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MADISON BUS FIRE | 20 YEARS LATER

Madison bus fire 20 years ago inspired burn nurse to become surgeon, researcher

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Madison bus fire 20 years ago inspired burn nurse to become surgeon, researcher
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Gibson and nurse caring for patient

In UW Hospital's burn unit, Dr. Angela Gibson, left, and nurse Marie Clarke check skin grafts on Terry Krause, of Ripon, who was burned last month when a gas tank exploded on his wife's farm. Gibson was a new nurse on the unit on April 19, 1998, when a fire on a Madison Metro bus brought in six patients, including a couple burned on almost all of their bodies. The experience inspired Gibson to undergo 14 years of additional school and training to become a burn surgeon and researcher. 

Five months after finishing nursing school, Angela Gibson reported to UW Hospital’s burn unit for a night shift that would change her life.

That afternoon — April 19, 1998 — a mentally ill man poured gasoline on an engaged couple aboard a Madison Metro bus and lit a match, severely burning the couple and seriously burning himself and three others.

Gibson, then 22, was assigned to care for the man, Salim Amara, found to have paranoid schizophrenia. Later, she became the primary nurse for the couple — Eric Nelson, then 29, burned on 97 percent of his body, and Heather Gallagher, then 24, burned on 87 percent of hers.

Through weeks of overtime, the delivery of excruciating but necessary wound treatments, months-long stays for most of the victims, Nelson’s near death and an emotional connection with Gallagher, Gibson discovered she thrived on the tension.

When the activity faded, she found stimulation in a different way: She got an M.D.-Ph.D. In 2015, after 14 years of additional school and training — during which she had two children — she became a burn surgeon and researcher at UW.

Now, 20 years after the inexplicable bus fire led Madisonians to raise more than $100,000 for the victims and cheer Nelson’s and Gallagher’s wedding the next year, Gibson is getting her adrenaline rushes from skin graft surgeries and satisfying her intellectual curiosity with lab studies seeking better ways to repair burned skin.

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Nelson and Gallagher getting married

Eric Nelson and Heather Gallagher are married aboard a cruise ship in Miami in December 1999. The most seriously injured of six people in a Madison Metro bus fire on April 19, 1998, they now live in Kansas City, Missouri with their son, Dylan, 13. 

“When everything settled down, I realized I still yearned for that continual high intensity,” Gibson said.

A major burn “is the most stressful thing your body can go through,” she said. “All of your organ systems are involved. Your largest organ, your skin, is completely visible, and you can watch it heal.”

Cindy Schmitz, a nurse practitioner on the burn unit, was nurse manager at the time of the bus fire and hired Gibson for her nursing job.

As a doctor who worked as a nurse on the unit, Gibson “has a more global view of all of the pieces of care,” Schmitz said.

For the nurses, “she speaks their language; she’s walked in their shoes,” Schmitz said.

Why not med school?

Gibson, now 42, grew up in Waukesha. As an undergraduate at UW-Madison, she considered pre-med but decided on nursing.

Four months into her nursing job, the bus fire engulfed the seven-bed burn unit. All six people burned — including passengers Rodney Scribner and Ernestine Wittig, and bus driver William “Gary” Isom — were brought in.

Gibson had to care for Amara, then 20, a homeless man who later told a psychiatrist that voices he thought were coming from Nelson told him the devil was out to get him.

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Bus fire scene

First responders converge on a Madison Metro bus after it was set afire by Salim Amara on April 19, 1998. The conflagration badly injured four passengers and the bus driver. Amara was also burned.

“I was the newest nurse, and he was the smallest burn,” with about 20 percent of his skin damaged, Gibson said. “It was one of those tests of your internal ethics — being able to shut down what you know happened and just take care of the patient.”

She spent months caring for Nelson and for Gallagher — who, like Gibson, was in her early 20s and engaged, reinforcing the idea that tragedy can strike anywhere and at any age.

By repeatedly cleaning the couple’s wounds and replacing their bandages, an intensely painful process that tests the nurse-patient relationship, Gibson got to know them well.

At one point, it appeared Nelson was going to die. Gibson and Schmitz brought Gallagher to his bedside to say goodbye.

But he rebounded. After nearly a year in the hospital, in December 1999, he married Gallagher on a cruise ship in Miami. Gibson was a bridesmaid.

She started talking about becoming a nurse practitioner or a physician assistant. When Dr. Michael Schurr, then co-director of the burn unit, overhead her, he said, “Why not just go to med school?”

Soon, she was volunteering in the lab of Lynn Allen-Hoffmann, a UW-Madison scientist who in 2000 founded Stratatech, a company that develops skin substitutes for burns and other wounds.

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Gibson talking to resident

Dr. Angela Gibson, talking with Dr. Natalie Liu, a surgery resident at UW Hospital, said burn care is a good fit for people who flourish on adrenaline. The circumstances that cause serious burns are unfortunate, but doctors and other staff get to help patients heal their skin, the body's largest organ. "We thrive in that environment," she said.

In 2001, Gibson embarked on an M.D.-Ph.D. at the university — four years of medical school and four years of graduate school, followed by six years of residency and fellowship training.

During graduate school, for which Allen-Hoffmann was her thesis adviser, Gibson and her husband had their children — Guyan, 14, and Sophia, 13, students in the Middleton Cross Plains School District.

Nurturing healing

In her lab, Gibson studies skin samples removed from burn patients.

She and others in the lab are looking to see if enough healthy cells remain in apparently dead tissue to allow surgeons to leave more of it on patients. If the right nutrients were added to spur the healthy cells to grow, some wounds might heal without the need for skin grafts from elsewhere on the body.

“I think we often remove too much (tissue), just to be safe,” Gibson said. “If we could take less ... and let the wound heal in on its own, the patient wouldn’t have to have a whole other wound.”

Products that could encourage such healing might include StrataGraft — a skin substitute from Stratatech, now part of the global company Mallinckrodt, in phase 3 clinical trials at UW and elsewhere — and even tilapia skin.

Last year, veterinarians placed the fish skin on the paws of black bears injured in wildfires in California, resulting in quick healing and discussion about other potential applications.

Gibson said caring for burn patients as a doctor and a nurse has helped her see that the invisible, emotional scars of trauma are often as much of a challenge as the physical ones.

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Gibson lecturing med students

Dr. Angela Gibson talks to students at the UW School of Medicine and Public Health about breaking bad news to patients. "Setting is huge," she said. "Even if you're in the emergency department, you can find a small, quiet place to go."

“Burn survivors are always burn survivors,” she said. “They carry that trauma with them for their lifetime.”

Still, the resilience of patients like Nelson and Gallagher, who carry on despite continual pain and public stares, is inspirational, Gibson said.

“They go through this incredibly difficult time, and then they’re OK,” she said. “They get through it.”

As she looks back on the bus fire that sparked a turn in her career, and on her doubts about whether she could pull off an M.D.-Ph.D. while raising children, Gibson points to two key people who helped.

One is Dan Gibson, her husband, a financial planner. The other is Sharon Smith, her mother, who moved in with the couple when their children were young and still lives near them in Middleton.

Angela Gibson may not have attended every soccer game her children have played in, she said, but someone from the family is usually there. They have dinner together most nights.

It’s a milieu that has allowed her children to thrive, Gibson said.

“It’s about providing the right environment,” she said. “It’s kind of like a wound, right?”

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David Wahlberg is the health and medicine reporter for the Wisconsin State Journal.