Epilogue: Surviving the worst

Bad burns so deep doctors can see tendon and bone in his fingers and arm.

Worse makes it hard to find undamaged skin after the Jan. 8 house fire in Belvidere scorches nearly 70 percent of his body.

Burn five people that severely, they say, and four will die.

He slips into a medically induced coma while death and life wage their battle.

But worse is patient. It waits for a winner to kick in the teeth.

So when Michael Simpson Jr. wakes from the coma about six weeks later in Lincoln, he learns the little boys are gone.

Lucas Paugh, the 4-year-old stepson he helped raise since infancy. Running, climbing, shouting, life-loving, attention-seeking Lucas.

And Tyler Simpson, his first-born. Quiet, observant, bright and shy 2-year-old Tyler who adored his older brother.

The 24-year-old Simpson still calls them "my boys."

Here's the worst:

"I was their dad," he says, his voice hushed with emotion. "I wasn't there to protect them. I wasn't able to get them out."

* * *

Panic slams him harder than the heat flashing through the bedroom. He needs to get his girlfriend and three children out.

The kids share their room. The five of them are staying in the house of his girlfriend's parents because he was laid off from his roofing job for the winter.

He jumps from bed and tries to beat down flames with his hands, stomp them with his feet. But the fire can't be beaten or stomped.

So he punches out the window above the porch while Candice Paugh grabs their infant daughter from her playpen. She and the baby climb out onto the porch roof.

By now, smoke and fire overtake the room, but he feels nothing other than panic as he searches for the boys.

He shouts their names but gets no answer. He gropes blindly, trying to find the toddler bed the boys share, somehow unaware his own flesh is burning. When he finds the bed, it is empty.

He hopes they escaped.

By now, he's suffocating, so he stumbles down the stairs and out of the house.

"I do remember standing in the street, screaming, 'My boys! I couldn't find my boys! Somebody come help!'"

Adrenaline seeps away. An overwhelming sensation of cold envelops his body.

As they load him onto an ambulance gurney, he hears someone say they found the boys.

He loses consciousness but feels at peace because he thinks they're alive.

It will be weeks before he learns firefighters found Lucas on the floor near his parents' bed and Tyler sitting in a chair.

Both died of smoke inhalation.

Investigators will rule they were playing with a cigarette lighter.

* * *

When he wakes from the coma in a Lincoln hospital, his girlfriend isn't there.

Over the phone, she tells him it's over.

It's perhaps the most unexpected loss, he says. They had disagreements like any couple but had been together for four years.

They had children together.

They planned to marry.

But problems existed in their relationship before the fire, Paugh says. Nothing dramatic or violent, but problems that changed how she felt.

"I just didn't love him anymore," she says now.

"It's crazy" what happened to her former boyfriend, the 22-year-old woman says.

"Hopefully, he gets better. I'd like him to have a full recovery, but I don't see that happening."

Simpson still cares for her. He thinks leaving him is something she did to cope.

"If she couldn't be happy with me, I wouldn't want her to be with me."

* * *

He spends 2 1/2 months in the burn unit at Saint Elizabeth Regional Medical Center.

Flames seared his fingers, hands, arms, shoulders, chest, torso, parts of his legs and feet. Heat and smoke also damaged his lungs.

He undergoes 17 surgeries to graft skin onto his wounds. Doctors prefer to use the patient's skin, but because Simpson has so little available, they use grafts from cadavers and pigs.

He catches infection, so doctors keep him on antibiotics and other drugs. Even after they take him off a ventilator, they leave a tube in his windpipe because he sometimes stops breathing.

His ravaged skin is extremely sensitive to heat, cool, breezes and sunlight. Baths become an especially dreadful form of torture.

Yet he beats the odds and slowly heals.

He transfers to Madonna Rehabilitation Hospital in late March. When he arrives, he can do virtually nothing for himself -- dress, go to the bathroom, hold a fork.

Scarring tightens the skin and makes movement difficult. So the physical therapy he undertakes over the next 3 1/2 months involves stretching, resistance training and building range of motion.

The therapy is hard, but Simpson works harder. He gives credit to his therapists for not only pushing him physically but also supporting him psychologically.

"There's times I've broken down and didn't think I could do it, and they were there for me, just like family," he says.

Occupational therapist Brooke Murtaugh says burn rehabilitation is extremely painful. While therapists do everything they can to encourage patients, they can't force them to comply.

Simpson never quits. And he hits goals more rapidly than she thinks he will.

"He has worked so hard," she says. "In Mike's case, he has shown so much determination."

The focus for that determination is a 16-month-old girl named Marci.

Simpson and Marci's mother have agreed to share custody of the girl. He'll have her every other month, and he wants to be directly involved in her life, said Mary Adams, his mother.

"He's a really good dad," Adams says.

He wants to be able to pick her up, change her diapers, feed her, play with her toys, teach her to fish -- just like he did with his boys.

"She's been a big inspiration in my healing," he says. "My daughter means the world to me."

* * *

He likes to cook.

"Because I like to eat," he says, smiling big through his reddish-blond beard.

So on Tuesday, his second-to-last day at Madonna, he makes pancakes during an occupational therapy session.

After stretching, he and therapist Mikayla Humm walk to the kitchen. Before gathering the pancake mix, he carefully removes the black compression gloves from his hands. They look raw, bony and a little small on his stocky frame.

But they work, and he's making them stronger every day. The medical care necessary to save his life likely cost more than $1 million; Medicaid will cover most of it, he says, because he is financially broke and permanently disabled.

He measures the mix, adds water and stirs it in. Then he puts a skillet on the stove and waits a few minutes before holding a palm over the pan to judge the heat.

A few minutes later, he flips the hot cake. It's a perfectly golden brown.

The next day, he leaves Lincoln for Osceola, Iowa. He'll live with his mother as he continues to heal, participate in therapy and undergo more surgeries.

But if a good attitude is as important to recovery as health professionals say, Simpson should continue his.

Faith has helped him endure loss he wasn't sure he could, he says.

"God felt it was my boys' time, and they're in a better place right now."

While fire has made his skin weak, it also has revealed the strength it takes to wear the scars. But not even a man as strong as Michael Simpson Jr. can carry the burden of blame.

"It wasn't anybody's fault," he says. "I know I did everything I could. For a while, I blamed myself."

Reach Joe Duggan at 402-473-7239 or jduggan@journalstar.com.