Burn Unit: Saving Lives After the Flames

On August 3, my wife was burned in central Anatolia. On August 15, we med-vaced her to the United States. On September 1, I bought this book. On September 20, I received the book. I was so rapt by the writing that I finished this book in two days. Understand, my wife was in the hospital at the time. Reading was not a priority. I visited my wife daily while I ran a family and my own business. Sometimes a writer's capabilities can so overwhelm the topic. A good writer can make the worst topics readable. Burns, sores, sepsis, pain, and scars are what I neither care to read about nor wish others to read about. The sterile black ink on the white pages cannot deliver the sensations to you of the stench associated with the dead skin, nor show you the grotesque complexity of the red and yellow skin which bleeds easily and often. I no more would ask a person to experience what my family has lived the past few months, than I would ask them to clean my plumbing. Burns are a horrible topic which Ms. Ravage has managed to make less horrible. I used this book for something more than enjoyment. The doctors' mouths, often as clasped as the arteries of their surgical patients, tell little to the patients' family, and when they speak, the language is too often cliched with inexplicables and nondeterminatives. This book answered questions, told me what to look forward to, and outlined what to anticipate. This was my "Burn Patients' Questions for Dummies." But, written well. I cringed. I cried. I swallowed hard. And, at times, I had to leave the book. The writng and insight were as razor sharp as the scalpels discussed and referenced in the portion discussing grafting. Good work Ms. Ravage! You helped a great deal. I can only tell others in my predicament, read this book. And, after you read the book, you will feel better about what there is looming in the slowly progressing and little discussed world of burns.

Left me informed and awed by the examples of persistence and resourcefulness in the medical field and by the resilience of the body and the spirit. Barbara Ravage did an excellent job of explaining the complications involved in burns in layman's language while keeping the story moving forward at a compelling pace with very interesting anecdotes and enough historical background to deepen appreciation of what it's taken for burn care to get to where it is.

Novels quite frequently keep me up till three a.m., but non-fiction? Not so much. Last night, at 3:15, I had to force myself to re-charge my KIndle battery and close my aching eyes. Burn Unit is that good.The book, as other reviewers have said, blends medical history, accounts of spectacular fires like the one at the Cocoanut Grove in 1942, personal accounts of two burn survivors, a physiological tour of the body after a serious burn, and, most of all, a description of the work of the famous Bigelow Burn Unit at Massachusetts General Hospital in Boston. Barbara Ravage seamlessly moves from one element to another in this marvelously researched and compulsively readable book.For me, by far the most fascinating component of Burn Unit was its riveting account of exactly what happens in a seriously burned body. One of Ravage's survivors is a young gay man burned over 35% of his body, who fell asleep upon an old mattress, choking on black smoke, inhaling toxins that would prove as damaging as the actual flames he'd fled. The other is a middle-aged father who, trying to dump a pot of 400-degree peanut oil, disappeared into a sheath of fire before his wife's horrified eyes. In relentless, compelling detail, Ravage tells us exactly what happens to such victims: the breakdown of capillaries that causes a deluge of essential fluids, the onset of the inflammatory response that causes a cascade of horrors, the way in which toxic smoke causes the cells of the airway, all the way down into the lungs, to char and begin to coagulate into a bloody glop that must be suctioned out, and the damage to epidermis, dermis, muscle, even all the way down to bone that will require efforts on the part of doctors, surgeons, nurses, techs, and other essential burn unit personnel to remedy.Although other reviewers have cautioned the squeamish to stay away, and although my spouse finally begged me to cease and desist explaining burn physiology, I didn't find Ravage's book revolting at all; I was too fascinated to learn about how the burned body often acts as its own worst enemy, initiating processes that may aid healing in the long run, but in the short run cause agony and near-disastrous breakdown. So much of what happens is counter-intuitive: did you know, for instance, that burn victims lose weight so fast that, if they are conscious, they are told to eat until they're ready to burst? (The inflammatory response elevates the body's metabolism so dramatically that calories literally melt away. ) Did you know burn victims must be kept very, very warm, in damp plastic chambers, to prevent the loss of body heat and the moisture that burn wounds need to heal. Did you know that, instead of leaving the blackened, tough "lid" on the surface of the burn in place, so healing can begin from underneath, modern burn specialists immediately scrape off this apparently protective cover, even though doing so makes infection more likely? Ravage presents all these astonishments, most of them very recent in burn care, so effortlessly that you need not have a medical background to understand...only the curiosity to learn exactly what happens, and why.We enter the OR to watch the surgeon and his team slice off blackened eschar, then slice off micron-thin slices of intact skin (with a device that resembles a pastrami-slicer) to make a graft. We learn about the curious substances that doctors have used to simulate skin: pig collagen, skin from an identical twin, even grafts from cadavers, which keep the burn wound moist and protected until they are finally rejected. Ravage describes the efforts, still in their infancy, to create a true artificial skin, the last remaining major breakthrough in burn care.Finally, she follows Dan O'Shea and Tom Parent into their new lives as survivors, showing us that emotional as well as physical recovery from burns is an enormous challenge.The book concludes with exhaustive footnotes and an index. My only complaint here is that the Kindle version doesn't explain what the paragraphs in tiny text throughout the book are; I coudn't tell if they were quotes from other sources, and there are no numbers in the text itself to correspond to the numbered footnotes at the end of the book.But these are quibbles. Burn Unit is dazzling. I learned so much, so effortlessly--easily the best non-fiction book since Andrew Solomon's Far from the Tree.Five Stars.

This is a powerful book, packed with information about the history of burn treatment, the structure and nature of skin, medical techniques, how the body heals and what it takes to work in the demanding field of burn care. The personal stories of the physicians, nurses, inventors, patients and their families sparkle with life.At times, I must admit, I became impatient with the structure of the book, the deep dives into details about historic fires or what felt like more information than I wanted to know about a particular medical technique. I longed to get back to what was happening with the people who came to feel like my patients, my staff.The wonderful thing is that Barbara Ravage can make you feel so intimately connected to the people she interviewed, the scenes she witnessed. You sense her driving curiosity and fascination. She makes descriptions of complicated information such as the body's responses to burns or difficult medical procedures vivid and clear. Sometimes her analogies will even make you smile.I plan to recommend this book to several friends.

Fantastic book for Burns staff

Great book and received promptly.