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Contentsred barHeroes of MedicineTo Hell and Back
Blk Bar Heroes of Medicine
A Childs Pain
The Plant Hunter
In Search of Sight
A Dark Inheritance
Too Big a Heart
Seeing the Future
The Tumor War
The $28 foot
Drop Your Guns
The Wired Prairie
To Hell and Back
Beyond the Call
Bloodless Surgery
Rescue in Sudan
Physician Heal Thyself
Dressings are changed twice a day for this patient, burned when he poured water on a cooking-oil fire. Each time, dead skin is removed and an antibiotic salve is applied

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To deal with the many consequences of severe burns, a growing number of major hospitals have established burn centers, staffed by the medical equivalent of police swat teams, that accommodate every need of critically injured burn victims. America's busiest burn unit is at Manhattan's New York Hospital-Cornell Medical Center and consists of some 100 doctors, nurses, therapists, social workers and dieticians who treat 1,300 patients a year in the unit's 46-bed facility. "The name of the game in burns is teamwork," says Dr. Roger Yurt, the unit's director since 1995.

Yurt, 52, began specializing in burn treatment while he was a doctor in the U.S. Army. Since he took over the burn unit, he has expanded the team to include highly specialized nurses and even a chaplain, who ministers not only to patients and their families but also to staff members, who are exposed daily to unnerving sights and suffering.

A few team members are particularly motivated by the fact that they too were once burn victims. Others, like Dr. Harvey Himel, a plastic surgeon on the team, are attracted by a long-term association with the patients. "It's the real partnership with the the patients that I treasure," Himel says. "I always feel that I'm connecting with them." That connection can last for years. Himel follows his patients from their most desperate moments immediately after a burn, through skin grafts, follow-up visits and sometimes through reconstructive and cosmetic surgery.

The New York burn specialists and their patients are benefiting from some remarkable recent advances in operating-room techniques and a more sophisticated understanding of how the body reacts to severe burns. "Patients who 20 or 30 years ago would have died now survive the injury," says Lisa Staiano-Coico, dean of research at Cornell University Medical College and the team's wound-healing specialist. "Now the issue becomes one of how do we ameliorate the burn wound, how do we improve the rate of healing with less scarring. Now it's gone beyond survival."

As recently as the 1970s, a middle-aged patient with 40% of his body burned had a 1-in-2 chance of survival if his respiratory system had escaped damage. Today someone who has as much as 70% of his body burned can expect the same odds. And the average hospital stay for a severely burned patient is considerably less than the old rule of thumb, which was one day for every 1% of the body burned.

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