Armchair Expert with Dax Shepard - Flightless Bird: Rabies

Episode Date: March 21, 2023

In this week’s Flightless Bird, David Farrier gets bitten by a squirrel, forcing him to come face-to-face with his greatest nightmare: rabies. Why does this virus have a near 100% mortality rate and how are you meant to be treated for it? David joins the 60,000 Americans who find themselves having to reckon with the risk of rabies every year, whether they are bitten by dogs, raccoons, bats… or in David’s case, a squirrel. To learn more, David meets fellow victims Courtney and Paul, who all had to have jabs in their arms, legs, and butts! David discovers that American emergency rooms can be very expensive and that rabies makes you terrified of water! For more on his rabies encounter, see Farrier’s newsletter Webworm: https://www.webworm.co/p/rabies Learn more about your ad choices. Visit podcastchoices.com/adchoices

I'm David Farrier, a New Zealander accidentally marooned in America, and I want to figure out what makes this country tick. Now I have to be honest with you here, I feel about 30-35% more scared in America than I did in New Zealand. Maybe this says as much about my timid New Zealand brain as it does about America, but I don't know, things seem scarier here. When I go on a walk, cars try to run me over way more than they do in New Zealand. And then there's other weird fears like being sued or offending someone by not tipping enough.

Maybe if I survive all that, someone will shoot me with a sniper rifle when I'm out on a hike. A tourist is shot and killed on a popular hiking trail in Highland Park, taken out in one shot by a rifle-wielding gunman hiding in faraway bushes. More recently, I discovered another fear. This is a voice memo I recorded on my phone. Okay, so I was in the park and a squirrel bit me. Ugh. We don't have squirrels in New Zealand,

so in my mind they're basically just a Disney character. They're there to be cute and entertain. Look, I'm not a boy. I mean, I'm not a squirrel. I'm a boy. A human boy, not a real squirrel. But life isn't a Disney film. It's full of pain, suffering, and for me, squirrel bites. I went home and googled what to do if a squirrel bites you. See your doctor, came the reply. I saw a doctor, and they said a word I don't think I've ever heard out loud before, outside of watching a movie. Oh my god, you're rabid.

Oh my god, you're rabid, Oh my god, you're rabid wasn't quite the words my doctor used, but the sentiment was similar. And thus began my journey into the world of rabies, a virus that has a 100% mortality rate, give or take 1%. So, check the attic for bats and your skin for tiny bite marks, because this is the Rabies episode. Flightless, flightless, flightless bird touchdown in America. I'm a flightless bird touchdown in America. I am mad at you. What, already? Because so many things happen beyond our control in life.

Yet, here you are putting your hand out to probably pet. We'll get into this. But I have a feeling to pet a squirrel and not knowing but should know that that's a horrible idea and that you will get bit you know who told me that beforehand fucking no one why no one told me that these animals that you have are dangerous it's not i knew that mountain lions can be bad crocodiles alligators no one warned me about the whole bat scenario, the squirrel scenario, the raccoon scenario. The bat scenario. This is probably the most American episode of this podcast about America that I've done in a while because it sort of gets into the healthcare system, American animals, and of course, rabies.

Yes. What do you know about rabies? Because until the squirrel bit me, I knew next to nothing. I grew up scared, rabies. Yes. What do you know about rabies? Because until this girl bit me, I knew next to nothing. I grew up scared of rabies. Right. At some point, people tell you, don't touch that animal that you don't know, this stray animal. It could have rabies.

All right. So that's something you're told by your parents. Somebody told. I don't know. I assume it was my parents. But yes, it's something you grow up knowing. Don't touch random animals because they could have a disease. So can I just, for my own defense, we don't have rabies in New Zealand. It doesn't exist. And so

it's not a danger we have. And that's in America, I'm walking around. I almost sometimes feel like when I leave the house, like I might not come back alive. Because again, that sniper rifle incident happened near my friend's house. Is that going to get me? Rabies is everywhere here. It's terrifying. Well, first of all, first of all, after this happened, my friend got bit by a dog. She went to the doctor and she was like, what about rabies, basically? And and they were like rabies isn't really a thing anymore right what you said is what i've heard as well the main thing i learned about this and especially when i made the documentary is that everyone has a different idea about rabies how prevalent it is who's got it what can happen but the thing is okay i found

out some facts about rabies i wrote these down because I didn't want to forget them. Rabies causes 59,000 deaths worldwide each year. Okay. That's a lot. That's a lot. 40% of which are in children under the age of 15. If you get rabies, you will die. It's present in more than 150 countries on all continents but Antarctica,

which actually negates what I just said that we don't have it in New Zealand. I've never heard of a case in New Zealand. But my point is, America has rabies and it's a real problem. Did you look up how many cases in America per year? I did. I'll get into this. Okay.

Look, this is going to be an intense episode. I warn you about that. The first thing I did as always, I canvassed the population. I said, what do you know about rabies? And people think a lot of different things. What can you tell me about rabies? Because we don't have rabies in New Zealand, but apparently you have it in America. Oh, I have something funny about rabies, actually. The other day, I was driving on the freeway and I saw a massive sign that said, rabies shots, $11, like they were on sale or something. What, $11?

Yeah, yeah, that you could pull over and just get your rabies shot. Do you know anything about rabies, any rabies facts? I know to watch for foaming at the mouth, and I know that my sister has shots for it. Why did she get them? She's a vet. I actually don't really know anything about it other than, like, my old dog, like I had to make sure he had a vaccine for it.

Oh, it's very scary. You can die from it. Definitely dogs will die from it if they're not vaccinated. If you are bit by a rabid animal, there's a prophylactic shot that you can get. Very painful. Goes right into the abdomen. It's reported to be really a terrible injection to get. I know it's really bad, and I know that it's very painful to get the injections if you get it. Can you tell me anything about rabies?

Well, you die. What else? Love that guy. Oh, my God. Wait, I forgot about the foaming at the mouth. Yeah, that's always a fear I didn't know you could take rabies shots preventatively Yeah you can

Like a tetanus shot? Kind of Yeah you can get them before you travel to certain countries It's recommended that you get them But it sounds like it's fucking miserable to get So that is a bit of misinformation Which I'm going to clear up in the doc But it's not in the abdomen

Right It's not That's like this thing And I remember I texted Rob And Rob said horrific That's what I always heard My mom was like It's shots in the stomach

That are really painful No so the shots And I know this Because it fucking happened to me Yeah They give your butt Your arms They spread it around

But it's not like straight Into the abdomen Maybe it used to be Yeah this was 20 years ago. Okay, I'm going to read this exchange. Okay. It was to me and Rob. Tuesday, January 3rd, 1147 a.m.

We're in the middle of recording, by the way, so I miss all of this. Yeah, nothing. Yeah, David says, a squirrel nipped my finger yesterday. Is that a doctor's visit, do you think? Just a scratch, not blood. What do you reckon? I forgot you have rabies here. And then Rob said, I think they'll make you get a rabies shot unless you have the squirrel's dead corpse for them to test, which I've heard are miserable stomach shots. And then you said stomach. And then Rob said,

or my mom just always told us that as kids to scare us into listening. Then you said stomach. Ugh. And then Rob said, or my mom just always told us that as kids to scare us into listening. Then you said, okay, final question. Would you try to see normal GP or do you go to urgent care? Rob, I think GP would be cheaper if you can get it. I also never go to doctors, so Monica may have more informed opinions. And then Rob sent a screenshot. He had Googled, should you go to doctor for a squirrel bite? And it says, if you're bitten if attacked by squirrel or any other wild animal victims need to wash the wound thoroughly

and keep it clean to fend off infection at any sign of infection like inflammation inflamed bite sight itching perpetual pain or pus the injury must be taken to the hospital for analysis you said cool i'll try and see my doc. And then Rob said, I read that as no need to, unless starting to look bad. Okay. I see all this at three 30 and respond. You should definitely go to the doctor tomorrow. Latest. When did it happen? What does the bite look like? If you can't get into your doctor tomorrow, you should go to urgent care. They will at least tell you if you need a shot. Yeah, you both summarized the vastly different points of view I was getting in general when

this happened. And one half was like, don't worry about it. The other half was like, no, go and see a doctor. I also got very armchair expert on it because then my next text was, especially if a squirrel was close enough to bite you that's not consistent with squirrels so it might have something weird like mange so you definitely need to check and i don't know anything about squirrels or mange or rabies or any of it but still well i appreciate you both replying you a bit late monica but you did reply and you cared

like you really were i said let me know if you need a ride anywhere. Yeah, and that did put me into a bit of a, because I was not going to do it. But then you and a few other people said you definitely should see a doctor. Yeah. And that's what kind of put me into this spin. Okay. So I'll fire up the documentary because I tried to kind of capture what all this is like. And yeah, it's a real journey.

It was both our faults. I. It was both our faults. I maintain it was both our faults. It was another normal walk in the park, my usual route that takes me through a woody little glen before ascending up a dusty path into the hills. They saw me first because they were the ones running in my direction. More specifically, they were scampering down a tree as I walked under it. The squirrel stopped at my eye height, about two feet from my face, running in my direction. More specifically, they were scampering down a tree as I walked under it.

The squirrel stopped at my eye height, about two feet from my face, and just stared at me. And I stared back. Slowly, the squirrel extended its tiny, cute squirrel hand towards me. I'd seen enough Disney films and I knew what this meant, friendship. In one hand I held my phone, while I extended my other hand towards the squirrel. I was concentrating so much on taking a good photo, I wasn't fully paying attention. And I was thinking that it was a beautiful moment, until that little shit bit directly into my finger. I'd become that person. The person I feared the most. The guy taking a selfie at the edge of a cliff. The guy showing off his abs in the waves before dropping his phone to the bottom of the ocean.

The woman texting in a mall and walking straight into a fountain. This isn't particularly great, I thought. Cutting my walk short to go home and throw some sanitizer on the puncture wound. At least it was a clean entry. Squirrel teeth are sharp. I googled squirrel bites, and various websites made it very clear I should ring my doctor. It was a weekend, plus my finger looked okay, so I left it for Monday. I tried my doctor, but there were no appointments.

So I did a telehealth appointment, seeing my doctor, but there were no appointments. So I did a telehealth appointment, seeing a doctor over an app on my phone. The first thing they said was that I needed to get the rabies vaccine. Hi, this is Courtney. Hey, Courtney, it's David. How are you? Hi there. Good. How are you? I wasn't the only one in America who had recently found themselves thinking about rabies, and Courtney in Michigan was one of them. Each year about 60,000 Americans have to get what's called

post-exposure prophylaxis treatment, PEP, after being bitten by an animal like a raccoon, a skunk, a bat, or a fox. PEP consists of two things, the rabies vaccine and a dose of human rabies immune globulin, which is a human blood serum that kicks the body's immune system into overdrive before the vaccine kicks in. Those 60,000 doses a year mean that very few Americans die from rabies, between one and three a year. Okay, so back to Courtney. So I live in the main floor of a house and would often wake up in the night, usually between like two and four, hearing rustling in the walls. Her housemate thought they had birds in the wall, pigeons or something. She'd moved in during summer and during fall and the winter, the noises in the walls went away.

But then last summer, the rustling was back. away. But then last summer, the rustling was back. And so again, I thought they were just birds and never saw any sign of anything in my living space. So I wasn't too concerned about it, but it also is very creepy to hear rustling in your walls behind your bed in the middle of the night. One of these nights that this happened, I went into my living room and thought, I just can't hear these sounds anymore. I'm going to go into the living room and thought, I just can't hear these sounds anymore. I'm going to go into the living room, turn on the TV and just get away from it. In the early hours of the morning, Courtney dozed off. And then suddenly there was something flying above my head.

And I didn't have lights on. I just had the TV on. So there's also the shadow of that happening. I just had the TV on, so there's also the shadow of that happening. So I grabbed a cushion and threw it over my head, thinking about what to do next. I was very scared because there's a bat flying around. And so then I did run to my bedroom with the cushion over my head. It's a good technique.

Yeah, I felt like that would at least protect me from it. Closed the door, and then I still heard the rustling noise in the wall. So that's when I figured out there's more than one for sure. Courtney had been living with a family of bats that came back every summer and they'd just been formally introduced. That morning she started talking to friends and texting, just like what I was doing. And her friends started saying, oh my God, Courtney, you need to have a rabies shot. She called the health department with her problem. They said, because you were asleep in a room with a bat, there's a potential that you had exposure.

So we would recommend that you get the rabies vaccine. And I just assumed that I would then be going to the health department to get a shot there. I was like, okay, great. I can do that. The health department is literally right down the street. And the woman I spoke to said, you will have to go to the emergency room to do this and it will not be inexpensive. With those words ringing in her ears, Courtney headed to the ER. She'd read up about rabies and it was all bad. For one thing, if you get rabies, you die. But before that, there's vomiting, violence, uncontrolled emotions, and a crippling fear of water. Yeah, rabies makes you terrified of water. Why? Well, I talked to a veterinarian about this, and the reason it makes you hydrophobic is to help spread itself around

more. Rabies makes you overproduce saliva, but incapable of drinking. So when you start biting everything in sight, there's an undiluted viral load in your spit. Higher the viral load, better rates of transmission. And whether you pass it on or not, in 99% of cases, you just die. And so with that in mind, Charlotte headed to the ED, or the ER, or whatever you call it in America. They in mind, Charlotte headed to the ED or the ER, whatever you call it in America. They're like, we have to give you six injections. We'll give you one in your arm and then we'll do two in each thigh and then one in your butt. And there were two nurses and they're like, we have two of us so that we can give you

the two in your thighs at the same time. And I was like, oh, like they do for babies. I was like, great, I'll take it. And then when they did the thigh ones, one of them started spurting blood and the nurse was like, oh, I really haven't had that before. I'm like, I'm so sorry. With the rabies vaccine, there are multiple shots. You get the first dose, then you go back on day three for another, day seven, and day 14. That's four separate admissions to the ER. And the price? It starts to soar.

Courtney's final day, day 14, fell on a holiday. And I said, oh, do you think you'll have less patients today because it's Labor Day? And she said, actually, I just have you and six other rabies patients. She said, yeah, there's been a lot of bats recently. The great thing about all this, Courtney is alive and well. She doesn't know if the bat she was living with had rabies. She doesn't even know if the bat had bitten her that night. And that's the thing with rabies.

You just don't know. So she had no rabies, but she was left with a big bill. I thought, oh, it's going to be like $1,000, which was a lot to me. $1,000 would have been getting off lightly. All those ER visits meant it was going to be a lot more than that. In my head, I was thinking I was going to be getting like one shot. So hopefully it wouldn't be anything outrageous. I'm still unclear. I pulled out all my bills this morning to see what cost what, and it's still a little bit unclear. So how much did you end up getting charged? How much out of pocket was it for you? So the total is $3,430. was it for you? So the total is $3,430. Right. And that's with your insurance paying the rest of it. That's with my insurance. Yeah. $3,430. That's just over $5,000 New Zealand dollars, I thought to myself. I am worried too that it will happen again. And then what will I do? I live in Holland, Michigan. And we're very well known for having

an abundance of squirrels and particularly black squirrels. They're everywhere. And I keep thinking, what if something happens again? And I have to decide if I need to get these injections all over again. This whole thing has had a big effect on her life. She's on a payment plan to pay the hospital. As a social worker, she's not making giant megabucks. She says she is making good progress on it. And while sleep has been a problem since the bats in the walls, she's getting better at that too. So this all happened in August. I moved back in September. I made it a New Year's resolution to sleep with the lights off because I have been sleeping with the lights on. All right. So you were keeping the lights on while you slept just as a precaution to keep

the bats out. More so I was just trying to think of what would be the least traumatic way to see another bat. And I felt like full light was the answer. So, yeah, as I was trying to figure out whether to get my shots, I was sort of starting to talk to people sort of in research mode that have had this happen to them. And yet a lot of Americans get bit by things. Or the thing with bats is that if you're in a room with a bat, you're not going to wake up if a bat bites you because it's got little needle teeth. But you don't feel it? No. And so you're in this weird situation where if you've been living with a bat, the advice from everyone is to get a rabies shot because it's just not worth the risk. But the frustrating thing is, there's a chance you

weren't even bitten. Right. And then you're paying all that money and pain. And rabies is bad. I went through what happens to you. There's three stages. The first one happens within one to three days. This is in animals. You'll start to get behavioral changes. Day four or five, it's called the furious rabies section. That's where you start to get angry. The third is the paralytic stage. And that's where it sort of gets into your nervous system. And eventually brain swelling and you'll stop breathing and you'll die. And so that's the weird lottery.

It's not like most things that happen to you when you want to go to a doctor where, ah, you know, maybe it'll be bad. If it's bad with rab things that happen to you when you want to go to a doctor where uh you know maybe it'll be bad if it's bad with rabies you're dead rabies is a hypochondriac's wet dream really nailed it i have a feeling i'm gonna think i have rabies a lot and unfortunately for me i can just go to the doctor and say i believe there there was a bat. Yeah, around me. There could have been a bat around me and I could have been bit and I'm going to need a rabies shot. I had this thought in my head. I got bitten.

I thought if I don't get the injection within a couple of weeks, I'll know if I'm going to die. And that kind of made it okay. Like within two weeks, I'll be either in the clear. If you didn't have symptoms. Yeah, or it's going to be bad for me. What I found out is that rabies can sit in your system for up to a year. And so I was thinking, okay, so I ignore this, right? And in a year's time or over a year, the rabies will basically get into my nervous system.

And then it's like, oh, no. It's too late. It did have rabies and it's too late. At that point, you're dead and there's nothing you can do about it. So in my mind, it was almost better if it was over quick unless I'd know if I was going to die or not. But not knowing if I was going to die in a year

just seems so much more stressful. Do you know what I mean? I do. The anticipation, I guess, builds and builds. But also, I'm not okay with you being just like willing to die over sticking out your hand in Griffith Park to get a selfie of you and a squirrel and like, oh, I guess I'll just see if I die. So what pushed me over the edge? I want to be clear about this because I'm not I'm an idiot, but I'm not a complete idiot.

I wasn't feeding the squirrel. And that's what I think pushed any doctor to tell me to go and get a rabies shot Because it came to me And then I put my hand out and then it just bit me really hard I wasn't feeding it nuts or a little chocolate bar It came to me I reached my hand out which was stupid and then it bit me But at least I wasn't feeding it I sort of wanted to high five it

It put its hand out, I thought it wanted a high five. And you think that's less stupid than feeding it? Okay, I'm going to stop talking because you're completely right. Wait, but you wanted to take a picture. That was embarrassing. I had my phone in one hand. Because it was going to be a beautiful moment, you know? It was going to be like one of those Nat Geo shots or something.

So is there a picture of you getting bit by a squirrel? That's what I want to know. There is, actually. It is a beautiful moment, really. Here it is. I've got a lot of photo squirrels on my phone. Oh, my God. Look at all these squirrels.

Okay, so this is the moment it bit me. That's when its mouth was... Oh, my God. On like... It's literally biting your finger. Ew. Ew. on like it's literally yeah biting your finger ew ew like it was and i want to be clear as well i said in that text here it was a scratch because i didn't want to freak you out but it really was a good bite holy shit david that squirrel looks angry too okay well that's the thing again and that's why it sort of pushed me over i did have a real worry because it had bitten me and i wasn't feeding it and it looked a bit mad listen so

can we circle back that i'm right that my armchair expert theory was correct when i said hey that how would have you felt rob if in a year's time i'd been in here recording and i started sort of twitching you didn't have to present the facts then. You lied about it. Because you said it was a scratch. I watered it down. I did. I was basing mine based on it just being a scratch.

But I'm saying my theory that it acted erratic, because I don't think squirrels just do that. The fact that it came to be in the first place. I thought your finger was food. I mean, we have squirrels in our backyard that come up to our sliding door. They like the kids. What I'm going to take from this is that Rob wants me to die. I think that's a good takeaway.

Stay tuned for more Flightless Bird. We'll be right back after a word from our sponsors. Flightless Bird is sponsored by BetterHelp. Now, I learned something about myself on this podcast recently where you tried to make me say things that I liked about myself. I find it really hard to compliment myself in any way. Getting to know yourself can be a lifelong process. Therapy can help that. It really can.

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Okay. I only sleep on my back and my side. Wow. Yeah, always. And when you're on your back, do you cross your arms like a vampire? Oh yeah, I've been told it's terrifying. Yeah, and sometimes I sleep with my eyes open. So yeah. Oh, what? Sometimes when I was shooting Dark Tour terrifying. Yeah. And sometimes I sleep with my eyes open. So, yeah.

Oh, what? Sometimes when I was shooting Dark Tourist, I would always share a room with my DP, Dom. Yeah. And he took photos of me. I'll show you sometime. I look terrifying. Oh. To put your mind at ease, they offer a 100-night trial and a 10 to 15-year warranty to try

out your new Helix mattress. Helix is offering up to 20% off all mattress orders and two free pillows for our listeners. Go to helixsleep.com slash bird. That is their best offer yet and it won't last long. With Helix, better sleep starts now. I decided to do something in this documentary. I'm not sure if it's worked or not, where I sort of cut up my story with other people's stories. Yeah, no, it's great.

Suspense. Yeah. Do I die at the end? That's the clincher. I've got it and I'm going to be dead in a week. Yeah, we hired an AI robot to play David for this. Let me be very clear. I was still debating if I should get the rabies vaccine and the immune globulin it's paired with. On the one hand, rabies was a horrible death, and I had been bitten by a wild American creature. On the other hand, all the literature I was reading said that squirrels hardly ever carry rabies. In America, apparently no squirrel has ever given anyone rabies ever.

And yet, the telehealth doctor told me I needed to get it done. And by now I'd talked to another doctor my insurance company had hooked me up with and they agreed. Look, I'm not a doctor. I'm the opposite of a doctor. I'm an idiot podcaster. I have no medical qualifications whatsoever. When I talked to Courtney, she had the same internal debate. I think what stands out to me is that it is something that has to be done if you don't want to have rabies.

And rabies, from what I read, sounds terrible. And it's something that the health department recommended to me and really pushed me to do. But then there's this huge cost to it, which is wild. Because even my friend, her husband said to her, I get that Courtney doesn't want rabies, but isn't it just a virus? And she said, no, she dies. If she gets rabies, she dies. At about this moment, I got a message from my friend, Josh. He was the one who tipped me over the edge. This is what he emailed me. I can't get over this. The survival rate for rabies is basically 0%. The number of people in recorded history who have survived the disease can be counted on one hand, and no one really knows why they made it. On before your inevitable death, it completely

fucks your brain up to the point where you become savagely thirsty yet unable to drink and develop a tendency to rage and bite people. It's so scary it might even be why we have myths of vampires and zombies. I can't think of anything in the world I'd be less likely to roll the dice on than rabies. I decided to get vaccinated. I spent a few hours on the phone trying to find a method that didn't involve an emergency department. I knew I'd have to get four shots, which meant four visits of $400 minimum, plus what the vaccine cost. I tried a travel center that gave weird vaccines for extreme travelers. They told me it would be over $500 a shot, $2,000. For a comparison, in New Zealand, where we don't even have rabies, it would set me back about $50 a jab, $200 for the whole thing. I tried my doctor again, and they told me to try a pharmacy or an urgent care,

but they all refused. I tried some private companies. If you have any medical information questions, please press 1. But like most American companies, it led to automated hell and a closed office. Our offices are currently closed. And so, a day after I'd been bitten, I reluctantly wandered into the ED and signed myself in. I sat amongst a lot of groaning and some vomiting and I waited. And as I waited, I thought about all the other Americans who've been in my position, 60,000 a year. So my name's Paul. I grew up in Dunedin, actually.

This is Paul. And as you can tell from the accent, he's also a New Zealander. I didn't know him before this phone call, by the way. He met his American partner in New Zealand. They got married, had two kids. And then about seven years ago, they all moved to North Carolina. I wanted to talk to Paul because like me and Courtney, he'd had a run-in with rabies. But while Courtney's bill was high, Paul was here to eclipse the lot of us. Greedy Paul. How did rabies come into your life? So one of the kids came and got me and said, Dad, there's a bat in the bonus room. And there it is sleeping, hanging upside down from the Venetian blind. So we picked it up and we took it outside. It was still daylight. So we left it under this little cage and we used a fishing net to get it out to the bonus room,

put it on the deck under a little cage, waited till it got dark, lifted up the cage and a couple of hours later it was gone. That was the first mistake. He says that because ideally you catch the animal that bit you so it can be tested for rabies to see if it's actually rabbit and if you need the vaccine. And then my wife had actually been bitten by a cat that we were fostering

and she was doing some research and realized that actually, even if you have not been bitten, there is a high risk that a little bat could be flying around the house, biting at will while you're asleep. Oh, right, so you're not going to feel it if it bites you necessarily. Exactly. Apparently, their teeth are very, very small. It wouldn't wake you up, and you may not realize that you've been bitten at all. This was all sounding very familiar.

We knew two things. We probably needed some treatment and that it was going to be expensive. Those are sort of the two things that we knew for sure. Shots don't scare us, but we really want to make the cost as low as possible. We tried with our family doctor and she's an independent practice. And I think technically, yes, she could probably have ordered it, but I think it was going to be just way more hassle. He called the public health department and found out that in theory, any medical practitioner can order rabies immune globulin and administer it. But in practice, only an ED will administer it.

So after trying to negotiate with lots of different places, we ended up just going to the ER. There's an ER just down the road about two miles away. It was a reasonably busy evening, but they managed to fit us in pretty quickly. My daughter and I sort of went ahead. And then when they said, yes, we can get you all in, my wife and son came as well. Like me, he felt sort of like a phony waiting in an emergency room surrounded by people with very, very full-on problems. He was put so succinctly by the physician there. He said, it's 100% preventable and it's 100% fatal. Obviously, rabies is a horrific death. I think you've got spasms and, yeah, awful, awful death.

For Paul, it wasn't just his potential death he was thinking about. It was his wife and his two kids. So, yeah, we tried to get a cost before we went in just because we knew it was going to be expensive. And, of course, there's four of us. So one health system who shall remain nameless would not give us a price at all. And I thought that was illegal. I thought they had to be would not give us a price at all. And I thought that was illegal. I thought they had to be able to give you a price up front. They could not, or would not. The other

hospital system said a vaccine would be $1,800. And so it's like, great. So we need a lot of those. Pretty quickly, Paul realized that hit their $10,500 out-of-pocket maximum. There was the multiple ER visits, the multiple family members, the multiple vaccines over multiple days, and the very expensive hit of Immune Globulin, that serum to kickstart your immune response, which can be billed at around $10,000 just for that. Here's Paul with a crash course in American health insurance. In our case, we pay the first $1,000, which is the deductible. So that would be four people times $1,000. So that's a minimum of $4,000 for the year. However, because it was

a family, we actually have a total for the family of $3,000. So that's great. We're going to definitely pay the first $3,000. And then we pay 20% of everything until we get to $10,500. And did you get up to that ten and a half thousand yes we did i'm pretty confident it would have been cheaper for me to fly back to new zealand and get it done there and have a holiday and then fly back again i briefly flirted with the idea of going to mexico paul works as a family nurse practitioner so he found the whole injection process quite fascinating so my weight was just a few pounds, and that's kilos for the New Zealanders, a few pounds over. And so they had to use a second vial. So the vials were, I think, $7,000 each. So I weighed 178

pounds. If I had weighed 170, then it would have been one vial. And so those few extra pounds meant they opened a whole second vial, just used a tiny amount of it, but I still got charged for two vials. Just a casual extra $7,000 on your bill. Exactly. And so the real cost to me was an extra $1,000. So everybody else paid $1,800 for that first visit. And then mine was $2,800. However, in the same room at the same time, my daughter is only using a small part of one vial. And we did jokingly say, hey, can you make sure you combine it? As a nurse, I get that that would be annoying. I wouldn't want to do that. And there's a risk of, you know, mixing things up. But it was just like, this is literally a thousand dollars extra cash that I have to find. Paul's glad he and his family got the shots. It did set him back over $10,000. As I waited in the

emergency department, I wondered what my bill would be. To make myself feel better, I got out my phone, went to YouTube and pulled up the rabies scene from Old Yeller. No, Mama. There's no hope for him now, Travis. He's suffering. That's Travis's mum talking, offering this tiny kid her massive rifle. Old Yeller is such a sad movie. It was made in 1957 and produced by Walt Disney, the man responsible for making me

think squirrels were harmless and would never bite me. In the movie, Travis adopts a dog, Old Yeller, who becomes his best friend, even saving him from a bear. But a rabid wolf bites Old Yeller, and Old Yeller gets rabies. Travis knows what he has to do. You know we've got to do it. I know, Mama. Grabs his mother's massive gun and points it at his favorite dog, Old Yeller, now fizzing at the mouth with rabies. In my opinion, Old Yeller is way sadder than Bambi. It was so loved it spawned a sequel, Savage Sam. But I'll never watch Savage Sam, because I just don't know how you top Rabbit Old Yeller. Eventually, after a five hour wait, it was time to get my shot. Well, shots.

The immune globulin and my rabies vaccine. They have to split the immune globulin into different vials to distribute it around your body. I got it in both arms, my thighs and my butt. Then there was the vaccine. For each jab, I wondered how much it would cost. The nurse had no idea. Neither did the doctor. I'd inquired at the front desk if I could get a bill or a quote, but they said that was a different department before getting distracted by a phone call. What I found so unusual about it is you never go in to buy something not knowing what the cost is going to be. It feels like a lottery in the ER, a bad lottery. You just don't know what the cost is going to be. Totally. The numbers, they appear made up. The total cost to our family

for four ER visits and then another three sets of shots each was, I think, $75,000 or $95,000. The insurance company then negotiates with the hospital system, and they negotiate that down to $25,000. And then we pay 20% of that $25,000 or something like that. I realize the numbers aren't quite exact, but suddenly $50,000 just disappears. And it's like, where does that go? I find American healthcare really puzzling. The quality of care is some of the best in the world once you get it.

But getting it seems hard. And it seems really expensive. The idea of American exceptionalism. And America does have great healthcare if you can afford it. You are likely to get amazing healthcare for cancer. You are probably going to get your hip replacement done really quickly, et cetera, et cetera. There is some very, very good healthcare, but you're paying almost five times much as anybody else for that privilege. And I don't think you need to. I would much rather pay, I don't know, another five grand in tax a year and just know that I

didn't ever have to worry about it. When I left New Zealand, I was paying know, another five grand in tax a year and just know that I didn't ever have to worry about it. When I left New Zealand, I was paying maybe $30 to my GP. GP stands for general practitioner. I think you say PCP instead of GP in America. Because it means that you use the system, I think, more sensibly, whereas here you're sort of umming and ahhing. Do I really want to call the ambulance because I know that's going to be $1,. Or do I really want to go to the ER? I'm sure there are people who delay treatment all the time because they cannot afford it. I went back to the ED a few more times to complete my shots. I felt embarrassed showing my butt to the nurse. I don't like my butt. I can't even remember being jabbed in the butt ever before now. First time for everything. I'm curious what

my bills will be. It feels like a lottery. I wish I'd never First time for everything. I'm curious what my bills will be. It feels like a lottery. I wish I'd never met that fucking squirrel. I wish I didn't have to weigh the minuscule chance of having rabies inside my body with the bonkers costs of getting vaccinated. I've decided I'm done with squirrels, like Paul is done with bats. We have made sure that bats cannot get into our houses anymore. We found where it got in and we don't talk to dogs and we make sure the cats don't have rabies. As for Courtney, well, she's still continuing to sleep with the lights off. Although there is a memory which is bugging her about the pest control people who got rid of her unwanted roommates in the walls. It did

concern me when the bat people did not go inside. And I said, it's great that you have found ways that they could possibly get in and taking care of that. But what about the one that was inside? But what about the one that was inside? I feel a shiver go down my spine. I hope it's not rabies. What a journey. That was incredible.

So I'm still waiting for my bills to come in, which is scary. It hasn't happened yet. So I went to the emergency room four times. So with my insurance, because I've got like a cheap insurance policy because I'm cheap, it's $400 a time. And then you pay for the vaccines on top of that for lots of the vaccines. And then that $10,000 immune globulin shot, which kickstarts your immune system. And also it was the time, you know, every time you go to the emergency room, it's at least for me, it was a three hour wait. Day one was five hours. There's a guy vomiting next to me. It's so full on. And I was just the whole time I was thinking, do I actually need to do this? And halfway through I was thinking I've spent maybe this much money. If I don't do the rest, am I saving myself thousands? But then if you don't

do the rest, the whole thing's useless. Yeah. So then you've already wasted money and you might die. The one thing I was really excited about was that I figured once I have it, I have like a lifetime of being able to play with squirrels and raccoons because I'm invincible from rabies. one thing I was really excited about was that I figured once I have it, I have like a lifetime of being able to play with squirrels and raccoons because I'm invincible from rabies, but it doesn't last forever. It gives you, I think like three or four months and then you're back to being potentially killed by rabies again. It sucked so hard. And the doctors, no one knows what they're doing. So I had this really beautiful, that's why I was so embarrassed. I had this really beautiful person giving me the shots,

and suddenly, like, it was in my butt. That was horrible. Show us your butt so we can weigh in on what it looks like. No, the thing is, she had never done this before. So she's on Google reading, like, how to give the shots and what to do and how to divvy it up. That was terrifying. I went to the CDC's website afterwards and they said,

and this makes me very suspicious, very clearly, don't give those shots in the butt. The butt's not where you give them because it doesn't get distributed through your body correctly. So you're not meant to give it in the butt. David. So I'm going, did it even do its job? Fuck me.

Maybe I do have rabies Maybe it didn't do its job Well you do seem angry Maybe it's in me Right now Your mouth is foaming a little bit I get angry thinking about What the bill's gonna be

When it comes in What is your deductible? Do you know? I think my maximum out of pocket Is $10,000 maybe So it'll stop there Which is good Now It's not great It's not great I think you're Maximum out of pocket is $10,000 maybe. So it'll stop there, which is good.

It's not great. It's not great. I think you're probably going to have to pay that. It's so annoying. Well, maybe not. It's just one person. Yeah, but it's four admissions, all the shots. The other thing that was crazy to me is that everyone I called didn't really know. So my PCP essentially told me, no,

you can go and get that at any pharmacy and just get it and bring it in and I'll give it to you. None of the pharmacies had it. CVS didn't have it. What's the other pharmacy? Rite Aid. Rite Aid. Nowhere had rabies. A lot of them laughed at me when I called up and said like, do you have the rabies vaccine? They just laughed. You were shamed. I was shamed. I was shamed. The nurse laughed at me the first time I came in and and said, like, do you have the rabies vaccine? They just laughed. You were shamed. I was shamed. I was shamed.

The nurse laughed at me the first time I came in. I said, I need a rabies shot. And she just openly laughed at me. It's life or death, I wanted to say. Yeah. This could be it for me. This could be it. Listen, now I kind of understand this black market $11 rabies shot.

When I talked to that person, this was post all of this. And I was like, oh my God, imagine if that was a real thing. And they were like $15 shots. Holy shit. Also, it sounds like some huge scam that was going on. It's definitely like fentanyl they're injecting. Yeah, it sounds like there was something horrific that I probably missed. Wow. The other thing, if you do get bitten by something, do try and keep it. It's often after something's bitten you it's not your priority to try and catch it. Like I didn't try and catch that squirrel.

I just let it run away. If you tried to catch it, you'd get so many bites. You would be covered in blood from that squirrel. It's true. How would you even catch anything that bites you? I might order a big net actually off Amazon and just have it with me The bat thing makes me feel really freaked out

It's unnerving Yeah, the fact it can bite you and you won't feel it It is awful It's a horrific concept If they're in the walls and stuff i mean now i'm anxious because at my parents house there was a squirrel living in the walls there's a squirrel for a bit yeah and it would make noises and you could hear it scurrying around and it was so annoying how long was it in there for? A while. And then someone came and got it out.

But what if it came out in, no, I guess my parents wouldn't know if they got bit by a squirrel. A squirrel, you'd probably feel it. I don't think squirrels are normally trying to bite people unless you're sticking your fingers in their mouth. Yeah, and that's the other frustrating thing. I did my own Googling and no one in America has ever gotten rabies from a squirrel. And yet every medical professional I talked to said really clearly, definitely get the rabies vaccine. But maybe they're just covering their own ass, right? Of course they are.

I don't think like that. I'm like, this is a doctor telling me I must get the rabies vaccine. But you have to think like that because the reason they have to cover their ass is because it's deadly. It's not and you might just get really sick. No, no. You'll die. So, yes, you absolutely have to. And they're probably scared that I'll sue them if I do get rabies, right?

And die. Well, you'll be dead. I don't know what you'll do with the money. I've never got two weeks of frothing where I could maybe start a lawsuit as well. I mean, that sounds like the worst way what i'm excited about now if i reach my maximum out of pocket i can just go crazy and just get a whole lot of procedures for free right because i'm not gonna it's not gonna cost me anything else yes yeah you should go like botox okay i don't think that's covered insurance doesn't cover that but you could get like a heart

scan and like a ek scan And like an EKG Yeah There's a few other lumps that have appeared Where? I've got a little lump in my neck Really? Yeah, so I might go and get that checked out Do you have one on the other side though?

Is it a lymph node? I think it's a lymph But it feels sore when I push it Maybe you're getting a little sick I might go and check that Do you know that you shouldn't play with snakes If you see them while you're hiking i know that okay they're also poisonous do you know what to do if i'm there and there's a snake do you do you remember what to do we carefully walk past

so now i've learned my lessons i've learned that rabies is a thing in America. You shouldn't go near animals if you don't know them. If you do think you have been bitten by something, you're going to end up going to the emergency room. There's no other way around that. And I will correct you. Rabies is a thing globally, as we have learned. It's not just in America. Yeah, you're right.

It is everywhere. There's a bit more of it here because of all the bats, I think. Right. But in New Zealand, if you go on a vacation and you get bit by something there, you still have to get a rabies shot. Well, I don't think that's the official advice. What? I don't think you do. It's official.

I think there must have. I'm going to need to look more into this. There's never been that advice given to me because I've been bitten by a lot of stuff in New Zealand because I'm always playing with animals, wild animals. And you never had to get one. No one's ever told me to, but it does, it is possible it does exist there. So I'll have to look into that a bit more. I mean, if it's a domesticated animal, no. Let me just Google rabies in New Zealand.

Yeah. Well, if it's domesticated, you have the animal and you can test it But they normally don't Like my friend who just got bit And I got bit once by a dog You just had to clean the wound Don't they assume that a dog you can tell if it's rabid or not? Oh yeah so

mpi.govt.nz Which is our sort of official agency New Zealand has never had a case of rabies Oh ever So yeah I think we are Another site said that it's everywhere but Antarctica But I think maybe no So yeah, officially nothing yet

Okay Did you get bit before or after you went back? I got bit After Oh, maybe I took it back with me Yeah, say maybe I'm just spreading it No, it was after

Because remember he was pathetic He went home, he was pathetic. He went home and he got pathetic. And then he came here and got bit by a squirrel and got COVID. It was horrible. I had a really bad run. You did. But you're back.

I'm fighting fit. What's that mean? I'm fighting fit. It means I'm top of the world. Okay. You're back at it. Yeah, I'm back at it. I'm okay. You're up and running.

Lumping your neck. No, I'm excited for you to get to try out all the procedures. I'm going to, maybe that could be an episode. This is a glass half full. Me just getting all the medical. It is. You're right. You've got to look at it that way.

Thanks, Monica. Well, I would say having encountered rabies potentially in the American healthcare system, I think more American. Big time. What a ride. That was a really interesting episode. I didn't know. It was a really stressful few days.

I'm sure. You don't share enough. I was going to say with us, but Rob is a rascal, so I get it. But you don't share that you're going through hard times. You need community. Maybe I do. I do sometimes. I don't want to worry other people too much.

I shut down. I shut people out. I push people away. You can I do sometimes. I don't want to worry other people too much. I shut down. I shut people out. I push people away. You can't do that. When I got cut by that knife, when I cut myself. When the knife jumped out at you because you were trying to pat it, high five it. Exactly. I called everyone.

I called everyone in my phone book. Almost. I didn't call Rob because I knew he had kids and I called everyone. I called everyone in my phone book. Almost. I didn't call Rob because I was, I knew he had kids and I was worried. I knew he would actually come to help and I didn't want him to leave his family. And I almost called you, but then I thought, well, David doesn't share his ailments. So I don't know if I feel comfortable. And I did think actually that was the main thing. I was like, he's going to have to run over.

Anyway, all to say, I'm really glad. Yes, emotionally be more open to the rest of the world. Don't pet random animals and don't try to take selfies with them. This is so ironic and classic that you're trying to take a picture for Instagram and you get bit by a squirrel. That's very American. Yeah, you're right to take a picture for Instagram and you get bit by a squirrel. That's very American. Yeah, you're right. You're actually right. It's probably the most American thing I've done. 40% more American. Thank you.

Bye. Bye. Bye.