A Good Laugh

Julie - Part of my job requires teaching people how to give themselves injections.  I teach all sorts of people how to inject insulin with tiny needles attached to pen devices and they’re not usually very happy about it.

I also teach young people how to inject estrogen or testosterone – thick fluid through large bore needles that definitely hurt.  They are always excited and happy to do it.  They’ve spent their lives in the turmoil of feeling that they were born the wrong sex and finally they are transitioning. 

Mostly now I teach people how to inject a drug called Forteo to treat severe osteoporosis.  There’s usually some apprehension but they know it’s only for two years and they’re willing.

The other day Betty (as I’ll call her), a woman in her 70’s, was on my schedule for a Forteo start.  My colleague, her regular provider, dropped in with a warning.  Betty was in the waiting room with her daughter, her husband (“overbearing but a really nice guy”) and her sister, who is also taking Forteo but her daughter, a nurse practitioner, gives her shot due to vision problems.  I herded them all into the kitchen/conference room and started my routine.

These old ladies always amaze me at how well they pick up the 16-step process (that I teach as a two step process).  Betty was no different.  The family was interested and I did my usual attempt to focus mostly on Betty while the rest of the family asked questions and tried to help.  The only time Betty’s husband spoke was just when she was getting ready to do her real injection and he asked if she wanted him to do it for her.  Perhaps he was subdued by the presence of these four women in this small room.

Betty did great and then I set up her insulated travel case to keep her pen cool on her way home.  I said, “Here’s the pen in the ‘pen compartment’ and here are the cold packs on either side of it.”  Betty, who had gone through the whole 45 minutes without asking many questions looked at me quizzically.   “Kotex?”  I startled.  I could feel it coming up from my gut. “Cold packs.”  I smiled. Someone chuckled.  She said, “Oh, I couldn’t imagine why I would need Kotex with this!” and I laughed.  I thought, “Oh, I shouldn’t really be laughing” but I couldn’t help it and Betty’s sister and daughter were laughing and I felt my throat open up and loud, clean, mirthful laughing was coming from my deepest soul.

I heard it and I loved the sound of it reverberating in the room.  I knew that my boss and her patient in the next room could hear.  Probably people in the waiting room could hear.  It kept on, it was filled with the humor of the moment, laughing in the face of medicine and the treating of a disease that might or might not cause problems in the future.  It was filled with my own sense of relief and joy and love and letting loose and the realization that I hadn’t heard, hadn’t felt, that sound in a long time.