Kids face long, painful recovery

There are plenty of questions about the early evening hours of January 28 at 3225 Galena Court. Did distraught mother Maria Darlene Joseph hide her anguish with smiles, or wear it for the children to see and fear?

Was time spent on the familiarities of family life like dinner, television and play, or was it full of desperation and tears?

Few may ever know what led to the 911 call that brought firefighters and police to a grisly scene where five children had been lit on fire. The youngest, 16 months, died and the mother is in jail, suspected of murder.

There’s no question about one thing: The four surviving children, wards of the state and hospitalized with burns, face a difficult future.

Two of them, 5-year-old Supreme Joseph and 8-year-old Domenic Gardner, are at The Children’s Hospital in Aurora. Domenic is in critical condition, and Supreme is listed as stable.

The other two, 9-year-old Dontrell Gardner and 3-yearold Amarjahan Joseph, are at Shriners Hospital in Galveston, Texas. It’s one of the nation’s most highly regarded pediatric burn units. It’s also a place that generally takes only the most severely burned patients.

One of Joseph’s children sent there is reportedly burned over 85 percent of the body; the other, 15 percent.

All children have been marked as so-called silent patients, meaning hospital officials are legally barred from acknowledging their presence. Police have released few details about their conditions, and attempts to reach relatives have been unsuccessful.

But virtually anyone hospitalized for severe burns faces a long and painful recovery, doctors say. While many children can find comfort with parents during a crisis, these cannot. The father who last lived with them committed suicide in October. Experts say the emotional trauma these children face — because of a painful recovery, physical scarring, family upheaval and the possibility they were intentionally harmed — will be substantial.

Dr. Cleon Goodwin is director of the Western States Burn Center at North Colorado Medical Center in Greeley. A burn specialist since 1972, he’s a past president of the American Burn Association.

Burns are among the most traumatic of injuries, he said. So traumatic, in fact, that severe burn victims are commonly used to train new doctors in serious complications.

If there’s smoke inhalation, patients are often ventilated and run the risk of pneumonia. Infections can run rampant when the body’s key defender — skin — is removed. Heart failure and kidney failure are constant risks, and surgeries often involve high blood loss and are dangerous.

As a rule of thumb, he said, a burn patient spends a day in the intensive care unit for every percentage of his or her body burned. For the two children at Shriners, that would mean nearly three months for one, and more than two weeks for the other, barring additional complications.

Patients could face dozens of reconstructive surgeries over months, even years.

Rehab also is extensive.

Severe burns trigger a kind of “muscle wasting” that must be fought with intense physical and occupational therapy. Skin grafts mean scarring, and the tightening process that follows can lead to immobility if not properly cared for. A child’s chin could “essentially (be) glued to the chest wall,” Goodwin said.

Many burn victims must also endure the emotional trauma of disfigurement. “They are very selective when they first want to look at scarring on their face,” Goodwin said. “That can be a traumatic event.”

Once they leave the hospital, the children are almost certain to get a new home, either with family members or in foster care. Barbara Drake, director of the El Paso County Department of Human Services, said the organization and court will decide where the children will go after an exhaustive process to determine what’s in their best interest.

What the children experienced last week, and what they will likely go through in the hospital, will make their emotional care a tough task for mental health providers, family and health care workers, said Michael Rovaris, a Colorado Springs child social worker with 15 years of experience dealing with abused and traumatized children.

How children process pain varies individually and with phases of development, but trauma often manifests itself in inability to concentrate, pants wetting, exaggerated startling and other unusual physical behavior.

The oldest children in the family, he said, could have a complex understanding of what they’re going through. He points to a 9-year-old who saw his mother shot by a boyfriend in a murder-suicide. The young boy told Rovaris he’d be fine for his siblings on the outside, but on the inside he’d be “dead.”

The younger children might experience bouts of crying, he said.

Rovaris said the children’s painful recovery from physical wounds was analogous to their emotional healing. Just as there will be a painful scrubbing of dead skin, there could be similar pain in scrubbing down the layers of emotion. One bright spot, doctors say, is that the two children in Galveston will receive some of the best medical care in the country.

The Shriners burn center, one of four, is considered the top hospital for pediatric burn care, said Goodwin and Dr. Ralph Hathaway of southern Colorado’s Al Kaly Temple of the Shrine.

Hathaway, who screens local patients for eligibility at Shriners hospitals, said children at the Gulf Coast burn unit get a team of experts working with them daily. “It’s almost a one-on-one with these kids,” he said.

DETAILS

Four small survivors of the Galena Court fire will travel a hard physical and emotional road back.