IN GOOD HANDS GENTLE TOUCH, SURGEONS' TOP-NOTCH SKILLS MAKE GROSSMAN BURN CENTER THE NATION'S PRE-EMINENT FACILITY OF ITS KIND.

Byline: Evan Henerson Staff Writer

Dr. A. Richard Grossman starts his day early. Always has. He leaves his Hidden Valley home at 3:30 a.m. to arrive at Sherman Oaks Hospital in time for rounds. Surgery begins at 6 a.m.

Then, as Grossman puts it, it's ``In and Out Burger'' - although after watching, you get the sense that Grossman, his son Peter and the burn center team give better service.

For the next two hours, at the 31-year-old burn center that bears his name, ``Dr. G.,'' as he is called, shuttles back and forth between two operating rooms, stitching, slicing, overseeing or checking in. Grossman can replace skin or bandage up a wound, but in burn medicine it's the body itself that will actually do the healing.

A 28-year-old construction worker burned by tar has burns on his hands and arms, requiring skin grafts taken from the man's own thigh. A 1 1/2- year-old boy, who grabbed a hot curling iron, needs injections of steroids into the burned area of his hands to aid the healing process. A young girl burned by soup on her shoulder and upper torso has skin removed from her scalp for the graft. This area provides a better color match, says Dr. Alex Majidian, who is performing the procedure, and the girl's hair will grow back and cover the scalp. That means a less noticeable mark than had they used thigh skin.

A 14-year-old boy burned himself with paraffin wax spilled from a can while on a scouting expedition. The boy probably had a few uncomfortable days before returning to town with his scout troop and getting treatment, but Grossman says the delay will not impede his recovery.

Many of the procedures are gory, but the sight of blood is a good thing. Healthy skin bleeds, an indication that it is ready for grafting either with skin from another portion of the patient's body or donated cadaver skin. And it's not as gruesome as it sounds. Human skin collected from cadavers - and kept in frozen storage - most resembles flesh-colored nylons. When run through a processing machine, it emerges looking like mesh netting. Then it's ready for grafting.

Between procedures, Grossman makes his rounds of the 30-bed center, checking in with patients. A man whose hands were burned in an industrial accident will be going home to Bakersfield and is scheduled to return the following week. ``Don't be a hero,'' Grossman tells him. ``Don't be a hero.'' He smiles at a teary toddler getting an extra dose of oxygen in a hyperbaric chamber and consoles a young girl in the hydrotherapy area.

Ginny Stevenson, whose husband McLean started the Children's Burn Foundation with Grossman in the 1980s, says Grossman has ``an ever-present gentle tranquillity.'' Jonathan Simons, the psychologist who counsels many of the burn patients, says Grossman ``could write a book on bedside manner.''

``It's little things, body language,'' says Simons. ``You will see Dr. Grossman do things like kneeling at the side of a patient's bed instead of standing over him. If a person's hands are burned, he'll hold the patient's feet while he's in the patient's room. He doesn't shy away from physical contact.''

Another 1 1/2-year-old boy, with both feet bandaged, sits quietly in a stroller at the nurses' station occupied by Helena San Marcos. When San Marcos places her glasses on the boy's nose, the child holds his head perfectly still, afraid to let them topple.

The child has been taken away from his parents and is now a ward of the hospital. Nobody is certain how he suffered his burns, but they suspect he was scalded by a parent or a sibling. When the child's mother took a lie detector test, Grossman said, she tested positive for speed.

``Years ago, you used to see child abuse where you'd see X-rays of kids with battered bones,'' Grossman explains. ``Then about 10 or 11 years ago we started seeing abuse by burns. A kid does something wrong and the parent puts his hand on the electric griddle or sticks them in scalding water as punishment.''

The center's Severe Child Abuse and Neglect (SCAN) team monitors cases and keeps emergency rooms and law enforcement agencies on the lookout for abuse by burning.

``We recognize that something is wrong with these (expletive) people,'' says Grossman. ``We've seen more and more abuse cases here. People know that we go crazy and we fight everybody to get the kid in a foster home and get them out of the way of this environment.''

In Room 106, family members watch the labored breathing of Juan Jimenez, who has been receiving treatment since January. The victim of an enamel vapor explosion at a construction site in Westwood, Jimenez was burned over more than 80 percent of his body. He has been given last rites five times, but, as Grossman says, ``he keeps coming back.''

Before returning to the operating room, Grossman, the man with an encyclopedic knowledge of burn medicine, treatment and skin cloning, offers a succinct explanation as to why Jimenez is still alive.

``God watches over people,'' he says. ``There is no doubt about it.''

High-profile patients and victims of media-covered accidents come through the center. KABC news reporter Adrienne Alpert, severely injured in a news van accident, spent 66 days at Grossman. Bill Jensen, the Glendale firefighter injured during the 1996 Malibu wild fires, was there for 3 1/2 months. Chris James, injured in a 1998 physics experiment explosion at Hart High School in Valencia, has had 22 surgeries. Several survivors from the Oct. 31 Singapore Airlines crash in Taiwan were treated at the center.

There are also the patients who come from out of state or internationally and receive treatment through the Children's Burn Foundation, which pays for transportation and hospital stays. The Grossman doctors perform surgeries on these children free of charge.

Young or old, wealthy or poor, people who suffer serious injuries will have to confront a new set of survival issues, from household heads concerned about getting back to work, to young adults worrying about questions of appearance or sexuality. Three full-time psychologists work with patients and family members.

Members of the center's ``community of survivors'' return for support group meetings or to help counsel new burn victims. Others leave the center and never return, looking to put the experience as far in the past as possible.

Not Jensen, who says he will return to Sherman Oaks as often as possible to help in any way he can.

``This place not only put me back together medical-wise, but mental-wise too. They saved my life,'' said Jensen. ``I'll be here a couple of times a week for the rest of my life.''

Around the center, Jensen is like an old friend. If medical propriety suggests that medical staff shouldn't bond too closely with patients, then the Grossman team has unapologetically tossed out the manual. Douglas Roy III, the victim of a car fire whose treatment inspired the Children's Burn Foundation, remembers his time on the unit. He also remembers hanging out on Dr. G's ranch, fishing and feeding horses with Grossman.

``We grow attached to our patients and their families,'' says San Marcos, a nurse at Sherman Oaks Hospital for 21 years - 11 at the burn center. ``When we lose one of our patients, we kind of take it personally.

Although he made a comfortable living doing plastic surgery, tummy tucks and breast enhancements, Richard Grossman has the air of a seen-it-all country doctor.

Tanned and white haired, wryly witty, he calls his nursing staff ``girls'' even though many of them have been with him for more than 20 years. Peter Grossman and Majidian, both surgeons, are ``the boys.''

While conducting a mini-tour of the burn center, Grossman introduces everyone he encounters, from nurses to maintenance staff. Most are longtime workers, devoted as much to the center as to its founder. ``It's a team approach,'' he says frequently.

For a budding plastic surgeon, there is nothing sexy or Hollywood-chic about burn medicine. Patients come in horribly disfigured, in great amounts of pain or, if they've suffered third-degree burns, with so much skin gone that their nerve endings have been fried. Burns occur because of household accidents, frequently in low-income households where the afflicted family doesn't have the means - much less the insurance - to pay for costly reconstructions.

``This isn't pretty surgery.'' says Richard Grossman. ``Just in a way, this is giving back. It's addictive and it works.''

``I made a good living doing the cosmetic surgeries. My boys - Alex is like another son to me - are taking over. They're doing the same things I did, and they're doing the burns as well.''

A couple of weeks earlier, on a Wednesday morning after the day's surgery slate has been completed, the next generation of Grossman burn doctors is freaking out an auditorium full of junior high school students, many of whom may be eyeing careers in medicine.

Dr. Peter Grossman, 38, moves through a slide presentation that has been recently equipped to show live footage. ``Before and after'' slides of severed hands, mangled digits, breast reconstructions cause a good number of students from Madison Junior High School's Medical Magnet program in North Hollywood to gasp, turn away or loudly utter variations of the word ``Eeww!'' repeatedly.

``In a foot-vs.-lawn mower accident,'' Peter says, a graphic slide illustrating the point, ``the lawn mower always wins.''

Those with their stomachs intact pepper Grossman with questions during a post-presentation q&a session. Never mind questions about necessary school experience or what parts of his job give him the most satisfaction. The students want to know how much he earns per year and what kind of car he drives.

``Some of them were totally interested in what we do,'' Dr. Peter - as he's known at the center, says later. ``Some of them asked if I'm ever grossed out.''

Of the two boys who used to trail Richard Grossman on his rounds before they could go out and play ball, Peter was the one who wasn't bothered by the sight of blood. He worked as an orderly at the hospital at age 17 and later went to medical school at Northwestern.

When Peter expressed an interest in focusing on cosmetic surgery and eventually joining the practice, his father urged both him and Majidian to get additional training in skills Richard Grossman didn't possess.

A few years later, with training in microvascular surgery for breast reconstruction (Peter) and specialized hand surgery (Majidian) under their belts, the two younger doctors joined the Grossman practice.

``Nepotism,'' Peter jokes, ``has been very good to me.'' Not entirely, says his father.

``They're both technically very good surgeons. They've got great hands,'' says Richard Grossman. ``But they're very educable. The one thing they've learned is that you sit down and talk with the patients. That makes a world of difference.''

Peter Grossman, who also does cosmetic surgery, once thought he'd move away from burn medicine, but that impulse is gone.

``It's not until you become involved in burn medicine that you see the rewards that come out of it,'' he says. ``It's so attractive and, for me, almost addictive.''

CAPTION(S):

9 photos

Photo: (1 -- cover -- color) HEALING TOUCH

BURN PATIENTS are in good hands when Drs. Richard and Peter Grossman are in command

(2 -- 5 -- color) Dr. Peter Grossman, left, removes synthetic skin from a case to use in surgery on a burn patient, while his father, Dr. Richard Grossman, below right, joins nurse Helena San Marco in consulting with burn patient Louise Murray. Below left, the two Grossmans chat between surgeries. Far left, doctors Alexander Majidian and Richard Grossman graft skin onto the hand of a 13-month-old child.

(6) Richard, left, and Peter Grossman perform a dermabrasion and reconstructive surgery on a burn victim.

Charlotte Schmid-Maybach/Staff Photographer

(7 -- color) CHRIS JAMES

Hart High School student injured in a 1998 physics experiment explosion, spent about one month at Grossman.

(8 -- color) ADRIENNE ALPERT

KABC news reporter severely injured in a news van accident, spent 66 days at Grossman.

(9 -- color) BILL JENSEN

Glendale firefighter injured during the 1996 Malibu wild fires, spent 3 1/2 months at Grossman.