A CLASSIC ACCOUNT OF A YOUNG LIFE IRREVERSIBLY ALTERED BY ILLNESS "I know about needles." All her life, Andie Dominick adored her older sister, Denise. She wanted to look like her, talk like her, be her. Unfortunately, she got part of her wish when, at age nine, she was diagnosed with the same disease from which Denise had suffered since age two: juvenile diabetes. In this beautifully written, revelatory, and profoundly affecting memoir, Dominick recounts her transformation from a free-spirited kid who enjoyed giving shots to her stuffed animals with her sister's castaway needles to a life-long patient who must learn to inject herself twice a day. Emotionally charged, tragic, but in the end hopeful, Dominick tells how she found the courage to embrace love and hope in the face of fear, and to live with a disease that has taken so much from her. Chosen in 1999 by the American Library Association as one of the best books for teenagers
I know about needles. My sister leaves them everywhere. I fill her syringes with water, transforming them into mini-water guns. I have diabetic Barbie dolls and cook meals for imaginary diabetic friends. I watch my sister give herself shots, and when she throws the syringe into the bathroom garbage can, I grab it. Looking out for my parents, I sit cross-legged on the tiled floor, remove the orange cap from the syringe, and set the point against the skin on my leg. I long to insert the needle into my body. I don't think about how it will feel, but rather how it will look, protruding from my thigh.
It seems like a natural thing, to give shots. My own pancreas works, but I love playing with the needles. I line my stuffed animals across my bed and shoot each of them with a syringe full of water before dinner. I tell them it will only hurt for a second, and they don't have any choice. They need to have insulin in their furry bodies if they want to eat. I understand the rules about when they have to get their shots, and I wrap my fingers around their arms and legs and push the needle deep. Then I feed them.
My older brother and I have water fights with Denise's needles after school. I dig through the bathroom trash can and pull out her syringes. The orange caps stand out against the crumpled, white tissues. I carefully pull the top off, dip the plastic tube into a sink full of water, and pull the plunger back. With three or four tucked in the pocket of my T-shirt, I surprise Brian watching television in the living room. The stream of water spurts from the end of the syringe onto his face and hair. He reaches out his chubby hand and grabs the empty syringe, throws it to the floor. Then he runs to the bathroom and locks the door behind him, pulls more syringes from the garbage can, and fills those up.
When he emerges, I douse him again. We try to see who can get the other one wetter. I always win; I can run faster. And I have been playing with the needles for years, popping the caps off and pushing the plunger down. I squirt him twice in the time it takes him to hit me once. I know how to keep bubbles out of the syringes too. With a tap of my finger, I can get the pockets of air to the top, push them out, and be armed with a loaded syringe. Brian isn't careful enough when he draws the water from the sink, and when he points his weapon at me, only a few drops dribble out at the end. The expression on his round face is always one of disappointment. Like he should be able to get it right by now. He narrows his eyes at the empty syringe in his hand and bites his bottom lip. I give him a moment to fully realize his mistake, and then I pull the spare from my pocket and squirt water into his eye.
Sometimes I hide my sister's needles in my backpack and take them to school with me. My friends gather along the fence in the corner of the playground, and I pull them out. The girls carefully take the needles from my hand and remove the caps. They examine the metal points with an expression of wonder and lower their bodies onto the grass. We take turns being the doctor, diagnosing rare diseases, giving our advice, and administering the injections. Pretend shots. We always push the caps back on before pressing the syringe against each other's arms.
We are discreet and never get caught by the teachers. I tell my friends it's just a game anyway. We can't get in trouble because we aren't doing anything wrong. I remind them that my older sister takes her needles everywhere. She keeps them in her purse next to two vials of insulin. Even if a teacher sees us, we won't get detention. But we still keep an eye out for the grownups and sit with our backs to the other kids playing on the swings. When the bell rings, I slip the syringes into the deep pocket of my baggy corduroys and head back to class.
All the kids know I have the needles. When older kids ask to see one, I tell them to meet me on the playground at lunch and I'll show them. They surround me as I pull a syringe from my pocket and squat down on the grass. I hold up the plastic tube for them to see, but I don't take the top off. I make them ask. Then when I remove the orange cap, I watch their faces. They narrow their eyes and stare at the tip glistening in the sun. Sometimes they ask if they can take one home. I've even been offered milk money for them. I always say no. I can't trust anyone else with the needle.
Last year I let one of my friends take a syringe home with her. She promised to bring it back the next day, but her mom caught her trying to push it into her younger sister's arm. When the telephone rang in our house that night, I knew I was in trouble. My mother's face grew red as she apologized to the woman on the phone. She told me that I shouldn't be digging in the trash and playing with sharp objects. Not that I shouldn't be taking needles to school or sending them home with other children, but that syringes aren't toys.
Denise doesn't care if I play with them. Sometimes she just hands them to me, saving me the trouble of digging through the trash. On Saturday nights I watch her get ready to go out. Wearing only her underwear, she gazes into the bathroom mirror and runs a thick comb through her long, dark hair. She sprays Jontue cologne all over her body. Then she quickly pops a needle in and out of her thigh. If I'm staring at the syringe in her hand, she'll place the orange cap back on and hold it toward me. I wrap my fingers around it as she turns back to the mirror. She applies mascara and dabs her lips with a piece of toilet paper. I fold my legs under me and balance on the edge of the tub, rolling the thin plastic tube between my fingers. She pulls her tight jeans up over her narrow hips and slips her feet into wooden-heeled shoes. When she climbs into her car and heads out to meet her friends, at a park outside Des Moines, I take the syringe to my room and tuck it deep under my mattress. Under the bedskirt and above the box spring so my mother won't find them. She would be mad if she knew I was collecting them -- the needles belong to my sister.
I'm nine years old when the needles finally start belonging to me. Denise has been away at college for two years, and she took the needles with her when she moved. The only syringes left in the house are the ones I've saved under my mattress, and those are falling apart. The needles have broken off and the numbers on the sides have been rubbed away. The kids at school don't ask to see them anymore, and now I play with my other toys.
Denise comes home on the weekends to see me. She teaches me her old high school cheerleading routines, telling me that if I start practicing early, I'll be guaranteed a spot on the squad when I get to Hoover High. The judges will be impressed at how much I already know. Even though I have to wait six years until high school, I love the sound of our voices yelling in unison. Denise tells me the crowds are noisy and I have to be louder than they are. My voice has to carry over the heads of the spectators and touch the Hoover Husky mascot painted above the last bleacher. Denise always reminds me to make my movements quick and precise. This afternoon I just don't have the energy to jump around.
"What's wrong?" she asks.
"One more routine," she says, cocking her head to the side and studying my face.
And then I lose my balance when I try to do a handstand. She tells me to do it again, knowing I usually have perfect balance on my own. When I get my legs in the air, she steadies them for me. But my arms buckle and I crash down on my head.
I don't cry.
"Are you okay?" she asks, smoothing my brown hair away from my face.
I just stare at her. Her green eyes squint in the summer sun, and the freckles on her nose are only noticeable because her face is so near mine. The wind blows a long strand of dark hair across her cheek. I am dizzy and she almost doesn't look real.
Denise tries to take me inside the house right way, but I tell her I want to ride my bike for a while first. Alone. For two hours I slowly ride up and down my parents' driveway. In the summer, I ride back and forth, garage to the curb, curb to the garage, all day. Usually I imagine I'm a police officer monitoring the traffic on a highway or I'm on a long road trip to see my grandmother. My brother and I have drawn lines with chalk to separate the driveway into lanes, and we've made parking spaces up next to the garage. My dad cut us signs out of cardboard that say POLICE PARKING ONLY. I write tickets to my friends if they park their bikes in my spot. Most days I pretend I'm chasing bank robbers. But now I think about the way my sister was looking at me when I couldn't do a handstand. A look somewhere between disappointment and concern.
When I finally go inside, my dad asks me to pee in a cup. I know what's going on. Denise has told my father to test my urine for sugar. She stares at my skinny legs as I take the cup from my father's hand and turn my back on her. I blame her for this, and while I'm in the bathroom, I think about mixing water with the urine, diluting it just in case sugar does show up in the test. The water will do something. It occurs to me to just put pure water in the cup, but I know my dad will notice that the fluid is too clear. He's been doing these tests for years. He knows what pee smells like. I hold the cup under the water faucet for several seconds. Weighing my options. Knowing in the back of my mind that eventually the truth will come out anyway. Finally, I pee in the cup and set it on the counter.
The orange cap of a syringe in the trash can catches my eye. It looks out of place now that Denise has been gone so long. She must have given herself a shot in the bathroom today. I sit down on the floor and pull it out. It feels familiar between my fingertips. I pull off the top and stare at the shiny metal. I want to break it off, but I don't. Instead I set the point against the skin on my bare leg, but I can't get up the courage to push it into my skin. I think about slipping it into my tennis shoe and taking it to my room. But I push the cap firmly back on and throw it into the trash can instead.
I walk past my family in the living room, glancing at them briefly and raising my eyebrows. My mother won't look at me. She is slumped into a chair against the wall. Her broad shoulders are small under her green shirt. She's running her thick fingers through her brown hair as she stares out the window. My sister is perched on the edge of the coffee table and looks up at me. I glare at her, hoping she's sorry now for telling my parents. My dad just winks at me like everything will be okay. Like he doesn't want to conduct the test any more than I wanted to pee in that plastic cup. He steadies his large hand on the side of the chair and eases his tall frame forward. I walk past the three of them and slam my bedroom door behind me.
I hear my dad in the bathroom. I know what he's doing. Mixing five drops of urine with ten drops of water in a test tube. Pulling a tablet from the glass bottle with a rusty pair of tweezers and dropping the pill into the solution. Waiting for the color to change. And I know by the soft knock on my door that the color in the test tube is probably orange from too much sugar in my urine. If the test had come back a negative blue, he would have knocked louder.
"Come in," I yell, jumping up and grabbing the miniature blender off my doll's refrigerator, pretending now that I have forgotten about the test. I act like it's any other night and I'm just making dinner for my dolls. I don't even turn around when he opens the door. I put my beanbag clown in his high chair and stir air in the pan on my stove. My father sits on the edge of my bed, rubbing his left temple and staring at me for a long time before he speaks.
"Andie, we're going to have to go to the hospital soon."
I start feeding my clown.
"We don't have to go right away," he says. Then he takes a deep breath. "But we'll probably have to go eventually."
There's fear in his voice and I start to cry. He walks over to me and takes the spoon and plate out of my hand, carries me to my bed, and holds me close to his chest. I press my cheek against the red cotton polo he wears every Saturday. He clutches me tightly to him. I don't know how much time passes, but when I open my eyes, and am finally breathing normally, it is getting dark outside. He starts talking again.
"We can try some other things first," he says. "Maybe cutting sugar out of your diet for a while. We'll see if we can't get the tests back down to negative."
I nod in agreement. I know what he's talking about. We watched a show on television a few weeks ago about two young diabetics who avoided insulin injections by not eating refined sugar. The kids went almost a year without giving themselves shots and had gained weight and seemed to be growing fine.
"It's worth a try. And even if we have to go to the hospital, you know it's going to be okay, Andrea. You know that we'll handle it as it comes."
I nod again, but a lump forms in my throat. I know too much. I realize the difference between playing water games with the needles and owning them. Between longing to put one in my body and having to. And my father knows as he kisses me on the forehead that I'm going to grow up more quickly. Responsibility has entered my life, and I'm going to grow up like my sister did.
"Are you ready for dinner?" he asks.
"I'm not hungry," I reply, exhausted from all the tears.
"Okay, kiddo." He squeezes my hand and leaves without looking back at me. He closes the door softly behind him.
I stare at the wall and remember Denise telling me that doctors used to diagnose diabetes by tasting the patient's urine. If they thought sugar was present, the person had to drink his own urine. Sugar was escaping and the person needed to replace it. Get the sweetness back in their bodies. And diabetics died because there was nothing that could be done for them, especially younger diabetics. Their cases were more severe. Denise told me that the needle was a great thing, a lifesaver. I remember agreeing. I said I would choose the needle over drinking my own pee.
"Hey there," Denise says, tapping on the door with her knuckle while she opens it.
I ignore her.
"You gonna lie in here all night?" she asks. "Why don't we take a walk, just you and me?"
I turn my head to the wall and stare at a single rose on my wallpaper.
"Are you mad at me?" she asks.
"Why'd you tell them?" I reply, my voice cracking. "You didn't have to go telling Dad before you asked me. You didn't have to tattle just because I couldn't do a handstand."
She slowly lets all of the air out of her lungs. "Maybe you're right. It's just that you'll feel a lot better after we get you to see a doctor. They can make you better."
"I don't feel bad now," I reply.
I won't turn my head, but I know she's looking around my room, trying to think of something to say.
"Go back to school," I tell her.
"Come on, Andie," she says. The springs of my mattress squeak as she lowers herself onto the bed. I inch closer to the wall.
"Leave me alone."
Denise has given me her disease. It's been hers for almost twenty years, and now it's mine. My mother has told me the stories of Denise's childhood. She was only two years old when she got diabetes. My parents say the doctors and nurses didn't know anything in 1962. It was like Denise was the first diabetic child the hospital had ever treated. My mother describes it as one disaster after another -- trying to get my sister to sit still for the painful injections every day, having trouble getting her blood sugars regulated. Denise was in the hospital for twenty-one days.
My parents left there feeling like they knew nothing. They learned about diabetes on their own, checking out books from the library and contacting pediatric doctors around the country with questions. My parents were scared, and they thought Denise was going to die. Eventually they learned how to control the disease, but they didn't know how to control my screaming sister at home. She cried every day when it was time for her shots. Before my father left for the office in the morning, he set my sister on the kitchen table and held on to her while my mom stuck the needle into Denise's skinny leg. Then they gave her another shot before dinner. My mother says they didn't have any choice. Those first needles were like nails.
They used a large glass hypodermic syringe. My mother boiled it in water once a week for five minutes and stored it in a jar of alcohol. Twice a day she pulled it from the jar and pumped it dry before filling it with insulin. She used that same syringe for years. The needle grew dull, and it was hard to get it into my sister's leg, but no one would sell disposable needles to the public. It got harder and harder to get the point through Denise's skin, and my mother finally begged a supply company to sell her some disposable needles. The representative on the phone felt bad, said he couldn't imagine a child that young in so much pain. He finally sold my mom the needles.
Those were sharper, but they were still thick. And Denise still screamed when my father set her on the table. When she figured out that screaming wasn't going to put an end to the injections, she started running from my parents. Instead of chasing after her, they would go ahead with dinner and wait for Denise to come out. She knew she couldn't eat until the needle was pushed into her flesh. Finally, she would appear in the doorway of the kitchen. My dad pushed their plates back and set my sister on the round oak table. My mom grabbed the syringe before Denise could change her mind.
My parents kept notes on everything back then. My mother wrote down what Denise ate at every meal, what color the solution in the test tube was, when Denise had insulin reactions, how much insulin they gave her. The insulin wasn't as concentrated as it is now, so the big syringe was full of the fluid when they put the needle into my sister's leg. My mom taped charts to the refrigerator and then took them to the doctor. For years she wrote down everything. She still has all the old charts buried underneath magazine articles and papers in the basement.
Sometimes my sister hid the syringe. She would climb up onto the kitchen countertop and pull it out of the jar, carry it off to her room. My father knew where to find it. Running his hands carefully over the carpet under her bed, he'd pull the syringe out from between books and stuffed animals. Back to the jar of alcohol it went. This went on until she was six. Then she started giving her own shots. And as she grew up, the needles became thinner and sharper. Now the packages read "microfine" and "designed for comfort." These are the thin needles I used to play with. The ones my sister owned.
My sister and I look alike. My mom digs out old pictures and shows me the resemblance. We both have green, squinty eyes. Our noses are the same shape. My mom says that when I was little, I did things that reminded her of my sister all the time. My teachers call me Denise by accident. They look down at their attendance sheets, see the last name, and call me Denise. They say something about how quickly time passes.
This bedroom used to be Denise's. She picked out this wallpaper with the pink roses on her sixth birthday -- years before I was born. My mother has told me the story of how this room became mine. When my mom got pregnant with me, Denise started rearranging the furniture in this bedroom, telling them that she was going to share her room with her little sister. My sister said she knew it was going to be a girl. God would not make her live with another brother like Brian. When my parents laughed and told her I should have my own room, she moved upstairs next door to Brian, saying she agreed the baby should probably be in the room next to theirs and she would just visit. But after I was born she never actually slept up there. My parents would tuck her into bed and the next morning they would find her wrapped in a blanket, sleeping in my room. There is a picture of Denise lying on the floor next to my crib, one arm wrapped around the wooden leg and the other holding my doll. She is almost a teenager in the photograph, but curled up on the shag carpet, she looks like a small child.
My sister's hand is on the back of my neck. My body tenses up when she leans down and kisses the top of my head. I try to ignore her, but she gently turns my thin body over. She smooths the wrinkles on my bedspread and tells me it's not going to be that bad. Things will be different, but everything will be all right. She rubs her left temple and says I'm going to grow up to be a beautiful, smart, and responsible woman. She tells me I'm going to have a happy life. Even if the needles belong to me.
Andie Dominick grew up in Des Moines, Iowa, and received her master’s degree in English from Iowa State University. She won the 1995 Writer's Digest Award for Best Essay for a piece that appears in altered form in Needles. She lives in Des Moines with her husband and dogs.
Sharman Stein Chicago Tribune Needles is a strong story and quite vivid.
Mary Swander author of Out of This World Anyone who has ever been challenged by an illness, anyone who has had an ill relative, or anyone who simply wants a greater insight into the human condition will want to read this book. And read it again.
Whitney Scott Booklist Graceful, elegant prose....[Dominick] has made some measure of peace with loss and developed the spirit not only to go on but to write absorbingly about the experience of disease.
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