I shot up in bed and scrambled madly for my phone: 1.03 am.
I quickly ran through my mental checklist. I had 20 patients in the ward – all of them alive last I checked, which was three hours ago. I’d given the pneumonia patients their antibiotic shots, had made sure all the diabetics had gotten their insulin, the heart patients their BP tablets, and I wasn’t on call duty.
So why on earth was I getting a phone call in the middle of the night?
Shoving my glasses over my nose, I peered at the caller-ID. My stomach dropped when I saw who it was. Tenacious didn’t even begin to describe this woman. I knew she would just keep calling until I answered.
The Dog-Bite Nurse. In just under a week, this woman had managed to become the bane of my existence. I was constantly fielding her phone calls – during meals, while driving, in movie theatres, and now, in the middle of the night.
I took a deep breath and answered the phone.
“DOCTOR!”, came the ear-splitting shriek. God, you’d think she was personally witnessing the apocalypse. “We have a case,” she announced. “Come at once!”
Let me give you some background on the situation. Every intern in the department of general medicine is expected to manage the infectious diseases ward for two weeks each, during which period they are in charge of tending to people with serious dog bite injuries. Anyone who shows up after being bitten by a dog is given the standard tetanus and rabies vaccines in the emergency department, where the wound is assessed. Those with minor scratches are sent on their way with instructions to complete all four doses of the rabies vaccine. On the other hand, if the wound is deeper than the skin, it requires administration of the anti-rabies immunoglobulin by the intern-in-charge (me, in this case). Hence the doomsday phone calls I was currently receiving.
I trudged along unhappily, all the while cursing nurses, dogs, and the entirety of mankind. I found the Dog-Bite Nurse sitting at her desk at the entrance of the ward. She did not even look up from her phone. Throwing her a dirty look (not that she noticed), I stormed inside.
“Paati got bitten by our dog,” a frazzled teenage girl told me, gesticulating wildly at her grandmother. Bite was an understatement; her left leg pretty much looked like it had been chewed on. I had to concur with the Dog-Bite Nurse’s non-verbal assessment of the situation – this was, indeed, serious.
My train of thought was interrupted by Paati herself, who was annoyed at her granddaughter’s histrionics and snapped at her to be quiet. The girl proceeded to burst into tears.
Now completely fed up, Paati turned her attention to me. I meekly asked her what happened. “I was only feeding Gopi some leftover chicken biryani. The poor thing must have mistaken my leg for a chicken leg piece. That’s all,” she barked, as if she was annoyed by the interruption to her day.
My cheap ball-point pen hovered over the case sheet, as I pondered what to write. Now, it is drilled into our heads that history must always be recorded in the patient’s own words. I imagined the look on the formidable duty assistant’s face if I actually wrote this down. Forget it. A systematic approach was needed.
First, the date, time and location of the incident. Okay, that was straightforward enough. Next, was it a stray dog or a pet dog? Easy, pet dog. Now for the million-dollar question. Was it a provoked or an unprovoked bite? I considered. Maybe the dog really didn’t like biryani? The duty assistant’s face flashed in front of me. Unprovoked, I wrote.
After sending Paati on her way with instructions to come back for the remaining three vaccine doses, I stepped out and found my path blocked by what looked like a canine gang-war. Coincidence or cosmic irony? I winced as a particularly loud howl pierced my ear. With a sigh, I plonked myself down on a bench. Nothing to do but wait it out. I checked my phone: 2.36 am. Ruing the loss of sleep, I halfheartedly typed ‘Rabies’ into the Google search box.
Twenty minutes later, I had learned that around 20,000 people die of rabies yearly in India. Talk about a sobering statistic – made more so by the fact that the rabies vaccine has been around since 1885. Though it is now fully preventable, the Dog-Bite Saga continues. Stray dogs remain unaccounted for. Supply of vaccines is sketchy in a lot of places. And it is not a notifiable disease.
Though we assume that public awareness about rabies is commonplace, 30% of Indians actually don’t even know what it is, a study shows. So, start telling people. Tell your maid, tell the watchman, tell the woman who sweeps your office in the morning. Sure, people might roll their eyes and call you a preachy bore. But it might also save someone’s life.
Sowmya Kruttiventi is a newly minted doctor trying do her bit to contribute to the Sisyphean task of public health education in India. She tweets @semya_k.
Featured image credit: Reuters