Courtesy: Medical Miracles, from Readers Digest 1981.
November.
From the frontiers of science and the far horizons of
personal courage, these stories of medical triumphs and miracles will reaffirm
your faith in the awesome powers of the human spirit. Dramatic victories and
human triumphs.
Selected and edited by the editors of Readers Digest
“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.”
