Forged with Flames

by Ann Fogarty

  The pain I was experiencing at this point was beyond anything I could possibly have imagined. Childbirth didn’t come close, not even remotely. Every part of my body hurt in the most excruciating way. My mind was frenzied, bursting with an intense horror. I tried desperately to think of something, some scrap of hope that could help me through the agony. Anything. I have to escape this… I can’t let go… Someone, please, get me out of this…

  Amidst the pain and confusion, I knew with a stark clarity that if I loosened my grip on life for even a minute I’d be gone. I was wheeled into surgery, and oblivion, for the time being.

  I woke up in the Intensive Care Unit—my new home, my lifeline and my prison. The ICU had been evacuated of other patients to accommodate the burns victims who were coming in from the bushfires, some of whom died very soon after admission. Much later, Judy, one of the intensive care nurses, recounted the medical condition I was in when she first saw me. I was black, my hair had been burned and there was significant swelling of my face, neck and body. I had seventy per cent thirddegree burns to my body—full thickness burns, the whole layer of skin gone. Much of the rest of my body had second-degree burns. All up, eighty-five per cent of my body suffered burns. My heart, kidneys, lungs and other organs were struggling as a result and I needed to be resuscitated many times. To put it bluntly, I looked grotesque, Judy recalled, and no one held any hope of me surviving.

  The Intensive Care Unit was a maze of beeping machines, with alarms and monitors going off all the time. The medicos moved quickly to put me on life-support. Gloved hands pushed tubes into my body, carrying infusions connected to pumps. I was hooked up to various devices by masked people reading my vital signs. Behind me the jagged thread of my life scrolled by on the screen of a cardiac monitor. All the time, the ventilator beat a steady psssh-psh.

  All I could see of anyone was their eyes. Every facet in the isolation room had to be sterile so anyone in there was wearing a white cap, mask, gown and gloves. I became aware of Judy, in particular. She had kind eyes and a compassionate voice. I knew I was in good hands with her; here was a born nurse. I needed to know that because I felt so vulnerable. She settled me into bed, helped by another nurse. They turned me over, which was agony.

  ‘Well done, you managed that beautifully,’ she said encouragingly. Such sparing, but reassuring, words kept me hanging on.

  In the first few days in Intensive Care, I was monitored closely, twenty-four hours a day. There were often two nurses in the room checking devices that were measuring my temperature, heart rate and rhythm, blood pressure, the pressure in my veins and arteries, respiratory function, renal function and anything else that could indicate what was going on in my body. The nurses dressed my burns and took numerous blood tests. Burns patients are extremely challenging to look after, particularly as they are prone to infection. To add to it all, the Intensive Care Unit was hot—about thirty-eight to forty degrees Celsius—because extensive skin loss means the body can’t maintain and regulate its temperature.

  To my left, were windows to the next cubicle, but there was no one in it. I looked up once, though, to see a doctor standing in that cubicle, just standing looking at me. ‘Why?’ I wondered. ‘Why are you just staring like that?’ On the other side was a door with a glass window, so I could just see out into the corridor and notice anyone coming in. There was no daylight, just a glaring overhead light that seemed to be on all the time. I couldn’t tell if it were night or day, as I lapsed in and out of consciousness. My entire being felt dislocated. I’d simply been caring for a family, tidying the house, making beds and meals, when suddenly I was catapulted into a world where nothing was remotely like anything I’d ever experienced. One day, a mother and wife; the next a medical case. I’d barely even been in a hospital before, except for the maternity ward.

  Terry came into the ICU the night I was admitted and returned the next morning, though my recollection of seeing him is hazy. After he and the girls arrived at his parents’ place on the day of the fires, Flo had stayed up late into the night to wash his clothes so they’d dry before morning. Until he had time to go shopping, they were the only clothes he had and he was worried about wearing them into the hospital still sweaty and smoky from the previous day. That struck me as poignant when he told me some time later. A simple, caring act in the midst of all the havoc. His only clothes. At the time I barely knew that he was there, let alone what he was wearing.

  In those early days, and at times over the weeks following, the doctors warned Terry that my chances of survival were negligible. ‘She could die at any time so don’t get your hopes up,’ they said. They called him into the hospital to bid me goodbye at least twice, telling him I wouldn’t make it through the night, counselling him to say anything he needed to. The helplessness in not knowing was the worst part of it all for him.

  In the first two days or so I could feel my body swelling. One of the critical risks of burns, I now know, is fluid lost to the circulatory system through evaporation and swelling. This is what was happening and as it did my face puffed up. My eyes were being pushed close as my eyelids swelled, narrowing into two slits of blurry vision. I strained to open them but couldn’t. I panicked that I was losing my sight, that on top of everything else, I would be blind. This creeping blindness seemed to last forever, but with time and to my great relief, my eyelids opened again.

  At one stage, I was taken off the ventilator for a few days, for reasons I couldn’t understand. I’d been burned internally—my throat and lungs were badly damaged, and I’d lost one of my vocal cords. But the effort to keep breathing on my own was enormous, and agonising. I had to consciously force myself to take each and every rasping, wheezing breath. Keep going. Just another breath. Don’t stop. Think of the girls. Don’t stop now. Don’t stop.

  The early morning hours were the worst. My body slowed naturally and I sensed it would be easy for it to give in. It felt as if I never slept for more than a few minutes at a time. I’d drop off in exhaustion, then wake myself immediately after with a start, alarmed at what sleep could bring: death, a deep, dark hole with nothing to hold on to, with no one to reach out and help me. In spite of my previous battles with fear—the constant social phobias that plagued my everyday life—I was filled with a terror I’d never known before, one that stalked every waking moment. The desperate thought that I hadn’t fully lived dogged me too, that for most of my life I’d never lived free of the shadow of self-doubt and fear. And now I might never wake up. Ironically, fear was keeping me alive.

  My situation was serious, but even though I was very sick at the beginning, I wasn’t at my sickest. That came later. When you’re badly burned the critical time is not just the first couple of days but the weeks afterwards. How glad I was that I didn’t know that then. As I struggled, I tried hard to think of better times, to escape for a few minutes. I’d recollect times in my childhood in England, like May Day. Every year on the first of May we’d celebrate leaving the cold weather behind and think of the warmth that was coming with summer…

  I see a girl of eight or nine, the May Queen. She is wearing a flowing white dress. A long train edged in white fur stretches out behind her, held up by four attendants carrying baskets of flowers. She has flowers in her dark hair around her crown, and she is holding a large bouquet. She parades down the streets of a town bigger than her own village as people clap and cheer. They are saying how pretty she is, how beautiful she looks, this May Queen.

  That girl was me. I’d been picked by my Sunday School for the honour. Auntie Nora, who wasn’t really an auntie but once a neighbour of ours, made the dress I wore, and my mother took me to the hairdresser in Nelson to have my hair curled especially for the occasion. It was a big deal to be chosen and heady stuff parading the streets of Nelson. I lapped it up.

  I was moved into the Burns Unit after four or five days. This single room seemed dimmer, more closed-in and somehow separate from the rest of the hospital wards around it. The door stayed shut all the ti
me and I no longer had a nurse aroundthe-clock. I lay encased in a ‘cage’, with a sheet over the top to stop anything touching my body. Only my face and neck were showing. Underneath I was swaddled like an Egyptian mummy, my hands clumpy balls of bandage. There was a buzzer to press for help but my hands were too injured to be able to use it.

  Around me was a small washbasin, a brown padded chair, boxes of medical supplies and tubes, tubes and more tubes. One of these tubes was inserted into my nose, leading into my stomach. I hated it with a vengeance. At night, it would dislodge itself and creep up into my throat, stopping, neither in nor out, and I would start choking until it became almost impossible to breathe. I would lie there rigid, battling to quell the rising panic. Help me, I’m suffocating. Please, someone come in and help me!

  After one tortuous, drawn-out night, I was so agitated that when the door opened the next morning I flung myself from side to side in the bed moaning; I had to alert the Burns Team coming in that something was really, really wrong. Professor Masterton, the surgeon in charge of the team who performed most of my operations in 1983, looked very concerned.

  I’d been in awe of the Professor when he first came into my room with his entourage of medical staff and discussed my ‘case’ in his strong Scottish accent. Beneath the professional demeanour and surety, though, I had glimpsed a great kindness and interest in his patients’ welfare. That morning “Prof”, as everyone called him, tried very hard to work out what was going on. He bent over me and asked what was wrong, then tried a few questions, peering at me for a response.

  ‘Do you need to see Terry?’ he asked. ‘Are you missing the girls?’

  I looked up at him, pleading with my eyes for him to somehow understand, to keep asking more questions. I was grateful for his attempt to communicate, but even this couldn’t allay my panic over the tube. The thought of another night of it made me want to scream and scream. I was moved back into the Intensive Care Unit where I was to remain for many weeks.

  Friends of mine apparently visited the Alfred in the first few days but they weren’t allowed into the ICU, nor were the girls. The second visitor I had after Terry, fainted when they saw me. I didn’t even find out who it was. How horrible for them. How awful I must look, I thought. I had no idea of this myself as most of my body was wrapped up.

  A couple of policeman with the unenviable task of getting statements from anyone considered likely to die, came in. But Terry warned them off trying to speak to me, telling them it could tip me over the edge. They didn’t return until weeks later to take my statement, when I was able to talk.

  Within a few days of the fires, Terry’s sister, Marilyn, flew in from Canada where she was working at the time, and was devastated by what she saw when she visited me. I remember seeing her, but was unable to talk to her. I was being ventilated from the mouth and couldn’t speak due to the tracheotomy tube; I had a tube through my vocal cord too. Before leaving Canada, she had maxed out her credit card buying clothes for the girls and Terry.

  At this time, communication was extremely limited. Judy and the other nursing and medical staff would talk to me and I’d nod or blink my eyes in reply. Even if I had been able to speak then, I could never have conveyed to anyone what was happening to me. Here I was, entombed by this existence, with no one—not even those who loved me the most—able to understand. I despaired at the seeming cruelty and injustice of it all. Just give in and let go, I thought. It’s too hard and painful. No one should have to deal with this pain. You can’t keep going like this. But another part of me answered back: You can do it. You’ve dealt with difficult things before. Just take it moment by moment. The pain will end, it must end. You’ll be glad you didn’t give in. But it was a long time before I could verbalise what I was thinking.

  Terry travelled in from his work at Bayswater every lunch hour and at weekends. I know he found these visits challenging. He wouldn’t stay very long. Sometimes I was in a coma and he felt helpless to do anything. He would just sit at the side of my bed, touching me on the top of my head which was the only part of me that wasn’t burnt. In my more lucid moments I longed to see the girls, just to look at them, even through the glass window. Sarah and Rachel seemed so far away. I was told that children weren’t allowed into the ICU, but I couldn’t understand in my early days in hospital why I didn’t see them, at all. Sometimes, in my drug-addled mind, I panicked that they were still missing in the fires or had died.

  The girls did see me one day, though I wasn’t conscious of it. Someone held them up to the glass window to look at me. They were looking at a woman with blackened skin who was very swollen. They screamed.

  11

  THE GIRL IN THE CORNER

  My sense of reality was hideously distorted for weeks after I was admitted to the Alfred. I had so many drugs pumping through me that I was constantly straining to work out what was real and what wasn’t. Terry was told that if I survived I would need such heavy medication that I’d become a drug addict. During this period, I would often hallucinate, descending into an even more topsy-turvy world than the one I was already in. For the longest time, I was in a boat out in the middle of the ocean, utterly lost and alone. Everywhere I looked was a vast, empty sea with no land in sight, nothing but water. I searched frantically for help, scanning the horizon for bumps, looking for shapes amongst the infinite waves. But there was nothing. Direction was meaningless. There were no bearings on where I was or who I was. I cried out into the blue but no one answered.

  At times I’d become convinced that my body no longer belonged to me and that all my limbs were on back to front. I’d thrash around in bed and plead with anyone in the room—the real room—to put them on the right way again. Then there were the times when I suspected that my bed was slowly moving up the wall. At first I’d think I was imagining it. Then I knew it had moved. It would slide relentlessly upwards until it reached the ceiling where it stopped and hovered. I would freeze, certain that if I moved just an inch, the bed and I would crash to the floor. This can’t be happening, I said to myself. But I could see it. It added a whole new dimension to that phrase ‘climbing the walls’.

  I’d be lying in bed sometimes then open my eyes and be back in England on the moors, the endless moors, or asking someone why Terry couldn’t sleep in bed with me. I struggled to work out who I was. I was Rachel or I’d believe the girls had been burnt and it would take me a while to realise that I was actually the parent.

  Sometimes I’d become preoccupied with worrying about not having enough time to get back from the Purple Pumpkin Patch or think I’d seen a purple miracle. A glorious, billowing purple miracle. I was often concerned about ‘the girl’ in the corner, the young woman with the dark hair sitting serenely, glancing down, a beatific expression on her face, calm and centred. I’d say to whoever was with me, ‘That girl in the corner doesn’t have a cup of tea. Can you get her a cup of tea, please.’ The nurse would say, ‘There isn’t a girl there, Ann.’

  But there was, and later I would find out who she was.

  In those early days, I was certain I’d never wake up again if I took the medication the nurses offered to relieve the sleeplessness, belligerently refusing to let them administer it. It was a bold move; my life was very much in the hands of these strangers and I didn’t want to displease them. My senses were on alert, as if for survival, and I could pick up immediately the goodwill or otherwise of those around me. A kind word or smile thoroughly heartened me; a rough touch or insensitive comment cut deep and made me alarmed that those I needed so much would desert me. Normally, I tried valiantly to be good, co-operating with every uncomfortable procedure or treatment. I’d been a good girl ever since I’d been a shy teenager, straining hard to do everything right. Dad certainly liked us to do as we were told, ‘and no messing about!’ But this time I felt I had to trust my gut feeling about the sleeping pills and keep refusing them.

  There were fleeting moments of joy and relief, though. One afternoon, one of the nurses came into my roo
m and switched on a tape of a recording by the French pianist, Richard Clayderman. A friend had sent me a little cassette player that sat by the side of the bed. I’d always found Richard Clayderman’s playing beautiful and, in some incredible way, those uplifting notes transcended the pain and discomfort, stirring something inside me. I felt a new surge of determination. You can do this!

  And so I kept going, one gruelling breath after another.

  I would teeter on the brink of life and death for nearly two months.

  12

  ON THE BRINK

  ‘If you want to let go, it’s alright.’

  Terry, my husband of thirteen years, was giving me permission to die. He was standing at my bedside, talking softly, selfconsciously, in between ministrations by the nurses.

  ‘It’s okay, Ann. If it’s all too hard, it’s okay.’

  It was probably three weeks since I’d been admitted and Terry had watched me endure unrelenting pain ever since. He could see the agony I was in, and was telling me I didn’t have to feel pressured to keep struggling for his sake or for that of the children. It was selfless and loving because I know that Terry couldn’t bear to live without me.

  At some point I started to sense that it was unlikely I’d survive—things I overheard, tell-tale looks, intuition. When you’re just lying there you notice things: the way the doctors look at one another, the things the nurses say when they think you’re not with it. Once, when there were two nurses in the room watching the heart monitor, I thought I heard one of them say, ‘We’ve lost her’.

  The Prof’s treatment regime was aggressive—it’s a race against time with burns patients to keep infection (septicaemia) at bay because bacteria spreads on dead skin tissue and poisons the blood. The toxins are often what kill you. But some of the other doctors must have grappled with the notion of keeping me alive when they could see the suffering involved, and knew what lay ahead, physically. They must have wondered about the wisdom—and ethics—of resuscitating someone over and over again who would ordinarily have died, as well as about keeping them alive through extreme pain. They would have known, too, about the quality of life faced by someone who’s been severely burnt and asked themselves whether it would all be worth it in the longer term.