The history of the UW Burn Center
By David Heimbach, M.D.
Until 1974, there was no organized burn care in Seattle. With the vision and support of the Medical Director at that time Harold Laws and the CEO, Mr. Robert Jetland, a Burn Center was promised to a team of physicians from Texas whose names sounded much like the stars in “The Godfather”: Drs. Canizaro, Carrico, and Curreri.
P. William Curreri, the “Burn Doc,” had the good sense to bring with him Janet Marvin who was the chief burn nurse in Parkland Memorial Hospital in Dallas, and she brought Leslie Einfeld with her. Harborview converted the labor and delivery ward on the eighth floor into a large ward using the labor rooms and an ICU using delivery rooms. This amounted to 14 total beds with four of them in small box-like cubicles monitored for the sickest patients.
Realizing they did not have to care for burns any more, the local hospitals immediately emptied their wards of the sickest imaginable patients. Responding to this influx, Nurse Marvin and Einfeld recruited and trained a cadre of nurses, many of whom had never seen a burn before. Prominent within this group was Verna Cain, who remains the nurse manager of the outpatient burn clinic to this day. As might be expected, the burn center flourished, but a high mortality kept the turnover high and enough to keep the census steady.
Early funding secured
In 1976 King County put up a bond issue to complete the north tower of the hospital using the Burn Center as the centerpiece. At a time when school bonds were routinely failing, Harborview’s huge bond passed by a nearly 80 percent favorable vote.
That same year part of the Texas physician contingent left for Cornell, including Drs. Canizaro and Curreri. Without a burn surgeon, Dr. David Heimbach was asked to head the search for a new director, to move from UW Medical Center to Harborview and to temporarily supervise the Burn Center.
New skin grafting brings positive results
Realizing what dismal results were produced by treating burn patients endlessly with salve, painfully washing and daily picking the infected wounds by the nursing staff, he suggested the team take the almost unheard of step of taking patients to the operating theater before they became infected - removing the burns surgically and applying immediate skin grafting. It wasn’t long before survival rates greatly improved, the length of hospital stay was reduced and patients’ ability to regain their quality and quantity of life was far better than that of previous methods. These positive steps re-kindled Dr. Heimbach’s interest in burn treatment –something he had lost after a depressing tour at a military burn unit during the Viet Nam war. Therefore, he agreed to become Burn Director in 1977.
General and plastic surgery a unique combination for burn centers
Also that year Dr. Loren Engrav agreed to become the Chief of the fledgling Division of Plastic Surgery. This began a memorable partnership between general and plastic surgery, which has spanned 25 years. Offering both general and plastic surgery was and still is unique among burn centers. Dr. Heimbach jokes that his and Dr. Engrav’s tombstones will be labeled “He tried to do it right the first time”.
Janet Marvin’s influence on research, nursing education and training was hugely important as the entire burn team learned new techniques together. Marvin, the only nurse to ever become an Associate Professor of Surgery, eventually left to become Nursing Director at the Shrine Children’s Burn Hospital in Galveston, and Leslie Einfeld was whisked away to marry Dr. Marty Robson.
Burn fellowship started
In 1980 a burn fellowship was started at the Burn Center and has trained a surgeon continuously for the past 24 years. The fellowship now accounts for about 25 percent of the young burn surgeons practicing in the United States. Nicole Gibran was among the best of these surgeons. She continued training with a basic science fellowship at University of Washington and then joined Heimbach and Engrav on the faculty, where her career has flourished. In 2002 she was selected as Director of the Burn Center. The past of the Burn Center is very rich, but the future holds even more promise.