Anthony Quinn as a toddler

Anthony Quinn was 8 months old the day a candle tipped over, igniting a nearby curtain and engulfing his Park Heights home in flames. It was Dec. 1, 2003. His mother had gone grocery shopping, leaving him with his sisters, ages 6 and 3, in a home lit by candles because it had no electricity.

His older sister managed to carry out their 3-year-old sibling, but when she went back for Anthony, the flames and smoke had gotten too dangerous. By the time firefighters put out the blaze and found Anthony in a closet, he had serious burns over his arms, legs, face and torso.

Anthony, now 21, was one of the first patients treated at the Pediatric Burn Center at Johns Hopkins Children’s Center, established in 2003 under the direction of pediatric plastic surgeon Rick Redett.

Today, after years of surgeries at Johns Hopkins, Anthony is tall and handsome, with few remaining signs of the tragedy. “If you look at my hands, that’s the only way you can really tell,” he says. He works as a security officer, details cars and spends hours riding his motorcycle.

“I don’t have any limitations,” he says.

Just a handful of pediatric burn centers exist nationwide, even though about 25% of burn victims are children, says Erica Hodgman, director of the Pediatric Burn Program since May 2023. 

In Maryland, the Johns Hopkins center is the only one certified by the Maryland Institute for Emergency Medical Services Systems (MIEMSS), a designation that means it provides comprehensive care for all types of burns for children age 15 or younger in Maryland and throughout the region.

If Anthony had been injured just a few months earlier, he would have been treated alongside adults at the Johns Hopkins Burn Center at Johns Hopkins Bayview Medical Center.

“Children are not small adults,” notes Redett. “Their care is so different and so specialized, especially critical care.”

A few examples: Children have less blood, and so can’t afford to lose as much as adults during surgeries. They may not follow care instructions as well as adults, especially if they’re young. They also heal faster and have fewer coexisting health conditions. 

At first, the Pediatric Burn Center treated 20 to 30 patients a year, says Redett; now that it’s a designated burn center, the number is more than 300 annually, including about 150 patients who require inpatient care.

A Long Day in the Hospital and Clinic

Rick Redett and Erica Hodgman

At 9 on a Tuesday morning, Hodgman is already in her small office on the seventh floor of the Children’s Center, scrolling through patient records. One of the pediatric surgeons, Clint Cappiello, stops in to chat. A sign above the door reads “Raise Hell, Kid.”

Hodgman is unusually suited for her role as the program’s director. After graduating from the Emory University School of Medicine, she learned how to treat pediatric burns while at the Parkland Burn Center in Dallas, and completed fellowships in pediatric surgery at Le Bonheur Children’s Hospital and St. Jude’s Children’s Research Hospital.

The burn center she now leads at Johns Hopkins is one of just 39 nationwide verified by the American Burn Association for providing the highest level of burn care for children in the U.S., a designation it won in 2018.

It’s also one of just five centers in a national consortium that share best practices and new treatment methods. (The others are Children’s Hospital of Michigan, in Detroit; Children’s Mercy in Kansas City, Missouri; Children’s National Hospital in Washington, D.C.; and Nationwide Children’s Hospital in Columbus, Ohio.)

“Very few places have all the pediatric bells and whistles, including a surgeon who is trained in pediatric burns,” she says.

One example of how the team shares its specialized knowledge: It recently created decision support guidelines for Johns Hopkins Hospital clinicians to use when evaluating patients who were burned. The guidance, incorporated in electronic medical records, includes information about smoke inhalation, frostbite and more. 

Hodgman spends her morning doing rounds in the fourth-floor pediatric intensive care unit. About a dozen clinicians attend these rounds, tapping notes into computers that sit on rolling carts as they move from one room to the next. They are nurses and nutritionists, social workers and surgeons, pharmacists and physicians, anesthesiologists and child life specialists. They discuss pain medications, dressings and ointments, whether a patient peed or pooped.

Some cases are severe, but not all. Hodgman talks with her team about a child who was admitted with a bad sunburn.

Later in the morning, she examines the hand of a toddler who touched a clothing iron.

The wound is deep, making the child a candidate for surgery, but it’s also small. “Let’s just let it heal, especially if she’s OK with dressing changes,” Hodgman says to the mom, who is holding her daughter on her lap, rattling a toy for distraction.

‘The Most Beautiful Child I’d Ever Laid Eyes On’

After the fire, Anthony’s mother knew she wouldn’t be able to care for him. Rebecca Bennet, a nurse for a medical software company and the mother of six now-grown boys, took him in as a foster child through MENTOR Maryland, a Baltimore-based program for at-risk children, and later adopted him. 

Bennet met Anthony when he was 13 months old and about to be discharged from Mt. Washington Pediatric Hospital, where he had been recuperating.

“I fell in love with this little, fat, pie-faced boy,” she says. “I thought he was the most beautiful child I’d ever laid eyes on. I didn’t even see the burns. I just thought he was so beautiful and happy.”

Over the years, Anthony has had 34 operations, says Redett, including 11 in the month after the fire to remove his burned skin and graft his wounds. After that, Redett performed frequent reconstructive surgeries, including operations to “stretch” the scar tissue on Anthony’s hands as he grew.

“He’s had so much surgery,” says Bennett. One procedure when he was 5, she says, involved injecting fluids into a tissue expander to stretch the skin on his shoulder, so it could be grafted onto his face.

In the months after Anthony was discharged from Johns Hopkins, occupational and physical therapists at the Mt. Washington Pediatric Hospital and in his home taught him how to do everyday tasks like lift a cup and button his shirt — tasks made challenging because he’s missing his right-hand small finger and the tops of several other digits. Fractional carbon dioxide laser treatments dramatically improved the appearance of his skin.

Through it all, Anthony remained mentally strong. Psychologists and social workers at Johns Hopkins helped with that, through counseling and by connecting him with the Mid-Atlantic Burn Camp, a nonprofit founded in 1992. Anthony loved it there.

“I was surrounded by people who were like me, basically,” he says. “That was my trauma cure.”

When Anthony was in fifth grade, a girl on his Baltimore County school bus called him a monster. Bennett called the school, and officials there decided to hold an assembly for Anthony’s fellow students, where they would educate his classmates about his burns and remind them to be civil. Bennett was advised to keep her son home that day.

“Anthony said ‘no,’” she recalls. “He wanted to be there to answer questions and speak for himself.”

During the gathering, students admitted they were afraid of him, and also asked if he was in pain. He replied that mostly he was not, although direct sun on his skin was not comfortable. “By the end, everybody was in love with him,” says Bennett.

Today, Bennett says she can’t imagine better care for Anthony, and appreciates that “everything was geared toward pediatrics.”

Coping with the Trauma

Children get burned in many ways. They are injured in house fires and car accidents. They touch curling irons and grab light bulbs. They are sunburned to the point of needing medical attention. 

They do TikTok challenges that go awry, such as the fire challenge, which involves spraying hairspray or another aerosol on a mirror, and then lighting the shape on fire; throwing boiling water on someone on a cold day; or making candy by microwaving sugar until it is molten and sticky.

The biggest culprit, though, is instant noodles.

One 2023 study found that 31% of pediatric scald admissions at the University of Chicago Burn Center between 2010 and 2020 were caused by instant noodles.

Children and young teens put the cups in the microwave to prepare lunch or an after-school snack, and then drop them because they are so hot to the touch. The broth contains starches that makes it particularly hot, and the noodles themselves can sear to the skin.

No matter the cause, burns can cause anxiety, guilt and depression in patients and their families. All Johns Hopkins patients with burns — both children and adults — receive counseling unless they actively opt out.

“The majority of things we’re focused on are day-to-day adjustments,” says pediatric psychologist Andrew Gill. That includes helping children and their parents cope with pain and itchiness, as well as changes in appearance and mobility.

Parents also get guidance for changing dressings, a task that can be difficult both because of the physical discomfort and also because the wound can be an unsightly reminder of the trauma that caused it.

Parents may feel guilt related to the events that led to their child’s burn injury, and they may worry that they will be judged by medical providers. “I want to get ahead of that,” says Gill.

“Unfortunately, injuries and accidents are a part of childhood,” he tells them. “You being here shows that you are loving and caring for your child. If you didn’t care, you wouldn’t feel guilty.”

Finding Comfort in Healing

Today, after years of surgeries at Johns Hopkins, Anthony Quinn has few remaining signs of his burns. “If you look at my hands, that’s the only way you can really tell,” he says. 

Two afternoons a week, Hodgman holds clinic hours in the basement of the David Rubenstein Child Health Building, on Wolfe Street in Baltimore. These follow-up, outpatient appointments for young patients with burns are opportunities for clinicians to monitor healing, ask parents and kids how they are doing, answer questions and make adjustments.

On hand are Hodgman, psychologist Sarah Radtke, nurse practitioner Cathy Baldino, child life specialist Edena Zewdie and nurse John Muller, all specially trained in caring for pediatric patients with burns and their families.

Hodgman meets with each family, assessing progress and answering questions. One dad asks about taking a trip with his son in two weeks, and Hodgman encourages him to do it.

Soshi Agular arrives with her 11-month-old son, Menachem, who had been burned by a light bulb two weeks earlier. He was rushed by ambulance to the Children’s Center, where he was sedated so the damaged skin could be removed and the three affected fingers wrapped, she says.

Before her son was discharged the next day, “They needed to train me how to dress the wound,” she says. “A child life specialist distracted him, and they taught me. They told me to change the dressing every 24 hours, but I do it more because he takes off the bandage.”

Gill, the psychologist, gave her a good tip: Don’t use Menachem’s favorite toy for a distraction, but instead choose a new or less popular one. It will be more interesting to him, and he won’t associate a special toy with discomfort.

Agular feels good, she says, knowing her son has received care from the region’s top burn center, that she has done a good job dressing his injury, and that he has healed well.

Baldino, who has worked with pediatric patients with burns for more than 15 years, says she likes caring for children because they are resilient and tend to improve quickly. That healing can be very comforting to parents, particularly if they’re not sure they’re changing bandages correctly, she says.

“I personally really enjoy being with families as the kid gets better,” says Gill. “They don’t always become whole as they were before, but there is definitely healing. You see lots of success stories.”