Phone
E-mail
English (EU)
Phone
E-mail
English (EU)
“Mom! Da, da!“ Marlene is 15 months old and has been able to walk for a few months. Babbling as she toddles around the motor home, she grabs at everything that comes within reach. Marlene wants to get out fast and go to the baker with her dad. He is already waiting outside the motor home. Mom Julia pours herself a quick mug of tea, puts it down and turns away. She doesn’t see Marlene reach for the mug and put her finger into it.
An empty mug falls onto the floor. Marlene’s eyes are wide open as the water runs down her body, across her t-shirt and over her legs.
“I had never before heard Marlene cry like that,” Julia says today. About four years have passed since the accident happened. She is sitting with her daughter Marlene, now aged six, at the Schwabing Clinic in Munich. Marlene is due to start school in a few months’ time. She and her mom are here today for a follow-up check by the burns specialist Dr Carsten Krohn.
Marlene, a dainty girl with blond locks and a frilled skirt, asks her mom for a euro to run the model railroad in the waiting area. She puts the coin in the slot, the toy train sets off, and the model world comes to life. “Look mom, that house there is on fire!” she says, pointing to a house that is flashing red and yellow.
“I was scared of losing our daughter”
She wasn’t shocked for a moment, Julia recalls. “I didn’t think of anything, I just grabbed Marlene, ran out the door and headed for the camping site’s fountain.” She ran past her husband, trying to pull Marlene’s clothes off as she ran. Her hands shook and her daughter hit and kicked around in wild panic. “I somehow managed to pull her pants off, but when it came to the bodysuit and its press studs I felt like screaming myself.” At last Marlene was undressed and Julia held her screaming daughter under the fountain’s cold water. Her skin was already flaming red and partly peeling off.
“The bystanders had immediately called for an ambulance,” Julia says, “but it simply didn’t arrive.” When it finally did, the paramedics were out of their depth and called for a second ambulance. Marlene continued to scream and writhe. The emergency physician gave her a sedative and called the air ambulance. Marlene was flown by helicopter to a hospital in Barcelona. Her parents were not allowed to fly with her.
“My Marlene was scalded, sedated, alone in the ’copter, in a foreign country on her way to a foreign hospital,” Julia recalls. “I was terribly afraid of losing her.”
Diagnosis: Second- and Third-Degree Scalding
Parents Robert and Julia had to drive to Barcelona. He could barely concentrate on the traffic. She was constantly on the phone to distract herself. Calling their health insurance, the German automobile association to take them home by plane, a pediatrician in Munich. “She told me about the Center for Severe Burn Injuries in the pediatric surgery department at the Schwabing Clinic in Munich. After that conversation I knew that I would take my daughter home as soon as she was fit to fly.” Julia was also able to contact the emergency doctor in the air ambulance from time to time. Marlene, she learnt, was as well as could be expected under the circumstances.
Barcelona’s University Hospital was a hive of activity but nobody at the entrance understood English. An acquaintance who spoke Spanish had accompanied them, but to no avail. “Nobody knew where our daughter was. We had to look for her.” Robert and Julia dashed around the hospital corridors, repeatedly asking and finally finding her in an intensive care ward, sedated, bandaged, with a stomach tube.
A doctor who spoke English explained how seriously scalded Marlene was. Nearly all the right side of her body, from her shoulder to her thigh, was affected. Scalding of this severity is treated “wet” at Barcelona University Hospital. That means the dressings, put directly on the wound, are changed daily. Twice a day Marlene was laid in a bathtub to loosen the bonded bandages a little more easily. “She screamed non-stop every time. There were up to 20 doctors in that tiny room. They just stood there as she lay naked in the bathtub with her open wounds. It was incredibly humiliating,” Julia recalls.
Julia tried not to listen as the Spanish doctors discussed the further course of treatment. She had long since made her decision. To leave Barcelona and fly home to Munich. Only one physician in the Spanish team respected her decision.
“I Was Allowed to Fly by Private Jet”
Waiting for her check-up, Marlene, who is now 6, has taken up position on a chair facing the toy railroad. It is out of action because mom Julia found only three euro coins in her purse. That is why Marlene is passing the time by watching Disney’s Snow White. The Evil Queen has just put in an appearance and Marlene prefers to look away and listen to her mother, who has now reached the flight back to Munich that they were able to take after six days in Barcelona. “We flew in a private jet,” Marlene says. Does she remember anything about her accident? Marlene thinks for a moment and shakes her head. “No,” her mom agrees. “Very infrequently she mentions the ordinary hospital ward in Barcelona and the helicopter flight.” Luckily, she has forgotten the tortures of “wet” treatment.
Fear of Transplants
Mom Julia in contrast has vivid memories of not only the dressing changes but also the fear of skin transplants and even more pain and more scars for her Marlene. “The doctors in Barcelona repeatedly told me they would have to transplant skin.” And a lot of it. Skin from the head that is normally used for transplants would not be available in sufficient quantity in Marlene’s case. They were thinking of using skin from her entire back. Julia still shudders when she tells the tale. “What would happen when Marlene’s development into a woman set in if all of the skin in the area of her breasts and stomach had been transplanted?!”
Initially, however, not even the Munich burns specialist Carsten Krohn could rule out transplants. “I had images sent to me from Barcelona in advance. They showed the wound to be very deep,” he explains. “That was confirmed here in the operating room on the day after Marlene’s arrival.”
Julia also learnt from Carsten Krohn that her initial fear for her daughter’s life was not unjustified. Around 30 percent of Marlene’s skin was severely damaged. For a 15-month-old infant that could indeed be life-threatening.
Healing Requires Closeness
In Munich the medics twice cleaned up Marlene’s scalds in the operating room. Dead skin was surgically removed. “Here at the Schwabing Clinic in Munich it is standard practice that all areas are then covered with the skin substitute material SUPRATHEL,” Krohn says.
The Schwabing burns specialists have worked with SUPRATHEL for nearly 20 years and have had good experiences with it. This kind of treatment has enormous advantages, especially for children, Krohn is convinced. “In contrast to open treatment—a hot room, extremely painful dressing changes and no visitors—children treated with SUPRATHEL can move around and, depending on the injury, snuggle up to mom or dad.”
A Summer like No Other
Marlene’s dressings had to be changed one last time under anesthesia because the wound area was so large, but a few days later she was allowed to go home—just 10 days after the accident. “That would have been inconceivable after a transplant,” Julia says.
Even so, the summer of 2019 was not easy for the family. Marlene’s wounds were still open and weeping. Because every piece of material would immediately stick to the wounds, she spent all her time naked, no matter whether at play, at meals or being told a bedtime story.
Initially, Marlene went to the clinic with Robert or Julia every day for her dressings to be changed or her wound healing to be checked. Marlene is curious and observed precisely every time what the doctors were doing. “I was impressed at that time by the strength and patience of Marlene’s parents,” Carsten Krohn recalls. “They did everything to enable the wounds to heal with as few scars as possible. For the overall course of treatment that was at least as important as dispensing with a scalpel and using SUPRATHEL.”
After a superinfection in her right shoulder in August the wounds finally closed in the fall. Marlene had to wear compression clothing 24/7 for nearly two years, followed by a year of physiotherapy.
“A Fantastic Healing Outcome”
“Marlene please,” the ward sister says. Hand in hand the six-year-old and her mother enter Dr Carsten Krohn’s consulting room. He smiles at the girl, Marlene smiles back and looks up to her mother. Does she remember him? Marlene shakes her head. The last check-up was a while ago.
The doctor asks her to take off her t-shirt so he can see her shoulder and chest. “Now stretch your arms out sideways please.” Marlene waves her arms around, giggles and then stands still. Dr Krohn tests the skin in her chest area with one finger and turns to her mother. He explains to her that Marlene’s skin will always be a little different in the areas that were scalded, but “there are no restrictive scars and in all probability her development into womanhood will progress perfectly normally.” He adds that laser therapy is also available that might improve the surface should Marlene later feel the need. Then he stops for a moment to ensure that he has Julia’s full attention and continues: “For that kind of injury it is a fantastic healing outcome. Marlene will be able to lead an entirely normal life.”
Snow White Instead of Piano Lessons
For a moment all is quiet in Carsten Krohn’s consulting room. Julia speaks quietly, just one word: Thanks. Marlene slips back into her t-shirt.
“I am infinitely relieved,” says Julia once they have left the consulting room. Marlene has made herself comfortable on a chair in the corner, is chewing a carrot and is pleased that she can watch the rest of Snow White. Mom Julia has decided to cancel Marlene’s piano lesson as too much for one afternoon and to let her take a break before they go home.
How “normal” is Marlene’s life? “She still wears her rash vest to protect her from the sunlight more consistently than other children,” Julia replies spontaneously. And otherwise? How do other children react when they see the scarred skin on her chest? Julia stops to think and recalls two events, both of which occurred when swimming. The first was in the summer, a year after the accident. A child told Marlene to put on a t-shirt because he didn’t want to see the scars. “Luckily, Marlene didn’t realize what that meant, but I was devastated,” Julia recalls.
The second occasion was about a year ago. Marlene’s best friend wanted to know what she had done. Marlene told him her story, how she had been scalded, about the helicopter flight and the private jet.
About Uncaring Parents and Other Feelings of Guilt
“Naturally I had feelings of guilt.” Julia looks at the coffee cup in her hands. “I always thought that kind of thing only happened to uncaring parents.”
When Robert and Julia repeatedly asked each other the same questions—Why did you not take Marlene with you right away? Why did you not put the mug of tea on a higher counter?—they decided to seek psychological help. They discussed the accident in individual and joint sessions. It helped them to understand that neither of them could have behaved differently at that moment and “that it was a concatenation of stupid circumstances for which nobody was to blame.” They learnt to accept the accident as a part of their story as a family and a married couple.
Julia has made the acquaintance of many other families that have experienced something similar and tried to cope with it on their own. She doesn’t feel that is a good idea. People often say nothing about it because they are ashamed and make the incident a taboo issue for the entire family. Carsten Krohn shares this view. “Scalding burns into the soul of the whole family,” he says. “Parents always blame themselves quite insanely because they realize, often rightly, that that the accident could have been avoided.”
Other People Have a Nose that’s Too Big”
Part of Julia’s open attitude toward the accident is that she has sought access to psychological help for Marlene too. “I want her to be armed when she reaches puberty or when the school goes swimming for the first time.” She must simply not feel flawed in any way. And something else matters to Julia. “Marlene may one day ask me ‘Mom, why weren’t you more careful?’—maybe in anger or maybe as the result of an event. It is important for me that that she then has somebody she can discuss it with.” That is why the Julia and her husband have consulted a child and youth psychologist. But he reckons the family has dealt so openly with the accident that there is currently no occasion to maybe ‘overemphasize’ the subject.
Julia looks over to where her daughter is sitting, looking at her children’s tablet with a smile on her face. The music makes it clear that all is well once more in Snow White’s world. “Come on, Marlene,” Julia says. “Let’s pack our bags and go home.”
Marlene is now six and awaiting her check-up at Schwabing Clinic in Munich.
The contents of a large mug of tea left Marlene, 15 months, with life-threatening scalds. In Barcelona the doctors strongly advised skin transplants.
After six weeks the places where Marlene was especially severely scalded are clearly recognizable.
Dr Carsten Krohn, physician and medical director of the Center for Severe Burn Injuries to Children at the Schwabing Clinic in Munich, is delighted that the treatment without resource to a scalpel was a success.
Carsten Krohn with Julia and Marlene. He is impressed by the parents’ patience and deidcation. “They did everything to ensure that the wounds healed with as few scars as possible. For the overall course that was at least as important as dispensing with a scalpel and using SUPRATHEL.”
“A fantastic healing outcome for that kind of injury,” says Dr Carsten Krohn. “Marlene will be able to lead an entirely normal life.”
“I always thought something like that only happens to uncaring parents”: She had naturally had feelings of guilt, mom Julia says. She and her husband had worked through the case together with a psychologist.