Drawn to Burn Care

Dr. Steve Morris , MD, and Brad Wiggins , RN, lead the intermountain west’s only burn center at the University of Utah. They have worked together for over 25 years, sharing a passion and commitment for the mission of caring for burn patients. Chrissy Daniels and Mari Ransco learn about their unique and enduring connection.

(Abridged transcript below)

START WITH "WHY"

1. How did you get started in your line of work?

[Brad:] That’s a complicated question. My work in the burn unit was really unexpected. I’ve been in the hospital for 29 years. I started in the storeroom in high school. I can honestly thank my mom and Lynda Faldmo (former nurse manager of the burn center and director of risk management). My mom knew I was done working in the storeroom at 19, and she had a conversation with Lynda in the hallway one day. They were talking about kids and life, and she said ‘Brad is looking for something new.’ I was hired as an 'equipment technician.' Seemed like I was going to clean equipment, but found out really quickly that it was another name for nurses’ aide.

At that point, I wanted to be an air force pilot. I was in ROTC here at Utah, but I very quickly fell in love with the idea of caring for burn patients. I would come home from flying and working on my private pilot’s license, and my girlfriend at the time would say, ‘you know when you come home from the burn unit you’re totally excited and lit up. You come from flying and you basically say, it was ok.’ Having a mom and a grandma as a nurse, there was no way I wanted to be nurse. But the burn unit changed that for me. I really quickly discovered how much you could make a difference in someone’s life.

[Steve:] The first time I ever thought about burns as a disease or injury was the week before I started medical school. I was single, I had just finished my degree in chemistry. From the time I was very young, I always knew I wanted to do medicine. I saw a physician as someone like Marcus Welby; then I entered medical school. The first time I was in the medical center as a pre-med (I had gone up there many times as the son of a hospital pharmacist), I was with my mother, and we saw this burn patient and of course my mother recoiled. I ended up taking care of burn patients when I was a medical student and as an intern.

I was drawn to burn care; here was a patient who otherwise would have died; who might never live a real life because of what had happened. And because of the strength they have in them, and you can see it, they become a person again. They get back to living, they get back to running, laughing, crying, teasing, whatever….that is what just drew me to burns. And of course when I realized how much I liked critical care, and I liked operating, all of that came together for me. It just felt right.

When I was a second year resident, one night I was post-oping patients, and another doctor, Jeff Saffle, said ‘what are you doing Morris? You ever think to take care of burns?’ I said ‘well, I’ve thought about it.’ He said ‘think real hard.’ That moment in time tripped a number of gates open and pretty soon I was an attending. Jeff ended up being my partner for 25 years, and Brad and I started working together.

Building a team beyond just critical care

2. The burn unit you’ve created has the most mature, team-based care of any condition that we care for in the hospital. You went beyond critical care and started looking at the patient from before they come to you to long after they leave you. How did that come about?

[Steve:] My original mentor, Glenn Warden, was a real iconoclast. He had a vision; he was a pugnacious guy and a lot of people didn’t like him. But he cared about the patient. He was really hard to work for, but he had human concern. I never thought of this before, but that human concern sparked something in me. I realized that a surgeon can’t do this (take care of burns), a nurse can’t do this, a social worker can’t do this, a psychologist can’t do this, a mother or father can’t do this; this is something that can be done by all of us together. The whole is much greater than the parts, and Glenn Warden saw that. He did some things that would really shock you sometimes, but he did it because of the patient’s welfare and he inspired others to do the same.

"I realized that a surgeon can’t do this (take care of burns), a nurse can’t do this, a social worker can’t do this, a psychologist can’t do this, a mother or father can’t do this; this is something that can be done by all of us together. The whole is much greater than the parts."

We were, and still are, in a silo because of that…but people get that spark. I did, Brad did, Lynda did, many people have; those that can see it stay. Those that can only see the wounds and the pain and the horrible twist of fate that caused the patient to be here; those that can only see that don’t last that long. There is a real culling process that goes on. We see people who are only here for 4 months, a year, and then they can’t do it - unless that light turns on. I guess that was what happened to me, and it’s never gone out.

3. How do you think your team would describe what the burn unit is about? What words describe the burn unit?

[Brad:] Passion. We have instilled passion in our team to believe that you can pull someone back from the worst injury of their life. That you can give them hope. Commitment. A drive for success. Those are things that Dr. Morris and I both had instilled in us from early in our careers. Burn patients bring that out of you.

The humanistic side ultimately is that you believe you’re going to be able to get them back on their feet again. On the hardest of hardest days, they come out of the fire and they come out of their challenges with amazing success stories and they go on to lead amazing lives. Not everyone, but a high percentage. We have very little death. We help people overcome something that from a public perspective is viewed as horrific, traumatizing and ultimately destroying of someone’s self-worth and together we prove them otherwise. We’re going to be here with you, cry with you, hold your hand, sometimes hurt you, but we push really hard for those things.

[Steve:] I think these relationships aren’t intentionally created. Of course, we know we have to work together as a team, but they happen because of the circumstances that we work under. Usually they happen not because of something you’ve said, but the relationships happen because we’re working at the bedside together and we look over at each other. I look into Brad’s eyes. Or Randy’s eyes. Or Sue Hill’s eyes. Or any of these people that I’ve worked with for decades, and there is that understanding. I remember, (I had no idea I would get emotional), one time we had a little 10 month old child who had an absolutely horrific burn on her upper extremity, and it was making her sick and we had to amputate. I was in the operating room with Randy. We completed the amputation, I looked at Randy, and there was communication without a word.

I consider Randy, Brad, and others, not necessarily the greatest friends but perhaps the most magnanimous and wonderful people. They work in the burn unit for a number of reasons. When things are hard, people will often say ‘how can you do this?’ I say, ‘I had no idea I could take it, I bet you didn’t have any idea either. But because we can, we must. These patients can’t help themselves, they need help from someone else. Those people that can do it, must do it. It goes far beyond a job.’

One time we were in a staff meeting, and I can’t remember what Jeff Saffle was talking about, but he was coming down on someone because they weren’t doing something they were supposed to. I looked over and said to Jeff, ‘remember this is a job.’ If looks could kill, I would have been dead, because the look Jeff gave me meant ‘this is not just a job, this is a mission.’ It’s almost like entering a religious order. It goes far beyond pay, it goes beyond the job, and it’s one of the most remarkable contracts. It’s a relationship that physicians, residents, nurses, case managers and so many others have with the patient. You set aside your own desires and wishes.

[Brad:] Dr. Morris’ and my relationship is exactly as he’s defined it. We’ve spent incredible amounts of time together, trying to save someone’s life. We’ve been successful and we haven’t. Those moments that we’ve shared together over the last 25 years define us daily in how we approach the rest of the team, and in what we expect out of the commitment to the patient. It is something we both expect. We expect the rest of the team to focus and commit to taking someone’s life and turning it around.

"The relationships happen because we’re working at the bedside together. I look into Brad’s eyes. Or Randy’s eyes. Or Sue’s eyes. Or any of these people that I’ve worked with for decades, and there is that understanding."

There are endless moments when I’ve looked across the bed at Steve, in the middle of the procedure. We don’t have to say anything; we’re both feeling the intensity of the situation. We understand the impact it’s having on us as professionals, and how much it’s grabbing a hold of our hearts. When you’ve worked with someone as long as we have, you can love each other. We do love each other, we have a significant relationship that way. That is unique. That’s the piece that keeps us.

People ask ‘how can you do burn care?’ It’s this conversation, it’s this moment. It’s the survivors coming back thanking us, it’s the graduation card, 5 years later, the marriage announcement, the baby announcement. They consider themselves family, that doesn’t go away. We chase that every day in the changing healthcare environment, trying to maintain something that grabbed ahold of us, and in a difficult time of healthcare challenges, we are lucky to have been here and to influence those around us to make impactful change.

This last year for us, we’ve added a lot of new team members to the burn center. We are creating the future of the burn center. We’ve welcomed many, many people into burn care, and in 15 years, some of them will still be here. We know that. We carry that message forward of compassionate, dedicated care to people who need it.

"When things are hard, I say, ‘I didn’t know I could work here, and I bet you didn’t know you could work here. I bet you didn’t know you could take it. But because we can, we must. These patients can’t help themselves, they need help from someone else. Those people that can do it, must do it. It goes far beyond a job."

A partnership of mutual respect and admiration

4. Brad, what’s the one thing you want Steve to know, and Steve, what’s the one think you want Brad to know?

[Brad:] That’s a challenging question for any partners. Over the years, we’ve had chances to talk about the successful moments we’ve had. We’ve even had time to talk about the challenges. He’s a brother in arms to me. He is somebody that carries the same torch as me. We share a vision of all of those things we’ve talked about here.

At the end of the day, the thing I’d want Steve to know is I care for you immensely, I’m proud of your dedication. You’re more dedicated than any physician I’ve ever worked with. Your commitment and your focus to go into a patient’s room, and connect with that family, and to believe you’ll do everything in your power to save their life, is untouchable to anything I’ve ever seen. That’s the standout piece for me. When someone says ‘tell me about Dr. Morris,’ it’s the unwavering love for everyone you care for. It’s unique and special. We have a lot of national exposure to burn care as well, and it’s something that is unique on a national level. We have something that’s personal, a personal commitment to each other. I love Steve very much for that.

[Steve:] Our careers have been very parallel. We started out very young, and we had the fun of watching our leaders struggle with the burn center (before we became the leaders), and the learning experience of going through it. I’ve seen Brad change a lot. It’s almost like a personal relationship in that we are so different.

I feel that we complement each other—like a hand in glove. We don’t always see eye to eye, but when we don’t, we have each other’s back. I am so grateful that you know I have your back, and I know you have my back. We disagree only because we’re different, yet we’re so much the same.

You are absolutely immovable. If you look at him, if you talk to him, you know one thing—when Brad has his mind set on something, you may as well get out of the way, turn around and go the same direction. That is something that has never changed, from the moment you were young. Your determination, your commitment to doing the right thing, your integrity, your moral uprightness, and your absolutely immovability in moving forward. I don’t think I’ve ever told you this, but this is what draws me to you, and this is what makes me respect you so much. I’m so proud to be your partner.