Some lie in a narcotic haze, waiting until their seared lungs can breathe without help from machines. Others have already had healthy skin peeled from places that escaped the flames' fury and grafted to their wounds.
Twelve people who were riders on a subway train in lower Manhattan last Wednesday when a firebomb turned their car into a furnace are patients in the burn center at New York Hospital-Cornell Medical Center. Each faces a long, painful struggle, and doctors caution that a few may not survive the fight."About a third of these patients have a very high risk of not making it," said Dr. Roger Yurt, acting director of the burn center.
One of those most seriously injured is Edward J. Leary, 49, the man who was arrested in his hospital bed, accused of carrying the incendiary device that exploded last Wednesday afternoon. While still protesting his client's innocence, Leary's lawyer, Stephen J. Murphy, said on Sunday that he had had difficulty extracting an account of the incident from his client, who drifts in and out of consciousness, his senses dulled by pain and morphine.
Leary and two others, Renfield Edey, 60, and Brenda Dowdell, 40, remained in critical condition on Sunday.
"The prognosis differs greatly by age and the percentage of the body that's burned," Yurt said. "About 50 percent of patients will die with serious burns in the range of 60 percent of their bodies, and the risk is higher the older the patient is."
Of all the people who were burned aboard the No. 4 train at Fulton Street, doctors say the outlook appears most grim for Edey, who has third-degree burns over 65 percent of his body. Dowdell has third-degree burns over 35 percent of her body, and Leary over 40 percent. Third-degree burns are burns all the way through the skin.
All the burn victims face a series of crises, some potentially fatal, in an itinerary of pain with which each of them will become all too familiar.
The first threat, a sometimes deadly one, is dehydration caused by fluid loss through the burn wounds, Yurt said. Next, for those whose lungs were damaged by the scorching air and smoke they breathed, are the challenges of taking in enough oxygen and averting pneumonia.
Just as the immediate risk from lung damage subsides comes perhaps the biggest threat of all: infection of open wounds that can, in some patients, cover half of their bodies.
"In most patients, it's typical that infection becomes a problem about seven days after the burns," Yurt said, adding that it can pose a grave peril for weeks or months, until all the skin has healed.