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For children severely burned in fires, like Naciere Beller, recovery is long

Stathis Poulakidas MD left Paul SeverMD right pose an unoccupied room pediatric intensive care unit John H. Stroger Jr. Hospital

Stathis Poulakidas, MD, left, and Paul Severin, MD, right pose in an unoccupied room in the pediatric intensive care unit at John H. Stroger Jr. Hospital in Chicago, Ill., on Thursday, January 3, 2013. | Andrew A. Nelles~Sun-Times Media

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Updated: January 5, 2013 3:42PM

On the fourth floor of the pediatric intensive care unit where Naciere Beller is fighting for his life, people talk in hushed tones.

The overwhelming silence is punctuated only by the beeps of monitors and babies’ cries.

Burned over nearly half his little body in a fire police say his abusive, mentally-ill dad started — killing himself, Naciere’s mother and his 4-year-old sister — the 9-year-old boy likely doesn’t even know he’s been orphaned.

But a team of specialists trained in treating horrific burn injuries like Naciere’s is working around the clock at Stroger Hospital to ensure that he’ll survive.

It’s a battle he’ll be fighting the rest of his life.

“This is a lifelong process. It’s not a one-and-done type situation,” Stathis Poulakidas, the director of Stroger’s burn unit said of the people he treats. “They’re going to have to endure multiple operations, a life-long of therapies.”

Data compiled by the American Burn Association shows that children in Naciere’s age group and with 45 percent of their bodies burned, will likely survive.

“The chances of dying from that burn are about 5 percent,” said Christopher Lentz, of the American Burn Association. “Kids are incredibly resilient despite the life-threatening severity of this type of injury.”

But Naciere’s little sister Nariyah didn’t make it — she died Monday after sustaining burns over her entire body. Naciere’s mom, Taniya Johnson, died in the blaze, too, as did his father, Nathaniel Beller, who police say poured accelerant over his family before sparking the fire.

Authorities this week faced tough questions about why Beller was free to kill after he’d threatened almost exactly the same act during a gasoline soaked stand-off with Cicero police three months ago. The Cook County state’s attorney vowed to do a thorough review on how that was allowed to happen after the Sun-Times reported that Beller was not charged with any felonies after the Cicero incident.

For the doctors and nurses at Stroger, such heartbreaking stories of children with severe burns are not unheard of.

“We’ve seen three and four patients come in with 90 and 100 percent burns simultaneously and [doctors] literally run room to room for hours,” Poulakidas said.

And while patients like Naciere and his sister are distressing, doctors know they have a job to do.

“Would every one of us just like to stop, break down [and] cry at the horrific nature of this? Absolutely,” Poulakidas said. “But we push right through and we have to move forward and actually do what’s best for the patient.”

Late this week, Naciere and another child with burns were being treated at Stroger. In both cases, the state is involved.

In 2012, three other Chicago children died from fire in cases where abuse or neglect was substantiated, said Illinois Department of Children and Family Services spokesman Dave Clarkin. In one case, two children — ages 1 and 3 — died in a house fire after kids in the home tried to warm up leftover pizza past 3 a.m. while their mother slept.

In another, a 3-month-old girl died in a fire sparked by a space heater left near her bed.

DCFS is investigating an allegation of neglect against Naciere’s foster parent, who was ordered by a judge to keep the kids away from their father unless a social worker was present.

The state agency has custody of Naciere and a spokesman citing privacy laws said the agency couldn’t release information about the boy’s treatment. A DCFS guardian is charged with making medical decisions for the boy.

The boy’s family is allowed to visit him in the hospital.

Doctors couldn’t discuss his case but they said burn victims cared for in that unit are typically swollen and covered in antibiotic cream and gauze.

Blankets keep them warm — they can’t regulate their body temperature when most of their skin is gone. A web of wires and machines keep them alive. Pain and anxiety medicine keeps them comfortable.

Outside a burn victim’s room Thursday, nurses bustled in and out grabbing gauze and other supplies from a crowded table set up outside. They were changing the patient’s dressings — something that has to be done at least once a day, Poulakidas said.

The patient is bathed with a special soap to wash away bacteria in the dead skin, and is covered once again in antibiotic cream and dressings.

Within the first week, doctors may remove some of the dead skin and perform skin grafts — transplanting healthy skin from one part of the body to the damaged area.

It’s a painful and complicated procedure.

“That opens up a whole new host of pain-related issues because now we’ve reintroduced a new wound,” Poulakidas said. “But it’s not just the wound [from] the dead skin — now we have donor sites.”

For badly injured kids the initial treatments alone can take months. Years of surgery typically follow.

“Kids are little and so they have a large amount of growth to do and so what happens is they outgrow the skin so-to-speak,” Poulakidas said. “They literally are looking at a lifetime, or at least until adult age, of operations.”

In the pediatric ICU at Stroger, about 40 percent of patients every year are burned children, the doctors said. Most of them are under age four, said Paul Severin, the director of the pediatric intensive care unit.

The kids are scalded by hot water or burned by a flame. In many cases, an abusive caretaker injured the child.

Those children are treated by specialists from the burn unit and from the pediatric intensive care unit. A large team of doctors, nurses, nutritionists, physical therapists and psychiatrists joins them.

Mental health is a key part of the treatment.

“The last thing they remember is the what we hope to do is alleviate their discomfort [and] make them have some amnesia to the event as much as possible,” Poulakidas said.

Children tend to suffer from anxiety after a traumatic event and even before the child wakes up, doctors are planning for that and for the likelihood they’ll suffer from post traumatic stress disorder, Severin said.

But Lentz, of the American Burn Association, said it’s easier for kids to deal with their injuries than for adults.

“Adults are potentially dealing with the regret where [kids] are growing up with this and they learn how to compensate better,” he said.

Severely burned skin will never again be the same as it was before the flame touched it. It won’t sweat, it won’t grow hair and it could be discolored. The person will have to care for his skin with moisturizers and other protectors, Lentz said.

“Skin, we take it for granted, but it does so much,” he said.

Even if he makes it to adulthood, Naciere will carry the scars that serve as a visible reminder of the horrendous way his family was killed.

“There is definitely a scar on every burn patient,” Poulakidas said.

Contributing: Kim Janssen

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