by Barbara Ravage
Da Capo, 2005
Review by Kevin Purday on Oct 10th 2006
This is an awesomely
well-researched and well-written book by a professional writer about health
issues. She is best known for her books on dieting perhaps most notably the Kiss
Guide to Weightloss. She is also the co-editor of an academic work on
bacteria. More recently she has written a book explaining how the glycemic
index works: The G.I. Handbook.
The book exemplifies the very best
of health journalism practice. The author uses two case studies to act as the
backbone of the book. The first is about a young man dubbed Dan O'Shea who in a
Friday night alcoholic haze probably leaves a cigarette incompletely stubbed
out and is very badly burned in the ensuing conflagration. He also suffers from
smoke inhalation over an unknown but certainly quite considerable time. The
second, Tom Parent, is badly burned when he tries to take a flaming pan of oil
out of the kitchen. The book follows what happens to these patients at every
stage of their treatment and all the crises involved. It also tracks the
effects on the two families.
The author is not content to merely
tell the history of two seriously burned victims; she wants us to understand
the context in which they were treated and that means having some idea of the
history of burns treatment. We are given an overview of the very early attempts
to treat burns with their almost complete misunderstanding of the course which
burns take, lack of understanding about the internal consequences of smoke
inhalation, and their occasional insights. We are then given a fairly detailed
account of burns treatment starting with the infamous Cocoanut Grove fire in Boston in 1942 and ending with the equally notorious Station music club fire in Rhode Island in 2003. She follows the development of burns treatment theory and practice by
following the careers of some of the specialists involved in the 1942 incident
and then bringing us bang up to date with the two case studies.
We get chapters on every aspect of
burns treatment all written in a highly readable and very informative style. We
learn about how paramedics have learned to keep open the windpipe, how the
burns are treated, the evolving understanding of materials used to cover and
protect burns, the effects of flame and electric and chemical burns, how the
body reacts to burns by often going into shock, and contemporary specialized
practice such as the use of a hyperbaric chamber -- something which the
reviewer knew all about from his diving experience although its use for
patients who have serious smoke inhalation effects was news.
The detail in some of the chapters
is both heart rending and stomach churning! Some of the procedures are painful
and, to an outsider, rather gruesome. We meet many of the medical staff, both
doctors and nurses, and social workers dealing with burns patients and their
families at the Massachusetts General Hospital and several other specialist
units in and around Boston. The dedication of these people is outstanding.
The book, therefore, is a cunningly woven tapestry
of case studies, history, mini biographies of the outstanding specialists, and
an extremely detailed account of the treatment from the time of the accident
until discharge and beyond. We gain an insight not only into the physical processes
but also into the psychological. We even learn about self-harmers and would-be
suicides who employ fire as their preferred method.
The book is quite riveting to read
but it is also a serious sociological and medical study. There are thirty one
pages of detailed references listing the author's sources for everything from
the feeding of burn victims to the range of ethical issues in treating them.
This is a first-class book and deserves to be read by everyone interested in
this field of medical practice.
© 2006 Kevin M.
Purday is a consultant in international education working mainly in Europe,
Africa and the Middle East. His main focus is on helping schools to set up the
International Baccalaureate Middle Years and Diploma Programs. He has taught
both philosophy and psychology in the I.B. diploma program.