Trolling through the medical press releases today, I was reminded of the only time I ever told someone that they would die if they didn’t do something. He was about 25 years old, and he’d been bitten by an animal earlier in the day. He didn’t want to get his rabies series, so he decided he’d ask in the pharmacy while he was picking up his prescriptions if it would be okay if he didn’t get the vaccine. He just didn’t want to make the effort, and he wanted someone to help him feel better about his decision.
My words were, “If you have been bitten by an animal, and it has rabies, and you do not get the rabies vaccine, and you become infected, you will die.”
(If you’ve been bitten by an animal, and it has rabies, then it follows that you’ve now got it, too. But I suppose there’s always the off chance that infection didn’t occur…)
It was very strange to hear those words come out of my mouth. Very strange. I remember turning the conversation over in my mind for a few hours afterward, examining it from every conceivable angle. Was I wrong? Had I been too emphatic? Perhaps over-dramatic? Is it possible to be over-dramatic when you’re trying to drive the gravity of a situation home? Perhaps it felt wrong because you can’t be emphatic about much of anything in medicine, so being emphatic feels out-of-place — even when it’s warranted — because the profession itself deals mostly in shades of gray?
People survive being shot in the head with bullets and other objects on a semi-regular basis. But so far, not rabies. (Then again, gunshot wounds are more common than rabies infections, so maybe if n for rabies were a little larger…)
In any event, he ended up getting the vaccine.
[tags]Medicine, pharmacy, rabies[/tags]
You were right on. The reality is the drama; no such thing as being “over”-dramatic in this case. Good for you. (I think I’ll post a similar-type incident; I’ll link to you.)
I cannot tell you how hard it was to convince my doc/clinic to give me the series when I had An Incident with a fox kit. Yes, it was probably not necessary (a scratch from a tooth, really didn’t break through my skin past a few layers; no blood) but hey, if you become infected, you will die.
Funny how someone who doesn’t want it gets the no-holds-barred talk and I got waffling. Mmmm, waffles.
Actually, if you are one 15 year old girl, you did not die. But she seems to be the only survivor. Still, not great odds.
http://www.jsonline.com/story/index.aspx?id=289357
Quite right, Chris. I had actually expounded upong the Milwaukee Protocol and Jeanna Giese’s story, but it detracted from my story, so I chopped it out.
There’s a great deal of controversy over whether her recovery was a fluke or not. I guess we’ll have to wait and see. Hopefully in the meantime, the Milwaukee Protocol can be formalized and studied more.
People survive being shot in the head with bullets and other objects on a semi-regular basis.
Going to the doctor isn’t anybody’s idea of enjoyment. There are typically long waits involved both in the waiting room then once again in the exam room. Nobody wishes to deal with costly co-pays or a physician who cant recall your name without looking at your chart.