The Phoenix Man

Those who treat the severely burned have a rule of thumb that roughly predicts a newly arrived patient's chance of survival.

They add the patient's age to the percentage of skin surface that's been burned. It wasn't so long ago that a patient whose sum exceeded 100 was most certainly going to die. And while medical advancements have undermined that certainty, the formula remains a useful way to measure the sometimes unfathomable depth of a burn victim's hurt.

On July 25, 1995, George Bennett was admitted to the Regional Burn Center at St. Mary's Hospital in Milwaukee, Wisconsin. Burns covered 70% of his body. He was six weeks shy of 49.

George was unconscious when he arrived, and he would remain in a coma long after his 49th birthday had come and gone. And when at last he had regained consciousness, when he had surveyed his injuries and had weighed their scope, when he had considered what his life had been and what it had become, George would conclude that, in his particular case, the simple formula had proved accurate.

He would say that on July 25, 1995, George Bennett died.

It was hard work, but it suited George. Sitting behind a desk bored him. Getting out on a project, solving its logistical and engineering problems, working hard with his hands, were honest pleasures.

As often as not, George would get home, change out of one set of work clothes only to put on another. Then he'd spend the evening fixing up the house or working in the garage on his collection of antique cars.

At 48, George was still broad-shouldered, handsome and vigorous, with pale blue eyes, an easy smile and powerful hands.

All the men in George's family had great hands: lean, strong and expressive. But George's hands were wired with particular grace and dexterity. There was nothing, it seemed, George couldn't handle, and from his adroitness, George drew a broad sort of confidence about life.

George figured that whatever happened - even if everything he had disappeared tomorrow - he could always make a living with his hands.

George and the Reid brothers climbed into George's car and drove down to Milwaukee.

Along the way, they joked about the heat and talked about that day's project: a 12,000-gallon gasoline tank buried 4 feet below the parking lot of a SuperAmerica gas station on the city's south side.

The tank was 25 1/2 feet long and 9 feet in diameter and looked something like a soda can turned onto its side. The men were to sandblast the walls of the tank's interior, clean up the debris, seal up the seams, then spray on a polyester-based material that would harden into a protective shell an eighth of an inch thick.

The cleaning and sealing took all morning. George did the sandblasting, then Aub climbed down to clean up, shoveling the spent sand into a bucket that Austin hauled to the surface with a rope.

The men worked as quickly as the heat and humidity allowed. By late morning, the temperature had climbed into the mid-80s, and though the sky remained cloudless, the air thickened toward a storm.

After a quick lunch, George pulled on the equipment he would need for spraying: first a baggy pair of white coveralls, which George wore over his jeans and T-shirt to protect him from the sprayed material, then a calf-high pair of rubber boots, which George sealed to his coveralls with duct tape, then vinyl gloves, also sealed with tape, and finally a helmet equipped with a plastic tube to feed George fresh air while he worked.

An aluminum ladder was lowered through the manhole, and George climbed down 13 feet to the floor of the tank. The temperature inside the tank was about 60 degrees. George could feel his skin tighten against the coolness as it worked through his clothes and mixed into the sweat on his back.

Aub and Austin hauled out the ladder. George walked to the far end of the tank and turned on his sprayer. The slightly pinkish liquid struck the steel walls. A bare halogen bulb hung down from the manhole behind him. The fresh coat gleamed in the bulb's pure white light.

George worked the sprayer back and forth, up and down, giving the tank one, then a second layer, leaving an unpainted path along the floor about 2 feet wide. Once in a while, he paused to tear a splattered strip of protective cellophane from the mask of his helmet, tucking the material into a pocket above his left boot. He could smell, just barely, the spray's sweet chemical scent.

Investigators have been unable to determine exactly what happened next. A spark - perhaps from the light cord, perhaps static electricity, perhaps a cigarette flipped carelessly from a passing car - ignited fumes in the tank. A rivulet of yellow flame swept over George's head.

George looked up and thought, "Perhaps it'll go out."

It was a moment of denial, a brief psychological postponement of what George knew would happen next.

Aub was sitting on a pile of sandbags stacked in the company trailer when he heard what sounded like a jet taking off from the parking lot outside.

He threw open the door just in time to see a pillar of fire emerge from the manhole and shoot 10 feet into the air. He could hear, above the roar, from inside the tank, George crying for help.

George watched the fire spread down the walls of the tank. His helmet ignited and began to burn away, and everywhere he turned there were flames, their roar and their terrible, terrible pain. Then, no pain at all, just everywhere the roar and the flames, and George figured that this was the way he would die.

The unpainted strip on the floor of the tank was the only place not on fire. George stopped calling for help and sat down.

Sometimes when George talks about the fire and he is describing this moment, he uses the words "just take it." He says, "I decided I would just take it," and a disturbing sort of flatness creeps into his voice.

As George sat on the floor, he thought about his fiancee, Vivian, and about his two kids, Clayton and Natalie. He could picture them. He could feel their presence. He thought how awful it was going to be for them, living with the image of him dying this way.

He wished there were some way to tell them that the pain had lasted for only a few seconds and that, in the final moments of his life, his mind turned to them and found comfort.

Something hit his legs. He looked up. Blobs of flaming material dripped from the ceiling and landed on his thighs. He watched them burn through his clothes and melt into his skin. It didn't hurt. He was dying. He was on fire. It was dreamy.

George heard a voice. It said, "George, stand up." George believed it was the voice of God. And though George couldn't stand, when he heard the voice, he thought - he was certain - he would live after all.

Then there was a loud SWOOOSH! It was Aub and Austin unloading two fire extinguishers into the tank. Then silence.

Blackness and silence.

Skin is formed early in the womb, a single sheath covering the outside and protecting the inside of our unborn selves. It is among our first and most elemental distinctions: Here is me. There is everything else.

Skin is more than the two-ply tissue we come wrapped in, the membranous envelope that contains our bodies. Skin is an organ. It is an organ just as the brain is an organ, or the heart.

But there is a difference, one that is subtle but psychologically telling.

When we think about ourselves, about who and what we are, we sometimes distinguish between our brain and our mind, between our heart and our soul. Skin, however, is a literal thing. It is so intimate, so corporeal, so essential to our sense of being physical creatures, that it tolerates no such abstractions.

Our skin is our flesh.

More than two-thirds of George Bennett's skin was burned away. He arrived at the Regional Burn Center at St. Mary's Hospital paralyzed and sedated. His hair was singed. His eyebrows were singed. Even the hair inside what remained of his nose was singed.

The pupil of his right eye, which had suffered thermal injury, was the size of a dime. The pupil of his left was a pinpoint. Soot was suctioned from deep in his lungs.

Burns are measured by degrees, by the depth of their destruction. First-degree burns are the mildest. A typical sunburn is an example. The skin is tender, swells a bit, but no blister forms. The wounded area heals inside of a week and leaves no scar.

Second-degree burns are sometimes called partial-thickness burns. The top layer of the skin, which is called the epidermis, is destroyed and the layer beneath, called the dermis, is also damaged. The skin is moist and weepy. Blisters form. Healing can take weeks. Scarring is possible.

Third-degree burns - full-thickness burns - extend through both layers of the skin. With second-degree burns, the skin peels from the body like paint from an old house. With third-degree burns, it is the siding itself that falls away, useless. In the worst cases, the injury reaches down to the connective tissues beneath, down to muscle and to bone.

Destruction is permanent. Healing can take years. Scarring is unavoidable.

Virtually all of George's burns were full thickness. They covered his face, his back, his chest, his arms, his hands. They reached down his buttocks and over his thighs and to portions of his abdomen. His feet, protected from the flames by his heavy rubber boots, were spared.

In the years to come, George's feet would prove useful in ways he never could have imagined.

It was about 4 p.m. when Vivian Zimmermann got the call.

It was Jack Bennett, George's nephew.

"George's been hurt," he said. "And I think it's pretty bad."

Viv was an administrative assistant at KU Corp., which provides executive services to a handful of companies. Its offices are handsome, quiet and discreet. She lowered the phone to its cradle in proper corporate style, then, to everyone's amazement, screamed.

It never occurred to her to ask Jack how George had been hurt. She knew. She had once worked for George as an office manager and understood what he did for a living. In Jack's voice, Viv heard the intonation of a long-held fear: George was burned.

But what that meant - the horrible biology of it - still remained an abstraction to Viv as she drove across town toward the hospital.

"Don't you dare die," she muttered to herself. "Don't you dare."

Almost immediately, the burned body begins to swell.

Not only at the wound sites, but everywhere. It is not uncommon, as in George's case, for the head to swell to three times its normal size within the first 24 hours. Some burn victims fear they have been blinded, their eyelids swell so tightly shut.

Burned skin is tight and leathery. It has no give, no stretch. It girdles the swelling body, compromising its already sluggish circulation. Sometimes, as in George's case, doctors must slice open the damaged skin along the arms, chest and legs - a procedure called an escharotomy - to give the bulging tissue beneath room to expand.

With large portions of its skin destroyed, the body expends massive amounts of energy as it struggles to maintain a steady core temperature of about 100 to 102 degrees. It will devour itself if it must to deliver the necessary energy to warm its core, absorbing its own muscle and hoarding the protein that might otherwise be used for healing.

The flow of blood to extremities slackens as the body concentrates on delivering fluid to its core. The heart swells from stress. The kidneys are overwhelmed and may stop producing urine, allowing impurities to build up, turning the blood toxic. The immune system stumbles, even as masses of dead and dying tissue invite infection.

Fluids, particularly plasma, leak from the body in quarts, soaking the burn victim's bedding.

One of the first tasks in burn care is to weigh the patient and estimate the percentage of his burns. Those numbers are then plugged into a formula that calculates how much fluid the burn victim will need pumped into his or her system during the first 24 hours. George needed about seven gallons.

Viv entered George's room wearing a mask, gloves and a yellow nursing gown that gathered at the wrists and tied at the back. George lay on his back, feet toward the door, on a mattress of porous air tubes. Minute streams of air blew through the skin of the tubes, lessening the friction of his body against the bed, drying the fluids that wept from his body.

A heater that hung from the ceiling above him was turned up high, and the room was exceedingly warm. Nonetheless, Viv couldn't stop shivering. Her legs shook. Her hands trembled.

She took one look at George, and fainted.

The long commute to work from her east side home was a hardship, especially for a divorced mother of two young children. Friends wondered why she didn't switch to St. Mary's, a hospital with a terrific program just five minutes away.

Every so often, the head of St. Mary's occupational therapy program would call Eileen, wondering the same thing. He'd offer her a job, but she always turned him down.

The reason: St. Mary's was a burn center, and Eileen did not want to work with burn patients. Their injuries were too devastating. Their disfigurement, too horrific. Their pain, overwhelming.

Eileen just didn't think she could handle it.

But after a drunken driver almost plowed into her car on her commute home from work one evening, Eileen reconsidered, and in 1989, she went to work at St. Mary's.

On July 25, 1995, Eileen watched a report on the evening news about a man who had been burned in an underground gasoline tank explosion. Remarkably, the man had survived and had been taken to St. Mary's.

Something inside her clicked.

When she arrived at work the next morning, she requested that she be assigned to the team of doctors, nurses, psychologists and therapists caring for George Bennett.

Three years later, Eileen still couldn't explain why. It was an impulsive act, and it would change her life.

Burned tissue is dead, its properties altered, denatured.

It will not heal. It will not grow back. It will only decompose or fall away, providing a swampy patina of necrotic material that, perversely, fosters infection while at the same time resisting the penetration of antibiotics.

Burned tissue must be excised. Cut away. As quickly and as extensively as the patient can endure.

The procedure - bloody and essential - is called a debridement.

On Aug. 2, 1995, surgeon Cynthia Pangallo hovered over George Bennett's body, which lay prone on an operating table, nestled by chest cushions and knee supports.

His dressings were removed, exposing his entire back. Full thickness burns - a mosaic of yellowish patches of waxy flesh bordered by char - extended from his lower neck, across both shoulders, reaching into his upper extremities, his flanks, through his waist area down to two large patches on his buttocks.

The room was exceedingly warm, a comfort to a burn patient's shocked system. But it is an irritation to the doctors, nurses and technicians, who for debridements sometimes wear additional layers of protective clothing because the operation is so bloody.

Using a flat rectangular knife - it looked something like a straight razor, something like a potato peeler - Pangallo began to slice, making smooth swipes over the broadly burned areas of George's shoulders and back.

All that was not healthy had to be removed. The only way for her to know whether she had reached viable tissue - vascularized tissue - was to keep cutting, deeper and deeper, until she encountered bleeding flesh.

In some spots, healthy tissue lay just beneath the surface. In others, it was buried deep under layers of lifeless eschar.

Hemorrhaging was checked by frequent spritzes of epinephrine, but still the blood flowed out, crayon-red rivulets that followed the folds in the surgical sheeting and dripped into shiny, dark puddles on the floor.

Pangallo's hands moved swiftly, gracefully, precisely over George's back, pausing only to change blades or deposit cellophane-thin sheets of tissue into a stainless steel pan.

In surgeries to come - and for George, there would be many - Pangallo would harvest skin from the few unburned portions of George's body and graft the tissue to freshly debrided areas.

But George was far too unstable for that now, and he would require a temporary skin until he was ready. For that, Pangallo would use cadaver skin.

As Pangallo finished her cutting, gloved technicians removed the cadaver skin from its steamy tanks of liquid nitrogen, thawed it in pans of water, then arranged the 4- by 10-inch rectangles on toweling sprayed with a saline solution.

angallo required 29 sheaths of cadaver skin to cover George's back, upper arms and buttocks, about 8 square feet. She placed the rectangles side by side, smoothed them down, trimmed them where needed, then stapled them in place.

When she was through, she covered the skin with a quilt of ointment-embedded gauze, which she stapled in place, then covered with a fine mesh dressing and sterile operative towels.

George was returned to his room, in stable but guarded condition, where he rested in the protection of his comatose state.

Flowers are not permitted. Flowers require water. Water nurtures infectious bacteria. And infection kills.

Six of the rooms are designed to provide critical care, and it's easy to tell them apart from the others: Rather than wood doors, they have doors of glass. Their wounded occupants are specimen-like in their display. Their vulnerability is apparent.

For the two months he remained in a coma, George inhabited Room 647. Behind his glass door, wrapped in pillowy gauze, cocooned deep within his injured body, George dreamed - oblivious to debridements, skin grafts, dressing changes, amputations and the daily parade of family and friends.

He dreamed of floating islands near Sturgeon Bay, of going to the movies, of a nightclub owned by Chinese doctors. He dreamed of going to a hospital and seeing a boy walking along the side of a road, of imaginary taverns owned by friends, of a hole in the ground that he followed to a cool blue lake.

But most of all, he dreamed of Vivian. In his dreams, they were married.

Vivian was the prettiest woman George had ever met. They dated eight years before he scraped together enough courage to ask her, on Feb. 26, 1994, to marry him.

They were in Vegas, at Caesars Palace, in the Palace Court restaurant. George had the rack of lamb; Viv, the shrimp. He wore a lavender shirt and a paisley tie. She, a gray sequined dress. She glittered and sparkled and smelled so sweet, and there were times that night that George looked at her and felt not dizzy, not spinning in orbit, not head over heels, but rather something more wonderful and surprising.

He felt clear-headed, grounded, certain. They had just finished dinner when two waiters appeared at their table, each with a domed silver platter.

Beneath the one for George was a piece of cake.

Beneath the one for Viv was a diamond ring.

A waiter placed a card at Vivian's elbow. A picture of two polar bears. Inside, it said, "Will you marry me?" Signed, two Xs, one O, George. The waiters put the platters on the table. They lifted the covers.

Someone snapped a picture.

After the accident, people wondered what Vivian would do.

Would she stay with George?

Wasn't it fortunate, they supposed, if something this awful was going to happen, that it would happened before the two were married, before commitments were formalized and difficult to withdraw.

But if Vivian ever entertained such thoughts, she shared them with no one. Later, she would tell George that it never occurred to her that she would do anything other than remain at his side.

Vivian's loyalty would be tested in the months to come, and she would exhaust herself managing George's business, holding down her own job and contributing all that she could to George's recovery.

Through the initial weeks of his injuries, George existed in his world, unaware of the yellow and blue lighted world of Vivian nearby. She missed him. And he, even in his dreams, missed her. It was as if they had gone on separate journeys.

Still, they kept their love in common, the way that lovers, separated by continents, still share a common sky.

The room number meant more to her than the name. Though just graduated from Marquette University's physical therapy program and on the job for less than a month, Lisa already knew what sort of injuries were treated on the sixth floor.

She got on the elevator and went to meet her first burn patient.

Lisa had trained at St. Mary's, but she had never seen anyone burned as badly as George.

His body was still horribly swollen, though most of its injuries were concealed beneath layers of fresh white gauze. His head was massive, discolored and hairless. A few days earlier, a surgeon had sewn George's eyelids shut to protect his damaged eyes. The silk sutures resembled eyelashes stitched onto a toy bear.

Lisa looked out the window, over the trees, over the rooftops of the neighboring houses, out toward the glittering lake. She examined the dozens and dozens of get-well cards taped to the wall and concluded that this George Bennett was somebody people liked.

Lisa found, taped among the cards, the picture of George and Vivian that had been taken in Las Vegas the night they got engaged. She tried to reconcile the two faces - the one in the picture with the one in the room. She couldn't.

She read through George's charts, took some notes, then performed some preliminary manipulations of his hips, knees and ankles, careful not to disturb new donor sites and fresh grafts.

George, of course, was still in a coma, or the pain of having these areas ranged would have sent him howling. The machines that monitored George's vital signs howled for him.

Perhaps it was the privacy of George's torment that touched her, or the vastness of his injury, but Lisa left George's room both moved and a little overwhelmed.

As she rode the elevator back down, she wondered if George would live through the night, if his name would be on her patient list in the morning.

From Lisa Hribar's personal notes:

Who was this man who lay so still before me? Communicating his agony through painful motionless silence.

Swollen legs, heavy w/ fluid, stiff and limp. Hot room. 85 degrees. In my yellow gown, gloved hands sweating as I ranged his heavy legs.

Eileen Riordan began to have troubling dreams about George, dreams filled with blood, skinned limbs, weeping wounds and swollen faces.

And though she knew her sessions, and Lisa's sessions, were a crucial preliminary to George's rehabilitation - if he survived - she struggled with herself every time she touched George and sensed his suffering deepen.

Why are we doing this, she wondered. Given the choice, could anyone injured to this degree possibly want to live? Eileen searched her own heart and concluded that she would not. It was difficult to imagine how anyone could feel otherwise.

Should George ever recover from his coma, Eileen wondered, would he be grateful?

For several days, George had been experiencing intermittent and somewhat stony periods of consciousness. In his fugue, nothing, no matter how ordinary, quite made sense. Nothing, no matter how bizarre, quite seemed unreal.

George accepted the world in much the same uncritical way that those who sleep accept their dreams.

He could hear the vacuum's hum push through the silvadine-soaked gauze that covered his ears. Unable to move his head, George followed the man with his good left eye.

The man emptied a wastebasket. Gathered up soiled linen. Straightened things a bit. The man smiled at George. George, who had no idea who the man was or what he was doing, smiled back.

On his way out the door, the man stopped and tore something on the wall. It was a calendar. He was changing the date. The calendar said, "TODAY is OCT. 8."

George thought, "That ain't right."

He was amused at first, then frightened. He tried to call the man back and apprise him of his error. With his tracheotomy, even though it was equipped with a plug that enabled him to speak, it was hard to manage more than a whisper.

For the rest of the day, George tried to absorb the date. October 8. October 8!

That evening, when Viv came in to visit, George wanted to know one thing:

"What's today's date?"

"October 8th," Vivian said.

George was stunned.

"What the hell happened to August and September?"

"You slept through them," she told him. "George, you've been hurt. There was a fire in the gasoline tank. You were hurt bad."

George didn't want to know any more.

Hurt bad.

It would take time to absorb that, too.

There would be more for George to absorb in the days that followed.

When nurses, therapists or doctors came into his room, they would frequently greet him by asking, "Do you know where you are?"

"Of course," he'd say. His voice a whisper.

"Where are you?"

"I'm in the hospital."

"That's right. You're in St. Mary's Hospital. In the burn unit."

George would nod and smile. Though he gave them the answer they wanted to hear, he knew in his heart of hearts that he was, in fact, at home, in his living room, playing some kind of odd game.

It was as if his mind was encamped on a beach separating an oscillating realm of dreams from an unfamiliar span of lucidity. George didn't know what to believe, whom to trust. He stood on sand, on uncertain footing, periodically bathed with fantasy:

He is at Cynthia Pangallo's house. There's a party. They're drinking and smoking cigars. Cynthia tells George to lie chest-down across her kitchen table. She takes out a knife and strips the skin from his back.

It was during this confused period that three doctors and a nurse came into his room. They lifted his left hand, peered beneath its mitt of bandages. They talked to each other, but George couldn't understand what they're saying.

Then they lifted his right hand. There were no bandages. The fingers were gone. Its pinched-off abruptness startled him. His hand. Not a hand. A lump of flesh.

George closed his eyes, said nothing to the doctors. How could he trust them? They were phantoms. They were ghosts. Their words, gibberish.

Yet, George knew somehow that what he had seen was real.

Throughout the afternoon, George told himself, over and over, "My fingers are gone. My fingers are gone. My fingers are gone. My fingers are gone."

When Viv came to see him that night, George told her: "They took the fingers off my right hand. It looks like a little frog's foot."

George's bed was huge. Viv's face crossed it, hovered close to his, kissed him.

"My fingers," he told her, "are gone."

"What do I look like?"

"You look pretty good."

"I'd like to see."

"OK."

The nurse walked to a corner of the room, removed a small rectangular mirror from above the sink. She brought it to George, held it for him in front of his face, a face he had tried to imagine but hadn't seen in months.

It was a balloon of scar and discolored skin floating above a collar of gauze. Eyes, mouth, nose holes and tubes. Not his. Not anyone's. The face that looked back at him from the hovering mirror was not a face at all. It was a mask, some kind of face-like thing.

At 49 years of age, George Bennett had been erased.

"I don't have any hair."

"That's OK. It'll grow back."

"I'm all red."

"That'll go away."

A pause. It would take time to absorb this.

"Well," George said. "Well. There I am."

"George is talking" was the talk of the department. Confused at times: relating instances of cars, fixing engines, bird in the room, puppy. Not oriented to time or place. ...voice speaking out from the body he could hardly move." '

By the end of October, some of the nurses had begun to wonder, now that George was talking, if maybe there wasn't some way to quiet him down.

It was nearly impossible to walk past George's room without being pulled in for a little conversation. And though the pain medications clouded his thought and his tracheotomy distorted his voice - it sounded like the voice of an elderly woman - the tide of chitchat that flowed from Room 647 seemed never to ebb.

"How many kids you got? You can't be a grandmother! What does this thing do? What's it like outside? What do you drive? Any boyfriends? Why does this smell like this? How do you like working here? Are you hot? They keep it hot in here. Turn down the heat if you like."

But always, always there was pain, a thick throbbing vein of it running just beneath the surface, easily aggravated and frequently punctured by skin grafts, dressing changes and bad memories.

At night, after Vivian and his kids had left and the floor quieted and the buzz of the hospital had lost its urgency, it was the loneliness that stung the most.

George dozed during the day. But at night, sleep eluded him.

Occasionally, someone might offer to turn on his television, but he preferred to keep it off, to lay propped up in his bed, his door open, talking with the night shift or passing the time alone, awake and vigilant, keeping watch over the burn unit until he felt the hospital come alive again and knew that it was morning, that it was safe to close his eyes, to rest.

As the days wore on, the thrill of having survived was hollowed out by the reality of what it meant to be alive: maimed, disfigured and always, always in pain.

One morning, Eileen came in to exercise George's arms. As she began to lift them, and the electric pain shot deep into his elbows and buzzed through his body, George's eyes narrowed.

"Get away from me," George told her. "Why do you have to hurt me like this? Get away."

I have to do this, Eileen explained, or you'll never regain use of your arms.

"Get out," George told her. "Get out."

Eileen left quickly, only to be followed by Lisa a few minutes later.

Lisa had barely come through the door before George backed her away.

"Don't touch me," he told her. "Don't touch me. Get out of my room. Go away."

That afternoon, George's pastor paid him a visit.

The Rev. Don Ellerman, of Calvary Memorial United Church of Christ in Milwaukee, listened to George vent his frustration. He knew George well enough to know that George was a practical man. When George asked why he had to suffer, he wasn't posing a philosophic question. He wanted to know what, specifically, his suffering would accomplish.

What's the point, George wanted to know.

"This is what you must do to get home," the pastor told him.

Home.

Researchers who have studied burn survivors have tried to isolate those factors that enable one person to endure what another person, with the same injuries, cannot.

They have found, among other things, that those who are supported by the love of family and friends are more likely to survive than those who face their suffering alone. Obvious, perhaps, but no less powerful.

George's family was devoted to him, and their affection mattered to him more than anything else. In the bustle of everyday life, George had taken their love for granted. It was a given. Part of the mix that formed the sum and substance of his life.

Now fire had reduced that substance to its most essential elements. George had little else left except his life and their love.

It was a painful lesson in alchemy, but redemptive. George would do everything in his power to return to home.

The next morning, when Eileen knocked on his door, he told her, "Whatever you have to do to get me home, do it."

They are in a world of their own, transported there by Versed and morphine. Of those who return, few can remember where they've been.

Their recovery, both physical and psychological, is slow and it is literal: The burn victim must be resurfaced.

With injuries as extensive and as deep as George Bennett's, temporary coverings are initially employed: artificial skins, pig skin, cadaver skin.

But these are merely stopgap measures, biologic dressings that reduce pain, slow scarring and keep wound beds healthy until a permanent graft can be harvested and placed.

As soon as George began to stabilize, surgeon Cynthia Pangallo began taking skin grafts from the unburned portions of his body.

Her tool of choice was an air-powered Zimmer dermatome, a hand-held device that enabled her to slice off sheets of healthy skin 3 inches wide and 12/1000ths of an inch thick.

Most surgeons prefer to apply the harvested skin in whole sheets, a technique that yields more function in the grafted area and a better cosmetic result.

But George's wounds were massive and his potential donor sites limited. Frugality took precedent over aesthetics. The grafts - from George's legs, abdomen and chest - were fed into rollers that meshed them with a diamond-patterned lattice, much the way steel sheets are meshed and then expanded into grillwork.

These thin sheets of George's skin were then expanded by a 1-3 ratio. Thus, one square inch of harvested skin could be stretched to cover three square inches.

With each harvest, the donor sites became open wounds, raw and excruciatingly tender. Each swipe of the dermatome exposed thousands of nerve endings, a sensation not unlike a second-degree burn. After 10 days or so, the donor sites would heal, only to be harvested again.

On Oct. 20, Eileen, Lisa and nurse Jennie Janke showed up in George's room, all three rubber-gloved, yellow-gowned and smiling.

"You're ready to stand up," Lisa said. It wasn't a question.

Eighty-seven days had passed since George sat down to die on the floor of an underground gas tank. Eighty-seven days since the last time he had heard a voice urging him to stand up.

He had tried to stand then but couldn't. He would try again now.

Lisa wrapped George's legs in pressure bandages. They would need all the support she could give them. It had been nearly three months since his legs had borne his weight, and they were a leaky patchwork of donor sites and skin grafts.

There were half a dozen tubes and lines that fed, drained and monitored George that had to be arranged. Then Lisa reached under the bed and fiddled with a red switch until she had let most of the air out of George's mattress, leaving just enough in to cushion his delicate backside.

It took all three women to get George seated upright, his blue-slippered feet planted on the cool linoleum floor. His head began to spin.

Eileen climbed onto the bed, grasping George beneath his arms while Lisa fashioned a sheet into a sling and slipped it around George's lower hips.

Then, with her toes planted in front of George's toes, with her kneecaps pressed against his, Lisa counted to three and the three women pulled George to his feet.

George stood for 17 seconds. It was long enough for someone at the nursing station to yell, "Hey, look! George is standing!" Long enough for the burn unit staff to rush to George's door. Long enough for someone to snap a Polaroid and for everyone to cheer.

And it was long enough for a smile to fix itself across George's face, though his eyes, focused straight ahead, tightened in pain. Blood rushed to his legs, oozing out his donor sites and skin grafts, soaking into his bandages.

George tried to deflect the pain with a small joke: "I'm standing, just like a preacher before his congregation." And when he felt he couldn't stand a moment longer, he said, "Are the pews full yet?"

Eileen, Lisa and Jennie lowered George to his bed. He was still smiling, but his face had turned bright red.

"How about that," he said. "I stood up."

The 17 seconds George spent on his feet left him exhausted. He laughed and joked with whoever stopped by his room to congratulate him, but he was through for the day.

Later, when Lisa changed out of her yellow gown, she found it smeared with blood where she had steadied George's knees against her own.

In the days to come, George would stand for 34 seconds, then 45 seconds.

He couldn't wait to tell Viv when he broke one minute.

Then he was taking steps, then walking, then climbing stairs. One afternoon, a nurse came into his room and asked to borrow his wheelchair. He never got it back.

George began meeting Eileen and Lisa in the mirror-lined physical therapy room on the hospital's first floor. One afternoon, Eileen arrived 10 minutes late.

"Where've you been?" George asked her.

"With a patient," she said.

"Oh." George felt a little irritated. Wasn't he her star patient? Weren't his injuries unrivaled? His needs most pressing?

Eileen took out a slip of paper and showed it to George. On it someone had typed:

"ABCDEFGHIJKLMNOPQRSTUVWXYZ"

"MERRY CHRISTMAS."

A woman's named was typed on the bottom.

"My patient," she said. "She's a 23-year-old quadriplegic girl, injured in a car accident. She made this for me and said that I could show it to you."

When George got back to his room, he sat down on his bed and felt ashamed.

"You know, George," he said. "Sometimes you forget how good you've really got it."

He would stand off to himself - usually he wore a pair of cut-off sweats and a blue surgical scrub shirt - and stare, stare the way he sometimes imagined others stared at him when he walked into a room.

There were times when he could hardly stand to look at himself. Yet, it was impossible to turn away. How could this be me? How could this be me?

More painful still: He tried to imagine what Vivian saw when she looked at him. Her beauty thrilled him. He had always been so proud of her when they went out together, proud of himself to be seen standing at her side.

Now: How could she bear to touch him?

And then he looked at his hands. The paddle of flesh on the right. The crippled thing on his left.

How could she bear to be touched by him?

"You know," he said to his scarred reflection, "you really, really screwed yourself up, George."

It was as if he was talking to someone he had once been close to but now no longer knew.

Primitive animals don't scar. They heal their wounds by mitosis, by regenerating exact duplicates of their missing parts.

Humans possess this power, but in a limited capacity. Cells in the liver can regenerate after mild exposure to toxins. Some nerves regenerate. Skin regenerates to patch minor scratches and burns.

But serious injuries overwhelm this capacity. Wounded humans scar. It is our primary method of repair.

When the body suffers injury - say a deep cut - special cells respond by forming a biologic glue out of collagen, a ropy protein that binds the healing wound together.

As the wound matures, collagen forms the primary ingredient in scar tissue. Under normal conditions, scar tissue remains within the boundaries of the wound and in time mimics the structure, even the color, of the tissues around it.

But critical injuries, such as full-thickness burns, trigger an outpouring of collagen that can billow into thick clusters of red scar tissue that continue to amass, even years after the wound has healed.

These types of scars, as crippling as they are deforming, are well named: keloid, from a Greek word meaning "crab's claw."

The treatment of burn injuries is to a large extent the management of scar.

Scar, both physical and emotional.

Skin grafts, compression garments and daily sessions with Eileen and Lisa helped George control the scars that covered his body. Viv, his family and his hospital psychologist helped him control the scars within.

But nothing was automatic. Nothing good came without struggle. The 17 seconds he stood with Lisa, Eileen and Jennie was one of the great moments of his life. The November day he pushed through the agony and touched his hand to his chin - which meant that soon he would be feeding himself - was another.

Each time he greeted a stranger without shame, each time he vanquished the small sickening voice that questioned how Vivian could possibly still love him, each time he looked at himself in the mirror and said, "That's me. Me," these were accomplishments, too.

But nothing was automatic. Nothing good came without struggle.

George understood this, put his faith in it, and tried with all his might, believing that if he worked hard enough, he would get better.

From Lisa's personal notes:

"Crash and burn.

"Like a foggy headlight - 1/2 as bright, 1/2 as clear. You get to the stop sign - which you anticipated and prepared for and realize you're not even at an intersection - no choice to even turn off the path you're on - no control.

"1.5 minutes, and my whole life has changed. I'm never going to be the same."

"Do you want to be alone?"

"You're my friend. You leave, then I'm really all alone.

"Deflated balloon, dusty cards now lay in a random collection in the corner of the room."

It came without warning.

It was late in the afternoon. A heavy, foggy day. George was in the therapy room, working with Lisa. A man walked up and said hello to George. George looked up from his mat.

At first George didn't recognize the guy. Oh, yeah. Now he remembered. He had been in the burn unit for a while and was now being treated on an outpatient basis.

The two men exchanged pleasantries, and as the man was saying goodbye, he told George to hang in there, things would get easier with time. As he walked away, the smile faded from George's face.

This guy had suffered injuries much smaller in scale than George's, was nearing the end of his medical treatments, and he looked absolutely horrible.

Is that what it meant to get better?

George clung to a not quite articulated fantasy that in time he would recover his pre-injured self. He looked at himself in the mirror and was overwhelmed with grief.

Who was he kidding?

He was never going to be the same. He was never going to be whole. He was never going to recover what he had lost.

He would always be wounded. Always be scarred.

How could that be?

George knew how to fix things. He could take a junked car, rusted and beaten to hell, and make it new. Better than new. In his hands, it could become something powerful and rare. Something beautiful.

Now he was junked. Unsalvageable.

He turned to Lisa.

"I'm never going to be George," he said.

And then he began to cry. He couldn't stop. It seemed like he cried for hours.

The truth, however, was more complex.

The psychological assault that accompanied George's burn was every bit as calamitous as his physical injuries, and equally slow to heal. There were days of almost exquisite suffering when it was unclear which inflicted the most hurt.

But what struck people who met George, who treated or worked or got better with him, was his willingness, always, to push further, and to endure whatever was required of him to get well enough to go home.

That, and his refusal to abdicate his decency, to become mean, stupid or unkind. George was a good and loving man before he was hurt. And he remained good and loving afterward.

In time, Eileen's dreams diminished then disappeared. In part, she simply got used to George's injuries. But there was something more to it than that.

Those who got to know George learned something that helped them feel fundamentally better and less fearful about life.

They learned that an injury, however annihilating, need not rob them of their love, their decency or their humanity.

They learned, in knowing George, that the things in life that they cherished most were unexpectedly resilient, and would endure.

From Lisa Hribar's personal notes:

"George brings a whole new feeling to the department, to the hospital. He readily welcomes others and all who stop to talk do not mind taking the extra time to spend with him.

"George gives back so much in return, leaving one with a feeling of unsurpassed satisfaction all channeled through the mere act of sincere appreciation. He never hesitates to give of himself, reaching out to others and unknowingly awakening hope and life within others."

Every day, it was the same routine: George would spend two hours with Eileen and one hour with Lisa in the morning, then spend another hour with Eileen, another hour with Lisa in the afternoon.

On Jan. 30, 1996, George arrived downstairs for his morning workout a little on the cranky side.

Someone had forgotten to bring him the French toast, bacon and juice he always had for breakfast. And when his meal finally did arrive, a nurse came swooping into his room, announced there wasn't time to eat, and that she would save a little something for him to have when he got back from therapy.

But when he got to the door of the therapy room, there was Lisa with an unusually big smile on her face. And just inside the door was Eileen, also smiling.

"What?" George asked them.

He stepped in. Someone snapped a picture. Everyone yelled, "Surprise."

A going-away party. George was going home.

There were muffins and doughnuts, coffee and juice, and for George, his favorite: a sausage Egg McMuffin.

Everyone was there, and there were plenty of long embraces and plenty of tears.

Over the six months, four days and 14 hours George had spent as a patient at St. Mary's Hospital, they had cared for him, guarded him and protected him.

They had contained him and shielded him through the most difficult passage of his life. They became what he needed most:

They became his skin.

Each small thing required a plan: the ritual of toileting, the ritual of getting dressed, the ritual of eating breakfast. Then, the trip to St. Mary's for daily sessions with Eileen and Lisa. Then home again, to rest and to wait for Vivian.

As patterns emerged, George found solace in them. It was easier to focus on the task at hand, on whatever needed to be done, that day, to get better, and not to think about the years to come, or the uncertainty that came humming to the surface during unexpected moments.

Lisa asked George what it felt like to be home.

"I almost feel human again," he told her.

Almost.

What bothered George, and bothered him deeply, were his hands, the mitt-shaped paddle of flesh on his right, the maimed monstrosity on his left.

George worked with his hands. He defined himself with their labor. Their floppy uselessness confounded his most basic sense of what it meant to be human, what it meant to be George.

"How can I live without my hands?" he asked Vivian.

On his way up to bed one night, George paused at the bottom step to pick up a pair of Vivian's shoes and to carry them to their room.

It was a small gesture. That he couldn't grasp them caused George to feel, somehow, ashamed.

In late February 1996, George and Vivian met with microsurgeon Hani Matloub, who suggested something that struck George as bordering on science fiction.

Matloub, a hand specialist at Froedtert Memorial Lutheran Hospital, proposed removing the second toe from George's right foot and using it to reconstruct a functioning thumb on George's right hand. Later, he proposed, he would remove the second and third toes from George's left foot and transfer them to the middle and ring finger positions of his right hand.

The procedure, pioneered in the late 1960s and early 1970s, had been advanced in recent years by microsurgical techniques that yielded reconstructed digits possessing not merely function, but also feeling. George would lose some function in his feet, and the rehabilitation program for his new fingers would be tedious and demanding.

Still, if all went well, George would be able to pick up a tool. Sign his name. Pull up his socks. Hold Vivian's hand.

"And what if I want go somewhere and have my nails done?" George asked Matloub. "Do I ask for a manicure or a pedicure?"

Matloub and microsurgeon Lawrence Sterkin completed the toe-to-thumb transfer that April. They would undertake the second set of transfers near the end of October. In between those surgeries, George began preparations for a new nose.

On July 30, 1996, Sterkin implanted a small balloon just beneath the surface of George's forehead. Over the next several months, he inflated the balloon with periodic injections of a saline solution, expanding the skin around it.

In time, Sterkin would construct the framework of a nose from pieces of cartilage harvested from George's ears, then cover the structure with a flap of tissue cut from the expanded skin of George's forehead.

Meanwhile, George tried to get accustomed to walking around with a toe sticking out from where his thumb used to be and a Twinkie-sized bubble of skin protruding from his forehead.

In October, George got a call from a neighbor, Gary Zurn.

Every year, Gary emptied out his barn and threw a gala Halloween party. He wanted George and Vivian to come. George said they'd try.

Ten months had passed since George was sent home from St. Mary's. Once the grand extrovert, now he rarely went out in public, and he restricted his socializing to gatherings at home with close friends and family.

It was a pattern George longed to break, and a Halloween party seemed like a safe place to begin.

It was past 10 p.m. by the time George and Vivian parked their car outside Gary's barn. Viv got out, dressed like a black cat, with whiskers painted across her face. George got out, dressed like Frankenstein, with plastic bolts stuck to his temples and cartoonish scars painted over the real ones.

Gary had built an elaborate maze at the entrance to the barn, a tunnel of horror guests had to pass through to get inside.

There was a panicked moment, just before George entered the maze, when he thought that maybe this was a mistake, that he and Vivian ought to go back home.

But as they worked their way through it, Vivian holding George's hand as they bumped into dead-ends and mirrors, George could hear the music getting louder, the voices of his friends more distinct.

George felt flush with excitement.

He could hardly wait to get through the tunnel, to come out on the other side.

He finished the deck, pruned back some of the shabbier trees, then, with his usual thoroughness, cleared away the brush from a path that led from the deck to the far end of his property. And when he was through, he put a chair out on the deck, sat down, and had a beer.

Perfect.

It was nearly a year before George saw the cabin again.

It was Memorial Day weekend. George was still on the mend from his first toe-to-hand transfer, but he felt well enough to drive up with Viv - with George thrilled to be doing all the driving, thanks to his newly installed thumb.

The first thing George wanted to do was take a walk down the path, but his heart sank a little when he stepped out on the deck and saw that it was nearly choked with brush.

"I'm going anyway," he told Viv. She bent down and tied the laces on his black Converse basketball shoes.

"Be careful," she said.

George had hunted the area for years. He figured he could make his way down a path.

But George hadn't gone 200 yards before the brush picked the laces loose on his right shoe. Irritated, he kept going. A few yards farther, and his shoe pulled off completely.

It was a serious problem.

George couldn't simply bend over and pick it up; his hands had no grip. He couldn't sit down and jam it back on; he would be unable to get back up. And he couldn't walk back to the cabin in his sock; that would risk stabbing the surgical wound on his right foot on a stone or twig.

At last he was able to lean against a stump and - gently, gently - stuff his foot partially into his shoe. Afraid that it would fall off again if he lifted his step, George limped back toward the cabin, dragging his foot along the ground.

By the time George got there, he was wild with frustration.

Vivian was sitting on the deck, drinking a Diet Sprite.

"Back so soon?" she asked.

George had spent months in the hospital, fantasizing what it would be like to be home. He just sort of assumed that things would pick up where they had left off, modified a little to accommodate his injury.

But things were completely different. Not that home was so different. He was different. And being home made the difference painfully clear.

The cabin had been where the old George had hunted and fished and messed around in the woods. The new George couldn't step off the back deck without becoming helpless.

George loathed what the cabin said he had become: a pathetic cripple.

And, at that moment, he loathed Vivian; he loathed her for being unchanged, he loathed her for being so crucial, he loathed her for loving him.

So George told Vivian to get out of his life.

And he told her a dozen other painful hot ugly things he hoped would push her away. He cursed her and wept. Vivian listened, and said almost nothing.

"Get out," he told her. "Get out."

And when he was through, and George sat exhausted in a chair in the living room, Vivian put a couple of steaks on the grill and cooked some dinner. She cut up his food and helped feed him, helped him use the bathroom, helped him to bed.

And in the morning, when George woke up, Vivian was there, her leg pressed against his own, asleep at his side.

It was Viv who selected the scripture that Pastor Don read, his voice pleated with emotion: Song of Solomon, Chapter 8, verses 6 and 7.

"Set me as a seal upon your heart, as a seal upon your arm; for love is strong as death, passion fierce as the grave. Its flashes are flashes of fire, a raging flame. Many waters cannot quench love, neither can floods drown it."

Everyone who had played a role in George's recovery was invited to the wedding, from a passer-by who helped yank George from the gas tank to the doctors who reconstructed his right hand.

They filled the church, and afterward, a ballroom at the Pfister Hotel. During the reception, George stood up and thanked them all, individually and by name. It was a lengthy speech, and at the end of it, George said:

"I had this real nice resident doctor. Just a delightful guy. Straight shooter, and he talked a lot.

"He came into my room one day, got finished watching his favorite soap opera and started looking through some of my records. He said, 'Well, it looks like you're going to make it.'

"And I said, 'Make it?'

"And he said, 'Yeah, you're over the top of the hill.'

"And I said, 'Top of the hill?'

"What he was saying was, you're going to live. You're going to live, George.

"He said, 'You're on top, and it's all downhill from here. You're going to get better.'

"Then he said, 'But it's a long hill.'

"Meaning, have patience.

"If I could expound on that a little, and paint you a picture of how I see things now:"

"Here we are, coming down this hill, Vivian and I. And we're riding a little soapbox derby kind of car. And we're coming down this hill. And we're laughing.

And it's fun. The wind is blowing in our hair, and we're on our way. And it's a great and enjoyable time.

"But we realize something: That little car of ours didn't just get on top of that hill. And Vivian and I couldn't have done it ourselves. It took a lot of pushing and pulling from all of you, and many more.

"And isn't that just how it is: You go up hills, you come down hills. And the more people you have pushing and pulling, the higher the hill and the longer the ride.

"We expect to have more hills to go up and down on in our lives. But in the meantime, if any of you would like to take our little car for a ride, we would gladly help push and pull it up a hill for you."

With that, George took Vivian's hand into his own and led her to the dance floor. They paused a moment, held each other, each grateful for the other, male and female, man and woman, husband and wife.

And then they danced.

Peter Brigham, president of the Philadelphia-based Burn Foundation, cites something called the Lethal Area 50 as an illustration.

The LA 50 is a statistic that is defined by the size of a burn injury lethal to half of all burn patients.

Twenty years ago, for example, average burn patients with injuries to a little more than 30% of their bodies had a 50% chance of survival. Today, average patients with burn percentages in the mid-70s have a 50% chance of survival.

In other words, the LA 50 has risen from the low 30s to the mid-70s in the past 20 years.

Most people would agree that this dramatic climb in the LA 50 is a good thing, a medical victory. Most people begin with the assumption that life is preferable to death.

But George's story challenges this assumption, even as it affirms it. Consider what George's story might have been if there hadn't been Vivian to give him reason to re-inhabit his body, or St. Mary's to minimize his hurt, or Lisa and Eileen to give him the benefit not only of their skills, but of their friendships as well.

"I'll tell you what I am," George likes to say.

"I'm just one lucky s.o.b."

Aug. 31, 1998.

It's the Burn Center Golf Invitational at the Grand Geneva Resort & Spa in Lake Geneva, and three electric golf carts come humming down the fairway of a par five hole. They stop behind a ball about 18 yards shy of the green. Five men get out, clubs in hand.

There's George and George's son Clay. There's George's brother Fred and Fred's son, Jack. And there's Vivian's boss, Bill Koehn. The men are playing one ball scramble, which means they take turns hitting their shots, then select the best lie of the five and hit their next round of shots from there.

It is their third shot on the hole, and they are about 75 feet from the flag. "Go for it, George," says Fred.

George drops his ball on the ground and lines up with a 7-iron.

A few weeks earlier, George told Eileen he really wanted to play in the annual tournament, which raises money for the burn center and for the Wisconsin Alliance for Fire Safety's Camp for Burn Injured Children.

Eileen, a decent golfer herself, had the grips removed from George's clubs and replaced with beefier putter grips. Then she carved notches in the grips so that the clubs would fit in George's hands.

"I'm gonna hit one just for fun," George says, lifting the club and then setting it down again. "See what happens."

George takes a little practice swing, scuffing the turf beside the ball. He makes a few minor adjustments, mental mostly, then begins his backswing in earnest. There's a pause, then THWACK!

It hadn't been George's finest round of golf. There had been drives that hadn't made it much farther than the women's tees, putts that rocketed pass the cup, chips lost in tall grass and woods.

But this one.

This one lands on the apron of the green, bounces prettily, then heads straight for the hole. As it rattles into the cup, it creates its own little staccato of applause.

Crocker Stephenson, 43, is a special projects reporter for the Milwaukee Journal Sentinel. He has won many awards for stories on topics as varied as welfare reform, urban violence and nursing home reform. A 1985 graduate of the University of North Carolina - Chapel Hill School of Law, Stephenson and his wife have four children, including 2-year-old twins.