When people come to visit, I often hear one common question: “What about the snakes?” I've had some close encounters with snakes since I've been here. One time when I went to the pool, I found a 6-foot Spitting Cobra swimming in the deep end. Another time I was riding my motorbike and a huge snake appeared out of the grass about 10 yards in front of me. Its head had disappeared in the grass on one side of the road before the tail appeared on the other side. Last December, I found four snakes on my doorstep during a two-week time period.

Remarkably, though, even if a person gets bitten, most do pretty well. The bite might cause swelling that lasts for about a month, but rarely leaves permanent damage.

Several weeks ago, we had the first severe snakebite I've seen at the hospital. The patient was sent from one of our referring hospitals and had been bitten 24 hours earlier. Usually with severe cases of neurotoxins, you expect a patient to die within minutes. Why this man had such a delayed reaction, I really don’t know. When the man arrived at the hospital he was barely breathing and the muscles all over his body were twitching uncontrollably. He was rapidly accumulating fluid in his lungs because his muscles were so weak. I knew we didn't have much time.

Time wasn’t the only thing in short supply; we have very little snake anti-venom in the hospital, because it's expensive for us to stock. To treat a severe case of snakebite you usually need around 10-15 vials of anti-venom. I knew we had a hidden stash in the bottom of the pharmacy refrigerator. It had expired in 2004, but I had resisted throwing it away in the hopes that it could still be useful. Anti-venom is made from horse serum and can be potentially dangerous or even fatal if a patient has an adverse reaction to it. So I'm contemplating giving a potentially dangerous drug, which when it's good can be trouble, and my batch was four years out of date and slippery from the mold growing in the bottom of the refrigerator. I've never given this drug, nor seen anyone give it to a patient. And there's always the chance that my diagnosis of “neurotoxic snakebite” could also be wrong, since I've never seen one of those either.

I was surprised when the hospital’s pharmacist said there were 18 expired vials, about 10 more than I remembered having on hand. The man was clearly dying, so I called in the other doctors who agreed that using the vials was our only option. We started with eight, which helped a little, but the man was still twitching like an electrocuted fish. At vial 16, his twitching finally stopped, and we ended up giving him all 18 vials to ensure his symptoms didn’t return.

The next day, the man was sitting up in bed, smiling, and saying he felt much better! He returned home the next day with only a slightly swollen leg. During his stay at the hospital, he also met with our chaplains and dedicated his life to Jesus Christ on the day he was discharged.

I can’t help but think that it was unusual for this man to take 24 hours to develop symptoms, to arrive at the hospital at just the right time (an hour later he would probably have been dead), to need 18 vials to get better, which just happened to be the amount that we had.

Perhaps there had been a plan for him made long ago that was difficult to see until that day.