22:20 - Walking back to camp from the showers that night after dark, I feel a strong prick on my left foot. I pause, dismayed, and shine the light down to see what sort of mischief has transpired, to find a single bead of blood growing on the inside arch of my foot. A quick flash of the light back to the scene of the crime, and laying there tense is a thin black snake maybe two centimeters wide, and a meter long, no pattern. A black mamba.
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Black Mamba (Dendroaspis polylepis) - Among the most venomous snakes in Africa, known for being very aggressive when threatened and will not hesitate to strike with deadly precision. Reputed to be the fastest moving snake in the world. If the victim does not receive medical attention, symptoms rapidly progress to severe abdominal pain, nausea and vomiting, cardiotoxicity, and paralysis. Eventually, the victim experiences convulsions, cardiac arrest, respiratory arrest, coma, and then death. Without anti-venom, the mortality rate nears 100%, the highest among venomous snakes.
</definition>
22:40 - After a mad scramble to wake the appropriate people, I get hoisted into a car off to the first of what will turn out to be many stops. I apply a tourniquet above the bite and keep it lower than my heart. (Later discovery: a tourniquet is not the correct first aid for a snake bite.)
23:05 - Liwonde Health Clinic. We arrive to a dead building. Five people running around banging on every door for several minutes manages to wake up a nurse. Meanwhile, I sit in a wheelchair in the deserted clinic halls, and light up my last cigarette, of the pack, and maybe my life. The pain is radiating up from the bite now. I can feel it coursing up my spine into my neck and out to my extremities. I ask for a beer. Because hey, if I'm going to go, I might as well go happy. No one takes me seriously, but they let me smoke in the clinic.
23:15 - I'm releasing the tourniquet every fifteen minutes or so for a bit to try not to oxygen-deprive whatever tissues down there are still alive. It does not feel nice when I do this; rather it feels like my muscles are being shredded slowly, tenderly, through a meat grinder, starting with my leg and up through the rest of my body. The local snake expert shows up. He's wasted. Completely smashed out of his mind. He none too gently prods me a couple times before I decide this is worthless and we better try the next place.
~23:45 - Tourniquet's off now, leg's raised, on the advice of the sober nurse at Liwonde. When we roll into the Zomba clinic, the entire staff is kneeling on the ground catching dragonflies. They don't move when we pull up. They don't move when I get wheeled up. They don't even get out of the way of the wheelchair until someone I'm with starts screaming at them.
The doctor ambles up and listens for a few minutes and then ambles away for a while. This one's sober at least, but is somewhat lacking an appropriate level of urgency. Community decision: we're gone.
~00:00, 27 November - We're back in the car racing for Blantyre, the largest city in the country. I pass out from the pain.
~01:00 - Mwaiwathu Private Hospital. Possibly the best hospital in the country, at least we've finally arrived at something that resembles a medical facility.
I'm screaming in pain now, but keep refusing painkillers until I can give the doctor clear symptoms.
~03:00 - I've finally delivered my medical report, and the Vicodin is kicking in. I drift off to the doctor saying they don't have the anti-venom on the premises...
Morning, ??:?? - I come to, groggy. I'm thick with pain meds, but I can still feel the dull ache of the venom pushing through the haze. I'm only now starting to finally truly realize I'm actually a goner if that anti-venom doesn't show up soon.
I'm in pretty bad shape. Even if the pain was light enough for me to move, I wouldn't be able to for all the tubes and wires they've got hooked up to me. All I can do it lie still, and wait.
Time passes.
~10:20 - The nurse strides up and brandishes the anti-venom like a trophy. In it goes. It burns, it burns through my veins and arteries. But as its searing flows through my vessels, it leaves in its wake nothing, no pain; peace, at last. My leg is swollen to the size of a tree trunk and still immobile, but I'm free again - I can curl my fingers and turn my head and twist my shoulders. I can even sit up. Redemption. At least for a while, since I'm blissfully unaware of the anti-venom side effects yet...
11:30 - I'm well enough to take visitors, and they're a welcome sight. They've been spared the sight of me through the worst of it (or so I think). We're having a jovial conversation about how I almost died when I start shivering. I don't really feel cold. But the shivering gets worse. I'm shaking violently and uncontrollably now, and my visitors' eyes are getting wide like saucers, which, let me tell you, is not comforting. My neck is so tense, I think it's going to snap, and my teeth are chattering like a wind up toy. I call over to the nurse, she takes one look and rushes to the phone. The doc is there a minute later injecting me with something that makes everything go dark.
Early morning, ??:??, 28 November - I barely come around through thick mist. There's a machine beeping loudly near my head, and it's distinctly not a friendly beeping, not a warm fuzzy beeping at all. The nurse and doctor are there, moving and speaking over me, but through the haze I don't understand anything. Again I drift off.
~06:00 - I wake up, possibly the first time in two days. I'm still a little cloudy, but I feel okay. Nothing weird in my body; no pain except for the leg. The machine near my head is beeping in a very soothing rhythmic way. I doze.
~10:00 - Doc stops in. He looks a combination of surprised and relieved to see me perky. I try not to think too hard about that. Apparently, I look good enough to be downgraded out of ICU. I spend the rest of the day staring at the ceiling, getting measured and prodded, and slipping in and out of sleep.
22:20 - 48 hours later. I've had dinner, and someone snuck me a chocolate bar for dessert, so I'm feeling pretty good. Almost all the tubes and wires have been removed so I can sit up and write this. I'm still weak - my hands shake and I tire easily, but I feel okay.
Thanks to Doctor Leo Vigna, Peter and Maresca and everyone at Chinguni Hills, Stephan, the random french guy, and Tavis, the wandering Aussie, for driving me all over the country in the middle of the night, and of course Nadine who was there for all of it. I would be dead if not for them.
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