B&W

Mary Swander

Once, I burned my hand in a kitchen grease fire. I went to the local hospital emergency room. There was no one at the admissions desk. I waited and waited, pain boring into my hand. No clerk, doctors, or nurses in sight. I knew they were probably short-staffed and busy with someone with greater problems than I had. So, I waited.

Then I looked for a bell, something, anything to get some attention. I waited longer, then finally yelled, “Burn patient! Burn patient!”

My insurance card was taken, then I waited for an hour, then was sent home with some ointment and a gauze bandage.

After three days, the wound was healing slowly. So, I wandered down the road in front of my house in the middle of the largest Amish community west of the Mississippi River and walked into the general store. There, on the rack next to the vitamin C bottles and the mantles for kerosene lamps, you can find small jars of B&W (burn and wound) salve, a thick rich blend of honey, vitamin E, wheat germ oil, aloe vera, and other herbs. Next to the salve is a pamphlet: The Care of Burns: Written by and for the Amish. Inside, large color photographs illustrate the necessary steps of care—from submerging the burn in lukewarm water to finally wrapping it in gauze.

“Let’s see that hand,” Ada, my Amish neighbor, said to me at the Christmas program in their one-room schoolhouse. I held my hand to the light near a window and she shook her head. “Have you been using the B&W?”

I nodded.

“And the burdock leaf?”

I shook my head no. Once you put on the B&W salve, you are to cover the burn with a burdock leaf, then wrap the whole area in gauze. But where was I to get a burdock leaf in the middle of the winter?

“Oh, they have them at the store—dried.”

Another trip to the Amish store and a word to the clerk uncovered a Tupperware box full of dried burdock leaves behind the counter. I soaked the leaf in water to rehydrate it, then wrapped my burn.

While my hand was bandaged, I heard all sorts of other B&W stories. First, there was Henry Chupp who burned the bottom of his foot, couldn’t walk, was in horrible pain, just hobbling around on crutches until he got to the store, bought the salve, rubbed it in, and lickety-split, he was walking again—just like that.

“Well, probably not that fast,” My other neighbor, Mahlon, said. “It will help you heal, but not that fast.” Mahlon’s fourteen-year-old son had caught his overalls in an auger when he was working alone at another neighbor’s farm. It ripped off all his clothes and he drove the tractor home naked, teeth chattering, his body badly burned from the force. At the emergency room, a half-hour drive, the doctors wanted to admit him to the burn unit, but his mother said, no, they would like to treat him at home.

“Can you change these dressings every twelve hours?” the nurse asked.

“Yes, I can do that,” his mother said, but the nurse looked skeptical.

The nurse didn’t have a clue about the Amish burn protocol and the mother wasn’t about to try to explain it.

Once home, off came the hospital dressings and on went the B&W salve. It wasn’t easy. The son had burns from head to foot and Mahlon’s family kept a constant vigil at his bedside, changing the dressings. But eventually, after at least a month, Mahlon’s son made a recovery without noticeable scars, climbing back on the tractor by the end of harvest time.

I don’t know if my hand would have healed as quickly on its own, but in the end, I had no infection and no scars. And for that I was grateful. By that time, I had lived among the Amish for twenty-five years. In 1983, I had come to the community searching for the organic food that I needed for my medical diet. I’d had a serious adverse vaccination reaction that landed me in the hospital for a month. No conventional doctor was trained in how to address such a situation. I finally found an alternative doctor in Chicago who knew enough to prescribe an organic diet to attempt to boost my immune system.

In those days, most midwestern cities were lucky to have a food co-op that might carry organic peanut butter and rice, but they stocked little other food that hadn’t been sprayed with pesticides or injected with antibiotics or hormones. My local co-op carried no meat, fish, poultry, or dairy. Their vegetables came from the same California truck making deliveries to Hy-Vee, the commercial produce selected and treated to make the long trip.

Instead of shopping at the co-op, I filled my pickup with Amish turkeys and ducks and drove them live to the processing site. I picked them up later, then drove back and forth to the Amish community, buying bushel baskets of vegetables and putting them up for the winter. Gradually, I got to know the Amish, a self-sufficient group of people more than willing to help. They taught me many gardening tips that allowed me to begin to grow more of my own vegetables. Eventually, I found myself driving to the community so often that when I saw an old Amish one-room schoolhouse for sale, I bought it and moved in.

Over the years, I’ve learned that the Amish use whatever medical technique costs the least and works the best, selecting from a wide array of treatments, from conventional to alternative. A “wait and see” attitude is the first line of defense. Home remedies come next. Sometimes the Amish wait too long, and more often than not, the remedies don’t work. But as I discovered with my own case, conventional medicine can also be useless. Without health insurance, a community like the Amish is always making a cost-benefit analysis.

The B&W protocol stands out as one of the better Amish home remedies. It doesn’t cure all burns and you need to have training and expertise to apply the procedure. But in many—not all—cases, it has been successful. Personally, I would still have a conventional physician examine any burn of mine. But then again, I have health insurance.

My conventional doctor had me check in every few days, monitoring the burn on my hand. “That’s healing so well!” he said. “That was a bad burn. But no, no infection.”

And now, just in case I have another burn, on the second shelf of the medicine cabinet I keep a jar of B&W and a dried burdock leaf.

I’ve lived among the Amish long enough to know that some of their remedies, like the burn protocol, are relatively new, while others were passed down through the generations, brought from Europe and used by communities for minor medical problems. In the early settlement days, the Amish in Pennsylvania traded herbal remedies with the Indigenous people. We “English” are so used to pills, surgeries, and accessible medical doctors in hospitals, that sometimes I have to remind myself that my own Irish grandmother was full of these treatments. For example, she used to put mustard plaster packs on her sore knees. Or eat watermelon for water retention. My great-grandmother travelled through the Iowa prairie countryside nursing neighbors and friends from one plague or another with herbal remedies. Upon her return, fearing she would contaminate her own family, she stripped down and boiled her dress in a kettle at the gate.

Most civilizations relied upon folk remedies for centuries. Women assumed the healer role. Gradually, in the Western world, barbers began to perform some minor surgeries and men eventually took over and capitalized on herbal remedies. My grandfather, a horse-and-buggy doctor in the early twentieth century, drove from farm to farm, the same route my grandmother had taken, his black medical bag filled with homeopathic remedies.

By the mid-twentieth century, we began “living better through chemistry.” More and more pharmaceuticals were developed to target specific symptoms, with a pill matching every ill. Herbs were dismissed as “quackery” along with the people who still advocated their use. The medical–industrial complex was born. Hospitals, surgeries, and medical technologies and interventions grew and developed. Prices went up. Health care became expensive. Health insurance was invented. For those who could afford it, Americans had access to better hygiene, preventative screenings, and emergency treatments. Lives were saved.

But the male medical model had little help for those pesky minor problems that could usually be treated with home remedies. Nor did it have any knowledge of larger immune system issues, conditions that were mostly carried by women. Nor was there help when one of its high-tech interventions backfired as it had for me.

For serious conditions, the Amish will, of course, despite the cost, seek standard medical attention. And some of those very doctors and hospital burn units in communities like those in Ohio, in turn, have adopted the Amish B&W protocol, a regime that came to a man by divine revelation.

“How did this original Amish healer think of the formula for the B&W ointment?” I’d once asked Ada.

“One day it came to him. Just like that. A gift from God.”

On a cold winter morning, a couple months after I’d burned my hand, the phone rang.

“My brother’s been in an explosion. Can you come?” It was one of my Amish neighbor girls calling me at seven in the morning from their phone shanty, a tiny shack in the middle of a field used by five or six neighboring Amish families, a small solar panel fixed to the roof. One of the few neighbors with a car, I get calls from the members of the community during emergencies.

I jumped in my RAV4, dashed down the gravel road and around the corner to the Yutzys’. Aaron lay on the couch in the living room, all the shades drawn. His mother bent over him with a plastic bag full of snow. Carefully, gently, Ada Yutzy molded the snow to her son’s raw face. His three sisters filled more bags outside, running fresh, cold snow into the house to his bedside. When one bag melted, another was there ready to be applied.

In the early morning darkness, Aaron had made his way, lantern in hand, to the garage where a faulty propane heater awaited him. He stepped into the building and the whole garage ignited and blew, Aaron pitched into the air and out onto the lawn twenty feet away. The garage came down around him in piles of two-by-fours, pieces of sheared siding, shingles, and broken windowpanes.

The first responders clanged into the lane, the fire chief assessing the burns that had spread across Aaron’s face. His eyebrows and eyelashes were singed off, but his nose hairs were still intact, indicating that the burns hadn’t reached his lungs. The fire chief wanted to call an ambulance, but the Yutzys thought they could handle the injury themselves.

“Come on, now,” I said when I arrived. “I’ll run you to the hospital.”

The Yutzys shook their heads. They had things under control. They were working on cooling down the burn. Ada and her three daughters kept the bags of snow moving. I knew what the Yutzys were thinking. A trip to an emergency room with a possible stay in the university hospital burn unit could cost them thousands, even hundreds of thousands of dollars. They were also visualizing infections, IVs, and one skin graft after another.

I knew the Yutzys were applying the divinely inspired B&W protocol, the treatment I had used when I’d burned my hand on a kitchen grease fire. But Aaron’s situation was much more serious than mine had been.

“Are you breathing okay, Aaron?” I asked.

“Just fine.”

“Are you in pain?”

“No pain.”

“I’m happy to take you to the hospital.”

Ada turned to me. “We want you to go get the burn nurse.”

Oh, good, I thought, there’s an RN out here who can help, but when I asked for directions, I found myself on the way to the Amish feed store where the owner’s teenage daughter appeared dressed in black bonnet and shawl with a bag of supplies dangling from her arm.

“I’m not really a nurse,” the girl said, stepping into my car. “They just call me that because I’ve been to Ohio and trained in the burn protocol.”

We sped back to the Yutzys’ where Aaron’s face had now reached the perfect temperature. Out of the girl’s bag came a large jar of B&W ointment. With a tongue depressor, the girl stirred the contents, dozens of herbs all suspended in beeswax. The girl spread the salve over Aaron’s face, applying the thick goo. Next, several large burdock leaves spilled out of her bag and she pressed them into the ointment. Finally, the girl wrapped Aaron’s whole face with gauze, leaving slits for his eyes, nostrils, and mouth.

“Are you breathing okay, Aaron?” I asked.

“Breathing just fine.”

“In pain?”

“No pain.”

Cooling the burn helped with the pain. The B&W herbs had more pain-killing, soothing, and healing properties. The burdock leaf, too, was healing for wounds. More importantly, the leaf kept the gauze from sticking to the wound and pulling off the scab, opening it to infection.

Later, the clerk at the general store told me you don’t really have to use a burdock leaf. You could use a cabbage leaf or Swiss chard, for that matter. Anything that would keep the ointment from sticking to the gauze.

“Well, if anything happens, don’t hesitate to ask me for help,” I said and scooted back home. The next day, I checked in at the Yutzys’ and the burn nurse was still there, changing the bandages, reapplying the B&W salve, the burdock leaves, and the gauze on Aaron’s face every twelve hours. After a week, the blisters had started to heal. After a month, the blisters were gone and not a scar or a trace of a burn could be found anywhere on Aaron’s face.

From the Care of Burns Booklet: Safety Precautions

• Don’t ever set hot water or any hot liquid on the floor for any reason whatsoever.

• Don’t leave the handles of pots and pans stick out over the edge of the stove.

• Don’t handle hot pots and pans with an apron that you are wearing.

• Don’t carry hot water in a kettle holding it in front of you. Carry it in a pail at your side.

• Don’t pour kerosene, gas, or anything flammable into any stove.

• Don’t fill lights, lamps, etc. more than three-quarters full. Cold fuel expands when brought into room temperature and can explode.

In a recent issue of Plain Interests, the Amish newspaper, I found an insert: Treating Burns. The editor suggests cutting the insert out of the paper and keeping it in your medicine cabinet. In very clear prose, the insert outlines the characteristics of first-, second-, and third-degree burns. It teaches you how to recognize shock, and everything from how to put out the flame to when to rush the victim to the hospital. For putting out the flame: A. First choice: water or milk. B. Smother with blankets, carpets, or flour. C. Stop, drop, and roll (in the grass is a good choice; use puddles of water if nothing else is available).

The insert discusses the difference between chemical burns, road burns (do not manually remove foreign material by scrubbing!), hot tar burns, sun burns, smoke- and flame-scorched lungs, preparing the B&W Ointment, preparing the leaves, securing the gauze, and finally how to remove the bandage and clean the wound without creating an infection. For the price of the postage, and a SASE, the editor offers to send you a copy of the article. Then you won’t have to cut up your Plain Interest paper.

Browsing through the issue a little more, I found an article written by a mother in Missouri whose seven-year-old son came walking through the door at five in the evening, moaning and crying softly, with holes burned through his pants. The family jumped into gear, applying the burn protocol. Soon, it became a community project, with the arrival of neighbors and friends, and those with more expertise, to help with the healing. The boy and his family went through a real ordeal. The B&W protocol wasn’t an overnight magic bullet. But at five weeks, an experienced RN examined the boy’s burns and advised the family to just keep on doing what they were doing. In the conventional medical world, the nurse explained, such burns wouldn’t have even begun to heal.

Lately, sitting at my breakfast table, browsing through my digital New York Times, I read an article on our dysfunctional medical system, how hospitals are now run like big corporations, with the nurses taking a hit on budget cuts and the mean and lean version of health care. For-profit hospitals purposely understaff units, nurses racing from room to room to try to keep up with demand.

I stared out the window at my neighborhood. We’d come through three long years of the Covid pandemic, with few Amish vaccinated, few masks worn, and little social distancing practiced. I had been terrified for the whole community. Yet we had only a few hospitalizations, and only one death. I wasn’t sure how all that had happened, but something had to be going right here.

There’s a nursing shortage. There’s a nursing shortage, has always been the insistent answer to patient complaints in the English medical model system. There is a nursing shortage, but apparently, that has a lot to do with the low salaries drawn by nursing professors. There is still a lot of demand for the profession. The bottle neck is in the nursing schools—finding professors to work for such low compensation.

Then once nurses have degrees and go to work for a hospital, it’s become difficult to retain them. The nurses know they aren’t able to give patients the attention that they need. They know that, due to inattention, patient outcomes are not what they could be. With the demands of Covid placed on top of regular duties, many ICU nurses have simply quit, or moved to less stressful positions. And what hospital floor sees the most nurse attrition? The burn unit.

“You just see such misery,” a nurse told me. “A nurse can only last about a year in the burn unit.”

I don’t have any easy answers. Maybe it’s better, if possible, to train a family to provide some of the medical care for a family member. Maybe, in the correct circumstances, a family can be more attentive. It wouldn’t always work, I thought, staring into my cup of tea. Most families wouldn’t be as supportive toward the injured as my neighbors are. But I flashed back to 1983, and the long nights when I was hospitalized with one nurse for fifty of us patients on a unit. I became convinced that a capitalistic structure just isn’t appropriate for a medical system.

I’ve lived among the Amish now for over thirty-five years, and I’ve witnessed all kinds of accidents. I’m glad that we have a major teaching hospital just fifteen miles away, one that does employ sophisticated science and technology. But who would know that in the shadow of that university complex where profit is the main driver, there is another group of healers, a religious sect who purposely lives in poverty but demonstrates ingenuity and skill? Without fanfare or sophisticated clinical trials, a group with just an eighth-grade education manages to wait for divine inspiration. For better or worse, they kindly and gently bind up their own wounds.

Mary Swander is the author of numerous books of poetry, nonfiction, and drama. Her latest play, Squatters on Red Earth, is about the white settler land grab from the Native Americans. Her latest book is a biography: The Maverick MD: Nicholas Gonzalez and His Fight for a New Cancer Treatment. Swander is the executive director of AgArts, a nonprofit designed to imagine and promote healthy food systems through the arts. She lives in an old Amish schoolhouse near Kalona, IA.