He was two months shy of 62, his fair skin bronze from the sun and his once-blond hair a striking gold and silver. Blue eyes sparkling with vitality, he could go 14 grueling chukkers of polo with men 10 to more than 40 years younger than he.
Now, one week later, he lay dead in a Fairfax hospital.
Most people would assume the man had suffered a sudden massive stroke, or had been in an accident. Had it been either of those causes his death would have been a painful shock, but perhaps more easily accepted.
My father, Rieder William Schell, died of Rocky Mountain spotted fever in June 1977, in the middle of "tick season" in Virginia, at a time when the state was experiencing a record number of cases. There were seven fatalities in the state that year, among 43 nationally.
Rocky Mountain spotted fever (RMSF) is a typhus-like disease caused by a microorganism which is transmitted to humans by ticks. In spite of its name, it is not localized in the Rocky Mountain area.
The Encyclopedia Britannica describes the disease as being abrupt in onset, with headache, muscle aches, fever, chills, nausea, increasing prostration, restlessness, insomnia, disorientation, and in the severest of cases, delirium, "merging into coma with death as early as the sixth or seventh day." A rash is often present.
In most cases recovery is with the relatively simple treatment of antibiotics, specifically tetracycline or chloramphenicol.
Dad, since my mother's death, spent most of his time traveling. He had been to Texas with one of my sisters for a polo-pony sale, to Montana to help another sister plant a rose garden and her veterinarian husband spay heifers. After a weekend of polo in Kentucky, he came to Reston to visit my family and for more polo.
A few hours after his arrival on a Monday afternoon, he was at the Reston Polo Club watching his friends play a game. The next morning he found a huge, engorged tick on his chest. We removed the tick, cleansed the swollen area and checked for more ticks. Not certain where the tick may have come from, we also checked the children and the apartment. We thought little more about it.
That evening, while dining out with friends, Dad started feeling ill and feverish with a severe headache. The next day he left a luncheon early with what felt like the onset of flu: aches and pains, fever, chills and nausea. When he Telephoned some friends to cancel a visit, they told him of some recent newspaper articles about Rocky Mountain spotted fever, that the symptoms resemble those of flu and that the area was having a record number of cases.
As a retired colonel after 30 years in the U.S. Army, Dad felt it was natural to go to a military medical facility while away from home. (New to the area, we had no family physician.) While my husband Bob drove Dad to the DeWitt Army Hospital at Fort Belvoir, I called ahead to the emergency room to alert them to my father's arrival and the possibility of his having RMSF.
The doctor who examined my father took note of all his symptoms, and of the fact that he had had a tick bite. The doctor even said he found a second bite. But in spite of all this, he told Dad that he just had "some type of virus." It was "too soon" after the tick bite for him to have developed RMSF, and, besides, he "didn't have a rash either."
The doctor couldn't explain the other symptoms of urinary and bowel problems and pains. (They also are symptoms of RMSF.) Dad was sent home with a pain killer. We took the doctor's words as fact that Dad "couldn't" have RMSF, and accepted the diagnosis of "unknown virus."
But his symptoms worsened and he became more and more uncomfortable and weaker, unable to keep down any nourishment and fighting a fever that would go up to 104 degrees. Bob took Dad back to DeWitt on Saturday, after a stop at another miliary facility produced no doctor on duty.
Dad told a different doctor of the tick bite, of all his symptoms and of the steady worsening of his condition. He asked to be admitted to the hospital. He was so weak he could barely hold his head up, and shiffled along like an ailing 100-year-old. The doctor told him he just had a virus and it wasn't necessary to admit him.
He was sent home again with another supply of medicine, but no antibiotics of any kind. Dad was hurt and upset about his treatment. "I can hardly move, and they say I'm not sick enough!"
That night and Sunday, drugged by the medication, he was able to finally get some rest. But through the night and early Monday morning his fever shot up again, the nausea and bowel problems worsened, he became much weaker and fell several times when he tried to get up.
I called the resue squad, fearing that even if it was "just a virus," Dad was experiencing some terrible complications. The squad took him immediately to ACCESS emergency center, where he was examined and monitored. They sent him on to Fairfax Hospital for further treatment.
By then his vital signs had deteriorated rapidly and he was sent to intensive care. The doctors worked around the clock, treating his high fever, trying to stabilize his vital signs, and administering antibiotics for Rocky Mountain spotted fever. Tuesday morning, June 7, one week after he found the tick on his chest, my father was dead from Rocky Mountain spotted fever.
In our law suit against the U.S. government, settled out of court last year, Dr. Cyrus Guynn, one of the physicians who treated Dad at Fairfax Hospital, testified ". . . Earlier appropriate treatment would have favorably altered the outcome of his disease. Delay in diagnosis and inappropriately withheld therapy is the primary cause of mortality in this disease."
Said another consulting physician at Fairfax who treated Dad, "I felt that it was peculiar that the military facility noted the presence of a tick bite, severe headache and fever, yet failed to start the patient on tetracycline. Although he had no rash at that time, the above history certainly would have forced me to start him on appropriate therapy. . . ."
There is no way, of course, to ease the anguish of our experience. But I tell this story with the hope of perhaps alerting someone else.