Atrox, Antivenin, & Amputation Anniversary


Well, today marks the one-year anniversary of my snakebite, and I believe I had promised a first-hand account to you all, dear readers. A year seems like plenty of time and then some to get over the pain and bother of it, I suppose. Over the course of the last 365 days I have had to reteach myself to type, and I can no longer feel anything at the end of what is left of my ring finger (except, of course, when I bump it on something) but other than that I can’t complain. So without further ado, here is a memoir of my painful, educational encounter with Princess Atrox…

*DISCLAIMER: any insinuation of intentional sadistic ill-treatment, gross malpractice, or sociopathic barbarism in regards to the doctors or nurses that treated me is to be taken lightly; I experienced a high degree of kindness and professionalism at both hospitals, from the nurses, doctors, anesthesiologist, and yes, even the surgeon…*

BEWARE THE IDES OF MARCH

(A HANDS-ON LESSON IN HEMO-TOXICOLOGY)

 

 with thy sharp teeth

this knot intrinsicate

of life at once untie;

poor venomous fool,

be angry, and despatch

 – Cleopatra

– Act V

 

​It is past midnight. A brisk, violent wind has blown in from the wild western plains, piloting the way for a slow-moving thunderstorm that is soon to come rolling across the cross timbers on this warm, early spring. I am writing by pen, as the current physical condition of my left hand has left me in a disabled state unsuitable for life behind the keyboard. Occasionally I glance over at my crippled, bandaged left, and my gaze is naturally directed toward that odd, inch-long space where my ring finger used to be but now is not. It is not because seven days ago, for the brief span of what had to be less than a second, a juvenile western diamondback was firmly fastened to it, her minute curved hypodermic dentition embedded to the hilt, swollen venom glands contracting and expanding as they delivered a full load of potent hemotoxic cocktail into the soft pad of my fingertip. As quickly as she had struck the snake released her hold. But the damage had been done. The complex combination of proteins and peptides went to work breaking down the absorbent subcutaneous tissue just north of my wedding ring, and my nerves sent a bolt of hot, searing pain into my brain exclaiming something like, “Thirty-five percent of venomous snakebites are dry! Congratulations! Welcome to the majority!” And shortly thereafter came the most painful part: informing my wife that her idiot husband had gotten that part of his hand adorned with his symbol of devotion to her a little too close to the homing range of a rattlesnake’s heat sensitive pits, those chemosensory red flags of danger ablaze on the flickering tips of a violet-black forked tongue, signaling its reptilian brain to strike out with mouth agape, elastic jaws stretched, fangs unfolded from their fleshy sheaths and pointed forward in that age-old, sinless self defense mechanism devoid of malice but damaging all the same. It is one that works superbly well, accomplishing its intended purpose with a speed of which few other things can compare. Touch a red-hot pan and you drop it without thinking. Take a bite from a crotalid and you stop messing with it instantly, I can guarantee you. ‘Don’t Tread On Me’, her whirring caudal appendage continued to resonate as I secured her quickly in the lock box. Yes ma’am. Message understood loud and clear, thank you very much, and further accentuated with every pulsing throb of my fiery fingertip, from which twin pinpricks of bright red blood had begun to escape from their normal vascular course and make their way on a redirected route across my bare skin. There was an instant shout of some unmentionable phrase that I can’t quite remember, a slang crude version of, “fiddly-dee, this is going to require a trip to the emergency room!” Whatever was said, my wife heard it, and by the time I could secure the snake and get to the kitchen and explain, she had the car keys in her hand. I removed the wedding ring in order to avoid blood flow restriction, then turned on the faucet and gave the now-searing wound a quick rinse, marveling at how the rapid onset of tissue degeneration, intended to dispatch and begin breaking down the snake’s prey even before it has been located and swallowed, had already caused the outer edges of the bite marks to become awash with the dull, faded purple hue of smudged ink. 


​It is a forty five minute drive to the nearest hospital that I trust (the local so-called hospital in nearby Decatur has killed more patients than Jack Kevorkian), but my wife turned on the flashers and transformed 380 into the Texas Motor Speedway, so we got there in about thirty. The Denton Presbyterian Hospital had been called and notified of the situation en route, and they confirmed they had the antivenin on hand. Meanwhile, I am keeping the hand elevated and trying my best to document the finger’s digression with the camera on my cell phone in order to keep myself from chewing my seatbelt off at the shoulder. Thanks largely to Amber’s uncanny ability to mask her concern behind a fortified steel wall of collected serious calm, we arrived safely with no dramatic curb-jumps or two-wheeled grand entrances, parked and headed for the doors of the ER.

​The venom of hemotoxic pit vipers is a thrilling, exquisite joyride of almost unbearable, indescribable pain that can best be described as having whatever extremity one so happens to have the ill fortune of being punctured by struck with a red-hot ball peen hammer. The fact that this particular bite was to the highly sensitive pad of my fingertip, where all the delicate nerve endings were gathered, made it all the more enjoyable. Remaining calm is the most important issue at hand ( pun intended), keeping the heart rate from going into hyperdrive and exploding in the chest cavity like a party balloon in a cactus patch. It is not the easiest thing in the world to do, mind you, but it is vitally necessary, and so I buckled down and did it. While Amber handed over my insurance information at the desk I took a seat in the waiting room among the broken-boned, accident prone cohorts who were likewise having a problematic weekend, checking my pulse by counting the painful throbs in my finger. ‘King!’, I soon heard the nurse call out, and I made my way to the back, where hopefully that sweet, sustaining bottle of polyvalent had already been shaken and stirred and was waiting for me in an IV bag…

 ACT II

Out of the Frying Pan, Into the ER

 

Surely life is not intended to be easy, because if it were it would cease to be interesting and we would atrophy

-CJP Ionides

 ​Of course it wasn’t. After answering the classic “twenty questions” ( I would become so sick of repeating these to each and every personnel I came into contact with that I would begin to feel like one of those pull-string toys)… I was finally led back into an ER bed, where I was assured antivenin was on its way. Michael showed up a short time later, which was a real relief, seeing as to how medical personnel is much more willing to accredit the statements and opinions of a professional-looking person in regards to proper snakebite protocol than they are a long-haired unshorn type with bug tattoos all over him. It was a good thing too, for the ER staff, while courteous, professional, and definitely a far, far cry from the primitive treatments of my hometown docs, which still prescribe whiskey for snakebite and dancing the tarantella for spider bites, was admittedly inexperienced in the matter. I met with a few nurses and doctors who were nice enough to begin administering an IV of morphine for my pain (which at this point had accelerated greatly, graduating from the burning needle-points of immediate envenomation to the feeling of having my entire hand squeezed in a vice, with the burning still present on top of this, of course). The discoloration around the pad of my fingertip had now spread to include the entire fingertip, and the ink-smudge purple hue had darkened to a most unsightly blue-black as the hemolytic juice dissolved the tissue. Pain from a hemotoxic snakebite has been described as one of the top ten most intense sensations that can occur to the human body, related to the feeling of a subcutaneous third degree burn, which is sort of what it is, with the venom working like acid as it dissolves flesh, muscle, and nerve tissue. To add to this already excruciating experience, sometime later (usually within a few hours) such euphoric and delightful symptoms as nausea, vomiting, skin tingling, hives, itching, muscle spasms, drowsiness, profuse sweating, chest constriction, breathing difficulty, and disorientation are thrown into the mix. The end result is the very definition of misery.  

​The morphine, while definitely helping to curb the burning and crushing sensations in my hand, was doing little more than taking the edge off. Michael kept asking about the Crofab, where was it and how soon could they get it out of the bottle and into my veins? Prompt administration of antivenin is the number one issue of importance when it comes to reversing the above mentioned symptoms of envenomation, and I had errantly assumed calling forty five minutes ahead of time would ensure they had it in an IV bag upon my arrival. Unfortunately, antivenin is such an expensive commodity with such a short shelf life that most hospitals cannot afford to just go breaking it open immediately, as many snakebite cases are either dry bites (where the snake injects no venom) or are bites from nonvenomous species. Of all the questions I had to answer, the “are you sure it was a rattlesnake” was the one that perturbed me the most. “Well, I’m pretty sure. Between the fact that the snake had rattles and my hand being swollen up like a plum I’d say very sure, in fact. While we’re on the topic of certainties, are you sure the antivenin is coming?” We kept being told that they were mixing it, and that I could be assured that it would get there when it did, and that in the meantime I was just going to have to be a gentleman and writhe in the agony of my ignorance in the manner of such.  

​I jest, but in reality the doctors and nurses were very caring and helpful; I was just giving in to my impatience due to the effects of the toxin flooding through my system, which was no one’s fault save my own, but I would like to think in such dire circumstances a man can be granted a little irritability.  

​At some point Michael deemed it wholesome to document a few minutes of my suffering on video. This he did in a series of snippets between 1 1/2 and 2 hours after the bite, somewhere between the morphine and the antivenin, whereupon I described the sensation as it escalated:

cold chill. intense cramping. severe burning. shaking. itching around base of middle finger. intense pressure. cold. like having my hand slammed in a door. no nausea. increased pain to entire arm.

​A short time later the blessed serum finally arrived, around the time the symptoms that accompany the spread of the venom throughout the body began to manifest. Again, Michael recorded a few of my comments:

hives. itching. swelling. tightness in face. pressure in ears.

​I had already informed the nurses that I was going to need something to throw up in, so luckily there was a bag present when it finally hit my stomach. Shortly after this the headache/glandular soreness/rash/profuse sweating/chest constriction/difficulty breathing reared its ugly head, which caused the doctor to become concerned about my possible allergic reaction to the antivenin. An administration of Benadryl was added to the IV just in case, which helped to alleviate some of those symptoms, but when my platelet count dropped from around 450,000 to 36, my blood pressure plummeted into the ‘DANGER’ zone, and my finger continued to swell, the doctor came in and made the decision to Careflight me to a hospital that had more antivenin as well as a hand surgeon on duty. They had already given me six vials of Crofab (the recommended beginning dose) and very wisely had decided to take no chances. By this point the mind-debilitating effects of the venom mixed with the morphine had put me in a state of delirium, and all I can remember about my chopper tour of the metroplex was looking out of the window of the helicopter thinking ‘this is one expensive express lane to bypass I-35 construction backup’ and ‘wouldn’t it be ironic if I rolled out and plummeted to my death in a state of venom-induced delirium…now that would be a news headline!’ ‘WORLD’S UNLUCKIEST MAN’…


 

ACT III

 RATTLESNAKE ETIQUETTE

 

Something was obviously wrong with my technique.

– -CJP Ionides, Mambas & Man-eaters

 

 ​I suppose this is the point in my story where I should attempt to explain the facts and opinions surrounding the nature of how I caused my skin to come into contact with the business end of a western diamondback rattlesnake in the first place. I will start with a word to the wise from the formerly ignorant. If you must keep venomous snakes (as some of us feel they must) you will do yourself a mighty favor to keep them one to a box. Perhaps even more importantly, make sure that box is not a Vision cage, or any other type of cage that contains an interior rim where the snake can hide itself. While the rattlesnake(s) I had were only temporary captives (being rescues from a friend of mine who comes across them frequently on his property and wishes to have them relocated rather than killed), I had them stored in a 24 x 24, x12” locked Vision. There were four of them in there, all juvenile specimens under 18” in length. I was well aware of the interior rim of the cage, as the snakes like to tuck themselves into this space to hide. I neglected, however, to think the snakes would ‘climb’ up onto the top part of the rim. This was my first lapse in judgment; as the great snake man of Africa, Ionides, wrote, “one can never be sure with snakes”.  

​I was in the process of transferring them from the Vision to a snake bucket so that my wife and I could go release them when the second lapse in judgment, the use of an improper handling tool, brought down the subsequent rain of misery on my head.  

I own a pair of cage tongs which are around 18” in length, as well as a small hook of same size, that I use for the transferral of any venomous snakes I happen to be working with. However, on this particular day I had misplaced them and opted to use a standard 48” field hook instead. I grabbed the hook about halfway down to make up for the excess length, as anyone working with small, often flighty juvenile diamondbacks can attest they do not usually ride a long hook very well. I looked through the glass and could see three snakes, so I assumed the fourth was beneath the bottom rim, where it typically liked to hide. Not placing my hand inside the actual cage itself, I was able to successfully ‘hook’ the first two snakes with no problem. The third, however, crawled to the back of the cage while I was moving the other two. Taking care to keep my hand as far away from the bottom rim as possible, I brought the hook in at an angle from the top instead, with my hand upside down. As I did, the tip of my fingers entered the cage beside the top rim, where the little female, unbeknownst to me, had been coiled (as opposed to her usual place on the bottom). I saw the chunky, triangular head launch down and out from above, sinking both fangs into the tender, fleshy pad of my ring finger for only an instant before she released and drew herself back up into the recess of the top rim of the cage’s interior. I put down the hook, slid the glass door back into place, locked the two remaining snakes back up, made sure the other two were secure in the transfer bucket, and then double locked the snake room and entered the house to tell my wife the wonderful news. That’s what happened. I’d swear on a stack of field guides.  

 ACT IV:

 PEEKABOO, ICU…
 “You will not surely die, the serpent said…

-Genesis 3:4

 I can only vaguely recall my transferral from Denton Presbyterian to Harris Methodist; only that the denomination of the hospital’s foundry did not concern me in the least, provided they had more Crofab they could pump into my system. There were hazy flashes of nervous apprehension in the emergency room…I heard a nurse exclaim “I’d forget my head if it wasn’t attached to my shoulders” and Michael’s voice sometime later “someone left a full vial of blood on the bed”. I kept expecting a booming voice to reverberate, ‘Don’t fear the reaper. Come towards the light, my son’, but instead woke up chained to a tangled procession of wires that seemed to grow out of two uncomfortable places on my right arm. There was an intense throbbing burn in my finger…oh, yes, the kiss of the snake…I was propped up in a tiny room, with a beeping, blipping machine behind me that, if I turned my head just right, revealed that my condition had significantly stabilized. Michael was there, as was my wife, and yet another group of nurses I knew I was going to have to repeat what happened to.  

​“Did I get the antivenin?” I managed to stammer in a groggy voice from between numb lips.  

​“Yes”, the nurse said. “Two more vials, which makes eight total. So how did you manage to get yourself bitten by a snake?”  

​“Well, it all started with a federal jury summons I received in the mail. I suppose there are better ways to get out of jury duty, although it seemed like a good idea at the time.”  

​One thing I learned from my hospital stay is that people who work in the intensive care unit cannot afford much time for comedy on the clock, and thus possess a very vestigial sarcasm radar. What they lack in comedic discernment they more than make up for, however, in concern and care for their patients. One of the worst parts of the full snakebite experience is the continuation of the pain; it never lets up, staying with you in varying forms and stages, throughout the day and night, whittling away your appetite, pulling you out of sleep about once an hour or so, and causing you general misery heaped on top of misery as the hospital staff goes about the seemingly never-ending routines of drawing blood, changing bags, monitoring your vitals, helping you exercise, measuring your rate of swelling, and asking you more questions than an income tax form. Thus I was very grateful for the ICU’s willingness to administer pain medication to thwart my writhing agony without raising an eyebrow as to my sincerity when I assured them that the pain scale rating should contain a number higher than ten. Using Fentanyl, one of the most efficient and powerful (and also addictive) painkillers known to man, they did an excellent job of managing my pain to the best of their ability without turning me into an opioid zombie.  

​In due time I was introduced to David C. Smith, the physician on the ICU wing. Conversing with him provided some much needed humorous relief, as he seems one who can appreciate as well as dole out a generous amount of humor into otherwise serious and dire situations. Laughter may not be the best medicine, but it definitely runs a close second to Fentanyl. The good doctor was baffled that someone who knew so much about snakes and the nature of their venom would be dumb enough to put himself in such close proximity to their fangs. The suggestion that perhaps I would be better off getting any further knowledge from toxicology handbooks rather than first hand experience was something I said I would try to remember to take to heart in the future.

​The days went by in the intensive care unit like one long, indistinguishable period. My platelet count dropped once again to an unsafe level and thus required an additional two vials of antivenin to stabilize. The swelling went down and stayed down. The pharmacist came in and we got to talk snake venom vs. polyvalent some more. The nutrition team seemed totally unable to grasp the definition of a vegan diet, forcing me to subsist on fruit breakfasts and lunches and mixed vegetable dinners, with my only source of protein coming in the form of soy milk and that advanced and complex form known as ‘hemotoxin’ (To their credit the meals I could pick around were superior fare as far as hospitals go). My mom watched my son the entire week without compensation, bringing him along with my aunt to visit me. My wife made daily hour-long drives to stand by my side for hours on end, on top of prior obligations to getting my son to school and going to school full time herself, and even stopped on the road once on one of her daily late-night trips home from the hospital to take a picture of a timber rattlesnake for me in an effort to lighten my spirits. And Michael showed up or called whenever he got a chance, monitoring and following my progress and putting up with my nonchalant references to death, amputation and gangrene while ignoring my insistence on his accomplice in ‘unhooking me from these infernal machines and busting me out of this joint so I could go herping.’ My cell phone virtually stayed abuzz with concerned checks from more friends and family members than I knew I had, offering much-needed and appreciated prayers, thoughts, well-wishes, support, and humor. This was often to the chagrin of my nurses in the fact that my ring-tone is the slow, menacing buzz of an angry diamondback rattlesnake, which always caused them to shake their heads at my assumed lack of sanity. And then the surgeon came in for debridement, and I only thought I had known what pain was.


 ACT V:  

 A TALE OF TWO SURGERIES

 

Buy the ticket, take the ride.

– -Hunter S. Thompson
Dr. Maxim Pekarev entered the room, sliding back the glass door and curtain in a single motion. He is a meek enough looking man, dark-haired, with smooth, gentle looking hands that beguile his real disposition as a merciless butcher of fingers devoid of empathy.  
​“Hello I’m Dr. Pekarev. I’m here to do the debridement”, he said casually. 

​“Hello”, I replied, extending my oversized purple hand, the affected digit of which had by this time swollen to the extent that it more closely resembled a grotesque black jumbo grape skewered on the end of a purple magic marker. “Forgive me for not shaking hands.”

​“Looks like you’re in need of some relief from that swelling”, he said, to which I quickly nodded in affirmation. Without further ado he seized me by the hand and proceeded to “debride” me.


​“All the tissue looks dead”, he commented as several onlooking nurses who were new to snakebite entered the room to observe the process and began passing out like cult members at a Kool-Aid party as he reenacted scenes from the movie Saw.

​“This shouldn’t hurt a bit”, he said, which to his credit was honest. It hurt a lot.

​He extracted a scalpel and quickly sliced into the swollen grape thing, causing a spurt of black blood to shoot out across the sterile towels on the wheelie cart he had laid my hand on. True to his word, I felt no pain. Not yet, at least. The finger immediately deflated like a bicycle tire with a broken valve stem. The doctor then replaced the scalpel with a pair of wicked curved tweezers, and began plucking at the thick layer of dead skin, ripping it off in sloughed sections. This didn’t hurt either, until he ripped backwards into live tissue, and I jerked back instinctively.  

​“That hurt”, I said.  

​“That’s just fear”, he said. “There can’t be any pain. It’s dead tissue.”  

​“It’s not fear!”, I retorted. “I was born without that gene! Check my record! It’s a recessive mutation! There’s live tissue under there.”  

​“Let’s see” he said, and brandished the scalpel once again, pressing it against the finger somewhere between the nail and knuckle. He pressed down, cutting beneath the skin, and again a burning bolt of pain raced up my arm.  

​“Yeah that hurts” I said.  

​“Okay. We’ll get you some anesthetic.”  

​A nurse came in with a needle that looked like a grossly oversized prop in a 1970s Mexican sitcom, and a few minutes later I was watching in painless interest as Dr. Pekarev finished the debridement of the finger, sliding the scalpel down a full half inch into the lateral tissue to see if the entire thing was indeed dead. No blood came out, and so he pronounced it deceased. I was a little concerned about that bright red patch of freely bleeding skin just north of the middle knuckle base, but at the time it didn’t hurt, so I shrugged it off. The shocked, horrified looks on the rookie nurses’ wincing faces, and the way that my wife had retreated into the furthest corner of the room, shrinking back like a frightened helpless rabbit while I gazed on with a sheepish grin and the Butcher continued to play Freddy Krueger on what remained of my finger should have served as an indication that this could not simply continue on in painless bliss. But he finished, applied a sterile wrap, then bandaged the whole thing up in gauze.  

​“The pad of the finger is definitely dead, and I don’t hold much prospect for the rest of it either”, he said. “The possibility of further necrosis is very likely. I will have to do a surgery that will at least require removal of the preexisting dead tissue and possibly half of the finger. The fastest thing to do with the quickest recovery time would be a simple amputation, although we can try to save as much tissue as possible, which would probably mean additional surgery involving skin grafts. But we’ll give it some time, do a reassessment, and save as much as we can.”

​“Sounds like a plan”, I said. “After all, what’s a little tissue loss between fingers? I’d probably be inclined to opt for the quickest route out of here if it were up to me. It is the beginning of snake season you know.”

​“You’re very brave”, he commented, and exited the room, the wide-eyed nurses, whom I suspected were at this point in no hurry to eat lunch, filing out behind him. Thirty minutes later, when the Lidocaine wore off, I doubt he would have accused me of such bravado had he still been present.

​At first it was just a slight prickle, a tingling sensation as the anesthetic dissolved. Tolerable enough.  

​“It’s beginning to hurt a little”, I commented to Kevin, the day nurse who was going on his second afternoon of caring for/contending with the poor sarcastic snake-bitten fool with the Tim Burtonesque macabre sense of humor in the room on the corner.  

​“Do you need something for it?” he asked.  

​“Nah, I’m going to try to tough it out”, I responded. “I need to begin trying to wean myself off of that glorified opium before I get out of here.”  

​Five minutes later I was hammering on my ‘call’ button, begging anyone and everyone within earshot to bring me as close to overdose as they could without jeopardizing my life, or else strike me in the head with the most readily available blunt object until I was rendered unconscious. Good old Kevin came to my immediate aide with a shot of Fentanyl. This time it did nothing, however. So they gave me the most they legally could for my body weight and then supplemented with Tramadol. Still I begged for something else.

​ “I can’t give you anything else until the Fentanyl wears off”, Kevin said. “Although I’ll administer some morphine as soon as I legally can. On a scale of one to ten, how much pain are you in?”  

​“Somewhere between ten and ripping that scale off the wall, twisting it into a cord and strangling myself to death with it!”, I yelled.  

​My finger literally felt like someone had skinned me alive and then doused the wound with gasoline and set a match to it. It was so intense that I could hardly concentrate, with the entirety of my left arm being engulfed in a single throbbing, agonizing sphere of indescribable torture. In what felt like a week another nurse came in and announced that she could give me a little morphine now. A short time later I passed out or went to sleep or something and the next thing I remember Michael was there and my wife was recounting my experience to him. Within the hour a nurse came in with a wheelchair and I said goodbye to the intensive care unit for good.


 ​I spent two additional days in a regular room in the inpatient care at Harris Methodist. My platelet count had finally gone down and stayed down, suggesting the venom had finally been neutralized by the antivenin, and there was nothing left to do but lie in bed with my arm elevated, awaiting what would either be the second half of my surgical debridement or an amputation. During this time I was kept on a steady diet of vegetables, ice water, Norco and Tramadol, and after my most unfortunate experience with the first debridement I had come to reassess that pain scale, as nothing I have ever felt before or since even came close. The throbbing, burning, hot-hammer pain that continued from the snakebite was thus quite tolerable by comparison, and I complained very little of it, sometimes going six to eight hours before requesting another pill, which my nurse Kathy insisted was only ‘glorified aspirin’. The day before the surgery Dr. Pekarev’s assistant came in to take photos of my hand so the surgeon could deem it keepable or tossable, and as soon as she unwrapped it I knew it was going to require at least a partial amputation. While the skinned part between the middle joint and the nail was still very much alive and blood-red, the distal tip was a dull, flat black, bloodless and lifeless. A short time later Dr. Smith appeared, announcing my surgery was scheduled for the morning some time before noon, with Dr. Pekarev presiding.  

​“Have you given any thought to whether or not you want to try to keep the finger or are you just going to have the whole thing removed?”  

​“I’m not sure”, I said. “What do you suggest? After all, I’m the one who went and put myself in harm’s way and got myself into this mess, albeit unintentionally. Obviously I’m not a champion decision maker.” “

​I think you need to be patient and let God work it out in His time”, he said. “Sounds like good advice”, I replied. “Que sera, sera, you know. After all, it’s just a finger.”

​The next morning they loaded me up with an extra dose of potassium and wheeled me down the hall to the surgical unit on my gurney. Dr. Pekarev met with me for a short time before surgery. He entered the room with that same humble look on his face, although this time I thought I could see the corners of his smile suppressing the anticipation of the drawing of blood.  

​“What’s up Doc?”, I said, doing my best to not let that twinge of recoil that was creeping up my spine show in my own face.  

​“Have you decided on what route you want to go concerning the finger?”

​“Just go in and do whatever you feel you have to do”, I said. “Save what you can and cut off the rest. Just make sure I’m out of it before you start cutting.”

​This broke the humility or ice or whatever you want to call it.  

​“Oh, I will, don’t worry about that. Had you rather have an anesthesiologist or more of that lidocaine like I gave you the other day?”  

​“I believe I’m going to have to go with the anesthesia this time. That way I’ll either wake up late with the worst of the pain past me or not at all.”  

​The anesthesiologist, Dr. Nathan Walters, came in shortly and proceeded to hook me up to the knock-out juice.  

​“Snakebite, eh?” he said. “I used to do a bit of cottonmouth catching in the swamps of Florida in my younger days.”  

​“A man after my own heart”, I replied.  

​“Ok, I’m going to give you a little whiskey in your IV now. You’ll be out like a light in a short while.”  

​There was a sharp, instant pulse in the crook of my right arm as the thick mixture of Propophol, Phenobarbital, and everything else went into my system. I managed to maintain consciousness up to the point where they wheeled me into the prep room under the bright dome, and the next thing I knew I was waking up in recovery with a groggy head, slurred speech, and a little less finger than I had going in.


 ACT VI:

 THE LONG ROAD OUT OF HEMOTOXI-CITY

(Giving the Hospital the Finger)

 

The man who can caress a snake can do anything.

– -Isak Dinesen, ‘Out of Africa’

 

 Today is April 4, 2017. Two full weeks have passed since that lovely little rattler sank her fangs into my finger. Yesterday was a full day back at Harris Methodist for my check-ups. As I walked through the doors I couldn’t help but feel like a small part of me had been left behind there. The plastic surgeon’s assistant unwrapped my finger, or what was left of it, and I got to see it for the first time in 11 days. It was severed just a fraction above the middle joint, a dog-eared, folded-over flap of skin stitched across the fleshy stump where the distal tip used to be, but the regrowth of tender pink flesh and the absence of any black, dead tissue looked wonderful. I was given some basic maintenance instructions and then off I went to get the lab work, which was faxed over to the doctor long before I could hoof it there on foot. In a short time I was brought in, and Dr. Smith came into the room.  

​“We meet again”, I said.  

​“Yes, how have you been?

​“Much better than the last time you saw me”, I assured him. “How’s the blood flowing?”

​“Excellent report”, he said. “Platelet counts have gone back up to 250,000. All levels returned to normal. I’d say you’re in the clear.”

​“That’s the best news I’ve heard in a while”, I said.

​“Yours was one of the worst cases of hemotoxic envenomation I have seen in ten years”, he then added. “It is rare to lose a finger these days due to a rattlesnake, especially after ten vials of antivenin. That snake must have come from a population with a very high toxicity.”

​“Yeah it came from Thurber”, I said. “Out in the rolling plains. The Big Empty. The snakes don’t have anything to do out there but sit around and get hotter and hotter.”

​We conversed a while on the marvelous nature of pit viper venom, its biological makeup, and how certain populations of the same species within a given range possess varying degrees of hemo and neurotoxic components. “So, have you learned your lesson when it comes to messing with venomous snakes?” he asked as I was walking out.

​“I certainly have”, I said. “Never misplace your tongs.”

​With three appointments down, the only other place left to go was therapy. After an hour and a half of various hand exercises, Dr. Sexton, my physical therapist, pronounced my hand ‘well on its way to healing’. While the amputated digit was still stiff, as was the pinkie finger next to it, the rest of my fingers had gained full sensitivity and dexterity, and by the time I left I was almost able to make a crude fist. And thus the final prognosis was one of overall excellence, with no infection, tolerable pain, no further surgery required, and only one more therapeutic and surgical follow-up to go, scheduled for two weeks out.


​We pulled out of the hospital parking garage and headed for home. Outside the window, I could see the road stretching out before me in that mirage-like optical illusion that seems to shrink it down to a sharp, fine point as it touches the horizon. With a year of pain, nerve healing, at-home therapy, and keyboard retraining ahead of me, it was going to be a long one. I couldn’t wait to get back out in the field, in the company of my beloved rattlesnakes, with a slightly shorter finger, a reclaimed smile of satisfaction, and a nine foot long pair of custom made tongs to reach into my mailbox with and extract my medical bills.  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4 thoughts on “Atrox, Antivenin, & Amputation Anniversary

  1. Great narrative Clint. I was totally engrossed in your account. It brought back some of my own memories as well. But yours was far more dramatic and very scary..
    Did you know Bill Haast was bit 172 times?
    But he lived to be 100 🙂

    Like

    • Yes I read ‘Cobras in His Garden” in grade school; guess I tried a little too hard to emulate Haast…no more subscription renewals to the ‘Sunken Fang Society’ for me, thank you very much…🤞

      Like

  2. I’m feeling a renewed sense of gratitude for the rattlesnake that, I’m pretty certain, ducked to avoid my foot as I almost stepped on it a few years ago. Devoid of malice indeed. I was not aware of the variable toxicity–fascinating stuff…and so many reasons to pay attention out in the world.

    Like

    • Definitely the gratitude is appropriate! It’s certainly not something to be wished on anyone (and makes you wish for a very quick death for the legions of kangaroo rats, cottontails, and other prey). Because of the regional variability of venom, even within one species, reputable venom producing labs use snakes from known localities and don’t mix venom from snakes originating in widely differing areas.

      Liked by 1 person

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