A Boy’s Trial by Fire
By JOSEPH P. BLANK
“After the second explosion, I ran out of my house
and looked down Avenue O,” a neighbor of the Von Kamps said “About 50 yards away I saw a ball of fire
moving toward me. Then I looked closer
and saw that the ball of fire was a boy!”
The
neighbor grabbed the boy, Bobby Von Kamp, and rolled him on the road to smother
the flames. Then he tore off the boy’s
charred clothing. As he worked, he
could hear the clang of approaching fire and ambulance sirens.
Bobby
Von Kamp, two weeks away from his 11th birthday, lived across the
street from a gasoline storage tank on the Houston, Texas, waterfront. At 7 p.m on January 24, 1961, he was
watching television with his 14-year-old brother Edward and a 12-year-old friend,
Herman Halocombe. His father, a seaman,
was on a ship off the coast of Florida, his mother had just gone to the grocery
store and his two older brothers were out for the evening.
As
the Bugs Bunny cartoon was going off the air, the boys smelled gas. High-octane gasoline had been leaking out of
the storage tank across the street.
Suddenly the vapors exploded.
Clouds of flame boiled through the air, licked through the open windows. The three boys dashed for the front
door. Eddie held open the screen door as
another explosion whoop the street. He
caught a burst of flames on his back.
Part of the screening in the door simply melted into nothing.
The
boys ran. Eddie slipped and fell. Herman said, “I’ll stay,” and knelt by his
friend. Bobby yelled, “I’ll get
help!” He ran down the street with
flames streaming from his clothing.
As
soon as ambulances arrived, Bobby and Eddie were sped to the Texas Children’s
Hospital. Herman, the least burned, was
taken to another hospital.
As
she entered the emergency room of Texas Children’s Dr. Alice Miller, (a
pseudonym to conform with regulations of the Harris Country, Texas, Medical
Society), a pediatric surgeon, saw Bobby, a “charred statue.” He was conscious, able to answer questions. Dr. Miller found that he was burned over 98
percent of his body—70 percent third-degree (deep) burns, 20 percent
second-degree, and 8 percent first-degree.
Only the soles of his feet had escaped the flames. (Extensive
third-degree burns are a near-overwhelming insult to the blood and every organ
of the body. Few people have survived
50 percent third-degree burns.)
Bobby’s
entire spine, all his joints and the tendons of his hands, forearms, feet and
legs were exposed. “Where are you going
to find the skin to cover him?’ a colleague asked Dr. Miller. Mrs. Van Kamp,
numbed by the horror of the tragedy, heard someone say, “It’ll be a miracle if
either of the boys lives.”
Dr.Miller
says, “I don’t believe anything is hopeless until it’s proved hopeless. I keep trying. In a serious burn case doctors and nurses have to care very
deeply.”
After
Bobby was wheeled into the operating room, he lapsed into unconsciousness. His arms were so burned that the doctor was
unable to take his blood pressure to estimate the depth of shock. His entire body was oozing liquids, joint
fluids and blood chemicals. At any
moment the kidneys might stop functioning—from lack of fluid, caused by oozing,
or from inadequate blood circulation, caused by shock. Bobby required injections of drugs, liquids
and blood chemicals, but his body was so burned that Dr. Miller had to search
for a good vein. She finally found one
in the left shoulder. At the same time
he was given antibiotics to control infection.
Bits of cloth and dirt were removed from the burns; each finger and tow
was dressed separately. Then Bobby was
placed on a Stryker frame, a special apparatus designed for minimum contact
with the body.
Eddie
meanwhile was receiving similar treatment from a general surgeon. (No doctor
can do justice to the care of two such patients at one time and still carry on
a practice) Eddie was, from the first,
only semiconscious; he never did become rational.
Dr.
Miller worked on Bobby throughout the night.
For several days she examined him every two of three hours. “Although he could move only his eyelids,”
the doctor said. “I could see that he knew what was happening. And I also saw that he had spunk and
determination. This was important. He would be on the edge of death for a long
time, and he would need the will to live.”
Pain
became a way of life for the boys. Each
hypodermic injection was excruciating.
Nurses had to change the boys’ position every few hours, and whenever
they were touched their screams could be heard on other hospital floors. In addition, blood transfusions were a
source of constant anxiety. The boy
sometimes received 20 to 30 pints of blood a week, and each new transfusion
carried the potential of fatal shock.
“Bobby
knew how badly his brother and he were hurt,” nurse Rae Whittaker said. “He kept trying to encourage Bobby. It’ll be better for Eddie to have a private
room.”
Before
he was moved to his new room, Bobby was first taken to the operating room to
have his dressings changed, a two-or three-times a week procedure so painful
that it had to be done under general anesthesia. While Bobby was in the operating room, Eddie died.
That
night Bobby’s temperature dipped to 94.4 degrees and his white-blood-cell count
doubled, signs of a massive infection.
The doctor suspected the onset of fatal septicemia—blood poisoning. Laboratory work to determine the specific
material required 48 hours. If the
infection proved to be blood poisoning, Bobby would be dead by the time of the
report.
Dr.
Miller decided not to wait. When
administered a highly potent drug, one known to be very dangerous to the
kidneys—which in this case already had undergone assault from the effects of
the burns. It was a risk based on
educated guesswork and hope. The gamble
paid off. Within 24 hours Bobby’s
temperature, blood count and pulse returned to normal.
In
his new room, Bobby waited more than a week before he could bring himself to
ask about Eddie. The loss shook him
profoundly. He felt that his brother,
by waiting to hold open the screen door, had sacrificed his life for him.
He
also knew that his own survival was uncertain.
Once he asked Dr. Miller, in a tone that combined pleading and
challenge, “You’re not going to let me die, are you?”
“No,
Bobby, we’re not,” she assured him.
He
asked to have his cowboy boots placed on a table where he could see them. “I’m going to wear those boots some day,” he
said.
A
little more than five weeks after the accident, Dr. Miller began skin
grafts. Third-degree burns are so deep
that the body can’t build new skin; the skin must be replaced. In the first operation she cut thin, almost
transparent patches of skin from the thighs of Bobby’s brother William, and
sutured them to the patient’s thigh, leg, arm and hand. Skin from another person’s body won’t graft,
but it will last tow or three weeks before being rejected. During that time it will protect the surface
from infection and reduce the loss of body fluids through oozing.
Then
from Bobby’s first-and second-degree burn areas, which do heal themselves, she
cut postage-stamp-size pieces of skin.
These she attached to the critical joint areas, suturing the larger
pieces but simply placing the smaller “stamps” on the wounds and applying a
pressure bandage to keep them in place.
The
long procedure—it took nearly seven hours—was a tremendous undertaking for
Bobby, and on the following day he weakened.
His temperature rose to more than 104 degrees. His pulse quickened. His neck veins became distended. He appeared to be going into heart
failure. The cardiologist could not
determine what was happening inside his heart, however, because there was no
place on his body to put the leads of an electrocardiogram machine. Dr. Miller assumed that an infection was
taking over all his body, and she put him on a regimen of antibiotics. For several hours he teetered between
failure and improvement, then gradually his pulse, breathing and temperature to
normal.
Week
after week the struggle to keep Bobby alive continued. As soon as the thighs of his older teen-age
brothers William and Sarry healed, the boys returned to the hospital to donate
more skin. Bobby’s own body contributed
bits of skin for permanent grafts. The
joints of one finger on the left hand and two on the right hand were so
hopelessly burned that amputation was required, but from these fingers the
doctor salvaged little pieces of skin for grafts.
In
the tenth week Bobby began to slide into a deep emotional reaction against his
ordeal. He refused to take
injections. He didn’t want to eat. Since burn cases require an intake of protein
to build tissue, the nurses spent hours cajoling, pleading and persuading him
to take a few bites of meat. Sometimes
they would retire to an office and cry, in frustration, before returning to
Bobby and trying again.
The
memory of the explosion and the fire now overwhelmed him. When a child popped a balloon in the
hospital corridor, he shook and cried.
Lighted matches disturbed him. He
asked his father not to wear a favorite yellow shirt. At night he had horrible dreams.
“Eddie, I smell gas!” he shouted in his sleep. “Let’s get out of here! I’m on fire!” Then he awoke screaming.
These
psychological problems were as dangerous to Bobby as infection. A clinical psychologist induced hypnosis
without Bobby’s being aware of it.
“Though a process known as hypnotic desensitization,” the psychologist
explained, “Bobby began to understand that the fire was past and couldn’t hurt
him now. He was in the hospital. He was safe.
It
worked. Bobby never had another
nightmare. His determination and
optimism returned. He continued to
improve. Then the evening at home, Dr.
Miller received the news that Bobby’s temperature was zooming, his stomach was
distended and he was vomiting. The
hospital resident ventured that it could be intestinal block.
Dr.Miller
rushed at once to the hospital, examined Bobby, and then questioned him about
the food he had eaten the past two days.
Well, he had had some candy that afternoon. Candy? How much? Four, maybe five bars.
The
doctor immediately ordered an enema, and then gave Bobby a blistering
scolding. When she was through, he
said, “I know I’m going to live now.
You wouldn’t have given it to me lied that if you thought I was going to
die.”
The
skin grafts were now taking beautifully, but the unexpected was always routine. Infections flared and subsided. Bobby’s lower right leg had been burned to
the bone. Since there was no base to
tissue on which to place skin, the orthopedic surgeon recommended
amputation. But Dr. Miller was
reluctant; she decided to try to save the leg.
She drilled tiny holes through the bone into the marrow; the granulating
tissue grew through these openings and eventually covered the bone. She had a base on which to graft skin, the
skin took and the sag was saved.
“Everything
worked,” Dr. Miller said, “We could
have lost Bobby at any time.
Septicemia. Other
infections. Kidney shutdown. Heart failure. Rejection of grafts. He
was transfused with thousands of pints of blood, and he went through some 70
major operations. He could have failed
during any one of these procedures, but he didn’t. In everything we did, we seemed to have the touch of god.”
She
had estimated that Bobby would spend more than a year in the hospital. But six months from the day of admission,
his parents helped him to wheelchair and took him home. Shortly afterward he began walking by grimly
holding onto the wheelchair and pushing it ahead of him. A few weeks later, when he first came back to
see Dr. Miller, he pushed himself out of the wheelchair in the hospital corridor
and then, wobbling and perspiring, walked without support into her office. The two embraced.
A
year and a half later, Bobby walked and ran with a slight limp. He played ball, rode a bicycle. Except for a scar near his left ear, his
face shows no sign of the ordeal. His
body shows scars and grafts, but he’s not self-conscious about them.
Several
times a year he returned to the hospital for more grafts. Grafted skin won’t grow, so until he reached
maturity additional skin had to be grafted to match his growth. When hospitalized, he likes to spend his
time with sick and injured children.
Once he stayed awake through the night, trying to give comfort to a girl
who had been burned. “When I see that I
make somebody feel a little better,” he told me, “I feel a little better. I tell them how bad off I was, and how I am
now. I’m not going to let what happened
to me stop me from doing what I want to-do.
I’m just walking on.”
“Bobby will make it, “Dr. Miller said. “He is proud of his life.”
