Struan Sutherland, however, is a name obscure to most of the world, but not the world of venoms and poisons. His magnum opus, “Australian Animal Toxins the creatures, their toxins, and care of the poisoned patient” is a true classic (the second edition had Jim Tibballs as his coauthor). This was the first book I bought after leaving the venomless shores of New Zealand for Australia’s wildly venomous Northern Territory.
Although much of the management advice given in the book is now dated, the descriptions of the animals, their toxins, and the effects they have on their victims offered by this book are invaluable. Among Prof Sutherland’s other notable achievements were surviving childhood experiments with explosives and electricity, the creation of the first effective antivenom for the menacingly lethal Funnel Web Spider (Atrax robustus), introducing pressure-immobilisation as first aid for snakebites, the development of the snake venom detection kit now widely used in Australia, and becoming something of a legend in the field of hydroponics!
He tells his story in his own eccentric style in an entertaining autobiography called, “A Venomous Life“, where he freely admitted:
” … an autobiography is an ideal vehicle for self-promotion and subtle shafting of one’s enemies!
Doulgas Adams met Struan Sutherland in Melbourne in the late 1980’s on his way to Indonesia to see the Dragons of Komodo with the zoologist Mark Cawardine. What follows is an illuminating excerpt from the brilliantly insightful and funny book, “Last Chance to See” – where Douglas Adams describes his memorable encounter with this remarkable Australian toxinologist:
There is in Melbourne a man who probably knows more about poisonous snakes than anyone else on earth. his name is Dr Struan Sutherland, and he has devoted his entire life to a study of venom.
‘And I’m bored with it,’ he said when we went along to see him the next morning. ‘Can’t stand all these poisonous creatures, all these snakes and insects and fish and things. Stupid things, biting everybody. And then people expect me to tell them what to do about it. I’ll tell them what to do. Don’t get bitten in the first place. That’s the answer. I’ve had enough of it. Hydroponics, now, that’s interesting. Talk to you all you like about hydroponics. Fascinating stuff, growing plants artificially in water, very interesting technique. We’ll need to know all about it if we’re go to Mars and places. Where did you say you were going?’
‘Well, don’t get bitten, that’s all I can say. And don’t come running to me if you do because you won’t get here in time and anyway I’ll probably be out. Hate this office, look at it. Full of poisonous animals all over the place. Look at this tank, it’s full of fire ants. Poisonous. Bored silly with them. Anyway, I got some little cakes in in case you were hungry. Would you like some little cakes? I can’t remember where I put them. There’s some tea but it’s not very good. Sit down for heaven’s sake.
‘So, you’re going to Komodo. Well, I don’t know why you want to do that, but I suppose you have your reasons. There are fifteen different types of snakes on Komodo, and half of them are poisonous. The only potentially deadly ones are the Russell’s viper, the bamboo viper, and the Indian cobra.
‘The Indian cobra is the fifteenth deadliest snake in the world, and all the other fourteen are here in Australia. That’s why it’s so hard for me to find time to get on with my hydroponics, with all these snakes all over the place.
We… asked him how many of the snakes he had been bitten by himself.
‘None of ’em’ he said. ‘Another area of expertise I’ve developed is that of getting other people to handle the dangerous animals. Won’t do it myself. Don’t want to get bitten do I? You know what it says in my entry in Who’s Who? “Hobbies: gardening – with gloves; fishing – with boots; traveling – with care.” That’s the answer. Oh, and wear baggy trousers. When a snake strikes it starts to inject venom as soon as it hits something. If you’ve got baggy trousers most of the venom will just get squirted down the inside of your trousers which is better than down the inside of your leg. You’re not eating your cakes. Come on, get them down you, there’s plenty more in the fridge.’
‘So what do we do if we get bitten by something deadly, then?’ I asked.
He blinked at me as if I were stupid.
‘Well what do you think you do?’ he said. ‘You die of course. That’s what deadly means.’
‘But what about cutting open the wound and sucking out the poison?’ I asked.
‘Rather you than me,’ he said. ‘I wouldn’t want a mouthful of poison. all the blood vessels beneath the tongue are very close to the surface so the poison goes straight into the bloodstream. That’s assuming you could get much of the poison out, which you probably couldn’t. And in a place like Komodo it means you’d quickly have a seriously infected wound to contend with as well as a leg full of poison. Septicaemia, gangrene, you name it. It’ll kill you.’
‘What about a tourniquet?’
‘Fine if you don’t mind having your leg off afterwards. You’d have to because it would be dead. And if you find anyone in that part of Indonesia who you’d trust to take your leg off then you’re a braver man than me. No, I’ll tell you: the only thing you can do is apply a pressure bandage direct to the wound and wrap the whole leg up tightly, but not too tightly. Slow the blood flow but don’t cut it off or you’ll lose the leg. keep the leg, or whatever bit of you it is you’ve been bitten in, lower than your heart and your head. Keep very, very still, breathe slowly and get to a doctor immediately. If you’re on Komodo that means a couple of days, by which time you’ll be well dead.
“The only answer, and I mean this quite seriously, is don’t get bitten. There’s no reason why you should. Any of the snakes there will get out of your way well before you even see them. You don’t really need to worry about the snakes if you’re careful. No, the things you really need to worry about are the marine creatures.’
‘Scorpion fish, stone fish, sea snakes. Much more poisonous than anything on land. Get stung by a stone fish and the pain alone can kill you. People drown themselves to stop the pain.’
‘Where are all these things?’
‘Oh, just in the sea. Tons of them. I wouldn’t go near it if I were you. Full of poisonous animals. Hate them.’
‘Is there anything you do like?’
No, I mean is there any venomous creature you’re particularly fond of?’
He looked out of the window for a moment.
‘There was,’ he said, ‘but she left me’.
Sadly, both men have now left us. Douglas Adams tragically died from a ‘heart attack’ in 2001 and Struan Sutherland passed away in 2002 after battling with a rare Parkinsons-like neurodegenerative condition.
They live on in our memories – and on Youtube (Douglas talks about Struan at about the 17:30min mark):
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health, a Clinical Adjunct Associate Professor at Monash University, and the Chair of the Australian and New Zealand Intensive Care Society (ANZICS) Education Committee. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of LITFL.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of two amazing children.
On Twitter, he is @precordialthump.