Most of the cases Children's Hospital sees are familiar. But once in a while, a child will be brought in who is suffering from an ailment that is virtually unknown. Such was the situation one night in 1983. But Children's saved the life of the 16-year-old patient just the same. My associate, Beth Schwinn, has reconstructed the strange story of the gaboon viper bite. Her report:
On the bitterly cold night of April 4, 1983, a 16-year-old boy from Southeast Washington boarded a Metrobus near the main entrance of the National Zoo. He was carrying a brown plastic trash bag. It contained what must have looked like coils of wire or rope.
As he left the bus, at the corner of 15th and K streets NW, he jumped and ran back up the steps, screaming to the bus driver, "I've been bitten by a snake!" Louis Morton had just become the first recorded gaboon viper victim in the United States.
The emergency room at Children's has grown accustomed to the bizarre, but this case still stands out in the memory of the staff on duty that night.
Louis, in shock and bleeding copiously through the nose, mouth and ears, was unable to help the staff identify the snake. The staff did not yet know that they were dealing with one of the most venomous types of snakes, a South African species that can kill untreated victims in minutes. But it was already clear from his symptoms -- and the wide separation between fang marks -- that Louis had not been bitten by any snake the staff was familiar with.
"We tried everything," said Dr. Ray Brown, a pediatric resident when the incident occurred. "Everything" included a drug called epinephrine designed to prevent massive shock, a tourniquet (which was ineffective because Louis had been bitten on the shoulder) and a snakebite antidote (known as an antivenin).
Only the antivenin did much good. But it could not counteract the poison completely because it wasn't made from viper venom. Still, it stabilized Louis' condition while the staff tried to obtain the correct antivenin. The initial dose of antivenin "probably saved his life," said Dr. Murray Pollack, the attending physician that night.
Meanwhile, doctors pumped massive quantities of platelets into Louis's blood in an effort to cause clotting. Brown estimates that they used most of the platelets in Washington that night. Meanwhile, the hospital began to search for viper antivenin -- a search that would soon lead all over the East Coast.
Amid all this activity, however, no one had identified the snake.
Ray Harper, the policeman who had responded to the bus driver's emergency call, found a five-foot-long snake lying in the street at 15th and K shortly after Louis complained of being bitten. Harper had some snake-handling experience and thus felt comfortable taking the snake back to Children's for identification.
The hospital staff contacted Michael Davenport, the collection manager at the National Zoo, and described the snake to him. Davenport tentatively identified the creature as a gaboon viper, and went to get the zoo's stock of viper antivenin.
It was then that he discovered that the cage containing the National Zoo's gaboon vipers was empty. The vipers were gone. Both of them. And even though he was not charged with a crime that night, and never has been, Louis was suspected of stealing them.
A frantic call sent someone from the D.C. Animal Rescue League to locate the second snake. It was found, still lying placidly in the bag, near 15th and K.
Fortunately, gaboon vipers are lethargic and not aggressive. They must be strongly provoked or stepped on before they will bite. The second gaboon viper, which had been bitten by his companion when they were stuffed into the garbage bag together, was in shock, and, being cold-blooded, was considerably slowed down by the fact that the temperature was below freezing.
This snake, too, was carried back to the hospital. The first snake had been shoved into a bucket and put in a dark closet, far from patients or the emergency room.
Meanwhile, Louis was injected with the National Zoo's supply of viper antivenin. "We needed a lot," Pollack recalled, because the snake's venom was so potent. Louis was still in danger of dying unless much more viper antivenin could be located -- and soon.
One staffer called the Rocky Mountain Poison Control Center, which was able to tell him which zoos on the East Coast had a supply of the correct antivenin. Then the phone calls really began.
It was necessary to wake zoo representatives, who collected the antivenin, delivering it in most cases to the police.
The police then took the serum by squad car or police helicopter to local airports. From there, the National Guard took it to National Airport, which normally closes at 11 p.m. but was kept open to receive deliveries from five zoos. From National, waiting Children's helicopters took the serum to the helipad just outside the emergency room.
"His recovery was amazing," said Brown. "He was bleeding all over. We had taken one shipment of antivenin -- I think it was from the Bronx Zoo -- and made a skin wheel around the wound with half of the antivenin. The rest was given intravenously. Within minutes, the bleeding had stopped completely."
The communications room at Children's remembers the gaboon viper case, too. All night long, they placed calls all over the United States in search of antivenin and advice. Even after Louis was out of danger, they continued to call all over the world, seeking further advice on treating this particular kind of bite.
"We called Africa," reported Pollack, "and discovered that we had done everything they recommended and more."
Later that night, Harper posed for a Newsweek photographer. He held one of the gaboon vipers, its body as thick as a man's calf, by the neck so that it could not bite. But Harper was courting greater danger than he realized.
"It should never have been picked up," said Davenport, because the snake is powerful enough to have twisted in Harper's grasp and sunk its inch-and-a-half-long fangs into his hand. It was fortunate that the snake did not do that, since all of the antivenin available on the East Coast had already been diverted to save Louis.
Louis was out of danger by morning and suffered no permanent harm. "He didn't even lose any skin," said Pollack.
"I think it's one of the most exciting cases we've ever had," said Brown, "not medically, but in terms of the outpouring of assistance . . . .That's the nice thing about this place. Any kid who walks in gets this kind of treatment."
As people found out about the incident, calls flooded the Children's switchboard. People in nearby rural areas offered supplies of antivenin and advice about snakebite, including folk medicine remedies. But Louis was already over the hump. Within a week, he walked out of Children's as if the incident had never happened.
One of the two gaboon vipers who went for a bus ride in 1983 now lives at an animal brokerage in Florida. He was traded there by the National Zoo for several eyelash vipers. The other gaboon viper still lies in his cage near Rock Creek Park.
What became of Louis in the 2 1/2 years since his bite is a mystery. He attended Friendship Community School in Southeast through the spring of 1984, but school records no longer show him as a student. The housing project where the family lived has been condemned. The hospital has lost touch with him. Somewhere out there is a kid who got very lucky one cold April night.
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