Fratianne: Physically healing burn victims is not enough

Brian Smith | Staff Photographer
Dr. Richard Fratianne, retired director of the Comprehensive Burn Center at MetroHealth Medical Center in Cleveland, speaks on the importance of showing patients unconditional care, love and understanding.

Soon after becoming director of the Comprehensive Burn Center at MetroHealth Medical Center in Cleveland, Dr. Richard Fratianne met a young woman named Gloria who had been burned from the waist up. A life-threatening injury, her burns covered 60 percent of her body.

Those at the burn center put Gloria through five major surgical procedures, Fratianne said. They rebuilt her face with skin grafts so she could open and close her eyes normally and so she could eat and drink without drooling; though her cheeks were stiff, she could still smile. A job well done, the surgeons thought to themselves.

But a week after being released from treatment, Gloria, in tears, came back to see Fratianne.

“I went home,” Gloria said to him, “and my little 3-year-old ran away from me.”

“You’re not my mommy,” her child would say. “Where’s my mommy? I want my mommy.”

“I told you to let me die,” Gloria told Fratianne. “Why didn’t you let me die? Even my own daughter doesn’t love me.”

Gloria’s experience was a lesson to Fratianne that healing doesn’t end when burn survivors leave treatment. There also needs to be healing from within, and that can take much longer. “Burn Scars Are Forever, Healing Comes from Within” was the title of Fratianne’s Interfaith Lecture, which he delivered at 2 p.m. Tuesday in the Hall of Philosophy.

Fratianne was the director of the Comprehensive Burn Center from its founding in 1969 until he retired in 2002. He formed a team there dedicated to helping survivors regain their sense of personhood and self-worth long after leaving therapy.

The physical nature of the burn is overwhelming, but it also destroys a survivor’s personhood, he said. The physical, intellectual, emotional and spiritual selves are all impacted.

“In the midst of the pain and … anxiety that a patient goes through, facing those damn dressing changes on that cart or in that tub where it feels like they’re scraping your skin off with a Brillo pad — you can’t understand it,” Fratianne said. “ ‘Why are they doing this to me? Why am I suffering like this?’ They can’t get their head around it.”

The emotional impact of a burn is especially pronounced when patients are physically recovered and thrust back into society. They feel ugly and unaccepted, and, like Gloria, they may feel that no one will ever love them.

Survivors frequently have the idea that God is punishing them, Fratianne said. They may even feel that God doesn’t love them because they did something wrong or didn’t do something that they should have.

“How can you get any lower than that as a human being?” he asked. “You can’t, because every part of who you are is destroyed. And that’s who we are trying to save.”

To recover their self-esteem and sense of personhood, patients need love that is selfless and unconditional, Fratianne said. He explained that the Greek language has a word for this kind of love: “agape.” And to deliver agape, Fratianne developed a team of people at the burn center such as nurses, doctors, therapists, social workers and chaplains who would try to form unshakeable relationships with their patients.

“When you have a person that feels hopeless and they start to feel the joy of belonging to people who care about them, who will bear their burdens with them, [they] start to have the beginning of a different appraisal of who they are,” he said.

Many of Fratianne’s patients have been able to recover their self-esteem and have gone on to be successful; one man who was burned as a teenager is now a plastic surgeon for other burn survivors. Four young patients who weren’t even sure they were going to go to college are now lawyers.

“One of the things that our team always told the patients was that ‘we would never abandon you,’ because that’s part of agape love,” Fratianne said. “There’s a lot of responsibility when you start reaching out to people and [make] that promise.”

This promise has led to an extensive aftercare program at the burn center. There are children’s camps, adjustment programs, support groups and retreats, all of which have survivors share and learn from one another during the recovery process.

Fratianne concluded with a poem Gloria wrote in recognition of the help she received from the burn center’s team.

“You saw past the ugliness of my wounds/ and the features that the flames had consumed./ You touched me with the gift of your hands/ the healer anointed to fulfill God’s plan./ While I saw no reason to live,/ you saw all that I had yet to give./ The emotional and physical pain engulfed me in sorrow./ With compassion and skill, you worked on me, for you saw my tomorrow.”