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Monday, December 11, 2023

Something Was Wrong. My Nightgown Was in Flames

I caught fire on November 16. I was on a patio, lighting birthday candles on a pan of frosted cinnamon rolls. I had on a cotton nightgown like a Victorian ghost. First a finger felt hot, and then an industrial furnace seemed to blast behind me. It was so very hot. Something’s wrong, I thought or whispered, turning to confront what I imagined was a steel foundry someone must have set up in our yard. My partner Richard emerged. It was his birthday. This was supposed to be a surprise, I thought, as out of the corner of my eye, I saw that I was the foundry, and the nightgown’s hem—now farther up the nightgown, now consuming my legs—was on fire.

Richard commanded “stop, drop, and roll,” and for a fraction of a second I wanted to say, I know, I know the slogan, we all know the slogan. Infinite options presented themselves, prismatically, but also on a spectrum—shades between cold and hot, or their new equivalents: life and death. My mind was also ablaze with self-justification. I can’t pitch forward because I’m on stone, and besides the fire is behind me, and … I aimed to fall backward, as in a pool plunge or trust fall, but instead I sat down hard. That made something good happen.

But not good enough. In a wordless exchange Richard and I agreed the fire wasn’t out, and I was conscious of needing to roll to supine, to complete the triptych, but before I could start, Richard clobbered me with an afghan. Patting, patting, patting, clobbering, now I knew it was out; I wanted to explain why I hadn’t rolled, but as I struggled to my feet it dawned on me that in a second or two I had undergone some kind of metamorphosis. I’d deal with the Gregor Samsa component of the morning later.

Happy birthday happy birthday I’ll be right back—I was a little overbright now. The Aquaphor was in my daughter’s room. The Tylenol was in mine. I was slipping back into real clothes when my right leg was suffused with something bad, so bad, something plausibly “evil,” underworld spirits with no name. The bath was running before I even got there. Sequences were becoming nonlinear. The cold water hit like a narcotic; my terror tilted into galactic well-being. My right thigh, now my sole preoccupation, was overwhelmed with gratitude. That didn’t last. The high waned almost the moment it started, and life-giving water betrayed me when its temperature mounted by even half a degree. I opened the cold tap as wide as I could and kept that glacial gush coming, and the bliss returned, but I was then frantic when the water warmed. Cold cold colder colder colder colder don’t stop ice ice icecold. I ordered myself to stay conscious.


After some number of cold-warm, bliss-agony cycles, I uncertainly called for Richard. He worried the water was too cold. Could anything be too cold? But my body was shivering and bluish. Richard carried me to the bed where he put a cold cloth on the burns. Thus started a cycle where washcloths in ice water were applied to the burns and the pleasure was extraordinary—for a few seconds. Then the neural storm kicked up, and raged. A cloth any warmer than freezing felt like a greasy boiling rag, and I’d groan like an animal, throwing it aside and grabbing a fresh icy one. Around and around like this for hours. Richard put socks and a hat on me, and a sweater, and blankets. For the rest of the day, icy cloths were my morphine, and I called out for them like a fiend.

In “Hyena,” an essay published in The New Yorker in 1996, the chimpanzee researcher Joanna Greenfield describes having been bitten by a hyena in Israel. People attacked by hyenas, like people whose cotton nightgowns ignite, often die. They’re eaten alive. But Greenfield made it. When she first rinsed her considerable wounds, she felt “no pain, but a tremendous feeling of wrongness.” She never felt pain, in fact, she reports—though she later suffered with surgeries and parasites. Instead, she felt inexplicably altered. It hit her when she first used a bedpan. “My life had changed. There is, after all, no simple dichotomy: intact and alive versus torn and dead.”

She found herself on the other side of a primordial horror, an eye-to-eye encounter with a superpredator hellbent on consuming her. In the essay Greenfield repeatedly reflects on the hyena’s remorseless speed: how its jaw, teeth and esophagus masticate and ingest in an instant. “Food slips instantly from toothhold to stomach,” she writes. She also considers a Nairobi boy she’d heard about, who died when a hyena ate his intestines. “I would have liked to ask him what he saw in the hyena’s eyes.”

If Greenfield had been the hyena’s food, I had been, for a moment, the fire’s fuel. Bedridden, I now aimed to master the ways of my new nemesis: fire. Torn and intact was Greenfield’s uneasy dichotomy, where mine was hot and cold.

Why in the world had humans brought fire in so close? Sometimes only Wikipedia will do. “Evidence for the ‘microscopic traces of wood ash’ as controlled use of fire by Home erectus, beginning some 1,000,000 years ago, has wide scholarly support.” Birthday candles jabbed into cake surely counted as “controlled use of fire.” In fact, the cuteness of the enterprise, my cartoon of domesticated flame, might have delighted my erectus forebears. What could show greater conquest over fire than to tame it for this frivolity?

Early humans had warm-blooded mammalian bodies that both required heat and abhorred combustion. Contact with fire causes system-wide chaos for humans, partly because it explodes the body’s inflammatory response. A burned body can lose fluid as it struggles to right its equilibrium with blisters to cushion healing skin and weeping wounds to clean it; blood pressure can drop sharply. At the same time, there’s edema: fluid trapped in the body. Shock can keep oxygen from lungs, heart, brain, and kidneys. Organs can sustain damage or even fail.

Still creepier stuff happens when flesh meets flames. For one, after a burn, veins can become permeable, compromising a range of bodily functions from oxygenation of tissues to lipid transportation to immune surveillance. Cytokine storms, the dangerous hyperimmune response seen in some 4 percent of Covid-19 patients, also appear in burn patients. Other phenomena with sinister names—”burn delirium” and “burn amnesia” among them—can also emerge from the smoke.


From pictures, my doctor identified my injuries as partial-thickness burns, here and there severe, but not deep enough to require grafts or a stint in a burn ward. That was a relief. To gauge need for fluids and hospital time, battlefield medics and EMTs evaluate burns very roughly, using the Wallace rule of nines, which separates the body into parts, assigning them each a different percentage: head, chest, abdomen, back, groin, and four limbs. One leg is 18 percent. As a half of my right thigh was burned, I put my Wallace measurement at about 4.5 percent of my body. Having learned that the average adult’s skin, at 22 square feet, fills slightly more than fills a standard doorway. I calculated more precisely that my 48-square-inch burn was 3.3 percent of me.

This was useful data. However limitless my perception of pain was, then, the damage to my body was contained. Perception and reality were on measurably different trajectories.

The wounds were blistering, but blisters, while destabilizing to bodily systems, have distinct local advantages, as they protect, like bubble wrap, injuries that sorely need it. To me all the blisters seemed precious. No doctor or startup could make something as strange and beautiful and healing as an amber-colored blister the size of a gaudy costume jewel.

Dan Ariely, the Duke professor of behavioral economics, was seriously injured in an explosion as a teenager. He suffered far, far worse than I did: third-degree burns on 70 percent of his body. During three hallucinatory years in and out of burn wards near Tel Aviv, he brooded on various fallacies of pain and pain management, which he later exposed in his first book. I could see how burns could make a philosopher of anyone. Because holy hell was this a—nervous breakdown? A breakdown of the nerves; that rang true. Time bounced around, while space contracted to the rectangle on the gruesome flesh doorway festooned with my hair and eyes. I kept staring at that doorway. Ariely wrote that when he confronted his charred body in a mirror he felt a vertigo and dissociation. He also couldn’t stop staring; like Greenfield, he had become a “whole new me.”

Surely, for Ariely, that sensation came from the distortion of so much of his flesh, including his face, by deep wounds and scars. I had nothing so extensive, although my leg looked the way Ariely described his facial wounds: “The whole right side was open flesh, yellow and red with all kind of pieces of flash and skin hanging from it. It looked as if it was made out of colorful wax and it was in the process of melting.”

But maybe the metamorphosis also happens invisibly. All of my body’s programming convulsed with this burn. Reviewing my racing thoughts on that first day, I find burn delirium, in evidence as I talked compulsively to Richard, half-hoping the patter would keep me conscious and lucid, and even create a record. A familiar version of myself, from before the burn, back before the pandemic, before Trump, before the financial crisis, before 9/11, before adulthood, in college, in preschool—that me had seemed to slip in and out of focus. It took me hours to admit to myself that Richard’s birthday couldn’t be saved. At the thought I cried frantically.


What set in as I resumed my life with a bandaged and rebandaged thigh was this: An absolute revulsion from fire. A cartoon character on “The Simpsons” caught on cartoon fire and I wondered why I’d ever let my kids watch something so disturbing. A restaurant called Flame brought tears to my eyes. A distant radiator. The sight of a book of matches or a candle. All of life—every part of being a biological entity, especially a mammal—suddenly seemed reducible to temperature. You’re warm when you’re alive. Too hot and you’re incinerated. Too cold and you’re a corpse. Keeping everything in the body at its right temperature suddenly seemed the brain’s sole reason for being.

I spoke to a therapist in hopes of preempting PTSD, even though I’m not sure that’s how it works. She had me tell the story of the accident slowly and specifically, a few times through. One assignment was to see the events not as a series of missteps but as a sequence of ingenious and elegant moves that couldn’t have been more perfect if they’d been choreographed years in advance. The retelling in which I was simultaneously before, during, and after the accident took advantage of the fact that time, throughout the delirium, had blurred. In addressing the wisdom in my cells maybe I was addressing the ancient part of my DNA evolved from those primates who both controlled and could never control fire.

I found that body and brain alike—somehow free of the “me” I typically consider myself—had done exactly what they were so finely built to do, so long ago. To recoil, to drop, to dowse, to chill, to seek help. To shout instructions. Then to nurse, to convalesce, to talk, to listen, to seek meaning. In my imagination, the primitive talking and listening and seeking of meaning happened around one of those legendary campfires, with all of the sapiens enjoying the warmth at a safe, safe distance.

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