North Dakota Firefighter, Burning, Ran for His Life

His bare arms were on fire -- flames visible, on the skin of his forearms. He may not have noticed that problem right away because there wasn't any pain.

Firefighter Mark Keller, 33, was busy running for his life, trying to get out of a prairie fire that had him surrounded. But it was taking so long, as if he were walking -- and then he looked down and saw that the flames had found him.

The Wilton firefighter had on a short-sleeved T-shirt when he bolted from his disabled firetruck, and now he saw his forearms were literally on fire.

So he stopped, dropped and rolled. And then he ran on. But when he looked down again, the flames were still there, eating his arms, and so he dropped again. But rolling wasn't working. Finally, he got within range of another firetruck and screamed for a fellow firefighter to turn the hose on him. He saw blisters, and skin was hanging off his arms.

That was April 8 -- the day that he kept saying "I'm sorry," over and over, in the St. Alexius Medical Center's emergency room to his wife of less than one year, Michelle Keller, 31.

"Don't be sorry. We're going to get through this," she said. She didn't cry then. The tears started on the emergency plane ride with him to the Regions Burn Center in St. Paul, Minn.

She remembers that his skin was gray, his face swollen. He wasn't dead, but he looked it.

Fewer nightmares

It's now late May. Keller is still running from fire, his arms on fire, but now it's in his dreams -- nightmares that sometimes wake him up as he lies in his bed at the burn center.

But the nightmares are less frequent than they once were, and progress is being made -- even though the saga is expected to continue for many months.

He has made it -- made it through such things as being wrapped like a mummy for about three weeks, with only his eyes, tips of fingers and nose showing; and through 31/2 weeks on the respirator; and then not having the strength to walk for awhile; and through pneumonia and strep throat and skin-graft operations on his arms and under his eyes.

The two firefighters who were on the back of the firetruck Keller was driving are recovering, too. James Meyer, who was wearing full bunker gear, sustained burns around his eyes because of the eye-slit opening in his mask. Meyer said recently that the burns now feel like a sunburn. Firefighter Geremy Olson, also in full bunker gear, ran into major trouble because he broke a leg when he jumped off the truck, which slowed his escape. And he lost a boot during the chaos and sustained burns. Keller said Olson, who had been hospitalized in Bismarck, is out now.

But Keller, who sustained third-degree burns on his arms and deep second-degree burns on his face, as well as less serious burns on his neck, chest and other spots, has a ways to go.

Hard lesson

"I've learned my lesson," he said.

Keller said that because it's difficult to drive a truck with full bunker gear, and it's terribly hot, he had taken off his bunker jacket and helmet, and only had on his bunker pants and a T-shirt when the firefighters ran into trouble while fighting a grass fire southwest of Wilton.

Everything seemed to be going relatively smoothly until Keller crested a hill south of 305th Avenue Northwest. That's when he realized what he hadn't known until just then -- and then it was too late.

He saw the other fire, just for a second, before it collided with the fire they had been fighting.

He realized, in that second, that the fire must have divided, at the base of the hill -- and then taken two different paths to get up the hill. The firefighters hadn't been aware of that. While Keller drove, Meyer and Olson in back were hosing down, successfully, what they thought was the only fire around.

But when Keller crested the hill, the fire they didn't know about collided with the fire they did, causing what firefighters called "flash over."

"It sucks the oxygen out of the air," he said.

That's what killed the truck's engine. He tried to start the truck once, couldn't, put it in park and got out.

He yelled at Meyer and Olson.

"Get out of the truck. Get out of the truck. It's dead."

The aftermath

Keller isn't yelling these days. It's a whisper mixed with grit when he talks, when he rasps -- the result of having a tube down his throat for weeks.

He was on a respirator for 31/2 weeks. But it came out just in time.

He wanted to be able to speak on May 1, at least. That was his first wedding anniversary and he wanted to tell Michelle, who has stayed with him the entire time, "Happy anniversary."

He got his wish. On April 30, they took him off the respirator.

He was too weak to get out of bed. The anniversary celebration amounted to just this: "We celebrated (the anniversary) by telling each other we loved each other," he said in a recent interview.

The doctors told Michelle that her husband would probably lose the tips of his fingers, his nose and ears -- the parts of him that were black.

But then came pneumonia and strep throat, which became kind of a blessing in disguise, because it meant that the skin grafting would have to wait. "No cutting," Keller said. While he recuperated from those illnesses, the tips began healing -- so he still has them.

It's when he wakes up that he feels the most pain -- in his joints and fingers -- until he can get his dose of pain medication.

From his elbows to his fingertips, it's new skin, kind of. It's all his -- transferred from other places.

Paper-thin sheets of skin from his thighs are now the new skin covers for his hands.

A sheet of skin from most of his back was used to cover his arms.

Model patient

Dr. William Mohr, the burn center's director, has been a physician since 1991 and has specialized in burn patients since 1996.

"His hands are about the worst I've seen that did not require some type of amputation," he said.

He said most people are fortunate enough to burn just the backs of their hands. Keller's were burned on both sides, making the skin grafting harder, too, as there wasn't unburned skin to tack the skin grafts onto.

But Mohr said Keller is the model patient. Mohr said he has had patients whose skin grafts were beautiful but because they weren't as dedicated to their therapy and had spouses who did too much for them, they ended up with hands that can't do much of anything. They even have difficulty feeding themselves.

"(Mark's) success is a tribute to his hard work with the occupational therapist," Mohr said.

"He is motivated. He doesn't complain. If he's asked to do something, it's not questioned," Mohr said.

And then there's Michelle Keller.

Mohr has had patients, even children, whose parents only occasionally, if at all, come around.

"Their only family becomes us," he said.

"As far as families go, there aren't too many families that are as dedicated as Michelle," Mohr said.

Very soon, the plan is to move Mark Keller to a local hotel and have him come to the burn center during the day -- a step toward home.

Keller trembles when he tries to use his arms and hands, which have some seams like a patchwork quilt in places, where the grafted skin has been stapled in place. But he said the shaking isn't about fatigue as much as it's about the new skin on his arms and hands not having stretched out enough. He shakes as he tries to reach in ways the skin won't go.

The new skin took except for on the ring finger of his right hand.

"It turned to mush," he said.

That finger had to be redone with more new skin from his thigh.

He has a cast on his left hand, except during therapy, to keep those fingers straight. His right hand, where skin grafting hasn't worked as well, has a glove on it to minimize scarring.

In addition to that, more tinkering had to be done to help his face. His burned facial skin had tightened up so much that his lower lids began drooping and then were starting to turn inside out. He was having trouble closing his right eye because of it.

To relieve that problem, on April 20, doctors cut out moon shapes under each eye and sewed in some thigh skin.

On Wednesday morning, when they removed the gauze that was sewed in with the stitches, the pain of it resulted in his popping an additional pain pill to get through.

He knows his tear ducts are working really well. " A few times tears have been running down from the pain," he said.

In a couple of spots on his hands, tendon is still exposed where the grafted skin isn't quite covering yet.

His fingers are fumblers right now. It's hard, for example, to open the small milk carton that comes with his meals, he said.

For four hours a day, he has finger-stretching therapy.

"It's crucial," said Lisa Rindal, 30, occupational therapist.

There also is mouth-stretching to be done several times a day.

"It's an ongoing battle," he said. An hour after doing mouth-stretching exercises, he can feel the corners tightening up again, he said. To help, a device is being made, a sort of skin-stretching retainer, that he'll wear whenever possible.

Even after Keller goes home, this stretching therapy won't end.

"This will go on for many, many months," Rindal said.

On Wednesday morning, Rindal, with gloves on, worked on his left hand while Michelle worked on his right. Rindal closed his left hand into a fist, so the new skin on the back of the fingers stretches.

Morning skin-stretching therapy goes on for two hours, albeit with breaks -- for the therapists. After 30 minutes, Rindal's and Michelle Keller's hands need a break.

He still needs help to take a shower. He tires easily. Stairs are hard. His appetite is pretty good, but he's lost 30 pounds. Doctors have explained that his body, in its intense efforts to heal, is using the same amount of energy daily that someone would use if they ran a marathon daily, Michelle Keller explained.

Rindal has been a therapist for five-plus years at the 20-bed burn center that gets patients mainly from out of state -- states such as North Dakota, Iowa and Wisconsin that don't have burn centers -- and from the Mayo Clinic.

She said she'll remember Keller.

Rindal said Keller has his down days, emotionally tough days, like all patients do. But she's accustomed to patients on those down days not showing up for therapy.

Keller never misses, she said. He's at therapy, regardless.

And he does more than that, even. In addition to therapy -- finger strengthening, as well as work on machines to improve his stamina and range of motion -- in the evenings, he takes hourlong inside walks with his wife.

Keller contends that Rindal remembers him because of the chocolate. He bribes her with chocolate to get those special T-shirts at the hospital that have the burn center's "Cool the burn" slogan on them, he said and laughed. He has a contest going with another patient to see who can get the most T-shirts out of her.

He has been outside, but has to avoid the sun. His grafted skin could easily be damaged and discolored from exposure.

Mohr said in about one year's time, Mark Keller will have recovered to about 100 percent of what he will be. Mohr said it's not impossible for Keller to become a deputy again. "It'll be a very uphill climb. But with Mark's motivation ... I'll be interested to see what happens," he said.

Mohr said there will be lifelong issues. The grafted skin is thinner, making it more temperature sensitive, pain sensitive, more prone to nicks and cuts. Mark Keller may someday have arthritis issues.

Keller said when his wife touches his arms, they're numb and yet the nerve endings go crazy, jangle, don't seem to understand how to interpret pressure on the new skin.

Community thanked

Michelle Keller is still able to be with her husband in part because her co-workers at Enable Inc. -- where she works with mentally challenged people --have donated vacation days.

And fund-raisers keep happening.

Keller is a volunteer firefighter whose paid profession is being a Burleigh County sheriff's deputy. His boss, Sheriff Steve Berg, recently was a barbecued-rib seller in front of Miracle Mart. Wilton also has had fund-raisers, and recently Keller's hometown of Center had an auction for Keller.

"It's so touching," Keller said of the community's efforts.

He isn't totally comfortable in the new role.

Keller said the main thing he remembers enjoying when he was a shy kid in Center, son of an electrician, was helping people. He remembers adults thinking of him as being trustworthy and dependable; he would help people by mowing yards, volunteering for things. That's how he ended up, at age 16, volunteering for Center's fire department. After high school, he became an EMT for an ambulance service. Then came a career in law enforcement after college and more volunteering.

Somewhere along that line there was a blind date. Love at first sight, then a break-up when they decided things were going too fast. But Mark and Michelle never stopped thinking about each other. Two years later, he picked up the phone and called her with a lame excuse. She had been thinking about him for two years, too, and they agreed to meet at Denny's for coffee.

About eight months after that, one evening, he was pacing back and forth near her and then he proposed. About 10 months later, they were married.

They started married life last year in a house he had bought in Wilton, a town he plans to stay in.

Keller signed up with Wilton's department about three years ago and had since become the department's training officer.

Until April 8 the young couple's biggest challenge was a tight budget, keeping the bills paid. Everything else reportedly was pretty peachy.

On April 8, he had some time, so he was at the fire station cleaning vehicles.

"A clean truck is a happy truck," he said.

So he had a clean truck, filled with water, when he got the page.

Turn the page.

Many, many, many months from now, he'll have all of this behind him, he expects.

And the community who helped him will get his help back.

Keller wants the community to know "it won't be forgotten."

"I don't know how to explain how I feel for all the people who have done this for us."

There also has been help in Minnesota. His wife, who arrived in St. Paul with just the clothes on her back, was taken under the wing of the Minnesota Fraternal Order of Police.

To be able to have his wife with him has been crucial: "I'd be lost without her."

He took off his wedding ring after the fire and gave it to a friend for safe-keeping. He can't wear it right now. It's too small and not the thing to be wearing on a healing finger that recently has been under the knife because the new skin wouldn't take.

That's OK. The ring is still in plain sight.

For someone needing to pick Michelle out of a crowd: She's the one with the big wedding ring on a chain around her neck.

And for those who want to pick her out, they'll have a special moment to do that. The couple just found out Thursday that he will be discharged June 5.

He made it.

Next step: Making it back to Wilton, from where he will commute daily to Bismarck for outpatient therapy.

They'll be arriving on a plane at the Bismarck airport. Details later.