Tragic Fire Inspired Healing Career

A note buried amid myriad plaques and awards on the wall of Dr. Richard Grossman’s office seems to summarize the frenetic life of one of Southern California’s most respected burn doctors.

It was written about 15 years ago by Grossman’s son, Jeffrey, on a night when his father had missed another dinner at home. The doctor had been called to duty at Sherman Oaks Community Hospital to treat four families burned in a fiery explosion when a gas truck lost its brakes in the Sepulveda pass and smashed into their homes.

“Dear Dad, I hope that these people feel better,” Jeffrey wrote. “I pray for them. I hope you come home EARLY TONIGHT.”

Not likely.

Consumed by Work

A plastic surgeon, Grossman, 52, is director of the Sherman Oaks Community Hospital burn center, the largest privately financed burn ward in the nation, with 30 beds. Described by his colleagues as a first-rate doctor consumed by his work, Grossman typically rises at his 63-acre Hidden Valley ranch at 4 a.m., is on the job by 5 a.m. and labors away until 7 p.m.

It is a 14-hour-session dominated by the macabre.

In a single day, Grossman, assisted by a team of doctors, nurses and technicians, may perform numerous surgeries on critically burned patients, delicately removing dead skin tissue from a wound and replacing it with healthy skin from another part of the patient’s body.

The victims range from a child who pulled a pot of boiling soup from the stove onto himself, to an industrial worker who suffered an acid burn when a pipe burst, to a man who mistakenly threw gasoline instead of lighter fluid on hot barbecue coals.

In between those surgeries, the gray-haired Grossman walks across Van Nuys Boulevard to his office, where he examines 25 to 30 patients a day for cosmetic surgery. In his private surgery center, which has five beds, Grossman takes knife in hand and alters noses, thins baggy eyelids and reduces breasts.

Additionally, Grossman, who also is a general surgeon, performs reconstructive surgery on individuals who have had cancerous tumors removed from their faces, necks or breasts.

“He’s a workaholic,” said Claude Thompson, a surgical technician who works with Grossman. “I can’t believe his energy level. He’s got a lot more energy than me, and I’m 10 years younger.”

Grossman describes the job as “a Dr. Jekyll and Mr. Hyde” existence.

“In the morning, I do the eyelids and boobs to make people feel good about themselves. And in the afternoon, I do this,” he said, pointing to an unconscious patient undergoing a grisly skin graft.

The pace has taken its toll. Twice divorced, Grossman said his wives grew tired of “playing mistress to a job.”

“I’m probably married to this job,” he conceded.

Grossman describes burn wards, with their charred, bleeding and bandaged bodies, as the “most repugnant places on earth.”

“I didn’t want to do burn work. . . . No plastic surgeon does,” Grossman said. “I’d rather do noses and eyelids.”

1958 School Fire

But the course of his life was determined in 1958, when a fire swept through a parochial elementary school in Chicago, killing 89 children and four nuns. Grossman, who was serving his residency at Cook County Hospital in Chicago at the time, said his responsibility was to “peer inside paddy wagons and decide if it was a boy or girl.”

Grossman reasoned that he could develop a skill that might help save lives of critically burned patients. “That’s why I started the burn center,” he said.

Sherman Oaks Community Hospital is owned and operated by Nu-Med Inc., a hospital corporation. The burn ward, which Grossman established in 1969 with two beds, now treats about 400 patients a year, 100 of them children. On the average, seven or eight patients die each year, Grossman said.

“That’s a really low number, but it’s still seven or eight patients,” he said.

“I blow up when I’m losing someone. And when it’s a baby, I agonize. There are no acceptable deaths. You always wonder if there was something more you could have done.”

Grossman, who is quick to credit other doctors and nurses who work alongside him, rattled off a list of unpleasantries about burn work, but had difficulty articulating the job’s attractions.

He explained, simply, “You develop a skill and you want to use it.”

His friend and colleague of 15 years, Dr. Harvey Kulber, a plastic surgeon who serves as the burn center’s ear and nose specialist, offered his own theory.

“There are a lot of perks in it--a lot of satisfaction,” Kulber said. “Knowing that you got someone back into society and helped him function is very rewarding.”

Stephanie Sinanian Case

Kulber cited the case of Stephanie Sinanian, an 11-month-old girl who suffered third-degree burns over 85% of her body last September when she fell into a bathtub of scalding water. When she was admitted, doctors gave her virtually no chance to survive. Eight weeks later, the “miracle baby” was released from the hospital in time to spend Thanksgiving at home with her family.

“When she was first brought in here, none of us would have bet that she would live,” Kulber said.

Stephanie’s survival helped the burn center staff overcome the memory of a house fire three years ago that gravely injured three children in one family.

“We kept them alive for three to four months, but they eventually died, one after the other, right around Christmas,” Kulber said. “That was really tough. We needed to win one. Stephanie was our win.”

Grossman said his rare vacations seldom last longer than a week.

“It’s not a case of being a working machine, but I’m like a kid out of school,” he said. “I love it at first, but after a week, I’m calling the office, asking, ‘Hey, guys, what’s happening?’ ”

Grossman’s casual gait belies his hectic schedule. And his slight build reveals nothing of his nutritional habits. His release, he confesses, is junk food.

“I drink six Coca-Colas a day and eat nine peanut butter crackers every day,” he said. “The Hostess Co. and I are good friends. Give me a Ding-Dong, and I can do three more surgeries.”

Escaping to his ranch, where he breeds cattle and has raised a 700-pound pig, allows him to regenerate, Grossman said.

Most Famous Patient

The burn center’s reputation for quality medical care attracts patients from throughout Southern California and beyond. Because a week’s treatment can run as much as $16,000, patients are required to show proof of medical insurance to be admitted. Indigents and those not covered by medical plans are referred to the burn facility at County-USC Medical Center.

Grossman’s most celebrated patient was comedian Richard Pryor, who spent six weeks at the center in 1980 after suffering third-degree burns over 50% of his upper body in an explosion at his Northridge home. The accident allegedly occurred while Pryor was using ether to purify a batch of cocaine--a process known as “freebasing.”

As testimony to the center’s drawing power, one patient being treated last week was Dr. Thomas Shaver, who runs the trauma center at Mission Community Hospital in Mission Viejo with his partner, Dr. Michael Kennedy.

Fire on Boat

Shaver and his 16-year-old son, Steven, were critically injured March 31 when a gasoline fire ignited on their boat in Dana Point. Shaver’s colleagues at Mission Community Hospital, which is not equipped to treat serious burn victims, telephoned Grossman and asked him to fly down by helicopter April 1 to examine Shaver.

The two Shavers were transported by helicopter the next day to Sherman Oaks. Steven was released last week, but his father is expected to remain hospitalized another week.

The surgeon was effusive in his praise of the burn center team.

“I’ll tell you this, it’s hard to match this place,” Shaver said as he showed off his grafted arms and hands, which were healing faster than he had expected. “This unit, man per man, is incredible.”

And, referring to Grossman, Shaver said, “There’s no way in hell you can make a unit like this work without someone who is motivated like that. This is probably the most difficult kind of center to hold together because of the complexity of care.”

Dr. Bruce Zawacki, director of the 37-bed burn unit at County-USC Medical Center, the oldest burn center in the country, said Grossman has “an excellent reputation in caring for seriously burned individuals.”

Zawacki said Grossman has conducted research in two important areas of burn treatment--the attempt to grow skin in a laboratory and the use of a high-pressure oxygen chamber to speed the healing process.

The hyperbaric chamber is a tubular device in which burn patients lie for one hour, twice a day, and receive massive doses of oxygen to hasten the growth of new skin. Use of the chamber, however, has not been widely embraced by burn doctors, and its doubters include Zawacki, who said he is unsure of the device’s effectiveness.

“The hyperbaric remains, at least to me, unconvincingly proven,” Zawacki said. “But I’m not aware of any damage it has caused.”

Research Foundation

Grossman acknowledged that the chamber is not a life-saving device but said the center’s statistics have shown that it helps reduce the patient’s stay in the hospital and the time it takes for the body to grow new skin.

Grossman two years ago helped establish the Foundation for Burn Research in Sherman Oaks, which is experimenting with a new concept to grow skin in a laboratory to aid in massive grafting cases.

Doctors and researchers at several major burn centers throughout the country have been working on the cloning procedure, in which small pieces of an individual’s own skin are treated in a culture with antibiotics and allowed to grow into pieces three by four inches. However, Grossman said, many critically injured burn victims die within the 35 to 40 days that it takes for the piece to grow.

The procedure received widespread media attention last August, when doctors in Massachusetts successfully used laboratory-grown skin to treat two young brothers who were gravely burned.

Grossman said he has cloned skin in several small cases in which the burns were not life-threatening, but is still working to perfect the procedure for extensive wounds.

He is optimistic that the cloned skin will someday enable the hospital to save some of the patients who now die as the result of burns.

“If we had the skin surrogate, it would be terrific,” Grossman said.

“Sometimes you think about a 70- or 80-year-old man who got burned in a nursing home accident. If he’s lived a full life, you become philosophical about it. But you can’t say that about a 6-year-old kid.”