Lissa the Rhino is struggling to keep her footing — and those aren’t small feet.
A team of doctors, surgeons and rhinoceros wranglers have gathered at Lissa’s pen at Lion Country Safari. They’ve injected her with a narcotic and are trying to maneuver all 3,500 pounds of wobbly beast into the center of her space and away from a hip-high pile of dung.
She has someone’s black windbreaker thrown over her eyes. Three grown men and one woman, each tug at lassoes looped around her neck.
Wherever she lands will be their operating suite for the next three hours.
Lissa has cancer. On her horn.
Jokes about rhinoplasty aside, this is serious. Few rhinoceroses in captivity ever develop cancer. There was the one in Arizona with a sarcoma on his foot. Another in Los Angeles had something on its horn, but the growth was very small.
The tumor here is bigger than a squished basketball. It’s not just on her horn, it’s in it.
And on this day in February, surgeons – the kind who work on humans and the kind who work on animals – are planning a two-pronged attack: cut out as much of the tumor as possible and then inject a chemotherapy drug into the rest.
They’ve already operated three other times. Those times they had to trip her into place. This time she sits on her back haunches first and then lowers that car-engine-sized head onto a pile of foam mats.
The surgeons have three hours. Not one minute more.
Let the timer begin.
Lissa was born Dec. 11, 1980 at Lion Country Safari, a drive-through zoo off Southern Boulevard in Loxahatchee. She’s one of 14 rhinos living on the property. Her most constant companion: her daughter Aliza.
“In the wild, if they live to be 35 that’s ancient. Here, we have some 40-year-olds and one 50-year-old,” said the park’s Wildlife Director Terry Wolf.
With the exception of the old man – he doesn’t play well with others – the rhinoceroses roam the park alongside zebra, wildebeests and the like during the day and live in their pens at night.
Lissa’s keepers first noticed a sore at the base of her horn in October and grew more concerned when antibiotics failed to make it any better. Worse: another sore surfaced.
Biopsies followed. Lissa needed to go under the knife.
“You have got to know knocking these animals down is risky business,” Wolf said. “Any drug we give them that is enough to put them to sleep is also going to affect their breathing, and we don’t have a respirator powerful enough to fill her lungs up if she stops.”
CPR, he notes, will not work on Lissa.
“Last time we had her down was almost three hours. They’re not moving that whole time. They can develop bad problems,” Wolf said.
The longer the animal is down, the more likely a complication is to arise. The very weight of her body can put enormous pressure on nerves and muscle and there’s the potential for damage.
Each time Lissa’s gone under, surgeons have had to hack away her horn. In the wild that horn would come in handy to defend her children and herself from predators.
Lissa is a white rhino, a name that harkens to her wide mouth and not the color of her skin, which is actually quite gray. Like her fellow white rhinos, Lissa has two horns.
The horn isn’t a bony extension of her skull but a compacted mass of hair that grows forming a protective sheath much like a pointy human fingernail atop the tip of her nose.
Poachers have been known to kill a rhinoceros to get a horn, which in some cultures has been revered for its medicinal properties. Some Asian doctors once held that powdered rhino horn cured asthma, chicken pox and demonic possessions. It’s been prescribed for polio and impotence.
But Lissa’s horn could kill her.
“In some instances it is better to do nothing. You have to find that balance. We don’t want to kill her in the process of curing cancer,” said Brian Dowling, Lion Country’s general curator who rides herd over the pen-turned-operating room every time Lissa goes under. “This is not one of the cases where you can do nothing.”
The first time they operated, surgeons took a sample and found cancer.
After that, doctors cut down Lissa’s horn to figure out how big the tumor was and make treating it easier. Each time, Dowling watches the minutes tick by and frets how quickly she will get up.
Dr. Elizabeth Hammond, the park’s vet and Lissa’s handlers have taught Lissa to sidle up to them for sweet feed (rhino junk food of grain and molasses), making it easier for them to conduct examinations and administer drugs.
For surgery, they have become pros at sticking her with the narcotic behind her left ear and then marking that spot with neon pink spray paint, less anyone on the surgical team touch the drug, which can seep out at the injection site.
Get pink on you? Wash up now. That drug is lethally potent in humans.
This day in February, new faces are gathered.
Dr. Mike Mikolajczak from the Wellington Orthopedic Institute is more accustomed to working on human hands and feet. But he connected with Lion Country when a chimp got in a fight and needed more than a dozen surgeries to allow him to return – one finger the lesser — to the primate island.
Dr. Mike, as everyone calls him, hit up his contacts in the surgical supply business and has brought a surgical Stryker saw and a cauterizer that uses water.
Chipping the horn off a rhino is not the delicate work of repairing a finger. It’s very bloody and requires strength and power tools.
Lion Country has its own portable X-ray machine – it costs more than your car, so don’t step on its cables, warns Dr. Genevieve “Genny” Dumonceaux, the vet at the Palm Beach Zoo, who has driven out to assist.
Also on hand is retired pathologist and member of Wellington Regional Medical Center’s board, Dr. Gordon Johnson.
He’s brought sealed bags of Lissa’s hope: Cisplatin.
This is Lissa’s chemo.
Not the kind that courses through your entire system. Can you imagine trying to gather enough drugs to treat a nearly two-ton patient?
This is a tumor killer. It is supposed to stop cancer cells from growing, causing them to die.
The drug is to be injected into Lissa’s sizable mass.
“It’s been used on equine sarcoma,” Johnson said. No one’s ever tried it on a rhino.
The surgical team erects a tent to keep Lissa from overheating in the morning sun.
At least a dozen people are on hand throughout the procedure: Someone leans on Lissa’s left should she deign to move, nurses run IVs, monitor the oxygen tank. Every once in a while, someone in the back lifts Lissa’s tail and checks for a droopy drop. A stiff tail indicates the anesthesia is wearing off.
The minutes stretch into hours as Dr. Hammond and Dr. Mike chip away at the tumor – and pause when Lissa twitches her ear or lets loose a shuddering sigh.
You can hear the chimpanzees making a ruckus not far away. A rhino walks by, gives a look and moves on. The curious zebra lingers.
Finally, more of the tumor is revealed, the Cisplatin is loaded into syringes – but Hammond struggles to push even these large gauge needles into the tumor’s rocky base. She gets several in. She wishes she had gotten more.
They put a cling wrap Band-Aid of sorts over the plate-sized void where Lissa’s horn once was.
And then Dowling calls time.
Never has an operating room cleared so quickly.
The doctors, nurses, their discarded needles, empty vials, IV bags hoses – even the tent and the four trucks they all rode in on must be gone before the patient awakes and that happens in a matter of a minutes. At the last minute someone grabs the black, now bloodied, windbreaker from Lissa’s eyes.
A line forms on the other side of the pen’s metal fencing.
Lissa looks like a drunk coming to. Head nods. Front legs stiffen and push and then collapse. And then again. Hind legs pump. Hind legs falter. Front legs move, dragging the back end around.
Dowling and Hammond and Dr. Mike and Dr. Gordon and the lasso team and the nurses watch.
And then Lissa’s up and slowly putting one foot in front of the other.
“That was the most stressful part of the day,” Dowling said. He gathers the team in a circle. “We were really aggressive. That’s good.”
In April, the crew gathered again. This time Dr. Mike found a better tool – a laser-like torch that made the tumor cutting easier and cauterized the wound at the same time.
And they also learned that 10 of them could roll the patient on her side mid-surgery. That seemed to help Lissa’s recovery.
Another surgery seems inevitable. Dr. Hammond and her colleagues are taking notes. The better to help the next rhino.
“We haven’t cured her,” said Dr. Hammond. “But her quality of life is good right now.”
In between surgeries, Lissa eventually healed enough to roam the preserve. Hammond’s goal is to make sure she returns.
“She was so happy running all over.”