Rattlesnake Bite Surgery
May 26, 2006 6:14 PM   Subscribe

Justin's Rattlesnake Bite is the true story of one man's adventures in surgery after being surprised by a rattlesnake which bit the palm of his left hand. The story makes for grim reading, but the pictures are very much worse. pics may be NSFW
posted by jonson (54 comments total) 4 users marked this as a favorite
Wow! Unbelievable. I had no idea. I've killed a lot of probably non-poisonous snakes in my yard (except for a couple I thought were copperheads). I'm glad I got them before they did that to my arm.
posted by Frank Grimes at 6:18 PM on May 26, 2006

I'm surprised it did so much damage. I was under the impression that rattlesnake bites didn't produce that much local damage.
posted by Mitrovarr at 6:18 PM on May 26, 2006

Holy crap.

Makes me think about all the time I wandered rattlesnake country as a kid and what that could have done to me.
posted by Kickstart70 at 6:20 PM on May 26, 2006

I know bupkis about rattlesnake venom...I had no idea it did such extensive tissue damage.

Oh, and I clicked on the picture link without stopping to think that I'd just unwrapped a taco...mmmmm.....tacos........
posted by pax digita at 6:28 PM on May 26, 2006


I was running in the hills in Thousand Oaks, CA last summer when I almost stepped on a diamondback. I was only one stride away before I noticed the thing so if the little guy was in bad mood (he wasn't, it was dusk and he was just slowly crossing the trail while keeping an eye on me) I probably would have been bit.

While I didn't think a bite would be totally awesome I figured it wouldn't have killed me but then I read this. This kid was with a bunch of people who had phones and such. I was a mile from my car and by myself.
posted by sideshow at 6:29 PM on May 26, 2006

well, if I wasn't profoundly terrified of rattlers before, I certainly am now.
posted by scody at 6:31 PM on May 26, 2006

Incredible. I had no idea that a snake bite can lead to something like that, and the first picture is fascinating.
posted by fire&wings at 6:35 PM on May 26, 2006

Yikes, that's horrible. He's one lucky kid. I don't get it though--in the movies, someone just sucks the venom out and all is well. :)
posted by etaoin at 6:36 PM on May 26, 2006

Yeah, looking at those pictures...

Even though it seems obvious, it's like watching Dr. Frankenstein at work; moving a peice of skin/flesh here, adding some there, patching and stitching it all up. But then again I haven't really perused many step-by-step surgical pictures before this.
posted by Stauf at 6:47 PM on May 26, 2006

Thanks for that, I... bleaugh!
posted by Pressed Rat at 6:49 PM on May 26, 2006

That was the coolest thing ever.

Thanks for the post!!!!
posted by agregoli at 6:51 PM on May 26, 2006

I've had the good fortune of working with a medical journal the specializes in wilderness medicine, so I was aware of the damage snake venom can do to tissue, but these are the worst illustrations of it I have personally seen. That he's recovered so well is really a testament to his surgeons (and the power of youth and good health).

One of the more exciting case reports I ever read involved a man who hunted rattlers and consumed the meat. Apparently, he improperly cleaned his kills, accumulted enough toxins in his system to put himself into a coma, and basically destroyed his digestive system. I don't have the journal at hand, but his suffering was truly epic, affecting every aspect of his health, from brain function to elimination.
So, be careful where you walk, and always clean your wild meat, folks.
posted by melissa may at 6:52 PM on May 26, 2006

...*that* specializes, damn it.
posted by melissa may at 6:54 PM on May 26, 2006

wow, that was one massive fasciotomy.
posted by Megafly at 7:00 PM on May 26, 2006

Holy fuck! Okay, I am never going hiking up Camelback Mountain again. I've heard heart those things off in the distance a bit, and gave them a healthy berth, but I had no idea they could wreak that kind of havoc.
posted by psmealey at 7:00 PM on May 26, 2006

I worry about my dog getting in a fracas with a rattler. He only weighs 30 lbs.; I don't think he'd stand much of a chance....
posted by mr_roboto at 7:13 PM on May 26, 2006

I live in an area with several species of rattlesnakes and have seen tissue damage on a few of the old timers that were bit years ago before the advancements in ativenin. All snakes are beneficial and we leave all but the Mojave Green to go about their business. While other rattlesnakes possess a venom that is primarily composed of hemotoxins, the Green's venom is neurotoxic and victims of its bite are likely to die if they don't receive antivenin wihtin 30 minutes of the bite.

There has been some evidence that rattlesnake venom is evolving into a more deadly mix in this area and all snakebite victims are helicoptered for specialized treatment that involves a complex cocktail of antivenin at Loma Linda University Medical Center (about a 100 mile trip). Even with helicopter transport, we still lose a few lives to snakebite every year in San Bernardino County.
posted by buggzzee23 at 7:17 PM on May 26, 2006 [1 favorite]

So, two guys are out camping in the Sonoran Desert. They are at the tail end of the day, and hanging out shooting the breeze around the campfire.

At some point, Sam, the tall one, gets up to go and relieve himself. Upon finishing his task, before he can zip up his fly, a diamondback rattler he had not seen strikes from beyond the dark, and bites him right on the tip of his penis.

In excruciating pain, Sam grabs the offending menace, pulls it away from him, tosses it on the desert floor, reaches for his shotgun and kills it with one shot. But the damage is already done.

He staggers, woozy and severe distress back to the campfire, and says, "Joe, I've been bit by a rattler, right at the end of my Johnson!! What should I do?? Help me!".

Joe says, "hang in there buddy, I have a first aid book with me. Let me take a look, and see what it says." Sam screams, "Okay, but hurry up! Please!!"

Joe fumbles for the lantern so he can see what he's doing, and grabs for the book in his knapsack. He looks up "snake bites" in the index, and flips harriedly to the right section. There he reads, "in case of rattlesnake bite, you must make an incision above the bite wound, suck out the rattlesnake poison, and spit it out. If this is not carried out expeditiously, the recipient of the bite will die."

Joe thinks about this for a minute.. Sam asks, "well, what the hell does it say???" Joe stops what he's doing, looks at Sam and very solemnly says, "the book says you're going to die."
posted by Tommy Gnosis at 7:20 PM on May 26, 2006 [1 favorite]

Oh, man. Those pictures are just awesome. Those doctors deserve medals. Giant freaking medals made of platinum and the royal blood of princes.
posted by eamondaly at 7:32 PM on May 26, 2006

Those are some amazing photos. I'm amazed at the close-up of the palm and how you can see the damage wrought to the muscle tissue. I never realized that rattler bites were still that dangerous - I'd assumed that modern medicine had rendered them pretty unthreatening. Consider me schooled.
posted by lekvar at 7:43 PM on May 26, 2006

Thanks for that, I... bleaugh!
Best comment ever.

Fasciotomies are serious fucking medicine. I am impressed with this guy -- but he doesn't say how much it hurt, or anything. I suppose he was pumped full of drugs for that month, but, goddamn. It healed really quite well.

Anyway, no more hiking for me in the US. Heh.
posted by blacklite at 7:49 PM on May 26, 2006

$700,000 worth of helicopter flights, surgeries, and hospital stays (paid by my insurance of course)

I like how the "of course" is tossed in there... if the snake picked some other unlucky American it might not only have hosed up their arm but bankrupted them and their family too.
posted by rolypolyman at 8:03 PM on May 26, 2006

Wow, those pictures are incredible. I know a bit about snakebite, but I had no idea rattlers could cause so much damage. I'm gonna stay away from the Midwest now.
posted by WidgetAlley at 8:03 PM on May 26, 2006

Yeah, it's often mentioned that 'with treatment, rattlesnake bites are rarely fatal', but that really is all, fatal. People lose limbs to rattler bites all the time.
posted by atrazine at 8:18 PM on May 26, 2006

Snake bites were my biggest fear as a child. This just revived that.

That second picture with the tissue in his hand looking so damaged, and further down where you can see the muscle wasting - his recovery is really REALLY amazing.

Thanks for the post.... but now I'm kinda freaked out.
posted by dog food sugar at 8:20 PM on May 26, 2006

I'm gonna stay away from the Midwest now.

This happened in California.
posted by kenko at 8:21 PM on May 26, 2006

That was the freakiest thing I've seen in a long time. 13 years old... damn. He'll have a hell of a story (and photos to go along with it!) to tell his kids and grandkids in the future.
posted by almostcool at 8:26 PM on May 26, 2006

Interesting post, thanks! Proper use of the 'gross' tag.

Photos of the natural history of a (possible) brown recluse spider bite. 'Possible' because the spider was never actually seen, and brown recluses are wrongly blamed for a lot of skin lesions caused by other things.
posted by Slithy_Tove at 8:29 PM on May 26, 2006

Much of the damage is done because viper venom stops circulation.
Wikipedia has a good writeup on snake venom, including this bit:

The Hedgehog, the Mongoose, the Secretary Bird, and a few other birds feeding on snakes, are known to be immune to an ordinary dose of snake venom; whether the pig may be considered so is still uncertain, although it is well known that, owing to its subcutaneous layer of fat, it is often bitten with impunity. The garden dormouse (Eliomys quercinus) has recently been added to the list of animals refractory to viper venom.

The evolution of snakes is interesting. Originally they were just sloppy with saliva, which pre-digested their prey. Then came grooved teeth, which were more effective in injecting the saliva, and finally long, hollow fangs that fold back in the snake's mouth.
posted by weapons-grade pandemonium at 8:35 PM on May 26, 2006

I like how the "of course" is tossed in there... if the snake picked some other unlucky American it might not only have hosed up their arm but bankrupted them and their family too.

rolypolyman, most of this was performed at the UC Davis Medical Center - one of the premiere medical institutions in the U.S., and with no small amount of funding. I have a cousin who suffered extensive third-degree burns due to an automobile accident and the subsequent fire in the car's engine. He was treated at UC Davis MedCenter free of charge to him or his family, because they lacked insurance or the means to pay. Luckily, there are funds set aside for situations such as these. The fact that he mentioned the fact of his family's insurance as "of course" notwithstanding, this incident would not necessarily mean the indentured servitude of the next four generations of any other unlucky American's children. I sympathize with the sentiment, though, as one of the unlucky Americans unable to get health insurance.

That said, what an amazing story.
posted by po at 8:39 PM on May 26, 2006

Freakin' snakes on a... rock. Justin seems pretty level-headed about this incident for 16 year old!

I've been lucky with snakes. There are four poisonous species of snakes in the U.S., and in one year I had close encounters with three of them. I stepped on a copperhead while looking at an orchid and stepped on a cottonmouth as I walked by a creek. The copperhead jumped back and the cottonmouth slithered away. But the most unnerving incident happened while I attempted to empty ashes from my BBQ pit.

I was looking over my shoulder and talking to a friend as I walked up to a woodpile to dump the ashes. I tilted the pit and the first specks of ash trickled out as I turned and looked down. Inches from my feet was a fat timber rattler, coiled up and looking at me-- almost daring me to dump ashes. He never rattled. I backed slowly away, shocked at how close I came to disaster.

Only if Justin were so lucky. Thanks for the link.
posted by F Mackenzie at 8:49 PM on May 26, 2006

Imagine if this happened on a plane.
posted by Falconetti at 9:30 PM on May 26, 2006

That's scary. The cowboys on a place I used to live used to cut their heads off with shovels. I've read that a lot of people are bitten by rattle snake heads after they've been disembodied. Freaking gruesome.
posted by rougy at 9:37 PM on May 26, 2006

Our local Red Cross chapter's medical director is also this guy. The link talks about Cobra envenomations, but at the bottom there are several more links regarding other snakes.

The younger snakes are more of a problem - they bite, but they haven't learned when to stop spraying venom into the bite. As a result, it's quite possible (and likely) to get a much larger dose of nasty venom from a young rattlesnake than an older one.
Up to 60% of adult rattlesnake bites are 'dry bites' where no venom is actually injected into the human victim.
The EMS agency I work with picked up a snakebite victim a few weeks ago. The kid was playing with the snake, and the snake was quite unhappy. It bit the kid. The kid tossed the snake into the bushes, so we couldn't get a look at it. Off to the ER went the kid.. (fortunately for the kid, the ER was only about 10 minutes away.)

If any of you guys are bitten by a snake, remember:
* suck & cut = useless. Don't do it.
* ice = bad. Can concentrate venom in one place. Bad.
* running around like a putz = bad. Try to remain calm.
* circle the bites with a Sharpie (or any pen, really) and keep an eye on them.
* keep the bite site at a level *lower* than the heart, and try to keep the patient calm.
* cover it with a dry, sterile dressing.

And get to the ER. Like, uh, now. :-)
posted by drstein at 10:10 PM on May 26, 2006

Never heard of such tissue damage from a rattler. I've never encountered one, either. I look back on a risk I took once (sleeping in a bag in open country, in Texas somewhere) and shudder. I had always thought a rattler would make me feel very sick, but probably not kill me.

Now I live in an area with adders (also pit vipers) and other, more scary snakes like the boom slang (which is Dutch for tree snake) and cobras (including one or 2 types that spit venom at your face). Weeee. I think I may have to rummage around and see where I put away my fear of snakes. Thanks!
posted by Goofyy at 10:13 PM on May 26, 2006

Guh. I never knew such tissue damage was possible.

I've had half a dozen really close calls with rattlers out here in the deserts. The most recent was about this time last year as I was biking off-trail to this arroyo I found that was shady and cool. I nearly ran over a diamondback. I watched it strike towards my pedalling (and heavily booted) foot, but it probably hit my chainstay or back wheel. It was a pretty pissed off rattler. Sure as hell scared the piss out of me.

I have a few friends that have been bitten, but they never suffered this kind of extreme tissue damage.

One friend was bitten while hiking back country desert wilderness without a phone or radio. He was bit on the foot. I think he may have had one of thos now-deprecated suction-based snakebite kits with him.

Anyway, he said the experience was like taking a very, very painful and extremely strong hallucinogenic. He was basically stuck up on the side of a small mountain, tripping balls and in writhing agony while literally baking in the desert sun for 3 days before the venom wore off and he could walk again.

He's probably lucky to be alive.
posted by loquacious at 11:24 PM on May 26, 2006

Metafilter: running around like a putz = bad.
posted by blacklite at 11:25 PM on May 26, 2006

As I'm turned off by sites like ogrish.com and rotten.com, I expected to be really grossed out by the pictures, but as seeon as I saw the first picture I was completely fascinated. Our bodies are amazing little machines of self preservation. Sure the kid's hands and arm look a little wonky, but damn it they practically cut his entire arm in half.

Oh, and snakes are scary and loquacious should check to see if his friend isn't a zombie.
posted by quite unimportant at 11:30 PM on May 26, 2006

Holy shit. I am 99% un-fazeable and have yet to be significantly grossed out by pictures of the human body...

... but oh man. I can't do the pics page in one go. The progression of surgeries is fascinating, but I need to take a breath.

(Also: I am incredibly afraid of snakes. This is not helping.)
posted by grapefruitmoon at 11:54 PM on May 26, 2006

Oh, and snakes are scary and loquacious should check to see if his friend isn't a zombie.

I'm not entirely sure he wasn't. He was a pretty odd character.
posted by loquacious at 4:21 AM on May 27, 2006

Fill the blanks

I didn't know "rattle snake bite" can be so dangerous
I didn't know "that kissing a van at 100mph" can be so dangerous
I didn't know "smoking" can be so dangerous
I didn't know "drinking" can be so dangerous
I didn't know "bad surgeons" can be so dangerous
I didn't know "religion" can be so dangerous
I didn't know "FILL OF WHATHEVER YOU WANT" can be so dangerous

better die to get rid of all this danger, holly shit
posted by zouhair at 4:27 AM on May 27, 2006

If any of you guys are bitten by a snake, remember:
* suck & cut = useless. Don't do it.

So this is no good for snakebite? Damn you, Kevin Kelly!
posted by Ritchie at 6:59 AM on May 27, 2006

I'm amazed at how barbaric the surgery looked. I'd expect very tiny, precise, nearly invisible stitches and staples rather than large black stitches and big rubberbands. I guess that shows how little I know about modern medicine.

I was fine with the photos until the skin graft. Something about the newly attached skin with holes perforating it really bothered me.
posted by [insert clever name here] at 10:13 AM on May 27, 2006

Falconetti wins...
posted by WhipSmart at 11:15 AM on May 27, 2006

Well, what do you know, drstein -- Dr. Norris is the editor-in-chief of the journal I referred to above. The man knows his snakes.

Thanks for the bite safety tips. One of the messages the society strongly promotes is that "cut and suck" -- whether with a device or your own mouth -- is ineffectual at best, and harmful at worst. (Great, now you have poison in your mouth, too!)
posted by melissa may at 11:17 AM on May 27, 2006

A bit of perspective, from someone who knows his snakes, or at least I like to think I do. (Note, though, that I have little to no experience with rattlesnakes. I'm not that crazy, but I've done my homework.)

The best way to deal with snakebite is not to get bitten in the first place, which in North America is spectacularly easy to do: most bites occur when someone tries to pick up, capture or kill the snake.

North American venomous snakes are generally not aggressive, comparatively speaking -- we don't have large, fast terrestrial elapids that chase after you like cobras, mambas and, well, most of the snake fauna of Australia. Even the more "aggressive" sorts, like diamondback rattlesnakes and cottonmouths, will tend to stand their ground. Generally speaking, we have to work at getting bitten on this continent. "Legitimate" bites -- the sort that affects the rest of the world, in places where fer-de-lances and saw-scaled vipers outnumber shoes -- are considerably more rare.

Among snake keepers, we have a saying: if a snake bites you, it's your fault.

If you're hiking in venomous snake country, it goes without saying that you need to know where you're putting your hands and feet. You're in the snake's territory; if he takes a swing at you, it's because he's scared shitless and is doing his best to stay alive. You're the smarter animal: it's up to you to avoid getting bitten. Generally speaking, you're much safer encountering a rattlesnake than you are a cougar or grizzly bear.

All told, though, both snakebite incidents and fatalities from snakebite are extremely rare in North America, especially when you factor out the bites by exotic venomous species kept in captivity by some of my crazier colleagues. There are a lot of other animals that kill more people each year than snakes. Like horses.

Frank Grimes: I'm not sure how killing all those non-venomous snakes prevented them from doing that to your arm, non-venomous snakes not normally being the sort to be capable of inflicting tissue necrosis. But if killing animals whose bites are amongst the safest in the wild (compare a relatively antiseptic rat snake bite to that of a squirrel, for example -- how many shots are you going to need for the latter?) makes you feel better -- whatever.

F Mackenzie: Allow me to nitpick: there are actually about 16 different species of rattlesnake (each of which has its own quirks) and two to three coral snake species (depending on authority), plus cottonmouths and copperheads.
posted by mcwetboy at 2:16 PM on May 27, 2006

"So this is no good for snakebite? Damn you, Kevin Kelly!
posted by Ritchie at 6:59 AM PST on May 27 [+fave] [!]"

Nope. They're useless. Studies show that while they do extract a little bit of poison, they're woefully ineffective and absolutely should not be relied upon.

They're great for giving yourself a hickey, tho.
posted by drstein at 2:45 PM on May 27, 2006

mcwetboy: Ack. Serves me right for googling instead of pulling out my snake book. Phylum, class, genus, species.. it's all Greek to me. Or Latin. I'll have to stop stepping on snakes and start reading my books.
posted by F Mackenzie at 3:20 PM on May 27, 2006

S'okay. I'll nitpick myself: I should have added in the U.S. to the above.
posted by mcwetboy at 4:01 PM on May 27, 2006

Hoooooly shit.

And for more venomous goodness, here's the comprehensive collection of brown recluse spider bites. Helpful hint: narrow your search results to those with pictures.
posted by Civil_Disobedient at 5:05 PM on May 27, 2006

compare a relatively antiseptic rat snake bite to that of a squirrel, for example -- how many shots are you going to need for the latter?

I don't think squirrel bites require that much care. A few months ago I read that rabies shots aren't really required, especially if the squirrel accidentally bit you while being hand fed and wasn't acting particularly rabid.

Anyway, I've been bitten by squirrels a handful of times. All I did was keep the wound clean for a few days, and I'm still here.
posted by Devils Slide at 9:46 PM on May 27, 2006

I was thinking tetanus, actually.
posted by mcwetboy at 6:06 AM on May 28, 2006

and I thought I was hardcore when I watched the plastic surgeon remove a ganglion cyst from my wrist.
posted by srboisvert at 2:10 PM on May 28, 2006

It is the rattlesnake saliva that causes most of the tissue damage. Rattlesnakes are not constrictors; they do not kill their prey by choking or crushing. Instead, their venom stuns or kills the animal, and they swallow it whole. This is why snakes' jaws can unhinge; it allows them to swallow an animal that is far larger than their own head.

Given that they swallow their prey whole, you must realize that their saliva and digestive juices are incredibly powerful. They do not chew their food; it is dissolved whole. A few weeks after they’ve eaten, all that is left is some of the victim’s fur. Everything else was liquefied and absorbed by the snake.

Unless the snake believes itself to be in serious peril, or is being badly hurt, it will most likely bite without using venom. Rattlesnakes produce very little venom, and once expended in a bite, it takes the snake quite a while to manufacture new venom. Since the snake depends upon its venom to feed, the snake is usually reluctant to waste it on a warning bite.

This by no means trivializes a snake bite; venom or not, it’s the saliva that will cause the most problems. Any snakebite, even one from a nonpoisonous snake, is no laughing matter. Always immediately see a doctor. While you generally cannot catch a disease from a snake, since they are reptiles and not mammals, the wound must still be thoroughly treated less the saliva cause massive tissue damage.
posted by nlindstrom at 4:41 PM on May 28, 2006

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