There’s really nothing quite like the experience of being very sick (or potentially very sick) in a foreign country. Like if you think you might have rabies, for example.
I recently had such an experience in Vietnam. I visited an island in the very picturesque Ha Long Bay called Monkey Island. What no one told me, but what I was soon to find out, was that the monkeys on this island are stupidly aggressive.
So I’m taking this moment to tell you now: if you visit Monkey Island in Vietnam, please be VERY cautious of the monkeys.
I crouched down to take a harmless photo of a monkey about six feet away. The monkey looked up from its grooming, saw the camera, and reacted like Björk to paparazzi.
I took one step back, then two, then started running backwards, performing the kind of high knees that my university cross country coach would be proud of. The cute-monkey-turned-terrifying-beast rapidly gained ground as a Spanish-speaking idiot yelled “ataque!” while filming the encounter on his phone. Pendejo.
Plot twist – a monkey behind me sinks its teeth into my left calf, stopping the rapidly approaching one in its tracks. Maybe monkey gentleman’s code says that only one monkey can bite one tourist at a time?
I look down, bewildered, at this newcomer to the plot. It still has its teeth planted firmly in my leg and is looking up at me curiously. If it weren’t for the fact that it was actively biting me, I would think it was only saying hello.
The minor trauma of being bitten by a wild animal is enhanced for me by the fact that I am normally very cautious of wildlife. I don’t get too close, don’t try to touch, nor do I attempt to aggravate. When people get bitten by animals, I tend to assume that the human was probably asking for it. After all, I’ve seen instances where real actual people have sat on tortoises in animal reserves, attempted to pick up wild iguanas in the Galapagos, and have generally treated wild animals like domesticated ones. In Thailand, I witnessed a monkey bite a tourist because he was manhandling a baby monkey. “Good.” I thought. Being bit by a monkey in Monkey Island was humiliating for me. Maybe I was getting a taste of my own medicine?
At least in this encounter, I was lucky in that I had a friend with me. Illnesses in foreign countries are infinitely scarier when you’re by yourself. This time I had someone to cry to and to tell me it wasn’t my fault that the monkey bit me.
Back on the boat, I washed the wound. Arguably, it was not much of a wound. The monkey bit me through my leggings, and there was only a tiny drop of blood that bloomed about a minute after the incident. But the cycle of panic and doubt began anyways. You don’t fuck with rabies.
When we returned to the hotel on scenic Cat Ba Island, I began the inquiries.
“A monkey bit me,” I tell the 12-year-old boy at the hotel – the only English-speaking family member at this family-run hotel. Between questing, or whatever it is they do, on Minecraft, he giggles at my predicament. In Vietnamese, he shouts my story to the other family members, who also giggle. The response is frustrating, but also hopeful. I assume the reaction carries the proportionate weight of the situation – and a giggle is not very serious.
The mother says something to me in Vietnamese and slaps her arm. The boy, still absorbed in his computer game, translates.
“She says she’s been bitten by monkeys twice and she’s never had a rabies vaccine.”
Nonetheless, I wanted a professional opinion. There were no hospitals or clinics on Cat Ba Island that carried the rabies vaccine, so the only option was to go early to try to make it to the nearest town that had the vaccine available, Hai Phong, and to do it within the 24-hour window.
At 8am the next morning, we arrive in Hai Phong only to discover that the vaccination center is closed during the lunar new year. Needless to say, I was more than baffled. I was angry. I was indignant. I was beyond belief. Doesn’t anyone know how rabies works? There’s only a 24-hour ticket to safety, for Christ’s sake. My increasing frustration and visible distress were met with nonchalance at best and outright dismissiveness at worst.
And because my anxiety is always multifaceted and multilayered, this distress was also coupled with my worry that I was being a ridiculous tourist – insensitive to the culture of the country I’m visiting and quick to react with indignation. Perhaps their coolness was merely a sign that this was a non-issue. Maybe rabies doesn’t exist in monkeys on Monkey Island. It seemed preposterous to think that a people as a whole could be so cold to a potentially very dangerous situation. Or maybe this was just their way of controlling the tourist population. (Kidding).
My friend and I boarded the bus back to Cat Ba Island and I assumed that if I wasn’t frothing at the mouth the next day, then I was okay.
But in the following week, I had plenty of time for paranoia to set in. I checked and rechecked symptoms and learned about rabies transmission.
I learned that rabies has an incubation period of a few days to multiple years (depending on which medical website you’re consulting). During that time, the virus is traveling through the body via nerves in an attempt to reach the brain. Many factors play into the variation of incubation time, including site of the bite, severity of the bite, type of rabies, and health of the bite victim. Once the virus reaches the brain, it is nearly always fatal.
If the discomfort of illness (or potential illness) is bad within the calming presence of a companion, it is immensely worse alone. At the end of two weeks, my friend went back home to return to his job. The vacuum left in that absence was quickly filled with panic about a deadly virus potentially making its way from my leg to my brain. Every minor muscle spasm or stomach upset or agitation was suddenly a clear sign of the virus.
And, the internet being the internet, information on rabies differed on each site I looked at. One claimed that the rabies virus was very fragile. Any amount of exposure to open air without reaching the bloodstream spells immediate doom for the virus. I reassured myself by recognizing that between the leggings and the delayed appearance of blood on the bite, saliva and blood probably never even became acquainted. But another site warned that even the most trivial of bites carry the risk of infection.
Ostensibly, anxiety is a symptom of rabies. I am a naturally anxious person but during this time I was also stressed about career options, worried about relationships, and was applying for a Chinese visa – a hectic endeavor in its own right. The anxiety made me feel crazy and the crazy made me feel rabid.
I eventually decided that I couldn’t spend the next seven years with the shadow of rabies hanging over my head. I just wanted to go back to regular ol’ stress and anxiety that didn’t carry with it the extra weight of my own mortality. So I went to a vaccination center in Hanoi.
Having been to various hospitals in different countries, I can certainly say that each culture has its own unique bedside manner. In the United States, doctors tend to be very accommodating and reassuring, sometimes to the point where you receive more euphemism than diagnosis. In Vietnam, doctors seem to be much more practical and straightforward.
When I told the doctor at the vaccination center in Hanoi that I was bitten by a monkey two weeks ago, he didn’t beat around the bush.
“Not good,” he admonished. He then asked if I had ever had rabies shots before.
Why yes. In 2016 I was bit by a dog in India. India has a history of rabies problems, and dogs anywhere in the world are the most common carriers and transmitters of rabies. The upside to this is that rabies vaccinations are highly available in hospitals in India, so I didn’t have the same problem finding vaccinations there as I did in Vietnam. I traveled from place to place in India, always making sure I was in a town with a hospital when my handy-dandy rabies schedule said that I needed another shot – five in total. The last destination on my rabies-hospital tour even took me to Pokhara, Nepal. I’m becoming like the Steve Ludwin of rabies. Perhaps I’m immune now?
I told the doctor that I had had five rabies shots in 2016. He instantly perked up and even shook my hand. The message was clear: this isn’t ideal but congrats! You’re going to live. I laughed near-hysterically at the relief I felt.
Rabies vaccinations work by introducing antibodies to the virus into your system. This is why doctors recommend that people traveling to countries that carry a risk of rabies get a pre-exposure vaccination. It won’t save you, but it will help slow the spread of the virus. Since I had five rabies vaccinations in the past, I apparently already had enough antibodies to warrant only a two-time vaccination two weeks from the incident. Thank you dog?