Alyssa Hummel rolled the tiny glass bottle between the palms of her hands, mixing the insulin inside and warming it up.
"It stings when it's cold," the 13-year-old explained.
Chief, Alyssa's diabetic Chihuahua, looked up at her warily.
The seventh-grader put the bottle down on the coffee table in her Staunton, Va., house, then picked up a hypodermic needle and pulled back on the plunger. Each of her pink-painted fingernails was decorated with a tiny daisy, and five rubber bracelets were bunched on her right wrist.
"Then I have to draw some air into it," she said. "I'm going to give him five units, so I draw five units of air."
Alyssa picked up the now-warm insulin and poked the tip of the needle into the bottle's rubber stopper. "Then I draw the amount I'm going to give him."
She pushed on the plunger, then slowly pulled it back about a quarter of an inch.
Chief wasn't running away, exactly, but his habit of trotting up and pawing at the shin of anyone near him in search of a nice scratch had disappeared. He'd stopped making eye contact with Alyssa, too.
"Oh, poor thing," she said. "He knows it's coming."
Alyssa's mom, Kim Cormier, hadn't expected to keep Chief. He came into their lives in February, when the Mosby Foundation, a Staunton charity that works with at-risk dogs, asked Kim to foster him for a while.
She said okay, but only temporarily. They already had three dogs.
"No more dogs," Kim told them. "This is plenty for our family."
Chief had trouble adjusting at first. He's 4 years old, weighs seven pounds and has dark brown fur and a drill sergeant's self-confidence. But his diabetes had affected his eyesight, made him prone to, um, accidents and required twice-a-day injections. His former owner just couldn't care for him anymore.
A lot of families wouldn't have made the effort. Alyssa, however, thought it was kind of cool that Chief had diabetes. "Because now there's someone like me in the family," she said.
When she was 5 and about to enter kindergarten, Alyssa learned she was diabetic. Her mother held it together in the doctor's office after getting the news. She kept her composure all the way out to the car. And then the tears came.
Alyssa gave her mom the sticker the doctor had given her as a treat. Then she asked if she was going to die. "Because of the word: die-abetes," said Kim.
No, Kim told her, it didn't mean she was going to die, just that Alyssa's life was now very complicated. "It was a fact of life, and we had to deal with it the best way we could and not let it get us down," said Kim.
Alyssa measures her blood sugar six to eight times a day. She calculates every carb she eats and how much time she spends exercising. (She's big into gymnastics and ice skating.)
She started giving herself insulin shots three weeks after her diagnosis: a 5-year-old who could wield a mean syringe. "I just didn't want anyone doing it anymore after I figured out how to do it," she explained. Then she started giving her elementary school art teacher his allergy shots.
"He knew I knew how to do them."
Two years ago, Alyssa got an insulin pump, a pager-like device she wears on her waist. A tube runs from the insulin-filled pump to a needle that's inserted under her skin and that she moves every three days to prevent infection.
One afternoon last week, Alyssa sat barefoot on the wooden floor of her living room. She scooped Chief up in her hands and propped him between her knees as he fussed a little.
"Stay still, Chiefy," she cooed. "Chief -- now, now, baby."
Chief might look small, but no dog thinks he's a small dog. Every dog thinks he is the exact right size. It's the other dogs that are either small dogs or big dogs.
Chief has found his place in this house of canines: Perdita, the Dalmatian and top dog; BB, the psychotic but loveable poodle-Pekingese mix; Spunky, the affectionate and always hungry dachshund. And don't forget the humans: Alyssa's bouncing baby brother, Tristan, her 15-year-old sister, Tara, and Kim's husband, Joe.
They're a family that takes things in stride.
Alyssa pinched up the scruff of Chief's neck and gently pushed the needle into the folds of skin. She pushed on the plunger as he squirmed.
"I do it in the scruff of his neck because that's where I think it hurts the least," she said.
Kim thinks a lot about the future. Her daughter is growing up, as teenage girls do. Soon Alyssa won't have someone there to remind her to carry test strips or batteries for her pump, or to check her blood sugar before dozing off at night.
"She's going to be all in charge of her own life someday," Kim said.
She's doing a pretty good job already.
The syringe empty, Alyssa pulled the needle out and produced a doggy treat. "You want a cookie?" she asked Chief. "You want a cookie, baby?"
Not surprisingly, he did.
Karen Edwards lives in the other Washington: the state. A bridge near Tri-Cities has flashing lights that are turned on if there is a problem. A sign warns, "Use Extreme Caution When Flashing."
Said Karen: "I would always use extreme caution when flashing, because I wouldn't want to get caught."
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