Venom and Vanity: Dispatches of Intensive Care
The day after celebrating my birthday in the desert late last month, a rattlesnake bit me and everything went sideways. On mortality, miracles, and overcoming fear with the healing power of love.
There are few moments in the high desert more beautiful than just after the sun sets. Words have been invented for the light magic that happens when the sun slips beneath the horizon, but it’s not yet completely dark.
Twilight. Gloaming. The “edge of the day,” a liminal space between evening and nighttime.
In Joshua Tree, California, where my husband and I and a few friends spent the weekend of my birthday, September 25, gives some of the most spectacular gloaming I’ve ever witnessed. It’s as if someone has dropped a rose-colored gossamer scrim over everything, softening the hues and hard angles into an illusory, penumbral dreamscape.
Just after sunset, about 6:30 p.m., Monday September 26, I decided to record a video post for my beloved This Numinous World subscribers to make up for the Sunday Stories one I hadn’t posted on my birthday. I grabbed a high metal chair and tall rusty plant stand from the side yard and dragged them toward a couple of Joshua trees, applied some lippy, pulled on my favorite desert hat, and recorded a few thoughts and two poems that had been meaningful to me in the days immediately preceding. Then I trooped back inside our rambling Airbnb to post it.
The video was fine, I thought. Imperfect, but that’s part of my thing here: authenticity. Not overproduced, filtered, or “fixed” in post-production. I loaded it onto the Substack platform and watched the first few minutes again before deciding whether to send it into the world. That’s when vanity got the better of me.
If I had just tipped the camera up a few clicks, I wouldn’t have had so many chins. Maybe I should do it again, I thought, looking over my shoulder to gauge the remaining light outside. If I was quick about it, I could re-record, at a slightly better angle, before the last of the gloaming had gone.
When I’d come in from taping my first attempt, I had pulled off the high leather boots I almost always wear when I’m in the desert. It was still hot (in the high 80s) and there was no AC in all but one room of the bohemian desert house we’d been renting. I had no time to waste, so instead of walking to the other side of the house to put my boots back on, I slipped into a pair of slide sandals, grabbed my laptop, and slid out a side door heading toward my makeshift al fresco studio.
About three steps later, I felt something hit the side of my leg and then a sharp pinch, as if I’d caught the edge of one of the many craggy bushes that surround the property and been pricked by a thorn.
Then I heard it.
A faint rattle.
I looked down and, in a millisecond that felt like an eternity, noticed two bloody spots on the sock on my right foot and then a small rattlesnake (most likely or a young Western Diamondback or the more venomous juvenile Mojave green seen here ) a few inches from my leg that was coiled and preparing to strike at me. Again.
I dropped my laptop and ran out of my sandals toward the house where I pounded at the first door I reached, which was locked, screaming bloody murder until my husband answered it a few seconds later.
“A rattlesnake just bit me, oh my God, call 911!!!” I screamed and kept screaming until he got the emergency dispatcher on speakerphone. My whole body was shaking, I was in unimaginable pain, and too terrified to shed tears. I just kept screaming.
This is what sheer terror feels like. I hope never to feel it again.
Miraculously (and I’ll be using that word a few times in this post), despite our relatively remote location, EMTs and firefighters reached the house in 10 minutes, and a few minutes later, I was in the back of an ambulance speeding toward the nearest trauma center, about 30 miles away. We were between two such hospitals and Katie, the wonderful EMT who cared for me and even made me laugh that first terrifying hour of this ordeal, was on the radio with both, trying to figure out who had the antivenom in stock. (I learned later that there is a shortage of antivenom worldwide. Because it is so costly to produce and store, many hospitals don’t keep it in supply.) At one point, Katie told whoever she was talking to that they had 60 seconds to figure it out or they’d have to pull the ambulance over and call the “airship” to fly me to a hospital farther away that did have an ample supply of antivenom. (“Ample” becomes an important word a little later.)
As soon as Katie got confirmation from one of the hospitals, she turned to the driver, Stephen, and said, “Code 3,” at which point he switched on the red lights and siren and put the pedal down. Somehow (again, miraculously) they got me to the emergency room via secondary desert roads in about a half hour. I was quickly triaged, saw the attending physician who prescribed the antivenin, received a shot of morphine (they’d given me two doses of fentanyl in the ambulance that did absolutely nothing to curb the howling pain that was not-so-slowly creeping up my leg from where the rattler bit me in the ankle about a half-inch from my achilles tendon) while I waited for the pharmacy to compound ten vials of the Anavip antivenom into an IV bag.
Not quite two hours after the snake bit me—on the outskirts of the most optimal time to treat a pit viper bite—antivenom began flowing into an IV port in my right hand. A few hours after that, I was admitted to the ICU at Desert Regional Medical Center in downtown Palm Springs, although I didn’t know where I was until several hours later when I finally thought to ask one of the ER nurses after it dawned on me that I had no idea where the ambulance had taken me.
That first night and day in ICU was a blur of agonizing pain and the Turner Classic Movie Channel that played on the TV mounted on the wall across from my bed. I didn’t have my phone or my laptop with me at first and, although heavily medicated, was kept too lucid by the pain of my leg doubling and then almost tripling in size from edema—a result of both the snake venom and the antivenin used to treat it—to bear commercial television. But I was also too scared to be alone with my thoughts and the bleeping of all the machines to which I was tethered by tubes and cords attached to my chest, abdomen, both arms, and the pointer finger on my right hand.
Cast a Dark Shadow, Nobody Lives Forever, The Honeymoon Killers, Hang ‘Em High…A silent movie marathon, two full days of Humphrey Bogart’s greatest hits. Stories that were largely unknown to me and somehow familiar enough that they were good company in my fearful solitude. I’d fall asleep to Geraldine Fitzgerald falling in love with John Garfield in post-WWII Los Angeles, wake up to twisted lovers Shirley Stoler and Ray LoBianco on a murder spree in 1960s New York, and, after more pain meds, drift back into my own private twilight as Bogie and Bette Davis flirted and sparred in 1937’s Kid Galahad. Strange bedfellows, indeed, and oddly comforting.
The pain began to relent (or at least become manageable) after the first 30 hours (and 20 vials of Anavip antivenin—made from horse immunoglobulin as opposed to the other brand, CroFab, which is made from the immunoglobulin of sheep)—one of those strange coincidences for me, in that my overall health has been dramatically improved over the last year since I’ve been receiving monthly IV immunoglobulin-G infusions to treat the advanced neurological Lyme disease I was diagnosed with in the summer of 2021. Immunoglobulin changed my life, rebuilding what was a non-functioning immune system a year ago, and now a different kind of immunoglobulin (thanks, horsies!) had saved it.
A word about rattlesnakes and antivenom: As I understand it, if one is going to be bitten by a venomous snake, rattlesnakes (which are all technically “pit vipers”) are the lesser of two evils as their venom contains predominantly hemotoxins, which destroy red blood cells, can cause blood to clot excessively or to not clot (both are bad), and result in tremendous pain. The greater evil are other snakes, such as coral snakes, mambas, cobras, etc., not found natively in southern California, with venom that is predominantly neurotoxic, affecting the central nervous system, including breathing and cognitive abilities.
A few rattlers, including the green Mojave, have venom that contains both. I had no obvious breathing or cognitive issues. I did have a tremendous amount of stabbing, throbbing, aching, shooting pain that emanated from the bite on my ankle upward, at one point almost to my groin. Coupled with extreme edema that also moved northward up my leg, I experienced the most physical discomfort of my life.
Please avoid being bitten by a rattler at all costs. It is not an experience you wish to have. Ever.
Rattlesnake bites can be fatal, although they usually are not if antivenin is administered as soon as possible. About five of of the approximately 7,500 people who are bitten by pit vipers in the United States each year succumb to the “envenomation.”
Before 1895, when French scientist Albert Calmette developed antivenom (or antivenin, both spellings are correct) for a cobra bite, antivenoms did not exist. In fact, they were not available in the United States until the late 1920s. The life-saving concoctions were later developed by injecting livestock (sheep and horses, mostly) with the venom of rattlers until they developed antibodies, which were then harvested and used as a serum to treat humans. As one family member who is a surgeon told me by phone last week, “If this was a hundred years ago the only treatment was to chop your leg off.”
Thank you, Jesus, for scientific advances.
A week after being bitten, I was able to walk a couple of miles, slowly and on pavement, on my own. Yesterday, I walked five. That is, in my book, a miracle.
A medical miracle. A miracle of science. A miracle. Full stop.
In those first hours and days and throughout my hospital stay, I often thought about something one of the Living School teachers, the mystic and psychiatrist Jim Finley told us many times: “God protects us from nothing and sustains us in all things.”
As with many physical challenges, mindset is half the battle. Becoming a “Lyme warrior” and learning how to live with the chronic disease has involved managing stress and anxiety levels, as they are two of the most significant contributors to the Lyme flaring in debilitating ways. The timing of that diagnosis, which came half-way through my tenure as a student of the Living School of the Center for Action and Contemplation, was providential in that the contemplative tools and practices I was learning helped immensely with mitigating anxiety and managing stress. One of the first things the doctors asked me to do after the snake bit me, was to do everything I could to remain calm. I am so grateful for that contemplative toolbox, which helped me stay present and as cool as I could muster.
From the time they loaded me into the ambulance and began speeding through the desert night to the hospital to the time I was discharged five days later, I must have silently meditated on the Jesus Prayer many thousands of times. It’s a prayer I first learned as a theater student in college, part of our company’s regular practice before rehearsals:
Jesus Christ (breathe in)
Son of God (breathe out)
Have mercy on me (breathe in)
A sinner (breathe out)
When I am able to fall into the ancient, breathing Jesus Prayer that some traditions believe is what the Bible means when it talks about “praying without ceasing,” it slows my respiration and heartbeat, calms my mind and spirit, and in the case of being bitten by a venomous snake, helped to slow the spread of the poison throughout my body.
In those first hours and days and throughout my hospital stay, I often thought about something one of the Living School teachers, the mystic and clinical psychologist Jim Finley, told us many times: “God protects us from nothing and sustains us in all things.” The rattlesnake didn’t bite me because I (or someone else) hadn’t prayed hard enough for my protection. The rattler bit me because I startled it and wasn’t watching where I was going and was wearing slide-on sandals instead of my tall leather boots, because I was walking through the bushes in the gloaming when snakes and other critters like to move about, and because in a moment of idiocy, I forgot to do all the things I know to do to avoid precisely what happened.
Yes. AND God was with me in the moment the snake bit me, as I ran away, as the ambulance and EMTs made it to our remote rental house in record time, as we made it to a hospital that not only had the life-saving antivenin in stock, but enough of it to treat the massive dose of venom I received from the overzealous baby snake that hadn’t yet learned how to modulate how much venom it gives the creatures it bites like adult rattlers do. God was with me in the worst pain I have ever experienced, in the waves of fear that threatened to overcome me, in the relief of morphine and Percocet and the blessed sleep that they often brought.
God was with me. God is with me. I was never alone. God was with me in the prayers, meditations, thoughts, candles lit, incense burned, intentions dedicated, good vibes sent, and the immense love beamed from friends, family, and strangers all over the world to my hospital bed. That profound, sacred attention and love was palpable. I felt surrounded by it like an oxygen tent. It calmed and comforted me. It cast out fear. It was the main reason why, to my mind at least, a week after the snake bit me and perhaps 48 hours after I was first able to stand on my own, I was able to go for a long walk on my own in Laguna Beach.
That profound, sacred attention and love was palpable. I felt surrounded by it like an oxygen tent. It calmed and comforted me. It cast out fear.
In all, I received 40 vials (a record for my attending physician at the hospital) of antivenin, a treatment that is obscenely expensive without health insurance, which I have never been more grateful for than I have been these last days. And I also am grateful to know that, should something go sideways and we get stuck with suffocating medical bills, there would be a way forward. God and the love of countless friends and family and strangers would be with us and sustain us in that, too.
Which reminds me of another contemplative practice I learned while a student in the Living School—a short meditation that goes like this:
Be still and know that I am God.
Be still and know that I am.
Be still and know.
I think I may have mentioned before in this space that I have been working on a project about fear for the last few years. It began in the months before my mother died in 2019 and continued as I prepared to turn 50 during the height (or what we thought at least at the time was the height) of the COVID-19 pandemic, and through two more years of “plague time” that has followed. I began by making a decision about stopping an inherited cycle of fear in my life. I did not want to go into the second half of my life being afraid—of suffering and illness, of loss, of doing it wrong, of being shunned, of not being enough, of being too much, of being a bad parent, of loud noises and being startled, of falling from a great height, of the unknown. I made a literal checklist of fears and set about figuring out how I could confront and overcome each of them.
I began two weeks after Mom died, by jumping off a bridge near Bend, Oregon.
In fairness, “jump” is doing a lot of work in that sentence. More accurately, I was gently dropped backward (and while tethered to a giant rubber band) from the base of a bungee jump on a bridge 300 feet above the Crooked River Gorge. While I didn’t choose the Oregon Bungee Company site for this reason, it turned out to be the highest bungee jump in North America. Go big or go home, right?
Why did I jump (or allow someone to drop me) off of a bridge? Because from earliest childhood, I had a recurring dream about falling through a suspension bridge into a chasm. It is one of my earliest memories, in fact, that recurring nightmare. I had it throughout my childhood (along with a stultifying fear of heights) and into adulthood. While less frequent in recent years, once or twice annually I would wake myself up bracing for impact as I had since I was a toddler.
I am no adrenaline junkie, nor am I a natural risk-taker. When I decided I was going to bungee jump off a bridge, it was the most un-me thing I’d ever contemplated doing, so much so that I told almost no one in advance. But (as you can see above) I did do it, if imperfectly. Fear and trembling all the way to the edge of the platform, where I’d prepared to swan-dive into the abyss. That is until my body refused to travel the last few inches and James Scott, the menschy owner of the bungee company, came to my rescue by turning me around, coaxing me to let go of the rails and grab his wrists as he tenderly leaned me into the void and let go.
When you’re free-falling several hundred feet toward a dry riverbed, your nervous system is too overwhelmed by the stupidity of what you have done to have a heart attack, throw up, or even scream. It’s not until you hit the nadir of the bungee tether and begin to bounce back up that the system reboots and, in my case, you begin to scream. It’s hard to hear but what I shouted, uncontrollably and without thought was, I TRUST YOU, I TRUST YOU, I TRUST YOU!
I wasn’t addressing dear James back on the platform, I was shouting at the Universe. At what I call God.
I trust you. I TRUST you. I TRUST YOU!!!!
For days, I was high from the massive jolt of adrenaline, accompanying dopamine, and self-love, so proud of myself for overcoming what was perhaps my most primal fear. And if you’ve seen my recent photos from the Grand Canyon on Instagram you’ll know that my fear of heights was successfully exorcised that Sunday morning in Bend three summers ago.
My list of fears to vanquish included other bete noirs, including being naked in public (ticked that off the list one night in the sulfur baths at Esalen) and being alone and silent with my thoughts for an extended period of time (knocked that on the head on the same trip to Big Sur when I stayed with my now beloved New Camaldolese monks at their hermitage for 10 days). But it did not include a fear I’ve had since I was barely old enough to walk: Snakes.
When I was about 18 months old and my mother was still a grade school teacher, she took her class on a trip to either the Bronx or the Central Park Zoo (I forget which and my parents are both gone so there’s no one to remind me.) My father went along as an extra chaperone and they took me with them. At one point, Daddy walked toddler me into the reptile house. And I began to scream bloody murder. I was a docile baby so this was unusual, or so the story goes. I would not stop screaming until he swept me into his arms and ran out of the reptile house. I have been afraid of snakes ever since.
Actually, it was more a loathing than a fear. They make me shkeeve. I don’t care whether it’s a tiny garter or a king cobra, keep it the fuck away from me. Rattlesnakes in particular made my skin crawl, just the thought of them and I’d find myself, even as a 52-year-old woman, unconsciously curling my toes, lifting my feet off the ground, and tucking them under my butt. Until last week when one finally “got” me, I regularly had nightmares about snakes in the bed or under the bed or in the kitchen or the car or … pretty much anywhere.
We’ve lived in Southern California for 13 years and I’m an avid hiker. I know snakes are all around and I do my best to stay far away from them. My husband and son know the cardinal rule that’s never had to be invoked but is there for a reason: If I ever saw a snake on our property, we would have to move. I’m pretty sure they’ve both seen them, but they’ve blessedly never told me about it.
The first autumn we were here, when Vasco was about 10, we went for a hike in the nearby Aliso Creek Wilderness. It was a warm day and I knew that snakes liked to cool themselves in the shade, so each time we passed through a shady area, I sped up. At one point, my clever and kind son said, very calmly, “Mum, look” and pointed about 25 feet behind where we’d just walked. There was a huge rattler stretched across the path. I had stepped over it. He had watched me do it, but had the presence of mind (and the sense of someone who spent his early childhood around black mambas) not to alert me to the snake’s presence until after I had cleared it. (Thank you, Vas.) Nevertheless, I shrieked and started running in the other direction. My son followed, dropping the hat he was wearing in the process. “JUST LEAVE IT!!” I shouted, running as fast as I could. “Just leave it” is now a well-worn family injoke.
As recently as three hours before I was bitten by the rattler last week, my friend Melinda (who shares my extreme snake aversion, so much so it was written into her wedding vows) and her two teen children who joined us briefly in Joshua Tree were talking about how much we hated snakes. Melinda’s son Anders had camped overnight inside Joshua Tree National Park and shot a short video of some kind of snake that morning. I caught a nanosecond of the video clip out of the corner of my eye while I was driving and he was playing it on his phone in the back seat and nearly drove off the road.
I had no desire to confront my fear (and loathing) of snakes.
Well, the universe had other plans. I still loathe them. My literal worst nightmare had happened and I survived it. Miraculously. Maybe it’s the experience of looking fear in the face and surviving it, perhaps it’s the 40 vials of antivenom—more than a few people have asked whether that comes with a superpower; you mean in addition to sarcasm?—whatever the reason, I am less afraid. I have no desire to encounter one ever again and you will not see me volunteering to go on assignment behind the scenes at a snake-handling church or the Festa dei Serpari di Cocullo in my ancestral Abruzzo. But the power the fear (or loathing or both) of snakes had over me for most of my life now is diminished.
I am investing in a pair of snake gaiters for hiking in the desert and similar wild places here in SoCal, and I’d be lying if I said I didn’t spend some time perusing Amazon.com’s collection of machetes while I was in the ICU. But snakes will not keep me from the magic of the desert, its spectacular light, and clarity.
Perfect love casts out fear, I’m told.
Thank you for all the love.
Video shot September 26 minutes before the snake bite
The birthday of the world
BY MARGE PIERCY
On the birthday of the world
I begin to contemplate
what I have done and left
undone, but this year
not so much rebuilding
of my perennially damaged
psyche, shoring up eroding
friendships, digging out
stumps of old resentments
that refuse to rot on their own.
No, this year I want to call
myself to task for what
I have done and not done
for peace. How much have
I dared in opposition?
How much have I put
on the line for freedom?
For mine and others?
As these freedoms are pared,
sliced and diced, where
have I spoken out? Who
have I tried to move? In
this holy season, I stand
self-convicted of sloth
in a time when lies choke
the mind and rhetoric
bends reason to slithering
choking pythons. Here
I stand before the gates
opening, the fire dazzling
my eyes, and as I approach
what judges me, I judge
myself. Give me weapons
of minute destruction. Let
my words turn into sparks.
BY PHILIP LARKIN
The trees are coming into leaf
Like something almost being said;
The recent buds relax and spread,
Their greenness is a kind of grief.
Is it that they are born again
And we grow old? No, they die too,
Their yearly trick of looking new
Is written down in rings of grain.
Yet still the unresting castles thresh
In full grown thickness every May.
Last year is dead, they seem to say,
Begin afresh, afresh, afresh.
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