As blackened victims from The Station fire filled the Kent Hospital emergency department, Dr. Candace L. Dyer worked swiftly to check their airways, assess their injuries, stitch up their cuts and give them medications.
And occasionally, with patients who were well enough to talk, she would take a moment to show them her hands. Deft, agile hands. Surgeon's hands. Hands rippled with the scars from a severe burn.
Dyer was burned over 65 percent of her body in 1987. As she cared for the fire victims, occasionally a staff member would stop to ask her if she was okay. She assured them she was fine. Like everyone, she was deeply focused on the needs of the victims from the Feb. 20 disaster.
Still, her heart went out to them as no one else's could. "My heart just broke for these badly burned patients, not so much because I feared they would die. I just know that road ahead," she says. "Their lives are never going to be the same."
But isn't Dyer's life the same? She's been back practicing surgery full-time for more than a decade since her accident.
Dyer smiles at the question.
"My life is better," she declares.
IT SURELY didn't seem better the day she emerged from a medication-induced coma to face what fire had done to her body and her life. "I didn't want to live," she recalls. Dyer had been practicing surgery only two years at the time of her accident. "How was I ever going to function? I'd probably never work again."
She had moments when she wished she had simply died in the fire. She thought about suicide.
Dyer was burned on a boating trip in August 1987 with her husband and their best friends. The alcohol stove she was using to cook dinner exploded while they were docked at Martha's Vineyard. She caught on fire and dove into the water. Her friend helped her up the ladder onto the dock as the rescue crew arrived.
Dyer knew she had been burned over 65 percent of her body. She was 35 years old. According to the old formula she had learned in medical school, add the percentage of body surface burned to the burn patient's age, and the result is the likelihood of dying. Dyer did the math and figured they would make her comfortable with morphine and let her go.
Instead, she was taken by helicopter to Massachusetts General Hospital, put on a ventilator, and pushed back toward life. For three weeks, she was in a coma, her burned eyes patched, her bed enclosed with plastic sheets that formed a warm, sterile, cubical bubble around her.
Her neck, the tops of her hands and feet, and most of her legs and arms had third-degree burns. They had to shave her head to graft skin from her scalp.
She awakened to find herself surrounded by relatives, encouraging her in recovery. Her neck was in a brace, her hands in splints, a morphine drip in her arm.
Through it all, no one told her that she couldn't return to work. Privately, though, her father and partner at Tollgate Surgical Associates, Dr. Richard Dyer, didn't think his daughter was likely to resume surgery. Another partner told the staff that she'd probably never come back.
DYER SPENT two months in the hospital, relearning to walk, to use her hands. Someone had to teach her how to eat. "I can't explain," she says, "what it feels like to be so useless, so dependent on other people. But I saw progress, one baby step at a time."
When she was discharged, Dyer went to live with her parents in Warwick. Her weight had fallen to nearly 70 pounds, and she still had open wounds. Physical and occupational therapists came to the home to work on improving her mobility. Her father changed her dressings, and her mother made sure she had three proper meals and stuck with her exercise regimen. They walked with her. Once, they took her to a swimming pool. "That was horrible. I looked grotesque. I had no neck. I had no hair."
Dyer says, "I had so much support, and people pushing me to get to do things." Her three sisters, her parents, her husband and stepchildren, and many friends offered their encouragement. Additionally, she says, "I got professional help. I'm not afraid to say it." Her therapist, she says, "made me realize what's important. . . . How you look is not important."
Dyer's accident occurred at a difficult time in her marriage. The boat trip had been part of an effort to reconcile with her husband, Dr. Hugo Jauregui, from whom she had been separated. Now, as she recuperated at her parents' home, their separation was prolonged. "This put an added strain on my marriage. I wasn't sure he wanted me," she says.
Four months after the accident, Dyer was invited to her office Christmas party. Terrified, she balked. "The night of the party, I didn't want to go. I sat down and cried. My father came down and said, 'These are people that love you.' "
Dyer pauses as tears come to her eyes. It's the only time she breaks up in more than an hour of talking about her ordeal.
She went to the party, where she received a warm welcome. "That was a big turning point. It's important for people to get out and be with people."
DYER RETURNED to work part-time, from January through May of 1988, seeing her patients in the office. She wasn't able to perform surgery, and she wanted to gauge how patients reacted to her appearance. Her neck was scarred, and the scar pulled on her lip a little. "I thought it was worse than it was," she says. "Most patients would say, 'I'm so glad you're back. You look wonderful.' "
The following summer, Dyer had additional skin grafts to improve the range of motion in her arms and fingers, and reconstructive surgery on her neck.
About two years after the accident, she returned to live with her husband. (In 2000, he died unexpectedly at the age of 65.)
Dyer yearned to resume surgery. "I had to prove to myself I could do it. I hadn't tied a surgical knot in a year and a half," Dyer says. She practiced on a pig at Rhode Island Hospital. The pig experiment succeeded: She could do it.
In January 1989, a year and half after her accident, Dyer resumed practicing surgery -- initially assisting her partners, then booking her own patients. "That was from working really hard," her father, who has since retired, said in a phone interview from Florida. "She had a rubber ball she was squeezing continuously, exercising her fingers to get the most out of it. She was very determined to get everything back to normal as much as possible. . . . With time, and with a lot of work, a lot of encouragement, she made a surprisingly good recovery."
But no, her life isn't the same.
Her skin feels stiff and tight, with diminished sensation. She struggles with self-consciousness over her appearance, wearing long sleeves even on summer's hottest days and avoiding beaches.
"You always feel people are staring at you. You've got to realize, they're just curious. They're not trying to be hurtful. . . . I hated to go shopping. I hated summer. I hate summer."
For four years, Dyer would "get weepy" on the anniversary of the accident. But on the fifth year, the day passed without her noticing it.
Today, Dyer says she has recovered as fully as she could hope for. Why is her life better? "You learn to focus on what's important in life. You learn there's a lot to be grateful for. . . .
"I have daily reminders of my accident," Dyer says.
"Maybe something will come along that will give me back my skin. I've just accepted that this is who I am. It's a process. You don't get there overnight. I know there's still a lot to enjoy out there and life can be good."
She offers this advice to those injured in the Station fire: "Try to turn it into a good thing. Use it as an opportunity to grow, to learn about yourself, what's important in life, to learn what your true potential is. There's nothing you can't do if you put your mind to it."
