In a World of Snapping Jaws, Dr. Ellie Goldstein Fears the Bite of the Dreaded Human
updated 08/20/1984 AT 01:00 AM EDT
•originally published 08/20/1984 AT 01:00 AM EDT
Although nobody keeps national statistics, Goldstein thinks the incidence of human bites may be growing because of man's more aggressive behavior. "People are embarrassed to admit to being bitten," he says. "There is a deep feeling in our culture that it is barbaric and uncivilized for one person to bite another."
Goldstein made a major breakthrough in the diagnosis of infection caused by human bites while he was treating a West Los Angeles patient in 1976. The man had developed a serious infection of the hand after punching someone in the mouth. The infection resisted all conventional treatment until Goldstein discovered the presence of Eikenella corrodens, bacteria commonly found in dental plaque. The discovery enabled him to gather proof that in human bites Eikenella is a factor in causing infection. To combat it, he and others are experimenting with a new antibiotic, Augmentin.
The initial symptoms of infected bite wounds take eight to 12 hours to develop, says Goldstein. Among the most frequent victims of human bites are muggers and their targets, battered women and abused children and dentists. Even politicos sometimes are attacked. At the Democratic National Convention last month, three delegates were bitten by a man after he had been asked to sit down during the Jesse Jackson speech. One victim required a tetanus shot and finger splint.
Goldstein predicts that half of all Americans will be bitten at some point in their lifetimes, "mostly by their dogs but occasionally by their lovers." In his experience love nips account for 10 percent of the human bites for which treatment is sought. The infections they cause may be difficult to diagnose because chagrined patients often don't admit how they were hurt. Goldstein recalls a case in which a 35-year-old man came to the emergency room with an abscess in his groin. A love nip, it evolved, had transmitted his girlfriend's scarlet fever to him.
Human bites can also transmit hepatitis and herpes. "We still haven't seen a case of AIDS contracted in that manner, but it's possible," he warns.
As the youngest of six children raised in the Bronx, Goldstein was encouraged by his father early on to become a doctor. But a week before he graduated from New York's Downstate College of Medicine a serious motorcycle accident hospitalized him for nine months while doctors fought to save his left leg from amputation. He still walks with a cane. His experience as a patient, he says, "taught me how important it is for a physician to communicate on a caring, human level."
Goldstein, a specialist in infectious diseases, now concentrates his research at Santa Monica Hospital Medical Center and the VA's Wadsworth Medical Center. "If I were a surgeon I'd spend all my time in the operating room," he says. "But when you specialize in bites, you wind up smelling pus, culturing bacteria and searching for clues to some of the world's most perplexing microscopic mysteries."
As a bacteria sleuth Goldstein strikes an offbeat note with his discount-store clothes. "He's the Columbo of bite medicine," says microbiologist Diane Citron. Replies Goldstein, not at all adverse to the comparison with the TV plain clothesman, "I've always looked on infectious diseases as detective work."