{"id":751,"date":"2025-12-03T19:40:34","date_gmt":"2025-12-04T03:40:34","guid":{"rendered":"https:\/\/dornsife.usc.edu\/scribe\/?p=751"},"modified":"2025-12-03T19:41:22","modified_gmt":"2025-12-04T03:41:22","slug":"a-history-of-healing-how-firefighters-have-revolutionized-burn-care","status":"publish","type":"post","link":"https:\/\/dornsife.usc.edu\/scribe\/2025\/12\/03\/a-history-of-healing-how-firefighters-have-revolutionized-burn-care\/","title":{"rendered":"A History of Healing: How Firefighters have Revolutionized Burn Care"},"content":{"rendered":"\n\n\n\n\n  \n    \n\n\n\n\n\n\n<div\n  class=\"cc--component-container cc--article-hero \"\n\n  \n  \n  \n  \n  \n  \n  >\n  <div class=\"c--component c--article-hero\"\n    \n      >\n\n    \n<div class=\"inner-wrapper\">\n          \n<div class=\"f--field f--image\">\n\n    \n    \n    \n    \n    \n    \n              \n      <img\n                            data-src=\"https:\/\/dornsife.usc.edu\/scribe\/wp-content\/uploads\/sites\/491\/2025\/12\/image-from-rawpixel-id-4031867-jpeg-768x432.jpg\"\n          data-srcset=\"https:\/\/dornsife.usc.edu\/scribe\/wp-content\/uploads\/sites\/491\/2025\/12\/image-from-rawpixel-id-4031867-jpeg-768x432.jpg 768w\"          data-sizes=\"(min-width:1200px) 75vw, (min-width:768px) 83vw, 100vw\"          class=\"lazyload\"\n        \n                  role=\"none\"\n        \n        \n                                      \/>\n\n    \n    \n  \n  \n\n<\/div>\n  \n  \n  <div class=\"text-wrapper\">\n    \n              \n<div class=\"f--field f--page-title\">\n\n    \n  <h1>A History of Healing: How Firefighters have Revolutionized Burn Care<\/h1>\n\n\n<\/div>\n    \n    \n          <strong class=\"author-field\"><span >By<\/span>Lexi Coyle McDonald<\/strong>\n    \n          <span class=\"post-date-field\">December 3, 2025<\/span>\n      <\/div>\n<\/div>\n\n\n  <\/div><\/div>\n\n  \n    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Although advances in burn care have produced<br \/>\nmassive improvements in patient outcomes, reducing the mortality of severe burns to less than<br \/>\nfive percent, their treatment still poses a significant challenge for medical practitioners<br \/>\nworldwide.1 Modern burn care involves a multidisciplinary approach aimed at stabilizing<br \/>\npatients, managing wounds, preventing infection, and promoting the patient\u2019s long-term physical<br \/>\nand mental recovery. Progress in these areas has accelerated over the past fifty years, largely<br \/>\ndriven by focused studies on the long-term effects of burns on firefighters. Since this group is<br \/>\nsubjected to high burn risks and also required to undergo regular medical monitoring, firefighters<br \/>\nare a valuable population transforming burn care for both first responder and civilian survivors.<br \/>\nIndeed, major breakthroughs in medicine and burn care are demonstrated in the contrast between<br \/>\nthe post-burn experiences of Sindy Lutz, an artist, former nanny, and hostess burned in 1969, and<br \/>\nLauren Manning, a famous survivor of the 9\/11 terrorist attacks in 2001. With the role of<br \/>\nfirefighter-centered research and programs as a foundation, examining the dissimilar experiences<br \/>\nof these two brave women reveals how advances in burn care have considerably enhanced the<br \/>\nphysical and psychological treatment of burn survivors.<br \/>\nThe experience of Sindy Lutz, who was burned as a child in January of 1969, exemplifies<br \/>\nthe limited medical knowledge and inadequate care that characterized burn treatment before<br \/>\nmodern developments influenced by research on firefighter injuries.2 The accident occurred<br \/>\nwhen Sindy was three years old in her childhood home on Long Beach Island, New Jersey. In the early morning, while her parents were still asleep, Sindy and her five-year-old brother had been<br \/>\nplaying with matches and candles when her pajamas caught on fire. At the time, there was no<br \/>\nhospital on the mainland in Manahawkin, so an ambulance first drove her north to Toms River<br \/>\nHospital, which turned her away due to her young age and the severity of her injuries. The<br \/>\nambulance then went east for another two hours until arriving at Saint Christopher\u2019s Hospital for<br \/>\nChildren in Philadelphia, Pennsylvania. Around 40 percent of Sindy\u2019s body was intensely<br \/>\nburned, including her left hand, neck, and chest, and she remained in the hospital for three<br \/>\nmonths.<br \/>\nThere were no intensive care units specializing in burns, so Sindy was treated in the<br \/>\ngeneral hospital ward. She received multiple surgical skin grafts taken from her legs, which were<br \/>\nunburned. However, since scars do not actively expand in size as an adolescent\u2019s body grows,<br \/>\nSindy had to keep receiving periodic skin grafts through her teenage years at Saint Barnabas<br \/>\nHospital in North Jersey, which was roughly two hours away. While physical therapy existed, it<br \/>\nwas insufficient and not tailored to the unique needs of burn patients. Additionally, because there<br \/>\nwere no rehabilitation centers nearby, the hospital merely gave Sindy\u2019s mom a list of exercises<br \/>\nfor Sindy to perform at home to prevent scar contraction. Furthermore, doctors completely<br \/>\noverlooked the psychological impacts of Sindy\u2019s burns and neglected to inform her of any<br \/>\noptions for group, family, or individual therapy, counseling, or psychiatric care. Eventually,<br \/>\nSindy\u2019s parents forced her to visit her high school\u2019s therapist due to major depressive and<br \/>\npost-traumatic symptoms related to the long-term effects of her burn injuries as well as<br \/>\nself-image issues stemming from the continuing surgeries. Unfortunately, the school therapist<br \/>\nhad a poor understanding of mental illness and worsened the situation by telling fifteen-year-old<br \/>\nSindy that she seemed \u201ckind of b*tchy.\u201d Sindy ended up leaving that school and was unable to find appropriate psychological care until her late twenties, which she credits to developments in<br \/>\nmental health resources as well as her purposeful attempts to seek support (albeit without<br \/>\nassistance from healthcare providers) while living in New York City. Although Sindy has been<br \/>\nable to recover exceedingly well, her story represents how, prior to the establishment of<br \/>\nspecialized burn units and advancements in medical research, the treatment of burn injuries was<br \/>\nrudimentary and focused solely on immediate survival and short-term physical recovery.<br \/>\nBy contrast, Lauren Manning\u2019s experience over thirty years later highlights the<br \/>\nsignificant progress made in burn treatment, particularly in terms of sophisticated physical care<br \/>\nand incorporation of both occupational therapy and psychological support into burn recovery. On<br \/>\nthe morning of September 11, 2001, Manning was entering the lobby of the North Tower of the<br \/>\nWorld Trade Center for work when a wall of flame exploded from the elevator shaft and burned<br \/>\nover 82.5 percent of her body.<\/p>\n<p>Although Manning was burned in exceptional circumstances, her<br \/>\nexperience is relevant because her journey from surviving over 6 months spent in mostly critical<br \/>\ncondition in the hospital to thriving was made possible by the intervening decades of<br \/>\nimprovements in burn medicine. Initially, Lauren\u2019s treatment did not appear to depart drastically<br \/>\nfrom Sindy\u2019s: Lauren needed specialized care but was placed in a shared room on the general<br \/>\nemergency floor at Saint Vincent\u2019s Hospital in New York.4 Lauren\u2019s first doctors were also<br \/>\nill-equipped to deal with her grave state even as they underestimated the extent of her injuries,<br \/>\nconcluding that she mainly suffered second-degree burns covering around 60 percent of her body<br \/>\n(an inaccurate assessment).5<\/p>\n<p>However, Lauren\u2019s situation shifted once her nurses contacted the New<br \/>\nYork-Presbyterian\/Weill Cornell Medical Center burn unit, asking for help. Recognizing the<br \/>\nseverity of Manning\u2019s condition, the Weill Cornell Hospital transferred her within the day to their<br \/>\nWilliam Randolph Hearst Burn Center, which is regarded as one of the best in the world.6 Lauren<br \/>\nwas assisted by a team led by Dr. Roger Yurt, the medical director of the Burn Center, who gave<br \/>\nher eleven surgeries that included using cadaver skin and skin grafts as she lay in an induced<br \/>\ncoma for two months.7 Dr. Yurt also consulted with Dr. Weiland of the Hospital for Special<br \/>\nSurgery, one of the nation\u2019s top hand surgeons, for some of Manning\u2019s procedures like partial<br \/>\nfinger amputations and joint fusions.8 Both during and after the coma, Manning had a fleet of<br \/>\nnurses who ensured that she received pulmonary support through ventilators, intravenous fluids<br \/>\ndelivering over 6,000 calories per day and several medications (namely painkillers, antibiotics,<br \/>\nand sedatives), visits to the \u201ctank\u201d (the room where patients are given a water bath to remove<br \/>\nburned tissue), and at least one daily occupational and physical therapy session to restore her<br \/>\nrange of motion.9<br \/>\nOnce Manning was stabilized, she participated in hospital-led group psychotherapy<br \/>\nsessions with other burn survivors as her occupational and physical therapy program intensified<br \/>\nto the point of being a \u201cfull-time job\u201d when she moved to the Burke Rehabilitation Hospital.10<br \/>\nThe doctors also gave Lauren\u2019s family and caregivers guidelines on how to best support her<br \/>\nemotional and mental healing by instructing them not to volunteer information on anything<br \/>\nrelated to her accident or the events of 9\/11 until she explicitly asked for it and then to answerher questions without elaboration.11 Like Sindy, Lauren struggled with her altered appearance,<br \/>\ngrappling with feelings of \u201cugliness and imperfection\u201d and of being a living \u201creminder of times<br \/>\npeople would rather forget.\u201d12 However, unlike Sindy\u2019s doctors, Burke Hospital was sensitive to<br \/>\nburn survivors\u2019 body image issues and focused on reintegrating patients into ordinary life<br \/>\nthrough therapist-accompanied group public outings, such as going to the movies, enjoying<br \/>\npizza, or buying makeup.13 Lauren eagerly anticipated these outings, which boosted her<br \/>\nconfidence and ameliorated her low self-image while helping her re-assimilate into the world<br \/>\noutside the hospital. Even though it is undisputed that Lauren\u2019s recovery would have been nearly<br \/>\nimpossible in 1969 without modern burn centers and state-of-the-art physical treatment, the<br \/>\ncontributions from her multidisciplinary teams, especially the psychological and occupational<br \/>\nsupport, cannot be overstated. In this way, Lauren\u2019s story indicates how burn care has evolved<br \/>\nnot only in terms of scientific knowledge and physical treatment, but also how it has grown to<br \/>\nholistically encompass all aspects of recovery, addressing the long-term healing of both mind and<br \/>\nbody.<br \/>\nThe current burn protocols that have saved the lives of countless individuals like<br \/>\nManning are direct results of research conducted on firefighters. A prime example is a ten-year<br \/>\nlongitudinal study on firefighter burn injuries performed by the same hospital that treated Lauren<br \/>\nManning, the William Randolph Hearst Burn Center. This Burn Center is New York\u2019s first, and it<br \/>\nembodies the longstanding connections between pioneering burn treatments and firefighters in<br \/>\nnumerous ways, most notably including its founding in 1976 in collaboration with the New York<br \/>\nFirefighters Burn Center Foundation.14 Together, these New York-based Burn Center<br \/>\norganizations provide \u201cprograms in wound healing, research, prevention, education, and<br \/>\nreintegration of burn survivors into their community.\u201d15 From July 1992 to June 2002, the<br \/>\nduration of the study, the burn unit at Weill Cornell cared for 987 firefighters (as well as<br \/>\nmembers of the general public like Manning) using a diverse team of burn specialists, plastic and<br \/>\nreconstructive surgeons, psychologists, critical care medicine specialists, nurses, physical<br \/>\ntherapists, occupational therapists, and other specialty staff.16 This study drew from data<br \/>\ncollected by the National Trauma Registry of the American College of Surgeons and the Medical<br \/>\nRecords Department on every Weill Cornell firefighter patient who suffered burn-related injuries<br \/>\nduring this period.17 Researchers reviewed their charts to \u201cidentify the etiology and risk factors<br \/>\nfor firefighters who acquire burn injuries, describe patterns of injury, and evaluate safety<br \/>\ninterventions\u201d for burn prevention and management.18 Thus, by analyzing nearly a thousand<br \/>\nrecords that detailed the different treatments, recovery times, complications, and long-term<br \/>\noutcomes of burn injuries over ten years, the study helped to improve clinical practices related to<br \/>\nburn care, which informed the protocols that Weill Cornell used to treat Manning.<br \/>\nOther crucial impacts of this decade-long study are related to burn injury prevention. For<br \/>\ninstance, as a result of this study, existing burn prevention programs that had been initiated in<br \/>\n1983 by the Fire Department of the City of New York, firefighter educators, and the Firefighter<br \/>\nBurn Centers were modified to address the risk of burns for both the general public and<br \/>\nfirefighters.19 Due to a noticeable rise in the number of firefighters receiving burn injuries in<br \/>\n1998, where such wounds accounted for approximately 25% of all injuries, the study prompted a reassessment of training protocols, equipment, and safety standards.20 These efforts have been<br \/>\nquite successful, as the National Fire Protection Association attributed burns to a mere 7-9% of<br \/>\nall fireground injuries in 2022.21 While these program modifications primarily aimed to reduce<br \/>\nfirefighter injuries, many new training techniques and safety tactics developed to protect<br \/>\nfirefighters were later adapted or incorporated into public safety measures. For example, through<br \/>\nthe Life Safety Code, which is revised every three to five years, the National Fire Protection<br \/>\nAssociation updated building codes and construction standards to set stricter minimum<br \/>\nrequirements on fire alarms, means of egress, sprinkler systems, smoke detectors, and<br \/>\nfire-resistant building materials, changes that have prevented burns for first responders and<br \/>\neveryday persons alike.22<br \/>\nSimilarly, after the Washington Hospital Burn Center in Washington, DC, reported<br \/>\ntreating 108 firefighter burn injuries in 2008, they partnered with the District of Columbia Fire<br \/>\nDepartment (DCFD) and DC Firefighters Burn Foundation to develop a Firefighter Burn Injury<br \/>\nAwareness Course.23 This comprehensive program covered a wide range of topics, including a<br \/>\n\u201cmedical perspective\u201d section led by a burn professional that detailed the seriousness of these<br \/>\ninjuries and described the lengthy recovery process that involves surgery, treatment,<br \/>\nrehabilitation, and reconstruction.24 After all 2,400 members of the DCFD took this course over<br \/>\none month, there was a 20% decrease in firefighter burn injuries, which underscored the<br \/>\nimportance of education on burn prevention for both firefighters and the general population.25<br \/>\nSince then, more widespread fire safety education campaigns and public service announcements<br \/>\nhave informed the general public on how to prevent burn injuries in households, workplaces, and<br \/>\npublic spaces.<br \/>\nSeveral studies on firefighters have also improved medical approaches to burn treatment,<br \/>\nparticularly in tackling psychological wounds. The Firefighter Behavioral Health Alliance asserts<br \/>\nthat more firefighters died by suicide than in the line of duty from 2014 to 2020, with increased<br \/>\nrates for those with Post-Traumatic Stress Disorder or other emotional \u201cwounds of the spirit\u201d that<br \/>\nare often generated by burn injuries.26 Furthermore, an ongoing survey by the International<br \/>\nAssociation of Firefighters in partnership with the American Burn Association (ABA) tracking<br \/>\nfireground burn injuries among firefighters in North America has also found that firefighters are<br \/>\nat heightened risk of developing psychological trauma and suicidal ideation following a burn<br \/>\ninjury.<br \/>\n27 Even though this may seem obvious, the mental and emotional consequences of burn<br \/>\ninjuries have been historically neglected, especially among firefighters who are reluctant to<br \/>\nreport mental health issues. Therefore, findings such as these \u2014 which were featured in the<br \/>\nABA\u2019s Journal of Burn Care &amp; Research, the only publication in the United States devoted<br \/>\nexclusively to the treatment and research of burn injuries \u2014 hold extra importance because they<br \/>\nvalidate the experiences of many survivors and have helped spur more research into this field.28<br \/>\nIndeed, experts contend that proper diagnosis and treatment of mental health issues is paramount<br \/>\nto rehabilitation therapy, as over 60% of all severely burned patients develop post-traumatic<br \/>\npsychological problems.29 Accordingly, psychiatrists and psychotherapists are now permanent<br \/>\nteam members in burn wards, which reveals a critical shift in how we approach the healing<br \/>\nprocess. In other words, patients with burn injuries are no longer considered recovered when<br \/>\ntheir physical wounds have healed; instead, in part due to research on firefighters, we now<br \/>\nunderstand that it is imperative to address the profound emotional scars that can cause long-term<br \/>\nalterations in one\u2019s well-being and overall quality of life.<br \/>\nResearch on firefighter burn injuries has thus significantly transformed the physical and<br \/>\npsychological recovery process of all burn survivors. The experiences of Sindy Lutz and Lauren<br \/>\nManning underscore the evolution in burn treatment over the last few decades. Although both<br \/>\nwomen were able to recover despite their life-threatening burns and would eventually meet each<br \/>\nother in person, Sindy\u2019s journey was hindered by the limited medical knowledge and lack of<br \/>\npsychological support at the time. Conversely, Lauren\u2019s recovery was characterized by an<br \/>\ninterdisciplinary care team that fully integrated advanced physical treatments, occupational<br \/>\ntherapy, and mental health support. Lauren\u2019s comprehensive treatment encapsulates current<br \/>\npractices that include all stages of the healing process: initial first aid, assessment of burn size<br \/>\nand depth, fluid resuscitation, excision and skin grafting, nutritional and pulmonary support, pain<br \/>\nmanagement, wound care, infection control, and physical, occupational, and psychological<br \/>\ntherapy. In this way, insights gleaned from studies on firefighter burns have increased survival<br \/>\nrates through pre-burn prevention programs and post-burn treatments while fostering a more<br \/>\nholistic approach to burn recovery that confronts the emotional impacts of these disfiguring<br \/>\ninjuries. As research continues to advance, we can hope for even better solutions that will further<br \/>\nimprove outcomes for all burn survivors.<\/p>\n<p>1 Hartmann, Bernd, and Lars Kamolz. \u201cA History of Burn Care.\u201d Medicina, Multidisciplinary Digital Publishing<br \/>\nInstitute, 2021, www.mdpi.com\/books\/reprint\/4631, p. 3<\/p>\n<p>2 The author would like to thank Lutz for sharing her story through a series of phone interviews in November 2024.<\/p>\n<p>3 Manning, Greg. Love, Greg &amp; Lauren: A Powerful True Story of Courage, Hope, and Survival. Random House<br \/>\nPublishing Group, 2002, p. 1<\/p>\n<p>4 Manning, Lauren. Unmeasured Strength: A Story of Survival and Transformation. Henry Holt and Company, 2011,<br \/>\np. 63<\/p>\n<p>5 Manning, p. 69<\/p>\n<p>6 Manning, p. 70<\/p>\n<p>7 Flayton, Leigh. \u201cAmazing Things: Lauren Manning.\u201d NewYork-Presbyterian: Health Matters, 8 Sept. 2017,<br \/>\nhealthmatters.nyp.org\/amazing-things-lauren-manning\/.<\/p>\n<p>8 Manning, p. 112<\/p>\n<p>9 Manning, p. 124<\/p>\n<p>10 Manning, p. 146<\/p>\n<p>11 Manning, p. 113<\/p>\n<p>12 Manning, p. 199<\/p>\n<p>13 Manning, p. 160<\/p>\n<p>14 \u201cWilliam Randolph Hearst Burn Center.\u201d NewYork-Presbyterian, William Randolph Hearst Burn Center at New<br \/>\nYork-Presbyterian Hospital, www.nyp.org\/burn-center.<\/p>\n<p>15 \u201cWilliam Randolph Hearst Burn Center\u201d<\/p>\n<p>16 \u201cWilliam Randolph Hearst Burn Center\u201d<\/p>\n<p>17 Rabbitts, Angela, et al. \u201cFirefighter burn injuries: A 10-year longitudinal study.\u201d Journal of Burn Care &amp;<br \/>\nRehabilitation, vol. 25, no. 5, 1 Sept. 2004, https:\/\/doi.org\/10.1097\/01.bcr.0000138290.49063.95.<\/p>\n<p>18 Rabbits, et al.<\/p>\n<p>19 Rabbits, et al.<\/p>\n<p>20 Rabbits, et al.<\/p>\n<p>21 Campbell, Richard. \u201cStatistical Report: Firefighter Injuries on the Fireground.\u201d NFPA Research, National Fire<\/p>\n<p>Protection Association, 31 July 2024, www.nfpa.org\/education-and-research\/research\/nfpa-research\/fire-statistical-<br \/>\nreports\/patterns-of-firefighter-fireground-injuries.<\/p>\n<p>22 \u201cNFPA 101: Life Safety Code.\u201d NFPA List of Codes &amp; Standards, National Fire Protection Association,<br \/>\nwww.nfpa.org\/codes-and-standards\/nfpa-101-standard-development\/101.<\/p>\n<p>23 Woods, J, et al. \u201cThe Effectiveness of a Firefighter Burn Injury Awareness Program.\u201d Injury Prevention, vol. 16,<br \/>\nno. 1, Sept. 2010, https:\/\/doi.org\/10.1136\/ip.2010.029215.472.<\/p>\n<p>24 Woods, J, et al.<\/p>\n<p>25 Woods, J, et al.<\/p>\n<p>26 Dill, Jeff. \u201cWounds of the Spirit: Moral Injury in Firefighters.\u201d Firefighter Behavioral Health Alliance, Firefighter<br \/>\nBehavioral Health Alliance, www.ffbha.org\/.<\/p>\n<p>27 \u201cBurn Injury Fire Fighter Tracking.\u201d American Burn Association, American Burn Association,<br \/>\nameriburn.org\/quality-care\/burn-injury-fire-fighter-tracking\/.<\/p>\n<p>28 \u201cJournal of Burn Care and Research.\u201d American Burn Association, American Burn Association,<br \/>\nameriburn.org\/research\/journal-of-burn-care-and-research\/.<\/p>\n<p>29 Spanholtz, Timo A. et al. \u201cSevere Burn Injuries: Acute and Long-Term Treatment.\u201d Deutsches Arzteblatt<br \/>\nInternational, vol. 106, no. 38, 18 Sept. 2009, doi:10.3238\/arztebl.2009.0607<\/p>\n\n\n\n<\/div>\n\n\n  <\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1036,"featured_media":752,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[32,1],"tags":[],"class_list":["post-751","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles","category-uncategorized"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - 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