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Eight year-old Vladimir Borowitz’s favorite actor is Arnold Schwarzenegger. The youngster likes to ride his bike and ATVs; he swims, takes taekwondo classes and would like to be the punter for Boise State University someday. Vladimir is silly but focused one moment, and can get pretty easily distracted too. It’s all normal stuff for an 8-year-old, and no one’s more excited to see that than his parents, Paul and Gina.
Vladimir’s life took a harsh turn for the worse on July 30, 2011, when an air freshener he sprayed near a candle in a bathroom ignited and engulfed the then 5-year-old in flames. Vladimir had second- and third-degree burns covering 28 percent of his body, most of it on his torso, arms and hands. The child, with his mom by his side, was rushed to the UMC Lions Burn Care Center, a unit whose 16 rooms serve the entire state, as well as parts of Arizona and California.
“By the time I got there, they already had specialists working on him,” Paul says. “They were ready. It was a full team of people,” he adds, recalling the agonizing minutes and hours after the accident.
Vladimir spent 28 days in the burn unit, underwent three surgeries and at one point had his arm held up by an “airplane” splint for 12 days to stretch the skin grafted from his leg to his underarm. The medical appliance, suggested by Dr. Terry Lewis, was used in hopes of avoiding a later surgery that’s often required to stretch skin as a child grows. Three years later, Vladimir still hasn’t needed a follow-up surgery.
“I still get a lot of itches, though,” he says.
Vladimir has shared his story with the media several times over the past 18 months. But now, he’s quick to point out, he’s forgotten much of the incident. He first spoke publicly about it to his kindergarten class halfway through the school year. By then, he’d already endured his share of stares at the jagged-shaped scars on his neck. Initially, he deflected those long looks the best way he knew how.
“I was silent. I was like this the whole time,” he says, forcing a tough, Schwarzenegger-like glare.
Roughly 300 patients come through the UMC Lions Burn Care Center each year. Not all of them have as positive an outcome as Vladimir. But many are able to find their way back into the world successfully, sometimes in lives similar to what they had before their accidents, others on new and unique paths. Treatment methods have advanced greatly through the years. But the burn center also has placed a greater emphasis on reintegrating patients back into the world, and tackling the psychological heavy lifting that comes with it.
Talking about an accident is never easy for a burn victim or family members, but it’s a critical step to recovery, says Kimberly Grettum, a certified child life specialist at UMC’s burn center.
“It really kind of starts day one. We ask what school they go to. If they are school age, we ask if it’s appropriate to put a (stuffed) monkey in their chair. … (Psychotherapist) Cara (Goodman) and I go into school, meet the teacher and the classmates; we update them, based on what (the patient) want(s) us to tell them,” she says.
The monkey is a playful sit-in for the burn victim, taking up the student’s seat, and is brought along to other classes and lunch by peers. The monkey also has a backpack so classmates can slip notes inside for Grettum to take back to the burn center.
“It allows the (burned) kids to still stay connected to the class,” she adds.
Grettum and Licensed Marriage and Family Therapist Cara Goodman, daughter of mayors Carolyn and Oscar Goodman, are an important tandem at UMC. While Grettum works with children on coping mechanisms and better understanding and working through their situations, Goodman helps children and adults process trauma.
“We talk about the Fourth of July, preparing for it, talking about smells and other triggers,” she says. “If it’s someone who was burned in a car fire, getting back into a car is something you want them to be able to do.”
A good portion of Grettum’s work also lies in pre-procedural preparation, or helping children understand the hospital, what’s done there and the different roles people have.
“It’s not through lecture. It’s through play. … We want the hospital to be a growth-promoting experience versus something that is dramatic and hindering to their development,” she says.`
So what does “play” look like? It can be simply manipulating medical tools, hooking up an IV to a stuffed animal, anything tactile and manipulative that can help the child better understand what is happening and make experiences less threatening.
“I’m always trying to see things through the child’s eyes, and help nurses and staff bring it down to their level,” Grettum says. “We’re not doing things to them but with them.”
Goodman takes inspiration from the child burn victim stories. She hopes, one day, to see a more energetic and lively adult burn patient population.
“You walk by a kid’s room and they’re playing games. The staff’s involved with them,” she says. “You walk by an adult’s room and it’s dark, depressing. They don’t come out of their rooms. … We really want to see how we can integrate and transfer the things from the children to the adults.”
She sees simple but impactful changes ahead. Strip performers who entertain for children, for example, can visit adults too. And while the monkey serves as a connection between a child and the school environment, more ways are needed for adult patients to maintain a connection with their work milieu as well.
“For adults, I think it’s a harder psychological hit,” Goodman says. “They’ve spent all of those years developing their identity, working on who they are as an adult. Children are very adaptable.”
Burn patients tend to have longer hospital stays too, and some can become a little too comfortable with the sympathetic burn unit team.
“You become isolated in this little bubble,” Goodman says. “’Someone’s bringing me my food. Someone’s telling me when to do everything. … I don’t pay my bills anymore. I don’t go to the grocery store.’ … It’s not until they go out into the world where they understand what their struggles are going to be.”
UMC holds regular burn survivor support group meetings. They’re open to patients, parents and loved ones. It’s where stories like Vladimir’s are often first shared. But they can be anything but dull.
“At one of them, we got to throw water balloons. … We did foot painting,” Vladimir says.
Due to scheduling issues, Vladimir is unable to attend many peer support group meetings these days, his father says. But it’s not uncommon for the child to ask his dad to stop by the burn center when he and his father are driving in the area. It’s a good sign, and a testament to the approach both Vladimir’s parents and the UMC team have taken.
“We wanted to protect him, but we didn’t want to baby him,” Paul says. “We focus on the positive relationships we’ve built here. … I’ve never really thought of the negative things, but the positive things we gained out of it. … They’re really good about telling you what you need to know. They don’t sugarcoat it. But you’re able to focus on the positive.”
Recently, 10 burn survivors and parents went through a SOAR — for Survivors Offering Assistance in Recovery — training program at UMC. Conducted by the Phoenix Society, the program trains burn survivors and family members to be peer supporters.
“Kim (Grettum) and myself, we haven’t been in (the survivors’) shoes,” Goodman says. “We can only do so much. It’s a whole different experience when (another) survivor can say they know how you feel.”