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Kentucky burn patients face long recovery at VUMC
Mark Pitsch, The (Louisville, KY) Courier-Journal
Monday, Mar. 3, 2003 The Tennessean

Infections, even simple everyday ones, can be deadly to Robert Baker.

That's why his father, Tom Baker, is draped in a plastic gown and his hands are gloved when he stands beside his son at Vanderbilt University Medical Center.

His 26-year-old son, burned over 70% of his body, lies motionless and doesn't speak. Tom Baker leans over the hospital bed, gently touches his boy and urges him to be strong.

''I just told him to hurry up and get well,'' Baker said later.

For survivors of the Feb. 20 explosion and fire at CTA Acoustics in Corbin, Ky., recovery will be long.

Doctors say that the five most severely injured patients, including Robert Baker, will face months of surgeries, skin grafts and physical therapy and will have to deal with the psychological toll on them and family members.

''There are a lot of different losses that burn patients have to deal with,'' said Dan Ramage, a clinical social worker at Vanderbilt's burn unit. ''There are some predictable stages of grief, but the stages are cyclical.''

Tom Baker knows that cycle.

''You have your ups and downs, you know, your very highs and your very lows,'' said Baker, a Laurel County, Ky., magistrate. ''Every time the phone rings, you know, you don't want to hear the phone ring. You're real anxious, yet hesitant. It's really hard to keep your emotions in check.

''The doctor said ... to be hopefully optimistic, and that's what we are,'' he said.

Federal and state agencies continue to investigate the cause of the blast. Investigators are focusing on a buildup of flammable dust inside the plant, which makes insulation for automakers.

Forty-four people were injured in the explosion, 15 of them going to burn units at regional hospitals. Six of the 15 were taken to Vanderbilt.

Of those six, three died last week. Baker and William Daniels, 34, are in critical but stable condition. Geneva Philpot, 49, was transferred from Vanderbilt to Nashville Rehabilitation Hospital on Friday.

Ray Pacheco, Philpot's son-in-law, said the survivors' families were rooting for one another and had grown close. ''Everybody's been keeping a positive attitude and praying,'' he said. ''We have each other here to get us through it all.''

When Philpot began rehabilitation last week, she became a symbol of hope for Baker's and Daniels' families as well as for her own.

As Philpot walked the hall at Vanderbilt, Tom Baker joked with her: ''Don't walk too far or they'll want you to go back to work.''

Philpot, who declined to be interviewed, had third-degree burns on her hands and face — more than 30% of her body, according to doctors.

Robert Baker had third-degree burns on his arms, legs, back and face, said Dr. Joel Maier of Vanderbilt's burn unit.

Daniels was burned on his legs, arms, back and face — about 70% of his body.

Baker and Daniels are wrapped in bandages, are fed through a tube and are breathing with the help of a ventilator. They are sedated and remained uncommunicative late last week. Members of Daniels' family declined to be interviewed.

Before the four CTA employees died, more than 60 relatives were holding a vigil at the Nashville hospital. Families can share the 15 minutes of visitation that they get four times a day with patients. Others spend their waking hours in the burn unit's waiting room.

Dr. Jeffrey S. Guy, a surgery professor and co-director of Vanderbilt's burn center, said, ''A big element of burn survival is not just the size of the burn, but the age of the patient and the smoke they inhaled.''

He said smoke-inhalation damage to the lungs typically doesn't show up for 48 to 72 hours. Three Corbin patients showed severe lung damage within 30 minutes of each other about three days after the accident.

''That's not a process we can reverse,'' Guy said. ''We can just treat it and ride out the storm.''

Teresa Oates, a nurse who is the burn unit's case manager, said previous medical conditions and, often, patients' willingness to battle the injury affect their survival rate. She said she had seen older, severely burned patients live while younger, less severely burned patients die.

Guy said Vanderbilt's surviving patients were starting to develop infections as their bodies healed and built up resistance to heavy doses of antibiotics. But he said the infections could be treated.

Guy and Oates said treating the burn victims had been emotional. ''I'd be lying to you if I said I didn't cry,'' Guy said. ''Losing three people in three days, even when you know the chance of survival is slim, is tough.''

Ramage, the social worker, and Guy have tried to convince the families of the survivors that their lives will never be the same.

Last week they had Nashville-area burn survivors speak to the families.

''Burns require a lifetime of treatment,'' Ramage said.

But Tom Baker says all he wants is for his son to survive.

''I can live with his scars, and I'm sure he can, too,'' Baker said.

Pacheco said Philpot's family recognized that it would face a number of challenges. He said his mother-in-law's injury was ''affecting everyone around her.''

Pointing to his children as they walked the hallway of the burn unit, Pacheco said Kaia, 2, and Ray, 5, were having a hard time understanding the event. They don't understand why she looks different and isn't as lively.

''Granny's not granny,'' he said. ''We just hope we can get her as close to normal as we can.''