As I turned the cold doorknob and entered the exam room, my ten-year-old patient quickly wiped away the tears on her face. Her father waved me in and happily introduced himself. My patient stood next to the desk, eyes red and quiet, as I sat down nervously.
“Hi,” she stated abruptly.
“Hello,” I paused, debating in my head what to say next. “What’s going on"?” I asked her, trying to assess her crying without making her feel uncomfortable.
“Well,” she started, as her eyes began to well up again, “I’m afraid of having to get a shot.” Her nose becoming redder by the second, I racked my brain about what to do. I knew she would likely have to get a shot, maybe even two. I did not want to lie to her, but I also wanted her to like me. I wanted her to trust me. I took a deep breath and tried to draw on my now rusty camp counselor skills.
“I can’t promise that you won’t need any shots today,” I started. Her shoulders drew up, her breath quickening with each moment that passed.
“But, I have a secret handshake we can do.”
“Really?” She paused. Her face turned from acceptance to skepticism. “What is it?”
“You hold your hand like this,” I said, as I placed her hand inside mine, “and the amazing part is that you can squeeze my hand as hard as you want, and it won’t hurt me event one bit. You squeeze my hand as hard as you possibly can while you get your shot, and I’ll be right here with you.” I stated it in as matter-of-fact a way as I could, trying to convince her confidently that this might actually work.
She stared at me, looked at our hands, and asked, “Can I try it right now?”
“Let’s see what you’ve got.”
She squeezed with all her might, scrunching her face together and bracing herself on the desk. I sat back, smiling at her, while her father laughed silently behind her.
“Okay,” she stated promptly, letting go of my hand. “This will work.”
“Perfect,” I said smiling.
I proceeded with our usual questions, finding out about her busy summer, her lack-of-vegetables diet, and her excitement for the fifth grade. Her face returned to its normal color, and she was far more talkative than I could have imagined when we first met. By the time the attending came in, I had more than enough information to present to her.
The 15-minute appointment flew by and before we knew it, it was time for her shot. She was shaky as she sat up on the exam table. Her eyes started to redden again as they darted around the room. I expressed her worries to the attending and told her about the deal we had struck.
As the attending prepared the spring, the patient’s father and I went to stand by her at the bedside. She gulped, and the tears started to flow.
“Ah, I don’t know. I’m scared. I can’t do this. Ah, please, no.” The words rushed out of her mouth, barely keeping up with the speed of her thoughts.
I placed her hand inside mine.
“Let’s see how hard you can squeeze,” I said, making eye contact and trying to enlist the trust she had given me. She squeezed away, closing her eyes shut as the tears streamed down her cheeks. The attending cleaned her arm, and our patient let out a small yelp. The syringe quickly followed, and I felt her hand around mine with renewed force.
“Done,” the attending stated. The patient opened her eyes in surprise. She looked at her father, looked at the attending, and then looked at me. Her eyebrows were raised, and her straight dark hair bounced as she looked around.
“I didn’t even feel it,” she laughed. She looked down at the band-aid on her shoulder. She then hopped off the table and looked back at us, as if it had never happened at all.
“Well, we’re done right?” she said, breaking the silence that had settled into the room. We all laughed. Yes, indeed, we were done for today. She began to head out the door when she turned around and waved at me.
“Thanks!” she said, looking at me. I smiled and waved back, realizing that a shot at the doctor’s office can sometimes be the scariest part of the patients’ day, and that a little trust, or a secret handshake, can help them through it.