One Crash Victim Dies, Three Cling to Life at Burn Center

The death of 11-year-old Grace Chung surprised some medical personnel who had cared for her since she was carried aboard an Air Force C-141 Aug. 8 for the 20-hour flight to San Antonio.

"I was absolutely shocked when I found out she passed away," said Army Capt. Liza Ludivico, a critical care nurse who hovered over the badly burned child throughout the long trip home. "She was the most responsive of any of our patients in Guam and responded well to the treatment on the way home and here. I really thought she was going to make it."

Chung, of Marietta, Ga., had been the only American survivor of the fiery Aug. 5 crash that also claimed the lives of her mother, sister and brother. Her father, who wasn't on the flight, flew to San Antonio with her from Guam. During the flight, Ludivico talked with and tried to comfort him.

"I told him her hands were badly burned and she probably would lose at least some of her fingertips," Ludivico said. "He said Grace liked to play the piano and asked me to do everything I could to save her hands."

The other victims brought here were Se Jin Ju, 28; Kyu Hee Han, 29; and Young Hak Jung, 39, all South Korean citizens. Along with Chung, they were the most severely burned survivors and needed the kind of treatment the Brooke Army Medical Center burn unit here provides.

"The governor of Guam requested our support through the State Department," said Army Dr. (Maj.) Lee Cancio, who led one of two burn center teams that arrived on Guam within 48 hours of the crash. Two Air Force critical care aeromedical transport teams from nearby Wilford Hall Medical Center also made the trip. One Air Force team subsequently transported some of the other 30 survivors to Seoul for further treatment; the other teams returned here with their patients.

Cancio said all four victims required mechanical ventilation to keep their airways open throughout the flight. "Their faces were swollen from severe burning," he said. "So we intubated them to make sure they'd be able to breathe all right and also sedated them heavily so they wouldn't be in pain. It was a very quiet and smooth ride for them."

The burns covered 45 percent to 80 percent of their bodies, Cancio said. Although Chung's burns were the least of the group, all suffered heavy smoke inhalation, a factor that raises the mortality rate in burn victims by 20 percent, Cancio said. "Age is another factor," he added. "Children and older people are more likely to die from severe burns than the average adult."

Chung's heart stopped after she underwent the first of many skin-graft operations she would have required. "Despite the efforts of our staff to resuscitate her, she didn't respond," Cancio said.

"Losing a patient does affect us," he said. "We returned from Guam with four patients who survived a long flight. There was a tendency to be self-congratulatory. But we knew the patients had a long way to go before they'd be out of the woods."

On the average, burn victims require one day of hospitalization for every 1 percent of their body surface burned, said Arcy Longoria, burn center spokeswoman.

Relatives of the three remaining survivors are being housed near the medical center. Korean churches and military spouses also volunteered their assistance, Longoria said.

The mission challenged the team members' endurance. After being notified of the crash, they immediately set up the mission and gathered the equipment they'd need. They had slept little by the time they arrived at Andersen Air Force Base, Guam, but would sleep even less the next several days. Most were still trying to recover when Chung's heroic battle ended.

The burn center provides counselors not only for burn victims and their families, but for staff as well. In most cases, however, the staff knows the power of their enemy -- and that theirs is an uphill battle against time and the elements of infection and human frailty.

"Some days you eat the bear, some days the bear eats you," Ludivico said philosophically. "You can tell people what it's like to work with burn victims, but that really doesn't convey the full picture. Mostly, we rely upon each other for support."

Each year, the burn center treats 250 to 400 patients with extensive, life-threatening burns. In the past decade, improved treatment has increased the survival rate threefold.

The center pioneered the concept of sending burn teams by air to distant disaster scenes and returning victims to Fort Sam Houston for treatment.