"Because if you try to make a fist, your balls are in the way. And by the time you get your arms out from under you, I'll be across the room."
I did not need two big guys to hold him down.
More recently, I had another patient like that. Only this guy told me that he'd kick me in the gut if I tried to start an IV on him.
"Not this time you won't," I said, calmly unpacking the IV supplies.
"No, seriously!" he insisted. I sensed a trend. "You gotta get a couple..."
"Big guys to hold you down?" I asked. "Yeah, except this time, I won't."
"Why not?" he asked, chin jutting out.
"Because I'm going to stick you once with two hands. If you kick at me, I'll stick you the second time with one hand." I tied the tourniquet around his upper arm.
"What'll you be doing with the other hand?" he asked.
"It'll be wrapped around your balls, ready to squeeze." I smiled sweetly.
One stick, no kick.