Melted

It was one of my first burn unit assignments. The streets of Pittsburgh were frozen solid, and the wind cut straight through your coat and into your bones.

So I could understand when this man, white and in his early sixties, told us that he’d fallen asleep in front of his furnace.

To this day I am not confident what a furnace is. Hearing his story made me feel like I was back in grade school, reading a “classic” book like ‘Old Yeller’ where the scene being set included geography and décor I had never heard of or seen before. I knew a furnace was akin to a fireplace and made a mental note to never sleep in front of either.

He sat propped upright in bed, wrapped in medicated dressings, and his face looking permanently exhausted. The burns covered large portions of his lower body. Any movement elicited a tightlipped groan or open mouthed yelp. At rest, he’d look sorrowfully into a distance. If making eye contact, he’d repeat, “my skin melted.”

My clinical instructor and I asked the usual questions carefully and curiously.

“Do you know where you are?”

“Yes.”

“From 1 to 10, what is your pain level right now?”

“It always hurts.”

Pause.

“My skin was melted in my jeans.”

He said it sad-matter-of-factly. Like discussing how a rainy day ruined beach plans.

I immediately felt sorry for him. He was a weathered man for sure. He looked like a man life had already handled roughly long before the burns ever arrived. I pictured him curled up beside the furnace trying to survive a brutally cold season. This sort of suffering did not seem fair.

It had been a day or two since his admission and he had not yet processed his condition.

Between our questions and mobility assessments, he kept returning to it.

“I tried to take my pants off and they were stuck to my skin.”

Sometimes with tears in his eyes.

Sometimes completely expressionless.

Sometimes “my pants melted to me.”

Sometimes “I melted to my pants.”

His mind was still trapped in the moment.

So I accepted that that’s how it happened. The man was too under the influence to feel the heat setting in. He must’ve felt comfortable, like the heat had warmed his bones. Only to wake and find that it truly almost had.

He still could not believe it had happened. Was it because he had followed this routine many times in the past? Or was something truly unique about this winter’s bite? I would walk about 4 blocks from my car to the hospital every morning and dreaded every step of the way. It was surely the coldest cold I myself had ever known.

Maybe he’d kept the furnace a little hotter than usual. Or he laid a little closer to it than usual. Whatever it was, his skin had melted to his pants.

I learned from the man that he lived alone. He had a bed but could not stay warm there. I knew from reviewing his medical record he did not have health insurance. I learned from the nurses that a bartender had called the ambulance. The man lived alone. No phone. No health insurance.

In the hallway, my clinical instructor explained to me knowingly, “see, events like these are usually alcohol-related. Patients will just leave that part out.” I figured she deduced this from the bartender being his emergency contact person.

“All I did was lay down to sleep.”

As if his body had betrayed him in the most unimaginable way over something so painfully human: Sleep.

This man was trying to process the fact that he had awakened burning alive. Or was he trying to process that he had drunk himself so deep into unconsciousness that he did not notice himself burning alive? That he only found help from the bartender.

Maybe poverty quietly pushes people into negotiations with survival that eventually turn deadly.

“My skin melted to my jeans.”

And every time he said it, the room went quiet for half a second because no one, us nor him, knew what to do with a truth like that.

Not the loneliness. Not the poverty. Not the drinking.

Only the burn.