Impacted by the death of their two boys, the van Dijk’s also go through the painstaking process of healing their physical injuries from a home fire. U.S. burn care experts weigh in on the prevalence and outcomes of these injuries and underscore a disconcerting trend across the nation.
By Fred Durso, Jr.
Nearly every year, when with friends at a lake house outside the Adirondacks in New York, I watch them fill a fire pit with strategically placed logs and kindling. Getting the fire to start is easy. Keeping it going is harder. There’s maneuvering the logs, some poking and prodding, and adding more wood. When done right, the results are rewarding. But human intervention is necessary to keep its glow going.
The opposite occurred at the van Dijk home. Intervention on their part wasn’t needed to aid the fire’s spread in what they initially considered a “safe house.” They say they had three exits, nine smoke alarms, and large windows. And no form of intervention by the family would have helped slow down this fire. Its speed made it impossible to do anything but attempt to flee.
A fire investigator stated in an investigation summary that the fire was accidental, and it’s his opinion that a grill on the front porch caused the fire, a claim the family defiantly refutes.
“I know personally, because I'm the only person that runs the grill," says Feike. "That grill wasn't on. I know that personally. I was marinating steaks. I never had the time to go outside and turn the gas on, because Noelle already asked me to feed the kids, the twins, bananas. And I remember exactly what my emotion was when she said, 'I didn't feed the kids yet. Can you please feed the twins?' I was a little agitated, because I wanted to start the grill and make my steaks. So I never got to that process.”
As Noelle puts it, everything happened so fast. They had mere seconds to make crucial decisions. “When we took our twins out of their high chairs, we didn't realize it until hours later, but we were making a decision on what child we were helping,” she says. “And that seemed like the most reasonable. They couldn't walk yet. They can't help themselves. They’re babies.”
Noelle was injured while attempting to go back inside the home for Noah and Zephy. Feike vividly remembers what despair sounded like that day.
“When I was in the ambulance and Remmy was on my lap wrapped up in blankets, burned, third- and fourth-degree, screaming, even the sirens were going off,” he says. “Sirens were coming in from the fire engines. I could hear the tin roof, the metal roof … just crumble up and pop off the building itself. That’s the moment I knew my life would change forever.”
Remmy acquired third- and fourth-degree burns on two-thirds of his body from a fire and was admitted to the Burn Center at University Health Care in Salt Lake City, Utah
Feike and Remmy, a baby at the time, were airlifted to the Burn Center at University Health Care in Salt Lake City, Utah, a little under 300 miles from Lander. Feike had second- and third-degree burns, mainly the latter, on his face, ears, nose, and right arm. The higher the degree, the more severe the burn injury.
Feike was treated and was able to be released a few days later, but Remmy’s condition was worse. He was in a coma. Feike rarely left his child’s side at the burn center. He even had his wound care done at his baby’s bedside. Feike still can’t recall exactly how Remmy was injured in the fire. Beanie, Remmy’s twin, was only a foot away from Remmy in the other high chair and wasn’t injured at all.
Noelle was enduring her own struggles. She received burns on her head, face, ears, and arms. Since hers weren’t as severe as Feike and Remi’s, she was treated locally. A self-described introvert, Noelle also wasn’t initially comfortable explaining what happened to her or discussing her son’s condition.
‘There was this headband that I tried on in a thrift shop in Salt Lake, and this girl was like, ‘Oh, honey, you don't have enough hair for that,’” says Noelle. “And apparently … I went off on her and said, ‘You know why I don't have hair? Because I burned it off, because I was trying to save two children out of a burning fire.’ And then I left. I just walked off. And I mean, I was trying to cope with this. There was so much to protect myself.
As for the two boys they lost, Zephy and Noah, I find it difficult to talk about them while inside their home for fear of upsetting the family. I don’t notice photos of them anywhere, and I wonder, three years since the incident, is talking about them too much? I decide one day to delicately ask about the boys.
“[Zephy] is a kid that would demolish everything,” says Feike. “But he had such a friendly character. The way he was built, he was stocky. He was really firm. But yeah, he was definitely the kid that would break things by accident, or sometimes on purpose.
“He had more stitches on his body than the years that he lived. And pretty much every year, he had a major injury with stitches. And this happened normally the week before his birthday. So we were kind of prepared because this just kept on happening with him.”
Noah's personality was different from Zephy's. “Very gentle, very funny, extremely smart,” says Feike. “He was the child with white blonde hair, clearest blue eyes. He did not really look like the other two boys, and the other two boys would make fun of it. His skin was very pale and fair, and he was extremely smart.
“Noelle and I…would make comments that Zephy would be working at the local dump. He would love his job, just picking up trash and throwing [trash] in a big truck, very physical work. Noah would be a doctor or surgeon.”
While mourning their boys, the couple also had to deal with the aftermath of Remmy’s injuries. There were frequent, back-and-forth trips to the Salt Lake City burn center.
Noelle with Remmy at the burn center in Salt Lake City, Utah
“Remmy was someone who was complicated because of the location of his injuries and the severity of his injuries,” says Amalia Cochran, a burn surgeon at the center who treated Remmy and assistant professor of surgery at the University of Utah. The burn center admits approximately 350 patients a year for in-patient care and 5,000 for outpatient. The center serves the entire Intermountain West region of the U.S., meaning it serves the largest geographical area of any burn center in the country. She confirms something that I’ve been told before: burn survivors involved in home fires typically suffer the most catastrophic of injuries. Tending to those injuries, she says, can be tricky and, unfortunately, very painful.
There’s skin grafting, a process of removing areas of dead skin tissue and replacing it with healthy tissue from what’s called a “donor site” from another part of the body. The donor tissue is then placed where the dead tissue once lived. It’s an exquisitely painful process, says Cochran, and also requires ample dressing changes to both the donor site and the site of the injury. Remmy underwent this process.
However, there is one upside not seen in other forms of physical care.
“One of the things that is a little bit different about burn care than some other aspects of surgery is let's say that you go to the emergency room because you've got appendicitis,” explains Cochran. “Your surgeon takes your appendix out, you go home a day later, and you see them in clinic a couple weeks later. That's it. That's pretty much your entire relationship with your surgeon who did your appendectomy. That stands in really stark contrast to our relationships as burn surgeons with our patients, where we continue seeing patients for months and years after their injuries and their initial surgeries.”
Dedicated individuals like Cochran fill burn centers nationwide, and they’re doing some phenomenal work. According to the Phoenix Society for Burn Survivors, an astounding 96 percent of people admitted to burn centers are surviving their injuries. However, less and less are choosing burn care as a career path. Since burn care is no longer a component of general surgery training, less and less are exposed to this field, says Cochran.
“Being a burn surgeon is a little bit of a tough lifestyle,” she adds. “We have unpredictable schedules. When we're on call, we never know what's going to come in. That aspect of not having control over your lifestyle is something that we know with medical students has definitely impacted specialty selection over the last 20 years.”
This trend could have a devastating effect on burn care. More than 70 percent of burns happen at home, with 40,000 requiring hospitalization and 30,000 additional people admitted to burn centers annually.
“These [burn] units are a national treasure, and I think they’re at risk,” says Amy Acton, executive director of the Phoenix Society for Burn Survivors, a nonprofit offering an array of resources to anyone impacted by fire. “Recruiting physical and team members into the burn team has to be focus, and how do we support them and maintain these units for when they’re needed? They are often a high expense area of hospitals. Our biggest fear is that we don’t have educated teams to take care of patients that have a devastating injury.”
Losing these national treasures, as Acton describes them, would be devastating for families like the van Dijk’s. They credit their physical healing by the dedicated staff in Salt Lake as an aspect of their recovery.
Feike and Remmy
As for scarring, you can barely notice Feike’s burns. Noelle decided to take a unique approach with the scars on her left forearm; she got a tattoo of a scuba diver intertwined with an octopus.
“I had something to remind me it's a sink-or-swim situation,” she says. “If I don't come out of that internal shell that was just constantly processing, that was constantly blaming myself, that was constantly thinking what could have happened better. If you don't redirect your thoughts, at night, when you're laying down there, thinking about your children screaming and coughing, you go back to that place.
“It's sink or swim. If I don't keep fighting and if I lay dormant, I'm going to run out of air, which I see as running out of networking, running out of support, and I'm in deep water. If we don't acknowledge it and we don't acknowledge that we need to keep going up to the surface, we will get taken out by random acts of life that are not kind to us. It's the issue with living in what I guess Christians call a broken world, but I think most of us can acknowledge a world that's full of pain and … suffering, but also refinement.”
Fred Durso, Jr., is communications manager for NFPA's Fire Sprinkler Initiative. "The Survivors" is produced by the National Fire Protection Association in cooperation with the Phoenix Society for Burn Survivors.
Burn Injury and Recovery Information