Milan appeared in the living room after he had just wrote his homework trying to catch up math classes he had missed last two weeks. Indisposed to talk about it with his mother, he said that everything is finished and correct. Indisposed to watch movie on TV with his brother too, he walked to a window and looked outside while sounds of slight rain were fighting for dominance over a silence with an lazy music from TV.
The car that has just arrived on parking place under the window looked familiar to him. It was white ambulance car that local clinic use for house calls. As car stopped, the nurse run into their building to avoid the rain. She was also familiar to him. It was nurse Helena, nice looking woman in her thirties. Milan's hearth begun to drumming immediately. His mind was filling with fear. That strange fear so known to him. Will she ring in a door?
Milan had no luck about his health that year. His body was growing up quickly, he became tall as his father, got some muscles and became one of those tall slim, skinny teenagers. His immunity system didn't follow his growing up. Every single cold he had got, became respiratory infection that needed antibiotic treatment.
In September when his paediatrician diagnosed him pneumonia he received extencillin injection and serial of ten daily penicillin injections. In November, his paediatrician suspect that respiratory infection could became pneumonia and ordered him serial of ten daily penicillin injections. Around Christmas and New Year he was visiting local clinic every day. He cut his head, got anti tetanus injection but also he had to receive serial of daily penicillin injections as prevention against wound infection. At the end of January he got pneumonia again and his paediatrician prescribed him extencillin injection and serial of 10 daily penicillin injections again.
He didn't like injections at all. When he was 7 years old he had made drama while he had been getting his first penicillin injections. Since then nurses insisted that he has to be hold over parent laps during injection. In meantime he received a lot of injections, but still, he didn't use to them. He could stand anti tetanus injection without tears or moan, but penicillin? He was leaving local clinic after penicillin injections without tears rarely.
Extreme pain during those injections was smaller problem to him. Greater problem was extreme embarrassment and shame he was feeling because he had to be hold over father's laps as so "big boy" and because, despite all of his efforts, he cried so often during those injections. He was ashamed by nurses that insisted he has to be hold, by numerous patients that laughing to him when he was leaving treatment room, by his parents that desperately trying to encourage him, by his younger brother that laughing and kidding with him every time when he would back home after injection: "I'm sure that little baby boy cried today again".
TWO WEEKS AGO
Two weeks ago Milan had felt ill again. Since his father, that usually driving him to clinic, was on a business trip those days, his mother called the doctor, family friend, to examine him. Milan knew that hard coughing, exhaustion and slightly high body temperature could be another pneumonia but he hoped that their family friend could find another therapy than his paediatrician. As exam at his home coming to its end, Milan realized that hopes will ruin soon. Everything was exactly the same as exams at paediatrician at clinic. First talk, then listening his lungs with stethoscope, then throat exam, then announcement: Milan has to receive 10 daily penicillin injections. Doctor also added something that Milan understand as "stronger adult dose".
That night Milan saw nurse Helena and that car for the first time. Few hours after doctor had left their home, someone rang on the door. A nurse, pleasant woman in his early 30s, all in white with a large black bag in her hands appeared on the door. "I'm nurse Helena. Doctor sent me to give injection to Milan". Mother called her to come into living room where she, Milan and his younger brother were sitting around a table and watched TV.
As they walked in living room Milan became extremely embarrassment. He knew he will get extremely painful injection very soon and he will probably cry. This time there were not only a nurse that will give him injection, but also his mother and brother. He was additionally confused because there was no his father. "Would nurse insisted to my mother to hold me"?
Nurse Helena was not working at Paediatric department so she didn't knew about Milan's previous incidents during injections. It was for the first time she will give him injection. She didn't mention holding, but talk about his age and school. He decided to stay where he is - sitting on sofa and wait for further instructions.
Nurse put her black bag on a table, opened it, and begun to placing “instruments” on the table. Mother was sitting next to her and Milan's brother pretending to play with toys in a corner. When Milan saw first metal box that nurse put on a table, and hear the sound he had been listening numerous times while nurses preparing injections in clinic, fear and anticipation starting to filling all of his body and mind.
Nurse placed two metal boxes, a bottle of medicine and a vial of bidestilate water, on the table, then took a small knife from a bag, cut a bit, then break the top of a vial. Then she opened metal boxes, larger one with syringes and smaller with needles, took a large syringe from large box then a needle from another box. She placed the needle on the syringe. She took a vial again and filled a syringe with water from it. Few bubbles of air stayed in a syringe. She left an empty vial on a table and opened a cover of the bottle with medicine, placed a bottle on a needle and pushed all water from a syringe into that bottle. Then she shook it few times and refilled a syringe. This time it was not water without colour. It was milky fluid.
Milan was staring to the syringe with his large opened eyes. He heard nurse's question was he receiving injections of penicillin before. He didn't answer. Mother did it. He wondered how much medicine nurse would fill into a syringe. A quarter, one half, more? Nurse filled all medicine from bottle. The bottle got empty and syringe got almost full with white milky medicine. It looked terrifying to him. He received so many injections but he never saw preparation process. Bending over father's laps in clinic he had faintly saw just a moment when nurse would raised already filled syringe. Those syringes looked smaller from that distance.
Nurse removed the needle with attached bottle from a syringe and took another needle from a box. She attached a needle with squeezers and raised a syringe in a level of her eyes. She pushed a plunger a bit to remove an air. Few drops of milky penicillin come out, almost a meter up in the air. She turned to Milan and told him:
- “Drop your pajama pants down and lay”.
Milan didn’t say a word. He turned head down, so long light brown hair covered his frightened face. He slowly laid on sofa, pulled down pajama pants till the half of his laps, then pulled down his white briefs too. Nurse Helena stand up from a chair and walked next to a sofa over Milan. His head was placed on a pillow and his hair partly covering his hands ready to grab a pillow. His pajama was apart. Shirt was wrinkly from his head till lower back and pants were pulled down till the middle of his laps. His feet were hanging in the air. He was obviously tall to fit a sofa. Part of his body from lower back till upper part of his legs, with a butt in a middle was naked.
- "Relax your muscles" nurse Helena said gently and rubbed upper outer part of Milan's left butt cheek.
The scene of large syringe was still occupying Milan's mind as he was trying to find out a way not to embarrass himself. His brother was younger few years, used to injections as 5 years old, and had never cried after that. He had never saw Milan receiving injections but he hear a lot of stories about how his older brother is crying during injections.
Milan felt nurse rubbing his butt with alcohol pad. Instead to relax, he tensed his butt muscles. He believed that’s the way to stay still. Obviously wrong. His body jumped a bit as needle penetrated his teenage smooth muscle. He tried to stop a scream with clenching teeth as needle penetrating every millimetre of his muscle.
Nurse Helena felt tensed buttock and realized there is no way to relax her patient. She pushed medication. Trying not to cry Milan closed eyes and clenched teeth even stronger. As pain continued he tensed all muscles on his face then grabbed a pillow squeezing it with hands. First tears fall down from his eyes.
As more medication spreading into his butt, with enormous efforts Milan finding additional strength to tense muscles, His face was shivering in pain and moans let out through clenched teeth. Aware that words can't relax the boy, nurse injected medicine into stoned boy's butt. Slowly but surely, till the end. When she finally withdraw a needle, boy's butt and body did the final shake. Better to say jumped a bit. Nurse quickly and strongly pressured a site with cotton for few seconds, then rubbed still tensed butt. With head buried into pillow Milan tried to reoccupied himself. When nurse had placed a cotton on injection site and told him to hold it there few minutes, It was a good excuse to him not to show his wet face. When he finally felt he get enough strength, Milan slowly backed briefs and pyjama pants on its place and raised up. He was still hoping that moaning he had been producing was not looked like crying.
His mother had been already in kitchen and his brother pretending to read a book. Nobody didn't say a word. Nurse Helena already cleaned a table of her “instruments”, closed her bag and with nice smile say bye.
The next morning Milan was stand up late, and didn't move from the sofa where he was laying and watching TV. Coughing and weakness were still strong. Older woman, their neighbour, was there and taking care of his brother and him while their mother was at work. When someone ring on a door Milan knew it was time for another injection. Nanny opened the door and female voice said
- “Good morning. I’ll give injection to Milan today”.
Fear and embarrassment exploded into Milan's mind since he had heard that voice. It was Nurse Lilly, neighbour of Milan's grandmother. Older women that knew Milan very well. Not only she was familiar with his family, but also she gave many injections to him. She was working in treatment room of Paediatrics, the place where he received most of his injections.
Nurse Lily was not one of his "favourite" nurses. She talked too much, ordering too much, giving injections roughly. He couldn't remember is he ever left treatment room without tears on her shift. She was also often guest into his grandmother's house and she didn't hesitate to talk about Milan's injections. Last time she lauded how he became nice boy, cute and tall, then told "Just he need to learn receiving injections". Milan was ashamed and scared for years that she can tell it to everyone and that his friends would hear about his behaving during injections. Now, She is about to give him another injection, to make him cry again, to make him afraid she would talk about it to everyone.
The nurse entered in a room and put her black bag on table. Milan was pretended like he is even weaker then he really was. He boded it could be one of those bad injections. He wanted to avoid talking with her so he immediately turn on his tummy like he is preparing for injection. While she was preparing an injection, with his head placed on a pillow, Milan tried to ignore nurse's voice while she was chatting with nanny. But, he couldn't ignore wacky sounds of touching metal and glass parts of syringe and metal boxes. He pulled down his stripe pajama pants and pulled up pajama shirt but he left briefs on his butt. Even he knew he can't avoid showing his butt during injection in front of so many people in the room he decided to pull it down just before injection.
With hands on sides of his head he was collecting strength while wracking sounds coming from a table. As he was looking to a wall just in front of his eyes, those sounds reminding him to many previous injections he had received from nurse Lily.
While he was fighting with anticipation nurse approached him and managed to pull his briefs down and massaged his right butt cheek. He wasn't prepared. Actually, she made just a single move with cotton and immediately started jabbing a needle. "Started" because she did it so slowly. Milan felt every moment of jabbing as needle was going millimetre by millimetre into his muscle. He left a short “ouch” and clench teeth not to scream even before nurse started to push medication. He closed eyes and tensed all muscles of his body. Not just butt muscles but muscles on his face too. As incredible pain was invading entire of his butt he didn’t see or hear anything. It seemed like she is pushing all of his body down with a syringe. He spent all of strength to hold a voice, but from the middle of injection he was kicking his legs and his sobbing was mixing with nurse's yelling “hold down, hooold down”. At the end, when she withdraw a needle and pressed injection site, instead of a scream he left a hundred of tears over his face and jabbed his head into a pillow.
When nurse had packed her instruments into black bag and left their home, he was still laying on sofa with bare buttocks and crying into pillow. Nanny had to pulled back his briefs and pajama pants.
When he had finally reoccupied himself, when he had stop crying and normalized breathing Milan sat on a sofa. His brother was playing with toys in a corner and nanny disappeared in a kitchen. .
For the whole day he was laying there and thinking about injections. From time to time, soreness of his right butt cheek reminded him to painful injection that nurse Lily had gave to him. Sometimes, When his brother would joked and mentioning big baby boy Milan was thinking how he had been embarrassing himself. He had heard many time that some of his friends are also receiving injections, but nobody never mentioned they cried. His two years younger brother is not crying during them. Only he did. In same time he was glad that nobody have to hold him during injection. He hoped that it is not accidentally just because there is no his father, or because he is receiving injections at home so there are no nurses from paediatrics to tell to his parents "would you hold him" .
Then when pain from butt cheeks would warn him to walk slowly he would remember nurse Helena hands and large syringe in it. There were 8 days more to finish therapy. There would be 8 more needle jabbing into his already so sore butt.
The next morning, just in time when he expected a nurse to give him third injection, the door rang again. Nanny opened a door and male in white coat entered in a room. He was very tall, in his early 50s and had grey hair. While he was greeting a strange man, confusion was visible into Milan's eyes. Till then he was used on male doctors and female nurses. Every doctor that had examined him till then was a male, and almost every nurse that had gave him injection was female. But, it was obvious that he is there to give an injection to Milan.
As difference from nurses, medical technician didn't speak to much with nanny but with Milan. Before he sat on armchair and prepared injection on a table he told Milan to remove a blanket, turn on tummy, drop pajama and turned head to a wall. While Milan was doing what technician ordered, wracking sounds of injection preparing begun a game in Milan's mind. But technician was obviously experienced. He recognized signs of fear into boys voice. He was asking the boy about school, about football. Answering to his questions Milan forgot sounds of preparation even he heard them somewhere behind. When those sounds disappeared a smell of alcohol attacked Milan's nose. He felt medical technician is approaching.
"In which side you want injection Milan?" technician asked
Milan was occupied with his preparation to a jab. He squeeze a pillow expecting he needle attack.
"Milan, in which side nurse give you injection yesterday?” technician asked again.
"Left" the boy answered, more to a pillow then to a technician.
"You got last injection in left side or you want injection in left side" technician was still looking for an answer. Both sides of boys butt had large blue scares from previous injections.
"I want it in left" Milan answered and tensed all of his body.
Hairy technician's hand gently rubbed outer upper part of boys tensed butt with alcohol pad. Then did it again telling the boy to relax as much as he can.
Needle penetrated boys muscle quickly, so fast that he almost didn’t feel it. But when plunger was pushed and first drops of milky penicillin entered into boys muscle, the boy tensed himself again. Pain started to grow. There were no doubt for such experienced medical worker that Milan will not relax his muscle. He stopped to telling him to relax and slowly continued to push medication into smooth butt. Injection was painful to Milan again. Maybe not as much as those before, but enough to him to clenched teeth and closed eyes. During injection as boys butt was tensing more and more, the technician asking Milan silly questions. According to Milan's answered it was obvious he tensed all of his face muscles and holding his breath. Finally, needle was withdrawn and place of injection pressed with cotton.
“You were great, but still you’re afraid a bit. Aren’t’ you?” was the question that Milan didn't answer. He didn't has to. It was obvious. After a minute of pressing and massaging injection site the old medical technician told the boy to pull my pants back.
It was still too hard to stand up for Milan with such pain in the butt, but he did it anyway. While he was looking how medical technician leaving their home he realized he didn't cry this time.
Those 3 days were just a beginning. Every morning for next 7 days, about same time, the same white fiat 750 parked in front of Milan's building, the door bell ringed and another one of those three nurses appeared in a room with large black bag. No matter who gave him an injection, after those ten minutes one of his butt cheeks was “decorated” with one more blue injection mark.
Milan realized that nurse Helena was kind of “ordinary” giver. Her injections hurt, made him to tense all of himself, clenching teeth, grabbing a pillow, sometimes to moan but never to cry loudly. Maybe just to drop few tears over the face. The old medical technician had the soft hand. That meant Milan didn’t cry, didn't even moan, but he was still tensing his muscles and clenching teeth. Old ugly nurse always made him cry. Especially during eight injection, the last one she gave him. He screamed during injection and cried ten minutes after she left.
It was Saturday when nurse Helena came to give him last, tenth daily injection that doctor prescribed to him. His father had returned from trip and all family were at home. He felt much better. Temperature was gone. He was satisfied when mother spoke with father about his injections. When she was talking how their friend, the doctor, arrange nurses to come to their home to give Milan injections father asked how Milan is behave. Mother said there were no scenes and drama.
- "He laid on sofa without a word. Nanny said he didn't cry, but his brother told me there were some tears. Well, doctor prescribed him strong adult dose. Those were large injections I saw.“
- "Those are good news". father seemed satisfied too.
Milan was on window when he saw white car and nurse that walking to his building with black bag in her hands. He knew exactly that his butt will be tortured soon, but somehow fear and anticipation was much smaller than previous days. He was thinking how to prove mother's words. He calculated that nurse Helena will be the one who will give him that injection. He managed not to cry at two of her three injections.
As soon as nurse entered in the living room he walked to sofa and laid on it. He pulled down his pajama pants down, his pajama shirt up and pulled white briefs till the bottom of his butt.
- "You hurried up like you want that injection" father commented. Milan didn't answer, just think into himself "It is the tenth one"
While first sounds of preparation coming from his left back side he started to imagining the scene that produced them. He imagining every single step of nurse's hand, just as he saw 10 days before. Opening of large boy, taking syringe, opening the small box, attaching needle, cutting vial, drawing medicine from the vial.... Just as he predicted sounds stopped and he hear the nurse is approaching. He felt cold alcohol on his right butt cheek. "Now she will jab that monster".
He felt a jab and tensed his face. Pain was sharp but short. Somehow cold as ice. He relax his face. "Now she will push a plunger". First drops of penicillin caused a burning sensation into his muscle. He tensed his face again. Milky medicine was slowly injecting into already tensed butt. Milan clenched his teeth. Pain didn't decreasing. Burning sensation from penicillin was exchanging with cold pain from needle stacked into tensed muscle. It hurt a lot. He was getting additional strength by tensing himself in effort not to let a voice from his mouth. First drops fall down from clenched eyelids. Nurse felt that plunger reached the bottom of syringe. She placed a cotton next to a needle and quickly removed a syringe from muscle. Milan jumped a bit a let short "ouch". Injection was over.