Just an ordinary raccoon — that's what you'd think at first. I know I did.
I couldn't have been more wrong; this was a special raccoon. This one set in motion the strange wheels of destiny, ultimately changing the world. The furry, black-masked character was in and out of our story in no more than five minutes. But he left a mark — two marks, actually, on my patient's right wrist. And one colossal mark on medical history.
This is a story filled with twists and turns, ups and downs, many people, diverse locations, happy and sad moments. But never forget that little raccoon who started it all.
It was six o'clock on the morning of July 25, 2015, when the raccoon furtively emerged from the shadows. He was wandering through the woods of Stark County, Ohio, looking for breakfast. Before him sat a grassy clearing, a promising one, and a four-foot wire fence enclosing it. He scampered to the top of the fence, prepared to drop to the other side — and froze in place.
Two raucous, yapping dogs had sounded the alarm.
The canine couple went by the names of Vivian Sue Dog and Vincent Van Dog. They were owned and adored by their human caretaker, Melissa Loomis. They loved her, too, but at the moment they were in a barking frenzy over discovering an intruder into their little world.
The two pets had gently awakened their owner a few minutes ago, as usual, by pushing their heads firmly against her bed. It was time for their morning romp in the wide world of the backyard. Melissa had tucked her toes into her slippers, yawned, and followed Vivian and Vincent to the door. The wire fence limited their travels, but there was still enough room for the dogs to stretch their legs, attend to crucial body functions, and sniff around for anything new and interesting in the way of critters — such as, in this case, a raccoon.
Squirrels and chipmunks were pretty much par for the course. But a raccoon? Well, that was a special visitor. This was a special day, and the dogs were lifting their voices to let the world know.
Melissa quickly hurried to them. She normally waited on the porch, scrolling through Facebook posts on her phone. But five minutes into their romp, she'd heard a hissing followed by furious barking. The neighbors were going to love that. Putting away her phone, she came running and saw the nature of the standoff.
A raccoon clung to the fence. Not a cute, fuzzy cartoon character as drawn by Disney. This one looked feral and desperate as the dogs yapped furiously, growled, and closed in on their prey. Vivian showed especially deadly intent; she was on the verge of launching her attack.
You might say Vivian Sue isn't the name for a savage, bloodthirsty predator, but Melissa would reply that you just don't know Vivian Sue Dog. She's loving but deadly serious when it comes to unwanted varmints. I once asked Melissa what breeds her dogs were. She told me Vincent is a beagle, and she believes Vivian is a Treeing Walker Coonhound.
Well, no wonder!
The raccoon was sitting on the fence for the moment, literally and figuratively, but Melissa was certain it wasn't going down without a fight; he looked ready to take the battle to the dogs, tooth and nail. Melissa was particularly worried about the raccoon, who wasn't going to stand much chance against two large dogs with hunting in their blood. But what were her options? She could go back into the house and get Neil, her husband. She could find a rock and throw it, hopefully chasing the animal back into the woods.
Neither of those would be timely enough. Things were about to go sideways. To heck with it, Melissa thought and came at the raccoon herself. She began waving her arms and shouting, "Shoo! Shoo! Get out of here, raccoon! Go away!"
I had to stop Melissa right there when she first told me the story.
"Really?" I asked. "Were you hoping the raccoon spoke English?"
"No, but —"
"And if savage, teeth-baring dogs couldn't scare the animal away, did you figure your birdlike, flapping arms would do the trick?"
Melissa just smiled and shrugged. It wouldn't have occurred to her to back down. She was worried about that raccoon, you see. Melissa has a heart for animals.
Things indeed went sideways. When the raccoon curiously eyed the strange woman, the distraction was just the opening Vivian Sue Dog had been waiting for. She sprang at the fence, clamped her teeth on the raccoon's tail, and flung the animal onto the ground, where the dogs could settle the issue.
Melissa had to do something and quick. My suggestion would have been, "Get the heck out of the line of fire!" Instead, she grabbed a dog collar with each hand, in hopes of dragging her pets back toward the house.
And that's the very moment when life for Melissa Loomis came to a fork in the road; she chose a hard left and accelerated down that unknown path with no chance of turning back — because the frantic raccoon jumped onto Melissa's right arm, sank his teeth into the bottom of her right wrist, and scratched her left arm in the bargain. Melissa grabbed the creature with both hands and heaved him over the fence.
Exit the raccoon, his role in this story complete. He vanished into the line of trees and the mists of uncertainty. Not so for Melissa. Her story had just begun.
She suddenly realized she was in pain — boy, was she in pain! She let out a serious howl. The dogs, their plans plummeted as they watched their hoped-for target flee into the woods, turned and regarded her with concern.
Melissa's yelp carried into the house and awakened Neil, who quickly ran to the back door, threw it open, and took in a sight he would never forget: his wife walking toward him with her arms thrust out before her, blood flowing from both.
I'll be honest. I hate the sight of blood — I hate it a lot — and my personal pain threshold isn't too impressive. And yes, this is a surgeon telling you that: somebody who performs, well, surgery, and deals with the sight of blood as a job description. It's true. When my kids skin a knee or lose a tooth, I don't handle it well. But if I'd been Melissa or Neil in this scenario, I'd probably have gone to pieces.
This was Melissa, however. She'd already put in her one good bellow and gotten it out of her system. Now she merely walked toward her husband and said, "I just lost an argument with a raccoon."
Sure, Melissa had been attacked by a feral animal, she had an arm throbbing with pain, and what was she up to? Tossing out a wry one-liner.
Ladies and gentlemen, Melissa Loomis.
Neil, a bit more practical at the moment, thought, This isn't good — at all. We need to do something — right now! All he knew was that his wife had been bitten and scratched by a raccoon. Was it rabid? Did it carry some kind of disease?
There was another factor to consider, and it added to Neil's concern. Melissa is a diabetic, making her risk of infection from a bite much higher than it would be for someone who didn't suffer from diabetes.
"We've got to get you to the emergency room, but we'd better do what we can first," Neil said. He guided her inside, where he helped clean her wounds, including the scratches, and bandaged her wrist with gauze.
Melissa felt it was a shame and a waste of time to be sitting in the waiting room of an ER on such a pretty summer morning. Her husband was eyeing those bites and taking the whole thing seriously. The dogs were at home, still trying to calm down. And somewhere there was a raccoon telling his forest friends that he'd just lived out the furry version of a horror movie.
But for Melissa, it wasn't a big deal. She took her phone to the medical facility so she could resume reading posts from her friends on Facebook. She had no idea that the wild ride of a lifetime was about to pick up speed.
Melissa kept track. She and her husband arrived at the ER fifty-four minutes after the raccoon sunk his choppers into her wrist.
They parked the car, filled out the usual forms, and saw an ER physician. He quickly took note that Melissa had diabetes. Diabetics lack the strength other individuals might have to fight off an infection, so physicians are very careful.
The attending physician decided to start Melissa on a rabies protocol and a regimen of oral antibiotics. The gauze was removed, the wounds were cleaned a bit more thoroughly, Melissa's wrist was dressed with sterile bandages, and she was instructed when to return for three more shots to finish off her rabies vaccine, while taking her oral antibiotics each day. Rabies inoculation and common antibiotics would normally end the story, so the patient was discharged.
You or I would have been ready to go home and get a little rest after all this excitement and pain. Who needs the daily hassles of a job? But Melissa went to her office, with her right arm wrapped. She simply couldn't see any good reason to "lie around the house." She worked as a food services director, and she knew there were menus to be prepared and supplies to be ordered.
"My blood sugars were stable," she pointed out later. "I didn't miss a day of work." She didn't say it proudly, just as a fact. She even attended a fund-raiser.
A few days passed and then a few more. The oral antibiotics weren't making much headway, the pain wasn't going away, and her arm was still red. She walked into our office, consulted with one of our doctors, and was immediately sent to the hospital for a more rugged round of antibiotics — this time to be administered intravenously.
"The hospital? Really?" Melissa asked. It seemed like overkill to her. Her arm was hurting, and that was an inconvenience, but things like this healed up quickly, didn't they? Surely if she had to check in to a hospital, she'd be in and out after twenty-four hours. This would be the first time she'd miss a day of work.
On the way she called her sister, Michelle Dalpra. "Can you believe it?" she asked. "They're going to put me on an IV. For a silly animal bite."
Michelle didn't like the sound of it, but she had to agree with her sister's good sense. How serious could something like this be? There are amazing medicines and doctors. This wasn't a big deal.
While all this was happening, I was at a North Canton, Ohio, high school football field. I volunteer as a team doctor at Hoover High School for all its athletic teams, and the football team was into heavy practices for the coming season. Nobody was suffering from heat exhaustion or a tweaked ankle, so I was just hanging loose and having a good time.
My cell phone rang. I glanced at the phone, and the caller ID said "Tyler Crockett" — one of my nurses, the guy who always knew where to find me.
"What's up, Tyler?" I said.
"We've got a forty-three-year-old lady who was bitten by a raccoon, Dr. Seth. We need you to admit her."
"Raccoon? Really? That must be some kind of bad bite."
"She's been on antibiotics, and they've made no headway. She's diabetic — that may be part of the problem. She needs to be in for an IV round."
"Gotcha. We'll try that for twenty-four hours, and that should tell us where we are."
It was normal protocol for an animal bite infection. You hope that intravenous antibiotics, which go directly into the bloodstream, will get the infection under control, and then you won't have to consider surgery.
"Thanks, Dr. Seth."
And that's how it began for me — nothing out of the routine, even for an animal bite. At this point in my medical career, I'd handled hundreds of infections. This kind of case pointed toward a forty-eight-hour hospital stay for Mrs. Loomis, and then she should get back to her life and I could move on to other patients.
Not until the next day did we finally meet face-to-face.
Melissa checked into the hospital. She had received three different oral antibiotics before I met her on August 14, 2015, almost three weeks after the bite. Immediately she was started on a penicillin-type IV antibiotic, my usual choice for infections. I've had success with it nearly every time.
Melissa took it all in stride, but Neil didn't find out she was in the hospital until after work. Like many people, he's not able to check his cell phone during work. As he left at the end of his shift, he turned on his phone and saw a text from his wife:
I was admitted to the hospital for IV antibiotics.
Worried, he hurried to the hospital and found his wife on the fifth floor, the orthopaedic ward. Several other members of her family were there as well, and they found out, like countless families before them, that there's not much to do while sitting around a hospital. Sometimes I think it takes the long vigil of waiting at a hospital to make families slow down for an hour or two and simply talk to each other.
The IV drips proceeded, and they could watch that; it was interesting for about two minutes. They joked around, kidded Melissa about her lack of success as a wild animal tamer, and heard the only real item of information: that a Dr. Seth would be checking in that afternoon. Still, it was just a raccoon bite — Melissa, her dogs, some silly raccoon. Nobody was too concerned.
Since she was a diabetic, however, nurses were monitoring not only her vitals but her blood sugars and whether they were staying within normal limits.
By Saturday afternoon Melissa had been on the antibiotics for twenty-four hours, so I could check on her and talk to the family. I remember it was a beautiful, sunny afternoon and a Saturday, so I'd been spending my time with my family. What I expected as I made my way to the hospital was a quick consultation.
I got to the fifth floor, checked in with the nurses' station, and caught up on a bit of paperwork before making my way toward room 5514. What I found there was a highly skeptical group.
"How are we doing, folks?" I asked in my breezy, here-comes-the-doc way as I bustled in. Straight ahead lay the patient, a pleasant-faced, smiling woman. To her right was her husband, Neil. To her left, David, her brother-in-law. These were bookend grizzly bears, large guys who could have played middle linebacker for the Cleveland Browns.
Michelle, the patient's sister, occupied a chair to the left. Dad was to the right. The patient's stepmother was in the corner of the room. In short, I found a patient who seemed to be enjoying her IV, with a grim supporting cast.
"Hello, everybody. I'm Dr. Seth," I said, smiling.
They nodded and mumbled, returning the greeting without too much enthusiasm.
"I hear what we have is an animal bite and a very stubborn infection."
Melissa confirmed those facts, and I asked her a few questions about the last couple of weeks of antibiotics.
She told me she'd developed a fever, and her right arm was becoming more swollen and painful. I gently felt the arm and saw she was right. Her entire forearm was red, with two small puncture wounds on the underside of the wrist — two holes the size of points made by an ink pen. While they were almost healed over, the red streaks moving up the arm were impossible to ignore.