SCREAMING PUMPKINS

I felt like and almost said “I love you…” as I followed the little four year old girl that I’d just given four shots to down the hall and into the waiting area.  She had come in with her mother and little sister for her four year old immunizations.  She was due for DTaP (diphtheria, tetanus, acellular pertussis), IPV (inactivated polio vaccine), MMR (measles, mumps and rubella) and Vericella (chicken pox) and because she hadn’t received a flu shot this year, her mother agreed to her getting one.  She was very reserved when I greeted her when she arrived, but warmed up as we talked while I was getting her height and weight.  She and her sister seemed to love the balls I gave them each to play with while I asked her mother questions and then went to draw up the immunizations.  With quite a bit of resistance and some loud crying, her mother held her tightly on her lap while I quickly gave the DTaP and MMR in one little leg and the IPV, Varicella and flu in the other.  She looked up with eyes that seemed to be asking why I had inflicted so much pain on her after we were just becoming friends.  Several Dora stickers came to my rescue and I think she understood when I explained that the shots would help her to not get sick with some very serious diseases.  It was so precious that she let me wipe her little eyes with a Kleenex and to see her smile again.

It feels very good to be having patients of my own now, from 15 – 18 months and up through adults for various immunizations, TB skin tests and pregnancy tests. The four year olds seem to be the most frightened of shots or are the ones most vocal about their fears.  Some children come in to get caught up on their immunizations, so might be receiving four or five when 6 years old.  They seem to be courageous, maybe feeling more in control of their lives or I think too, more conscious of what others think and not wanting to cry loudly in front of siblings and a stranger.  They are so precious, most times stoically letting me give them their shots and then looking up, smiling and saying, “that didn’t hurt at all.”    

Another little four year old seemed very happy to have come to the clinic, but was obviously very afraid at the thought of being there to get shots.  I sat down with her and her mother and we looked at a colorful version of the immunization schedule and I pointed out that she was almost done with her shots, having had most of them when she was littler.  She pointed to each square asking, “have I had that one?” and to the next, “have I had that one yet?”  Seeing that the majority of the little squares were ones she’d already had, she agreed to sit on her mom’s lap and get her four this time.  Not to be too atypical of four year old clinic expectations though, she commenced to scream very loudly at the top of her little lungs while I quickly, but with my heart in my throat, gave her all of her immunizations.  She immediately stopped crying and was glad to get down and pick out a sticker and her mother asked her what all of the screaming was about.  I think the fear of needles is greater than the pain felt during or after the shot and I imagine being necessarily wrapped up tightly in Mom’s embrace to stabilize little arms and having her legs held between Mom’s might add to the fear.  What a little pumpkin = )

Bertrand tentatively asked, “so how are you doing?” when I emerged from my exam room looking a little on edge and laughed, telling me that he’d had hundreds of experiences like that…am sure this little girl will be back when she’s six, eleven and older and we’ll look back and smile at the memories of her four year old immunizations.  It’s pleasant to think about being here for that many years, similar to my Grandma Swanberg’s public health nursing career in Nome that spanned 25 years and many children’s lives.

A third little four year old, a bright eyed little boy, seemed altogether happy to be coming to get his shots.  We looked at the immunization schedule together and he seemed very impressed that he’d already had most of his shots.  He enjoyed picking out his four band aides and then sat quietly on his mom’s lap, took all of his shots in stride, made a small whimper and then jumped down to play with the new plastic car that came afterwards. 

I’ll be away in late March/early April for two weeks spending time with my two favorite little pumpkins and family in Washington.  Request submitted, all required signatures appropriated, calendar cleared, and tickets purchases.  Little Jordan (five years old) asked if I could stop on the way to her house from the airport to buy her and her sister a toy before I get there, but liked the thought of us going shopping together even better.  She is planning to fly up to spend time here with me when she is ten years old “and then we will go to other places together, Oma, and we will give cows and chickens and goats and lambs to people who don’t have any food.”  Yes, let’s do that…sounds like a wonderful plan my little Giordano!  I love you and your sister so much…is nice to not have to catch myself before saying = )