DOOMED TO RABIES?

Pie Darkstone

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October 30, 2014

Dr. xxxxxxxxxxxxx

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RE: October 15 Appointment Presenting with Bat Attack/Rabies Exposure

Dear Dr. Xxxx,

I visited your office the day following a bat attack. You briefly looked through my hair on the side of my head and found one small scratch.You told me at that time my exposure to rabies presented an insignificant risk. You told me it had been 30 years or more since you'd had to deal with rabies and knew that your office didn't keep the vaccine on hand. I was told to go home and wait to be contacted by your nurse by that Friday.

I was indeed contacted by your nurse on Friday, October 17, at 11:49AM—eleven minutes before your office closed for the day and for the weekend. She gave me the name, XXXX XXXX, and the phone number to the health department. I later found out that XXXX XXXX is “The Rabies Man” at the county health department office. I had to call him myself in order to reach him, he then immediately returned my call.

I told Mr. XXXX I had been attacked by a bat on October 14 at 2:30AM. His response was, “OH DEAR LORD! Drop what you are doing right this minute and go to  XXXXXXX's Emergency Room—they are the only location here with the vaccine. Don't waste any time, go there NOW! There is a very short window of time to get treatment, GO NOW! I will call you later this evening to follow up. GO NOW!” I am not exaggerating his response in the least. He was very brief, very terse, and where I have used capital letters, was practically shouting into the phone.

I went immediately to XXXXXXX's ER. Initially I was told that I was already out of time, that I was no longer in the protocol window for optimal treatment. Treatment should begin within 72 hours. I demanded the shots, saying,”You're going to doom me to rabies because I'm a few hours late? You're kidding me, right? Give me the shots. Now.” I got the shots. I hope they work, that's all I CAN do, since you should have sent me for treatment IMMEDIATELY, the very day I came to see you.

Before treatment began I was given a pain pill and an anti-nausea drug. The ER nurses then went through the entire side of my head with a fine toothed comb and a magnifying glass. They found multiple bites and scratches, at least one of the wounds being “very deep.” Each bite or scratch had to be injected with immunoglobulin, using up 3 syringes in the process, and was extremely painful. The remaining 9 syringes of immunoglobulin was injected into my thigh. I then got one vial of vaccine and a tetanus shot for good measure. I returned on October 20, and October 24 for more vaccine. My last treatment will be on November 7.

I have since learned from Mr. XXXX and the CDC that any contact with a bat, especially if bites or scratches are involved, is considered a category III contact. The fact that the bat attacked me while I was sitting still further indicates that something was wrong with it, that it was likely ill, and very likely rabid. Bites on the head or hands, because of the relative density of nerve endings, are considered higher-risk exposures.

Bats are a major vector of rabies in the state of Arkansas. ANY contact with a bat should result in immediate treatment. Even if a bat is found inside a house, the occupants of the house should all seek treatment. My attack was not a thing to be taken lightly or considered “insignificant.”

Dr. XXXX, I am sending you this letter for a number of reasons, the first being that this never happens to another patient of yours. Hopefully you will spread this information to other doctors in your clinic to make sure it does not happen to any of their patients either.

Secondly, I realize that XXXXXXX's Hospital is your competitor. However, they are the only repository of rabies vaccine in this area. Unless XXXXXXXXXX Hospital intends to keep the vaccine on hand, you should not hesitate to send your potential rabies victims to XXXXXXXXXX's Hospital for treatment, and do not waste any time in doing so.

Thirdly, it should not have been left up to me to contact the health department to find out about treatment. This rabies information should have been gotten immediately by your staff while I was in your office. Instead, my case was treated lackadaisically.

Lastly, I was attacked and bitten by the animal on October 14 at 2:30AM. My treatment began approximately 84 hours after the attack and 12 hours out of the protocol window. I think you're a good doctor otherwise, but you really fumbled the ball here. Not just you, but your entire staff is involved. Surely I needn't remind you of the fatality rate of rabies? Bat attacks should never be taken lightly, and certainly not shoved to the side until it's convenient for a nurse to phone the health department. For God's sake and the sake of any future bat attack patients, get them treatment IMMEDIATELY.

I intend to remain your patient. As I said, I think you're a good doctor for regular problems and I actually really like you. I really have no complaints other than this one big giant huge complaint. That's why I am sending you this letter instead of sending it to an attorney. Please understand I am trying to be as tactful as I can while still urgently making my point.

Sincerely,