Bitten By the Big One II:

Looking in from the outside.

By Mary Welch

OK, so I let him tell his story as he remembers it. This is how it went from our side of things...

Like Bret said, "This one's going to hurt in the morning!" It depends on which morning he could have been talking about. For the first two days they kept him sedated. But I can say that I was not feeling too damn skippy in the morning either! Actually it was not until they had him stabilized at the third hospital that they allowed him to wake up. At hospital number two they sedated him with what they called "mother's milk". Apparently it was to keep him knocked out and to keep him from remembering what they were doing to him, as a nurse told me. But I will admit he was definitely not a happy camper when he did wake up.

Through the basics of what he has already told of this story: thirty-five minute ride & many run redlights and stop signs, three hospitals, incompetent medical staffing, to a group of friends at the zoo & one trauma specialist that saved his life...

Oh wait! I was going to tell you about the merry-go-round we went on with the idiots at one of the hospitals. And the friends that pulled the strings that helped save his life.

One nightmare after another...

When Bret was transported to the second hospital, his vitals were low. Bret's blood pressure was at 60/38, body temp. 95.6, potassium was at 2.8 (3.5 is considered borderline cardiac arrest), and he had to be intubated due to respiratory failure. And according to his medical reports he was even at one point overdosing on his own adrenaline. It was apparent to me that he was also in the midst of liver failure as well. His skin color had gone to a high yellow tone as well as his eyes, this enroute to hospital number one. I spent a couple years in the fire service and know a little in the field of emergency medical rescue. I never saw anything like this, however. Bret looked like a corpse, and was not far off from it.

While he was transported to the second hospital I was still at the first one filling out paperwork. But I arrived at number two just seconds after he did, in enough time to see him as they had brought him in from the squad. What I saw of him was not reassuring. They took him into the emergency room without hesitation. That was the last time anyone got to see him until he was moved to C.C.U. (Critical Care Unit), 7 hours or so later. While I waited in the emergency room with his colleagues, T.P. the Botanist, who did the driving to the hospital and D.H. the Zoologist, who showed up at hospital #2 a couple minutes before T.P. and I did, my mother-in-law showed up and had no idea of the severity of the situation. So the first thing she asked was, Well, is he dead yet? A joke to her, but far to close to reality for me. After I got ahold of myself, we told her about what had happened and how bad it really was. Shortly after she arrived we got to speak to the doctors for the first time. What they had to say, I did not need to hear. They informed us that they did not believe that Bret would survive that night. His condition was extremely critical. At that point we asked if we could see him. They told us that they would have him cleaned up and we would be able to see him soon. Soon turned into five hours later.

When we finally got to see him his sister had been able to fly in from the Austin area at the last moments notice. Due to the circumstances we had contacted his father, as well, in Houston. And he too was there by the end of the night. Upon our first visit we didn't know quite what to expect. Bret had tubes everywhere. He was on a respirator with IVs here and there. And this was the first time we were told about his efforts to fight the staff in the emergency room. As for the IVs, I asked what they were administering. They nurse told us about the Mother's Milk, antibiotics and the Antivenin. I then asked how much they had given him and what kind. The nurse told us that they had given him Two of Two, and I quote. What on earth was two of two? We asked, and we were answered. But what we were told was as horrifying as the whole situation. The nurse told us that they gave him two ampoules of Crotalidae Polyvalent, Wyeth and two Black Widow. And the Crotalidae Polyvalent was being given to him as we were standing there with him. About 8 hours after the bite! Two vials! That was all we could ever get them to tell us and afterward we started questioning their competence. They denied the Black Widow antivenin after two or three other nurses had confirmed the fact that it had been given to him, reading it off of his medical charts right there in front of us.

Anyhow, day two was far more exciting... Twenty-four hours after the bite and we were no more closer to answers from doctors. I finally was able to get in contact with a friend of ours, D.M., who is the head keeper at the local zoo herpetarium. He in turn told his supervisor, C.A., curator of the exhibit, who in turn told her boss and then proceeded to contact the trauma specialist that takes care of zoo staff in emergency cases such as this. After some minor setbacks with a receptionist at the doctor's office on my part, C.A. got in touch with the specialist. She also called the hospital to confirm what it was I had relayed to her and D.M. After the nurse in the C.C.U. approached me and proceeded to threaten me for contacting the zoo and whatnot, we made the arrangement to have him transferred to hospital number three. Even after it was all said and done, one of his nurses said getting him out of there was the best thing we could be doing for him. He told us that they had never dealt with anything like this before. Pretty sad when even the attending nurses will admit to being incompetent!

Hospital Number Three.

I had made arrangements to meet with D.M. and C.A. there, before Bret got there. When I got there they were there waiting. I told them about everything that had gone on and of Bret's condition. My mother-in-law stayed at the second hospital with him until they moved him. Which was at about 9:30pm. It took about half an hour to reach the third hospital. By the time we were all at the third hospital there was a total of 6 of us, not including the Dr. and his nurses & colleagues. Five of them. The Dr. was a saint. He allowed us all to go into Bret's C.C.U. room with them. Kind of like a circus. The room Bret was put in was not very big at all, and with 10 people in there trying to see how bad he was, it was pretty cramped. Doc looked him over, gave his orders to the nurses and explained what he saw and what he had been told by previous attending physicians. What he was told was that Bret was basically a lost cause. What he saw was someone who had no desire to give up. He told us that Bret would pull through. It was one breath of fresh air that most of us most certainly needed at that point.

As nerves settled, and hearts lightened, we got some pictures. Figured Bret would not wanna miss out on what we saw. (LOL!) The zoo also figured they would be nice to put on exhibit to inform people of the what could happen ifs... The snake that hit him was a little over 7 foot in length, with a measured 6 cm fang spread, meaning a very large head. Perhaps the biggest rattler I had ever seen, not in captivity.

I stayed with him after that, day and night. Bret was given five more ampoules of antivenin, and eventually woke up the following morning - three days later. Other than the intubation tube and IVs and severe pain (and an itch on his knee), Bret was fine. They kept him in C.C.U. for five days for treatment and monitoring. No one really knows how much antivenin he received in total for this bite. I saw five administered, two days after the bite. The medical reports don't mention anything about the quantity of antivenin he received at hospital number two. And after several attempts to obtain the actual medical reports and files from that hospital, they told us that after so many days they purge their records. So any information we might be looking for has been erased or gotten rid of. To this day they still refuse to send us an itemized bill for services rendered. That's the merry-go-round with idiots!

Aftermath.

As of January 2002, Bret's hand has healed on the outside. But the scars and the inability to get real use of it are a constant reminder. He lost virtually all the soft tissue in his hand. What is left of the tendons have distorted the shape of his hand. And it is all due to the negligence of the hospital that did not follow or have a snake bite protocol. And the only means of ever getting use of it back is reconstructive surgery. The longer without surgery, however, reduces the chances for fully repairing it. One knuckle is forever un-repairable, due to a previous bite in 1996, in which he ended up with necrosis of the bone and the knuckle had to be cut out and replaced by pins. PIP Fusion. The loss of that knuckle was also due to incompetence. We have done medical tests on his blood with a toxins research facility here in Texas and have found out that Bret is now producing his own antibodies towards snake venom now. So perhaps we can all learn something new from all of this. After a bite this past August 2001 by a button C. atrox and a two-hour drive to the hospital, Bret received no antivenin, due only to the fact that it was not needed. The only thing that happened from this last bite was some local swelling. No pain or tissue damage. And it was by no means a dry bite though.

Granted, snake & heloderm bites are not the most common means of ending up in the hospital. But no matter the case, EVERY emergency medical facility & response unit should have protocols to follow in such cases. As is done in Florida. We lived in South Texas, where farming and agriculture are the most common means of a living. Meaning that there are people that do get bitten by snakes, for the simple reason that they live and work in places that snakes live and hunt. Shortly after my husband's bite, an elderly man was bitten on his ranch repairing a fence line. The snake that bit him was only a juvenile. But he slipped into a coma, and family found him passed out by where he was bitten. I am not entirely sure whether he survived. But the last thing we had heard was that the hospital cut him up pretty bad. For Herp's in South Texas I recommend: MOVING! It's not the greatest place to be bitten. Once in a while you might meet a doctor that has dealt with snakebites before. And whose goal is not to cut you open. We were fortunate to have had the friends we do. Without their help Bret might not have survived. As you might imagine, we no longer live in South Texas.

No, instead we now live where he has six different species of venomous snakes to study, not just C. atrox and S. catenatus edwardsii anymore.