By Maureen Gilmer, IU Health senior journalist, firstname.lastname@example.org
First, she told her mom she was sorry.
Later, she said, “I don’t want to die.”
Sarah Zofkie cries when she remembers these moments with her daughter from just a few weeks ago.
Natalie Zofkie was rushed to Riley Hospital for Children at IU Health in critical condition, burned over 93% of her body. And yet, she was conscious.
It was Oct. 4. She had been spending the night with a friend, and they wanted to make s’mores over the fire pit in the backyard. Natalie, 11, made a mistake that would change her life forever.
She poured gasoline onto the fire, her mom said.
Fumes from the gas can enveloped her and fire quickly engulfed her.
As her young friend watched in horror, Natalie ran screaming into the house, where a quick-thinking adult pushed her to the floor, rolled her in a rug and wrapped her in a blanket, smothering the flames.
“If he hadn’t acted as fast as he did, she would have died for sure,” Sarah Zofkie said during a phone interview last weekend.
Her daughter is three and a half weeks into a grueling, painful recovery at Riley. But she is alive in no small part due to the heroic efforts of the hospital’s burn team, led by Dr. Brett Hartman.
“Natalie was one of the sickest patients we had in the hospital when she arrived,” Dr. Hartman said. “She was in a critical state. We got a breathing tube in right away, and she received 19 liters of fluid over the first 24 hours.”
With a burn that significant, he said, the human body is unable to control heat and retain fluid, so patients are given massive amounts of resuscitative fluid to save vital organs.
A FIGHTING CHANCE
Before Dr. Hartman got to the hospital that night, he had been told her burns covered 100% of her body surface – an unsurvivable injury. After taking a closer look, the team determined it was closer to 93%. That would give the burn surgeon and the young girl a fighting chance.
Still, most of her burns were third-degree burns, meaning they penetrated deep into the layers of skin and into fat, he said. All of that tissue had to be removed before he could begin the process of covering her with temporary skin, then grafting skin from the small parts of her body that were not burned – her scalp and under her arms.
“Using those areas, I’m able to cover her entire body using the advanced technologies that Riley has here in our burn center,” Dr. Hartman said, relying on a combination of her own skin, spray skin and cultured skin, which is “grown” in a Boston lab from small pieces of her own skin. That new skin comes back in pieces the size of playing cards, and he expects she’ll need about 100 pieces to finish covering her body.
“Using all of those advanced technologies, we’re able to save her life. She has just enough skin for us to be able to do that,” he said.
Natalie’s face was left untouched by the fire – a miracle in itself. In fact, when Sarah Zofkie first saw her daughter in the emergency department, she was momentarily confused. Natalie looked like Natalie, and she was awake and talking. The Noblesville sixth-grader knew where she was and what had happened.
It wasn’t until Sarah learned the extent of her injuries that she understood her baby girl might not make it.
“I told her it’s going to be OK, and I told her to pray.”
“FUTURE IS FOREVER CHANGED”
Today, Natalie, who loves “Grey’s Anatomy,” “The Office” and singing, is about halfway through the numerous surgeries required to replace her skin, Dr. Hartman said. He has been amazed at her strength through it all.
“Every step of the way, she’s been fighting and fighting. Her future is forever changed, but she has a great support system, and I think that will make all the difference to help Natalie get through this horrific injury.”
Besides her mom, Natalie’s biggest supporters are her three older siblings and her dad, Michael Zofkie, who jumped on a plane from Florida when told about his daughter’s accident. He and his former wife have been alternating visits to be with their daughter, due to visitor restrictions put in place because of COVID-19.
Zofkie, who has shared many messages, stories and Scripture readings on social media since the accident, says his little girl is a true champ.
“Natalie has a fighting side of her that I’ve never seen,” Michael Zofkie said in a phone call from the hospital. “I’ve never seen anybody take what this little girl is getting and then open her eyes, see me and tell me that she loves me.”
Natalie’s hospital room walls are plastered with large photos of her with friends and family, along with cards from well-wishers. It’s one way of letting her care team know who is underneath all of those bandages.
But the nurses, doctors and other team members see beyond the burns. They see Natalie.
“They are the most compassionate, intelligent people, combined with a bedside manner and customer service attitude that makes Disney look ridiculous,” Michael Zofkie said.
As bad as the situation is, Sarah Zofkie agreed that her daughter’s nurses have been a blessing.
“Oh my God, those people are just amazing,” she said. “They come in there with smiles on their faces, and they make it not horrible. I don’t want to get in their way, but they’re so good about telling you what they’re doing, why they’re doing it and what the plan is. I can’t say enough good things.”
Natalie likely will remain in the burn unit at Riley for several more weeks, before being transferred to Riley’s in-patient rehab unit, where she will receive intense therapy to learn to walk, eat and care for herself again.
She turns 12 on Nov. 11.
While her injuries are among the most severe he’s seen in a child, Dr. Hartman said about 20% of the burn injuries at Riley involve someone pouring gasoline in or near a fire, as well as kids getting burned while playing near bonfires or fire pits. Adult patients he sees at Eskenazi Health often have suffered similar injuries after using gasoline when burning trash or brush.
With autumn a popular season for bonfires and fire pits, fire safety experts advise everyone to follow strict guidelines to prevent injury. Tips include:
- Make sure it is not too dry or windy for a fire.
- Never leave a campfire or brushfire unattended. An adult should supervise at all times.
- Keep a bucket of water and shovel nearby to extinguish the fire.
- Never put anything but wood into the fire.
- Never use an accelerant such as gasoline, diesel fuel or kerosene.
- Don’t pull sticks out of the fire.
- Keep a safe distance from the fire at all times.
If an injury does occur, Dr. Hartman said the familiar refrain “stop, drop and roll” really does work to extinguish the fire.
Natalie, who was supposed to compete in her first gymnastics meet last weekend, faces long days of treatment and therapy at Riley. She wouldn’t be human if she didn’t sometimes get agitated, but she has done everything her care team has asked her to do, her mom said.
Dr. Hartman offered the same assessment.
“She is extremely tough,” he said. “She has tolerated everything we’ve done to her up to this point. She’s been here close to a month and she is doing great.”
Plenty of challenges lie ahead, but the surgeon is confident in his team and in the fighting spirit of his patient.
“I can’t say enough about the burn team,” he said. “The care they provide is amazing. I couldn’t do it without them.”
And while her accident will be a life-changing event for Natalie and her family, Dr. Hartman finds inspiration in his young patients.
“I see a lot of success stories come out of Riley for us and our burn team. Those kids are some of the most resilient I see.”
Twenty years ago, the story likely would have ended differently, he added. But because of advanced technology and the dedication of the Riley team, Natalie is alive and Dr. Hartman believes she can look forward to an excellent quality of life.
Even when Natalie goes home months from now, she will need to continue rehab daily at home, Dr. Hartman said.
“She’ll see us probably two to three times a week for additional rehab, and that will last up to a year. But Natalie will be my patient for the rest of my life and the rest of my career here. As she grows, that skin may not grow at the same rate; the skin can sometimes get tight and she would need further surgical interventions to help with mobility down the road.”
For now, as her family stands vigil by her bedside, Natalie continues to fight for her life and for a chance to be a kid again.