The burn unit at the U.S. Army Institute of Surgical Research in San Antonio, Texas, is hot. Sometimes, it gets up to 102 degrees in there, among the patients.
People with severe burns can't regulate their own body temperatures well, so the air has to keep them warm.
"We see a lot of gruesome stuff," says physical therapist Melissa Boddington. At the height of the fighting in Iraq and Afghanistan, more than 1,000 wounded service members were flown to the hospital.
The burn center's mission is to treat members of the military for burns from fire, explosions, chemicals or radiation. The treatments can include skin grafts, amputations and inpatient rehabilitation to regain mobility or learn to live with a body that has changed dramatically.
More than 15 years of war have led to major advances in burn care. In one case, a roadside bomb blast in Afghanistan burned more than 97 percent of one Marine's body. He was flown to San Antonio, and survived.
Thousands of U.S. troops are still in war zones, but with the end of major combat missions in Iraq and Afghanistan and fewer soldiers coming home badly burned, the military burn center is treating more civilians.
Col. Booker King, the director of clinical services, says burn specialists also work with orthopedists, eye doctors or kidney specialists because people who come in with burns often have other serious injuries as well.
Most of the patients treated at the burn center right now are civilians who were burned in car wrecks, house fires, cooking incidents or workplace accidents in the oil industry. Because the hospital is on a military base, Fort Sam Houston, a special dispensation from the Secretary of the Army allows them to be treated there.
Seventy-year-old Marty Wender spent 90 days in the intensive care unit at the burn center after he fell while he was taking a hot shower. He either passed out or hit his head. By the time his wife found him unconscious, he had burns over 20 percent of his body.
"When EMS showed up, they thought I was dead," he says. "It was across my chest. The biggest burn was on my back and on my right arm and my two hands."
The staff at the burn center helped Wender recover from his injuries. He lost two fingers.
"It keeps everybody honed, ready to get the job done," says James Williams, a physician assistant in the burn unit. "It's a very tactile type of medicine. If you're not using your skills, you can lose them."
"[We] treat a 17-year-old who got burned from throwing gas on the grill the same as we would treat a soldier who may have gotten injured in combat," he explains.
ARI SHAPIRO, HOST:
Now let's look at one way the U.S. military keeps its skills sharp far away from the battlefield, a way that requires other Americans' participation. At the U.S. Army's burn center at Fort Sam Houston, military medics are treating civilians alongside soldiers. Texas Public Radio's Wendy Rigby reports from San Antonio.
WENDY RIGBY, BYLINE: A hot shower turned into a life-changing event for 70-year-old Marty Wender. He either passed out or hit his head. His wife found him unconscious with burns over 20 percent of his body.
MARTY WENDER: When EMS showed up, they thought I was dead. It was across my chest. The biggest burn was on my back and on my right arm and my two hands.
RIGBY: Wender is a civilian, but it was military care that saved his life.
(SOUNDBITE OF BEEPING)
RIGBY: He spent 90 days in intensive care at the burn center of the Army's Institute of Surgical Research in San Antonio.
(SOUNDBITE OF BELL)
RIGBY: The first thing you notice when you walk into the burn unit is how warm it is - as hot as 102 degrees. Burn patients can't regulate their own body temperature well, one of many factors making it tricky to treat patients.
MELISSA BODDINGTON: We see a lot of gruesome stuff, so that's the hardest part.
RIGBY: That's Melissa Boddington, a physical therapist. The mission of the burn center is to treat members of the military for fire, explosion, chemical or radiation burns. But most of the patients right now are civilians burned in car wrecks, house fires, cooking mishaps and oil industry accidents. Special dispensation from the secretary of the Army allows them to be treated on post.
JAMES WILLIAMS: It keeps everybody honed, ready to get the job done.
RIGBY: That's physician assistant James Williams.
WILLIAMS: It's a very tactile type of medicine. If you're not using your skills, you can lose them. They treat a 17-year-old who got burned from throwing gas on the grill the same as we would treat a soldier who may have gotten injured in combat.
RIGBY: At the height of fighting in Iraq and Afghanistan, more than a thousand wounded service members were flown here, the only place where the military treats burn patients. That treatment includes everything from multiple surgeries like skin grafts and amputations to months of inpatient rehabilitation.
UNIDENTIFIED WOMAN: Stand up - right foot.
RIGBY: Advances are happening quickly. New wound dressings that can be left on for days at a time allow burn patients to go home sooner. Researchers here have developed a type of spray-on skin. Colonel Booker King is the director of clinical services. He says often patients have more than just burn injuries. Orthopedic and reconstructive surgeons work side by side with eye doctors and kidney specialists.
COLONEL BOOKER KING: It's what we do. It's our mission. It's what drives us.
RIGBY: Marty Wender, saved from his shower burns, says he feels fortunate to live near a burn center that treats 700 patients a year.
WENDER: They saved my life.
RIGBY: Incredibly, one marine burned over 97 percent of his body in a roadside bomb blast in Afghanistan was flown here and survived, an outcome that used to be unimaginable. For NPR News, I'm Wendy Rigby in San Antonio. Transcript provided by NPR, Copyright NPR.