Close-ups

A Patient's Perspective

A Burn That Keeps Hurting



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Am Fam Physician. 2010 Apr 1;81(7):829.

In 1967, I was severely burned on my upper body and face in an explosion with a riding lawn mower. The priest actually gave me the last rites. When I asked him if I was going to die he said, “No—it's just a formality.”

I was in the hospital for 16 weeks undergoing the most painful treatments you can ever imagine. The dressing changes were excruciating. I needed multiple skin grafts. At one point, I just couldn't take it anymore. The nurse had left the room for a moment, and I ran to the window intending to jump out. The nurse came back in and grabbed me just in time. When I saw the tears in my wife's eyes and thought of my children, I knew I'd never try to do that again.

My life was hard for the next 30 years. I had multiple medical problems, and had to have more than 40 surgeries. Finally, in 1997, I was referred to a psychiatrist. He said it was a good thing I came to see him, because I was on the verge of committing suicide. It was mostly because I was never really able to work after my accident, and I had constant anxiety attacks. During the next few years, I went to counseling, stopped drinking and smoking, and started antidepressant medication. Then, everything changed. It was like being born into another life.—w.b.

COMMENTARY

W.B. is one of the most emotionally centered patients I have ever met, so it was a surprise to hear details about the explosion, his burn injuries, and the ramifications it had on his life. Burn injuries are associated with a high rate of anxiety, depression, and posttraumatic stress disorder (PTSD), which is attributed to the trauma of the initial experience, the severe pain of the treatments, multiple surgeries, long rehabilitation, and bodily disfigurement. PTSD symptoms may develop long after the trauma occurs. At the time of his injury in 1967, W.B. was not given any kind of therapy to address the emotional consequences. However, even 30 years later, it was very helpful to him and changed his life.

MARIETTA ANGELOTTI, MD

RESOURCES

Morgan ED, Bledsoe SC, Barker J. Ambulatory management of burns. Am Fam Physician. 2000;62(9):2015–2026.

Web site: http://www.aafp.org/afp/20001101/2015.html

National Center for PTSD

Web site: http://www.ptsd.va.gov

Phoenix Society for Burn Survivors

Web site: http://www.phoenix-society.org

Close-ups is coordinated by Caroline Wellbery, MD, associate deputy editor, with assistance from Amy Crawford-Faucher, MD, and Jo Marie Reilly, MD. Questions about this department may be sent to Dr. Wellbery at afpjournal@georgetown.edu.

A collection of Close-ups published in AFP is available at http://www.aafp.org/afp/closeups.

The editors of AFP welcome submissions for Close-ups. Guidelines for contributing to this feature can be found in the Authors' Guide at http://www.aafp.org/afp/authors.


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