6:00 A.M. A DEAD DOG IN THE KITCHEN
March 1st was just another Saturday for the majority of the inhabitants of Caracas. But for a group of people who didn’t even know each other, who are not superstitious about Saturdays and who woke up that morning aiming to have an ordinary day, in Caracas, Chicago, Maracaibo, New York, and even at an altitude of twelve thousand feet, in a cargo plane crossing the Caribbean on its way to Miami, that date would be one of the most agitated, anguished, and intense of their lives. The Guilléns, having to confront the reality of the situation after the maid’s discovery, got dressed as fast as they could and went out without breakfast. The husband went to the corner store, looked quickly through the telephone book, and called the Institute of Hygiene, in Ciudad Universitaria, where, he had heard, they examined the brains of dogs that died of unknown causes, to determine if the dogs had contracted rabies. It was still very early. A porter with a sleepy voice answered and said that nobody would be there until 7:30.
Señora de Guillén must have walked a long and complicated route before arriving at her destination. In the first place, she had to remember, at that hour, on the Avenida Los Ilustres, where the good and hardworking neighbors who had nothing to do with her anguish were just beginning to be out and about, who it was who had told her on Saturday last week that her dog had bitten a child. Before eight, in a store, she found a Portuguese maid who thought she had heard the story of the dog from one of her neighbors. It was a false lead. But later she got some approximate information that the bitten child lived very near to the San Pedro church, in Chaguaramos. At nine in the morning, a van from the nearby health center took the dog’s corpse away for examination. At ten, after having gone through every building close to the San Pedro church one by one, asking if anyone knew anything about a child who’d been bitten by a dog, Señora de Guillén found another piece of evidence. The Italian bricklayers on a construction site, on Avenida Ciudad Universitaria, had heard people talking about this over the course of the week. The child’s family lived a hundred yards from the place the anguished Señora de Guillén had been exploring inch by inch all morning: the Macuto building, apartment number 8. At the door there was a piano teacher’s card. She had to ring the bell, to the right of the door, and ask the Galician maid for Señor Reverón.
Carmelo Martín Reverón had left that Saturday, as he did every day, except Sunday, at 7:35 in the morning. In his light blue Chevrolet, which he parked by the door to the building, he had driven to the corner of Velázquez. The dairy products company where he’d worked for four years was located there. Reverón is thirty-two years old and from the Canary Islands and surprises people who meet him for the first time with his spontaneity and good manners. He had no reason to worry that Saturday morning. He had a steady job and his colleagues’ respect. He’d been married for two years. His son, Roberto, had reached eighteen months in good health. On Wednesday, he’d experienced another satisfaction: his wife had given birth to a baby girl.
As a scientific delegate, Reverón spends most of his day out in the streets, visiting clients. He arrives at the laboratory at eight in the morning, takes care of the most pressing matters, and doesn’t come back again until the next day, at the same time. That Saturday, because it was Saturday, he returned to the laboratory, unusually, at eleven in the morning. Five minutes later he received a telephone call.
With four words, a voice he’d never heard before, but which was the voice of an anguished woman, transformed his peaceful day into the most desperate Saturday of his life. It was Señora de Guillén. Her dog’s brain had been examined, and the result left no doubt: positive. The boy had been bitten seven days earlier. This meant that by then the rabies virus might have progressed throughout his organism. It had had time to incubate. Even more so in his son’s case, since the bite had been on the most dangerous part of his face.
Reverón remembers the movements he made after hanging up the phone as if it had been a nightmare. At 11:35, Dr. Rodríguez Fuentes, from the health center, examined the boy, gave him an anti-rabies vaccination, but did not offer much hope. The anti-rabies vaccination that is manufactured in Venezuela, and that has shown only very good results, begins to act seven days after application. There is a danger that, in the next twenty-four hours, the child might succumb to rabies, an illness as old as the human race, but for which science has not yet discovered a cure. The only recourse is the use of morphine to soothe the terrible pains, until death arrives.
Dr. Rodríguez Fuentes was candid: the vaccination might be futile. The other thing to do would be to find, in the next twenty-four hours, three thousand units of hyperimmune, an anti-rabies serum made in the United States. Unlike the vaccine, the anti-rabies serum begins to act the moment of the first application. Three thousand units do not take up more space or weigh any more than a packet of cigarettes. It shouldn’t cost more than thirty bolívares. But the majority of the pharmacies in Caracas that were consulted gave the same answer: “None here.” Some doctors hadn’t even heard of the product, in spite of it appearing for the first time in the manufacturer’s catalogs in 1947. Reverón had just twelve hours to save his son. The redemptive medicine was three thousand miles away, in the United States, where offices were getting ready to close until Monday.
12:00 P.M. VÍCTOR SAUME SENDS OUT AN SOS
The uninhibited Víctor Saume interrupted the Twelve O’clock Show on Radio Caracas-Television to transmit an urgent message. “Please,” he said, “any person who has ampoules of hyperimmune anti-rabies serum, please contact us urgently by telephone. We need it to save the life of an eighteen-month-old child.” At that very instant, Carmelo Reverón’s brother retransmitted a cable to his friend Justo Gómez, in Maracaibo, thinking that one of the oil companies might have supplies of the drug. Another brother remembered a friend who lived in New York—Mr. Robert Hester—and sent him an urgent wire, in English, at 12:05, Caracas time. Mr. Robert Hester was just about to leave the gloomy atmosphere of the New York winter to spend the weekend in the suburbs, as a guest of family friends. He was closing up the office when an employee of the All American Cable Company read over the phone the cable that had just arrived from Caracas. The half-hour time difference between the two cities benefited that race against time.
A viewer in La Guaira, who was having lunch in front of the television, leapt out of his chair and called a doctor he knew. Two minutes later he put through a call to Radio Caracas, and that message provoked, in the next five minutes, four urgent phone calls. Carmelo Reverón, who didn’t have a telephone at home, had taken the child to number 37 Calle Lecuna, Country Club, where one of his brothers lived. There he received the message from La Guaira at 12:32: the health center of that city informed him that they had hyperimmune. A patrol car, which showed up spontaneously, drove there in twelve minutes, through the snarled midday traffic, running red lights at seventy-five miles an hour. They were twelve wasted minutes. A calm nurse, lethargic in front of an electric fan, informed him that it had been an involuntary mistake.
“We don’t have any hyperimmune,” she said. “But we have large quantities of anti-rabies vaccine.”
That was the only concrete response the message on the television brought. It was incredible that in Venezuela no one could find anti-rabies serum. A case like that of the Reverón boy, whose hours were counted, could happen at any moment. Statistics demonstrate that every year people died as a consequence of bites from rabid dogs. From 1950 to 1952, more than five thousand dogs bit eight thousand inhabitants of Caracas. Of two thousand animals placed under observation, five hundred were contaminated by bites.
In recent months, the public health authorities, worried by the frequency of rabies cases, have intensified the vaccination campaigns. Officially, they are vaccinating five hundred people per month. Dr. Briceño Rossi, director of the Institute of Hygiene and international authority on the subject, had suspicious dogs submitted to a rigorous fourtee
n-day observation. Ten in a hundred turned out to be contaminated. In Europe and the United States, dogs, like cars, need a license. They are vaccinated against rabies and a little aluminum tag is hung on their collars with the expiry date of their immunity etched in it. In Caracas, in spite of Dr. Briceño Rossi’s efforts, there is no such regulation. Stray dogs fight in the streets and transmit a virus to each other which they later transmit to humans. It was incredible that in those circumstances anti-rabies serum could not be found in the pharmacies and that Reverón should have had to turn to the solidarity of people he didn’t even know, whom he still doesn’t even know, to save his son.
“MONDAY WILL BE TOO LATE”
Justo Gómez, in Maracaibo, received the cable almost at the same time as Mr. Hester in New York. Only one member of the Reverón family had a tranquil lunch that day: the boy. Until that moment he had enjoyed apparently perfect health. In the clinic, his mother had not the slightest suspicion of what was going on. But she got worried, at visiting hours, because her husband didn’t show up. An hour later, one of her brothers-in-law, feigning a serenity he was far from feeling, went to tell her that Carmelo Reverón would come later.
Six telephone calls put Justo Gómez, in Maracaibo, on the trail of the drug. A petroleum company, which a month before had been obliged to bring hyperimmune from the United States for one of its employees, had one thousand units. It was an insufficient dose. The serum was administered according to the weight of the patient and the severity of the case. For a child of forty pounds, one thousand units were enough twenty-four hours after the bite. But the Reverón boy, who weighed thirty-five, had been bitten seven days ago, and not in a leg, but in the face. The doctor thought it necessary to use three thousand units. In normal circumstances, that is the dose for a 120-pound adult. But this was not the moment to refuse one thousand units, given for free by the petroleum company, but rather to get them, as quickly as possible, to Caracas. At 1:45 in the afternoon, Justo Gómez communicated by telephone that he was driving to the Grano de Oro airfield, in Maracaibo, to send the ampoule. One of Reverón’s brothers checked what planes were arriving that afternoon at Maiquetía and found out that at 5:10 an L7 plane from Maracaibo was landing. Justo Gómez, at fifty miles per hour, went to the airfield, and looked for someone he knew who was going to Caracas, but didn’t find anyone. Since there was space on the plane and not a minute to lose, he bought a ticket in the airfield and brought it personally.
In New York, Mr. Hester did not close the office. He canceled his weekend plans, requested a telephone call with the top authority on the subject in the United States, in Chicago, and collected all the information necessary on hyperimmune. It was not easy to acquire the serum there either. In the United States, due to the authorities’ control over dogs, rabies is on its way to total eradication. It has been years since a case of rabies in a human being was last recorded. In the last year, they only recorded twenty cases of rabid animals in the whole territory, and all of them were in two states on the periphery, along the Mexican border: Texas and Arizona. Since it is a drug that doesn’t sell, the pharmacies do not keep it in stock. It can be found at the laboratories that produce the serum. But the laboratories have closed at noon. Another telephone call, this one from Chicago, tells Mr. Hester where he can find hyperimmune in New York. He gets hold of three thousand units, but the direct plane to Caracas had taken off a quarter of an hour ago. The next regular flight—Delta 751—would leave on Sunday night and not arrive at Maiquetía until Monday. Nevertheless, Hester sent the vaccines in the care of the captain and sent an urgent cable to Reverón, with all the details, including the telephone number of Delta in Caracas—558488—so he could get in contact with their agents and pick up the drug at Maiquetía, at dawn on Monday. But it might be too late by then.
Carmelo Reverón had lost two precious hours when he ran, panting, into the Pan American offices, on Avenida Urdaneta. Carlos Llorente, the employee on duty at the ticket desk, attended to him. It was 2:35. When he heard what was involved, Llorente took the case as if it were happening to him and pledged to bring the serum, from Miami or New York, in less than twelve hours. He consulted the itineraries. He explained the case to the company’s air traffic director, Mr. Roger Jarman, who was taking a siesta at home and thinking of going down to La Guaira at four. Mr. Jarman also took the problem on as if it were his own, phoned the PAA doctor, in Caracas, Dr. Herbig—Avenida Caurimare, Colinas de Bello Monte—and in a three-minute conversation in English learned everything there is to know about hyperimmune. Dr. Herbig, a typical European doctor who speaks German with his secretaries, was already worried about the problem of rabies in Caracas before hearing about the case of the Reverón child. The month before he had attended two cases of people with animal bites. Two weeks earlier, a dog died outside his office door. Dr. Herbig examined it, purely out of scientific curiosity, and had no doubt that the dog had died of rabies.
Mr. Jarman phoned Carlos Llorente and told him, “Use all resources necessary to get the serum here.” That was the order Llorente was waiting for. By a special channel, reserved for airplanes in danger, he transmitted, at 2:50, a cable to Miami, New York, and Maiquetía. Llorente did so with a perfect knowledge of the itineraries. Every night, except Sundays, a cargo plane leaves Miami for Caracas arriving at Maiquetía at 4:50 the following morning. It is flight number 339. Three times a week—Monday, Thursday, and Saturday—Flight 207 leaves New York, arriving in Caracas the following morning, at 6:30. In Miami and in New York, they had six hours to find the serum. He informed Maiquetía, so they would be aware of the operation there. All the employees of Pan American received the order to remain on alert to messages arriving that afternoon from New York and Miami. A cargo plane, flying to the United States, picked up the message at an altitude of twelve thousand feet and retransmitted it to all the airfields in the Caribbean. Completely sure of himself, Carlos Llorente, whose shift would be finished at four that afternoon, sent Reverón home with a single instruction:
“Call me at 10:30 on 718750. That’s my home phone number.”
In Miami, R. H. Steward, the employee on duty at the ticket desk, received the message from Caracas almost instantaneously, through the office’s teletypes. He telephoned Dr. Martín Mangels, medical director of the Latin American Division of the company, at home, but had to make two more calls before he tracked him down. Dr. Mangels took charge of the case. In New York, ten minutes after receiving the message, they found an ampoule of one thousand units, but by 8:35 they’d given up hope of finding the rest. Dr. Mangels, in Miami, having almost exhausted his last resources, turned to Jackson Memorial Hospital, which immediately communicated with all the hospitals in the region. At seven that night, Dr. Mangels, waiting at home, had still not received any response from Jackson Memorial Hospital. Flight 339 was leaving in two and a half hours. The airport was twenty minutes away.
LAST MINUTE: A DEGREE AND A HALF OF FEVER
Carlos Llorente, a twenty-five-year-old Venezuelan bachelor, handed over his post to Rafael Carrillo at four, and left him precise instructions on what he should do in case any cables arrived from the United States. He went to wash his car, a green and black model 55, thinking that by that time, in New York and in Miami, a whole system was in motion to save the Reverón boy. From the gas station where he was getting his car washed, he called Carrillo, who told him that no news had arrived yet. Llorente started to get worried. He went to his house on Avenida La Floresta, in La Florida, where he lives with his parents, and ate without appetite, thinking that within a few hours Reverón would call and he wouldn’t have an answer for him. But at 8:35, Carrillo called him from the office to read him a cable that had just arrived from New York: on Flight 207, which would arrive at Maiquetía on Sunday morning at 6:30, one thousand units of hyperimmune were on their way. By that time, one of Reverón’s brothers had met Justo Gómez, who bounded down the steps of the Maracaibo plane with the first one thousand
units, which were injected into the boy that very afternoon. They still needed another one thousand units, as well as the one thousand that were definitely coming from New York. Since Reverón had not left any telephone number, Llorente did not advise him of events, but he went out a little bit more calmly, at nine, on a personal errand. He left his mother a note:
“Señor Reverón will call at 10:30. Tell him to call Señor Carrillo at the PAA office immediately.” Before going out, he called Carrillo himself and told him to, if possible, keep the central line free after 10:15, so Reverón wouldn’t get a busy signal. But by that time, Reverón was feeling like the world was falling in on him. The boy, after the injection of the first dose of serum, did not want to eat. That night he was not as lively as usual. When he put him to bed he had a bit of a fever. In some cases, very infrequently, the anti-rabies serum entailed certain dangers. Dr. Briceño Rossi, from the Hygiene Institute, had decided not to produce it until he was absolutely convinced that the person who was injected would not run any risk. The fabrication of the ordinary vaccine did not present complications: for animals, it is a live virus in a chicken embryo that gives three years of immunity in a single dose. For humans, it is made from the brain of a sheep. The production of the serum is a more delicate operation. Reverón knew it. When he noticed that his child had a fever, he thought all hope was lost. But his doctor calmed him down. He said it could be a natural reaction.
The Scandal of the Century Page 16