The First Shot

by David Goldman

Being born with Type 1 diabetes at age one and a half was in some ways a good thing. I know that must sound a little crazy (okay, a lot), but I believe it’s much easier to adapt to radical changes in your life when you’re young. Consequently, the dietary restrictions and having to receive an insulin injection everyday were never really a big deal. I never experienced anything different, so they seemed normal to me. Every morning when my mom would wake me she’d have a syringe in her hand, and before I got out of bed, she gave me my shot and I got on with the day.

However, there was a big change coming. One that every diabetic child has to deal with: giving myself a shot.

Having my mom deliver the insulin each day was a breeze, although it did hurt a little. Back in those days there were no disposable syringes or needles. Every night my mom or dad would boil our syringes (my dad was a diabetic as well) in distilled water to sterilize them. The syringes were made of Pyrex glass and the needles were stainless steel. But because of their constant use, they were relatively wide. Plus, being used over and over again dulled their points so when they went in, you’d feel it. But it was a pain I got used to. I guess repetition either dulls the sensation or I just learned to cope with it. I knew there was no avoiding the inevitable. It was something I had to do, so I might as well do it and get it over with.

Eventually though, I was going to have to learn to fill the syringe and inject it myself. I don’t know when I first came to this realization or if I was told by my parents that it was something I would  have to do one day. The thought of filling the syringe properly didn’t bother me in the least. Injecting myself? That was another story.

The vision of jabbing a syringe into my arm or thigh terrorized me. My doctor and all the experts at the time preached teaching kids to do it themselves at as early an age as possible. Just like not eating sweets, getting used to it at a young age gave us less time to fear it, or form rejection toward it. So, one morning when I was five years old my mom came into my bedroom in the morning, carrying a bottle of alcohol, a box of cotton, and a filled syringe. She told me she wanted me to take my shot myself . I tried not to let on how scared I was.

I knew the process well. Tear off a piece of cotton from the roll in the box, unscrew the cap from the alcohol bottle, put the cotton on top of the bottle and quickly turn it upside down keeping the cotton in place and letting it absorb the alcohol. Then, wipe down the area of the skin where the needle was to penetrate, thrust the needle in, and push down on the plunger. I had already gotten used to that part. My mom would put the needle into me and I would then push the plunger in.

Now it was my turn for the whole thing. I opened the box of cotton and tore off a small piece; I unscrewed the bottle and doused the cotton piece with alcohol. So far, I was handling this like a pro. Then I took the needle and syringe from my mother’s hand. I stared at it for a long time. The clear syringe with numbers and lines carefully etched in it, the cloudy insulin in the chamber, and the frosted glass plunger inserted far enough that there was no air inside the syringe. The silver-colored needle at the end with the word Lily inscribed on it by the manufacturer, a tiny hole at the end through which the insulin would flow and keep me alive. “Come on David. Put the needle in,” my mom said, snapping me back to the task at hand.

When she gave me my shot it was always with the same routine. She held the syringe’s body between her thumb and first two fingers. She’d count, “One, two…” and move the syringe toward the injection site on each count. Then came, “… three” and she’d plunge the needle in. So I took the syringe in my hand and held it the same way. With my other hand I wiped down a small area on the side of my thigh and counted, “One…” my wrist bent quickly down until the needle was within a half inch of my leg before rising back up, “two…” down again toward the spot, “three!”. The needle came straight down toward the cleaned spot and stopped. I couldn’t make it pierce my flesh.

“That’s okay, let’s try again,” my mom reassured me. So I went through these same motions a number of times, but the longer I tried to complete the job, the more difficult it became. I just could not bring myself to insert that needle into my skin. Finally, my mom gave me my shot that day and said we’d try again later. Later was good with me. Much later would be even better.

She tried again in a couple of weeks and once again I went through each step meticulously, except the final one. I really wanted to be able to do this, but it was as if I couldn’t control my own hand. I could not move it or will it past that point where the needle hovered just above the skin. It seemed like an impossible task.

My mom and dad both tried their best to have me do it in the coming, weeks, months, and years. My father took a slightly heavier approach. “C’mon, you can do it! Just stick it and be done with it!”. But it was hopeless. I was hopeless. I thought I would never be able to do it and it embarrassed me. This was something I needed to do and I should be able to do it. That’s what I kept telling myself. But I just didn’t know how to do it that first time. I’d pretend it wasn’t my arm or leg, that there was no needle on the end, or try with my eyes close, all intended to enable me. None met with success.

I was nine years old when my mother took a grapefruit and put it on the table. She said I was going to practice giving it a shot. So I loaded the syringe with distilled water, placed my thumb and forefinger on the grapefruit and formed a semi-circle, and went through the “one, two, three” mechanics and thrust the needle in. She had me take it out and do it over and over again.

I didn’t understand how this would help. Putting the syringe into a grapefruit was not like putting it into myself.  Here’s where my mother surprised me. She went and got another sterilized syringe and needle, loaded it with distilled water again and said, “Now you’re going to give that shot to me.”

And I did. Not the first or second time, but the third time, I did it. She had me do it four or five times to her that day. It made me happy that I was able to give a shot to somebody, but I knew it hurt my mom and I felt bad for that. I also felt like I had finally broken that invisible barrier that was separating the needle tip from the skin. “Tomorrow morning you will give yourself your shot,” my mom said. And I did that too.

Between the time I was diagnosed with diabetes, and my successful pancreas transplant at age 41, I’ve calculated that I took roughly 31,000 insulin shots. The great bulk of them, self-administered. Once I crossed that first hurdle there was nothing to it. It became as routine as any daily task, but I don’t think I would ever have been able to do it if it wasn’t for my mom holding out her arm that one day and saying, “Now you’re going to give that shot to me.”