How to Save People From Snakebites

The desperate search for better antidotes that can work against many types of venom.

Matt Lewin waited for the paralysis to set in. Two anesthesiologists and an emergency-room doctor monitored his vitals while the mivacurium moved through him. Mivacurium paralyzes skeletal muscles the same way a cobra bite does, with the venom’s most deadly effect: It causes the diaphragm to stop contracting, and the victim suffocates. The doctors had chemically immobilized

Lewin, like a snake would, to see if they could reanimate him with a new snake-venom antidote.

It was an antidote Lewin himself had developed: a nasal spray of the compound neostigmine. Doctors first described neostigmine’s ability to undo snake-induced paralysis in 1972, but it is usually injected, and administered by doctors in a hospital. Lewin wanted to create a first-aid–style, no-supervision-required version that a person could stick up her nose after a cobra bit her. But his Afrin-like version had never been tested against snakebites—not even in mice, rats, chimps, or the other lab-test favorites that usually precede humans.

Lewin, prone in the research room, was the first test subject. (A known antidote to mivacurium waited right next to him, just in case.) At first, the effects of mivacurium felt relaxing, the ultimate shavasana. Then, Lewin couldn’t see. His breathing got shallower. He had trouble swallowing, couldn’t lift his head. Speech departed.

He felt impatient and dependent, like a child whose well-being depends on others. “Even though I knew I was being monitored intensely, they appeared to me very casual,” he says, “because they couldn’t experience what I was experiencing.” And what he was experiencing was a slow, staggering walk toward death (metaphorically, since he couldn’t even wiggle a toe). He could only hope that his antidote would grab his hand and lead him back.

“Everything that was going on was just in my head,” he says, “which was, give me the drug. Stop talking about Hank Williams, Jr.”

Underneath his anxiety, though, he knew that the doctors were confident and focused, playing out the scenario they had dress-rehearsed and planned for months. When he heard them approach his nose with the antidote, he got so excited that his heart monitor began beeping like crazy before the mist even entered his nasal cavity.

The effects were almost instantaneous. The muscles under his face jerked awake and reordered themselves. It felt cartoony, like CGI of a human morphing into an animal. Minutes later, the rest of his body worked. He rose from the bed like Lazarus.

“It worked!” he said.

His words came out slurry and garbled. He cried.

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