Firepit Burns: Bowie's Story

Even before falling into a firepit and suffering serious burns, this Atlanta two-year old clearly had no love for doctors, nurses and hospitals. Now he looks forward to visits and seeing his surgeon.

Kristen Waltz says she will never forget the moment her then two-year old son, Boaz “Bowie” Waltz, now 5, fell into the firepit at her parents’ house: “He was tugging on his tricycle really hard but it wouldn’t move. Then he lost his grip and fell backwards into the fire.”

Waltz’s dad quickly pulled Bowie out, but the damage was done with burns to his right hand and forearm up to the elbow. She didn’t realize how serious the burns were before the ambulance and paramedics arrived, but she did know that Bowie, nick named after the late singer-songwriter David Bowie, would not do well at the hospital.

“Before all this,” she explains, “he struggled just to see a doctor for a physical or to get his blood pressure taken.”

A Stepwise Approach

Bowie was taken to a public hospital in Atlanta where he and his mom met surgeon Rohit Mittal, M.D., a specialist in burn care and critical care. Mittal immediately explained how he works with young patients and their families in a stepwise approach.

“What I generally find when families come in is they are so overwhelmed,” says Mittal. “The first thing I tell them, we’re going to be with you every step of the way and you’re going to see us for a long time, for years, just to let them know we’re not going away.”

Mittal then describes what children with serious burn injuries may face—physical and psychological trauma from both the wound and wound care: “As they grow, the scars they developed as a result of the burn do not grow with them, so they end up needing a number of surgeries over the course of their life, sometimes up to 100 different operations.”

The burn team’s goal, Mittal says, is to make sure the child receives state-of-the-art medical and wound care. The good news, he adds, is that advances in burn care have come a long way. Mittal is participating in a clinical trial of a gel containing an enzyme extracted from pineapple and designed to target and dissolve burnt skin while not affecting healthy skin. This combined with new technologies, like spray-on skin, allows for faster wound healing, while reducing pain and time in the operating room.

For Bowie, his initial set of surgeries focused on healing his right hand. The next step and phase of care would be reconstruction surgery to open contractures caused by scarring and skin tightening that curled the fingers inward and kept his hand closed.

“He couldn’t open it because his palm had contracted down so much from scarring,” says Mittal. “There are so many ways to manage burns and wounds, and once they get better reconstruction is the most important aspect of their care. We create a list of all the child’s problems and how to address them in a systematic way to add value and quality in their life.”

Waltz liked what Mittal had to say and his approach in working with Bowie and the family over the first two years of his care. Then Mittal left the Atlanta hospital and joined the burn program at MUSC, but not before letting Bowie’s mom know she could reach out to him with any concerns. She did, noting that Bowie wasn’t using his injured hand and seldom slept through the night. He also struggled being anywhere near a shower, which triggered moments of burnt skin being washed from his body.

At the same time, Waltz shared with Mittal, she had her own worries as the parent of a child burned in her presence. Like many parents, every now and then she questioned whether she failed her son. As she met other moms of patients with burns who shared similar feelings, she reciprocated and found the exchanges therapeutic.

“Going through this, so many parents sit down and tell me their hardest moment is answering the door while the bath was still running,” says Waltz. “We work on allowing accidents to not have fault. We don’t have to carry the weight of it, we did the best we can.”

Care at MUSC Children's Health: An Immediate Impact

After talking to Mittal and visiting him at the MUSC Shawn Jenkins Children’s Hospital, Waltz jumped through all the hoops to change the family’s health insurance to continue Bowie’s treatment there. The impact was immediate.

“Care for a kid here is drastically different—this was his first surgery where he was not pulled away from me in tears heading to the operating room,” says Waltz. “They were able to bring me back with him, to help him go to sleep while I was still there, so he never realized he was away from me for the entire time.”

In another surgery, Waltz adds, Bowie did not want to take his clothes and shoes off to get into a gown, so they let him go back into the OR with his clothes on to feel more comfortable. Recovery after each procedure was also less of a burden for Bowie as child life specialists interacted with him as needed to keep him comfortable and entertained.

“We want Bowie to be a little bit older before performing complex reconstructive surgery so he can better understand what I’m doing,” says Mittal. “The laser, because it’s a relatively minor surgery in terms of pain, helps build that trust relationship moving forward, especially when it comes to reconstruction.”
– Rohit Mittal, M.D.

Another advantage is the focused substance of burn reconstruction surgery itself at MUSC. Mittal, a Shriner’s Hospital trained surgeon,* is able to deliver the latest reconstruction services to treat the problems patients suffer from, including acute pain, loss of function and psychological trauma. The next step for Bowie, he notes, is laser reconstruction of his hand and surgical reconstruction of the web space between four of his fingers to strengthen them and ease the tensions in his scars.

“We want Bowie to be a little bit older before performing complex reconstructive surgery so he can better understand what I’m doing,” says Mittal. “The laser, because it’s a relatively minor surgery in terms of pain, helps build that trust relationship moving forward, especially when it comes to reconstruction.”

Perhaps a factor in why Bowie, on one recent long trip from Charleston to Atlanta, stunned his mom: “Bowie tells me he had a wonderful experience and wants to go back to the hospital again. I know right? Who wants to go back and have surgery? He’s like, when am I going back?”

So, what happened to the kid who didn’t like doctors? Child Life, the nurses, physical therapists, the entire team and especially Dr. Mittal, says Waltz, were all influencers.

“He loves his surgeon, so much so that he has a little photo book of pictures with Dr. Mittal and sends him pictures of his dog,” says Waltz. “It’s so sweet. Watching my kid be able to process what’s going on and feel safe in the environment has been comforting.”

In other ways, Waltz figured, maybe Bowie’s one-eighty wasn’t such a surprise: “He has always been incredibly dramatic, and a 100 percent extrovert and a bit of a rebel since he was a two-year old. But he reads so much, has this huge vocabulary where all these wild unpredictable words come out. He loves everything about oceans, turtles and fish.”

That reminds the mom of a recent visit with her now five-year old to the aquarium in Charleston. There he connected with a little bird he named Phoenix after the mythical bird Phoenix who, as legend has it, lived for centuries in the Arabian desert before burning itself to ashes and re-emerging with renewed youth.

“Bowie said the bird was waving to him,” says his mom. “He does have an imagination, and he desires to see someone similar to himself walking a similar journey.”