Last week, I was scheduled to do a flex-nail of radial/ulnar fracture on a healthy two year old (first case of the day). Pt shows up to hospital 90 minutes late (i.e. 10 minutes after scheduled start time), and surgeon considers cancelling because he has clinic. He decides to do the case, and after the 35 MINUTES it took to admit a 2 year old to the hospital (you know, to ask about her religious preferences and if she has asbestos in her home, etc) we bring her back to the OR. Surgeon is pissed at this time. At that point, we mask her down and I go to start IV. 30 minutes (and >12 pokes by me and a partner) later (nothing to see, no luck with blind saphenous, IR vein-finder, etc), we still don't have an IV. Surgeon decides to go talk to pts dad. As soon as he walks out, we get a 22 in the EJ. He walks back in and says he's cancelling case to go to clinic. I let him know we're ready to go and recommend he be late to clinic. He refuses and decides to send her home to do later in the day. I inform him that I won't send her home with a neck IV and she is unlikely to be an easier stick later in the day (more NPO, etc). He says wake her up and get her out of here. I run in 500 cc IVF to try to hydrate her a little, wake her up and pull the IV. Long story short, she comes back in 4 hours, and I pop in an AC under US with a single stick. Case done, no further complications. Basically, the kid got an unnecessary anesthetic because the surgeon didn't want to be late for clinic. Probably no big deal in the grand scheme of things, but man was I pissed. Thoughts?