"If you become infected, you will die."

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]