Mad Dog Disease

Photo: G Cooper. The Waiting Room.

The patient took hold of the glass. He tried to take a sip of the water, but it was clear that he was very frightened. His hands shook. The doctor, a female physician from Australia, said to me quietly, ‘Hydrophobia. Mad dog disease. He has rabies’.

This happened in 1976 in Nepal. The sick man had come to Tansen Hospital to seek help – a feral dog had bitten him a couple of weeks earlier.

‘What will you do?’ I asked.

‘We’ll have to send him home,’ she replied. ‘There is no cure and he will die of rabies. It would be dangerous for our nurses to keep him here. The family will take care of him.’

I was concerned about this decision.

Later in the week I was working with Dr Jonathan Yoder, an American surgeon for whom I had great respect. I told him the story.

‘I understand why you are worried,’ he said. ‘But I remember when I was working in India in the 50s and the son of the hospital’s medical director developed rabies. They tried to take care of him, keeping him in a room on his own. But he was delirious and steadily getting worse. He escaped from the room and was running back and forth in the garden of the hospital frightening everyone. A policeman came with a rifle and shot him dead.’

When I returned to Nepal in 1988, I heard nothing of rabies although dogs which appeared to be pretty wild were common in the streets of Patan, near Kathmandhu, where I was working in June. In the sultry nights, dogs could be heard barking as if they were running through the streets of the town up to some sort of mischief.

We were living, my wife and I, in a flat within the hospital compound which had a high wall around it. During daylight hours an attendant kept a watchful eye on the people who were coming and going; at night there were streetlights.  

Before I finished my spell of work in Patan, however, we were invited to dinner at the house of a physician and his family who lived in the town itself. It was nearly ten o’ clock at night when we were walking back to the hospital compound through the dark lanes – no-one else was about in them.

At the very moment we came round the corner fifty yards away from the main gate, there was furious barking and we saw seven or eight dogs running quickly towards us.

We stood where we were and didn’t move a muscle. There was no way of escape. Neither of us said a word as the dogs closed in on us.

When they were only a couple of yards away, they suddenly stopped. They sniffed the air. Then they turned round and ran off down the road, barking again.

It felt like a dream.

As soon as I came to, my first thought was that someone on the other side of the world had been praying for us.

Postscript. There is no cure for rabies once symptoms develop. Nowadays in countries where rabies is common and where there are medical resources a person would receive anti-rabies immunisation if he or she went to a physician as soon as possible after being attacked by a dog (PEP – post-exposure prophylaxis). The WHO has estimated that over 29 million of these prophylactic vaccinations are being given each year, preventing hundreds of thousands of human deaths from rabies.

https://www.who.int/news-room/fact-sheets/detail/rabies