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"It's clear the Burn Center saves lives. But we try to save the rest of the person's life."


A Firm Foundation

Therapists and nurses from Bayview's Center for Burn Reconstruction
ease the trauma and promote healing of burn patients with cosmetics.

Still facing two more surgeries, Rhunette Fisk thrives under the tender touch of occupational therapist Michelle Ober, center, and physical therapist Debra Stillman. Not satisfied with the color of the lipstick applied to Fisk's lips during her first make-over, Stillman went shopping and found another lip color for "Ms. Fisk."

The four reconstructive surgeries Rhunette Fisk has had since an arsonist set fire to her home on a cold night in January 2001 haven't erased the physical and psychological scars she carries. Fisk, 54, still hesitates to leave her home to shop, eat out or visit with friends. She feels the stares, sees the finger pointing and hears the breathless gasps.

A weekly support group at the Baltimore Regional Burn Center at Johns Hopkins Bayview Medical Center helps her answer invasive questions and insensitive reactions without anger. But this summer, a new therapy was introduced that may help prevent the painful encounters from happening in the first place. Called corrective cosmetics, it has brought a little Hollywood glamour to East Baltimore.

"I love it," says Fisk. "It makes me feel great."

For years, a former Burn Center employee, who was a part-time model and cosmetologist before she suffered facial burns, taught patients how to use make-up to camouflage their scars and graft lines as part of the developing comprehensive burn care program at the Burn Center. But when she left in 1995, the lessons abruptly ended. Last spring, Robert Spence, the director and founder of the Center for Burn Reconstruction, sought to reinstate a comprehensive image and behavior enhancement program at Bayview, making it the only hospital on the East Coast to offer this unique blend of therapies.

"It's clear the Burn Center saves lives," Spence says. "But the Center for Burn Reconstruction tries to save the rest of the person's life."

He secured a grant from the Community Fund for the Baltimore Regional Burn Center, a charitable foundation associated with the Burn Center, to pay for the make-up and training in corrective cosmetics and behavior enhancement provided by Barbara Quayle, a burn victim and psychologist at UC Irvine Medical Center. In addition to the cosmetics training, Quayle's course taught therapists methods burn survivors could use to respond to difficult social situations with the general public. The therapy could reach more than the 300 patients who annually come through the Burn Center, Spence says, because hundreds more from around the country and the world are treated at the Center for Burn Reconstruction.

"Every patient who has had this done looks terrific," Spence says. "They feel so much better about themselves. But Barbara spent a great deal of time with the therapists instructing them how to help burn survivors modify their behavior in social situations. Even with corrective cosmetics, they still get the questions and the stares."

The grant covered the cost of training seven therapists, and nurses in the art of make-up, everything from redrawing eyebrows to creating full lips. They work with Cinema Secrets, a line of cosmetics developed and used by Hollywood make-up artist Maurice Stein on stars like Barbra Streisand and the actors from "M*A*S*H". Also used for special effects, the make-up is thick enough to even out the discoloration caused by the scars and the redness that erupts following a graft procedure. It also has staying power. "It lasts for hours, even under heavy lighting and sunlight," says Debra Stillman, a physical therapist at the Burn Center and project coordinator who also wants to offer the therapy to those who have scleroderma and lupus.

Since the training sessions, Stillman and her colleagues have collaborated on the make-overs of a half-dozen patients and taught patients how to apply the make-up themselves. More patients are being scheduled as the staff grows more comfortable in its ability to do a make-over without a partner.

Rhunette Fisk benefitted from the team approach when she had a second make-over. After Stillman coated Fisk's right side with a dark foundation, occupational therapist Michelle Ober took over to fill in on the left. Before they moved on to the setting powder, they studied Fisk's face for gaps or heavy handedness. The give and take between the therapists wasn't just a learning lesson for them. Fisk picked up on the techniques, too. Next time, she will begin the practice of doing one-half of her face while a staff member does the other side so that she will have the experience and confidence to eventually do it all on her own.

Therapists like Stillman and Ober are hoping that another grant Spence has requested is awarded so they can do community outreach, purchase more cosmetics and aid young burn survivors at the Mid-Atlantic Burn Camp in Virginia.

The program has been therapeutic as well for the participating therapists and nurses, says Stillman, because it is one way they aren't asking their patients to do painful exercises. Plus, "it is important to rehearse with them how to respond and to be prepared for questions. But it's better for them not to be the target of the remarks. With the make-up, they won't be."

"We are giving them confidence," adds Michelle Ober, an occupational therapist, "to show themselves in public."

-Seana Coffin



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