Your venomous serpent bites you, and the clock is ticking. America’s zookeepers—and a cooler full of rare antivenom—are your best chance of survival.
Because even bites from native species are so rare, medical teams unaccustomed to the unusual traits of envenomation might recommend treatments like fasciotomy, an invasive surgical procedure meant to relieve pressure that venom experts say is rarely if ever medically necessary to treat snakebites. Gifford arrived at the hospital after his bite with a sheaf of care instructions he’d prepared ahead of time—and told medical staff that he did not consent to a fasciotomy. Medical facilities can be especially unprepared for the quirks of an exotic bite and the wide variety of venoms involved, and those who seek care for them often face worse outcomes.
Even if antivenom is swiftly administered, patients can suffer grievous long-term effects, including tissue damage and amputation. “They can take out your kidney function just because they’re breaking down so much protein, and it will obliterate your kidneys,” Pecori says. “I know people have gone on dialysis after being bitten by some of these.”
In 2017, Boyer retired from the University of Arizona, and the Antivenom Index needed a new institutional home. Last year it found its way to Ohio’s Toledo Zoo, which houses one of the country’s largest collections of reptiles (150 species), including more than 60 venomous ones. As a result, Toledo also has an unusually diverse bank of antivenom, and has responded to many an Antivenom Index call.
John Chastain, the zoo’s general curator, jokes that the emergency antivenom calls always seem to come in the middle of the night. “I usually sleep through a phone call or two and then eventually hear it,” he says.
Chastain has driven antivenom to hospitals himself and met helicopters on a University of Toledo helipad. On one occasion, he drove antivenom to a Cabela’s in Dundee, Michigan, to do the handoff. Sometimes the hospital or poison center summons highway patrol to get the precious cargo where it needs to go: Lights and sirens have a way of speeding things up.
In 2022, Chastain was summoned to the zoo in the wee hours to pull vials for an Indiana resident who’d been bitten by a saw-scaled viper. The bite, left untreated, would cause internal bleeding, hemorrhaging, and very likely death. Chastain tucked the antivenom between bags of frozen vegetables and handed it to a waiting police officer, who took off at a run for his squad car before ultimately passing the cooler off to another officer waiting at the Indiana state line—a sequence captured on body cam footage.
Boyer, who is now the chief scientific officer at the pharmaceutical company Ophirex, acknowledges that the Antivenom Index is an imperfect system. Zoos have plenty of reasons to be less than enthusiastic about providing antivenom this way. “I personally think we shouldn’t ask zoos to be the de facto pharmacopeia,” she says. “It’s a really strange way to manage a rare disease. The zoo is out thousands of dollars every time it helps a person in need, and you can bet that generates some unhappiness, probably more among the finance departments than among the reptile keepers.”
