Coping: The Initial Few Weeks

By: Michael Appleman, M.S.

During the first few weeks following a near fatal burn is a time most survivors would prefer to forget. These are days of crisis when the human body must obtain all its reserves in order to compete with the traumatic shock, unyielding pain, numerous surgeries, daily dressing changes, infection, toxicity from burn breakdown products-the physical response of a body under siege.


Mentally the first few weeks is a time of anxiety, depression, post traumatic stress disorder, flashbacks and nightmares. Crazy images appear, these images race through the individual's mind. This disrupts the brain's chemistry and enduringly reshaping its output. For every man, woman and child who has suffered through those weeks, life will never be the same. In spite of everything, their individual accounts do have much in common:

1. Helplessness: A bad dream, nightmare in which one is paralyzed, unable to act;
2. Timelessness: Time has no meaning. A minute can feel like forever and then an hour can fell like a minute or a week or forever;
3. Loss of identity: The concept of "Self Deterioration": "Something is happening to me. Who am I?"
4. Hyperawareness: A spooky sense that one knows too much, that one can see right through people.
5. An Overwhelming Amount of Truth!: Life and the burn can no longer be separated. BURN is
everywhere, tainting everything and everybody.

This then is what the burn survivor's internal world is like during those first few weeks. Four walls and a hospital bed. People always wanting to know what is going on inside the burn survivors' brain at that particular moment. A shapeless frightening mindscape in which concepts of time, place and person lose their boundaries. A true friend will have the courage to listen to the burn survivors pain, anger and perception of life. As this friend will begins to understand the trauma this individual is going through, he/she will be able to give the love, support, encouragement, concern and friendship their burn survivor needs in order to get through the first few weeks.