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by Barbara Ravage
Da Capo, 2005
Review by Kevin Purday on Oct 10th 2006

Burn Unit

This is an awesomely well-researched and well-written book by a professional writer about health issues. She is best known for her books on dieting perhaps most notably the Kiss Guide to Weightloss. She is also the co-editor of an academic work on bacteria. More recently she has written a book explaining how the glycemic index works: The G.I. Handbook.

The book exemplifies the very best of health journalism practice. The author uses two case studies to act as the backbone of the book. The first is about a young man dubbed Dan O'Shea who in a Friday night alcoholic haze probably leaves a cigarette incompletely stubbed out and is very badly burned in the ensuing conflagration. He also suffers from smoke inhalation over an unknown but certainly quite considerable time. The second, Tom Parent, is badly burned when he tries to take a flaming pan of oil out of the kitchen. The book follows what happens to these patients at every stage of their treatment and all the crises involved. It also tracks the effects on the two families.

The author is not content to merely tell the history of two seriously burned victims; she wants us to understand the context in which they were treated and that means having some idea of the history of burns treatment. We are given an overview of the very early attempts to treat burns with their almost complete misunderstanding of the course which burns take, lack of understanding about the internal consequences of smoke inhalation, and their occasional insights. We are then given a fairly detailed account of burns treatment starting with the infamous Cocoanut Grove fire in Boston in 1942 and ending with the equally notorious Station music club fire in Rhode Island in 2003. She follows the development of burns treatment theory and practice by following the careers of some of the specialists involved in the 1942 incident and then bringing us bang up to date with the two case studies.

We get chapters on every aspect of burns treatment all written in a highly readable and very informative style. We learn about how paramedics have learned to keep open the windpipe, how the burns are treated, the evolving understanding of materials used to cover and protect burns, the effects of flame and electric and chemical burns, how the body reacts to burns by often going into shock, and contemporary specialized practice such as the use of a hyperbaric chamber -- something which the reviewer knew all about from his diving experience although its use for patients who have serious smoke inhalation effects was news.

The detail in some of the chapters is both heart rending and stomach churning! Some of the procedures are painful and, to an outsider, rather gruesome. We meet many of the medical staff, both doctors and nurses, and social workers dealing with burns patients and their families at the Massachusetts General Hospital and several other specialist units in and around Boston. The dedication of these people is outstanding.

The book, therefore, is a cunningly woven tapestry of case studies, history, mini biographies of the outstanding specialists, and an extremely detailed account of the treatment from the time of the accident until discharge and beyond. We gain an insight not only into the physical processes but also into the psychological. We even learn about self-harmers and would-be suicides who employ fire as their preferred method.

The book is quite riveting to read but it is also a serious sociological and medical study. There are thirty one pages of detailed references listing the author's sources for everything from the feeding of burn victims to the range of ethical issues in treating them. This is a first-class book and deserves to be read by everyone interested in this field of medical practice.

 

2006 Kevin M. Purday

 

Kevin Purday is a consultant in international education working mainly in Europe, Africa and the Middle East. His main focus is on helping schools to set up the International Baccalaureate Middle Years and Diploma Programs. He has taught both philosophy and psychology in the I.B. diploma program.