The case of the burning child: spontaneous human combustion?

One morning last week, through a friend on Twitter, I came across a shocking piece of news in The Hindu, arguably, one of India’s finest newspapers. The story entitled “Rare medical condition sets Chennai baby afire repeatedly” detailed the peculiar case of an infant who allegedly caught fire spontaneously shortly after birth. According to the story, widely repeated in both Indian and international media, the boy, Rahul, suffered burn injuries three subsequent times after that first horrifying event.

To quote the story:

He suffers from an extremely rare condition called spontaneous human combustion, doctors at KMC [Kilpauk Medical College Hospital] say. R. Narayana Babu, head of paediatrics at KMC, says the baby was referred to the hospital by the Villupuram collector.

“The dean got a call from the collector and the child came to us on Thursday evening. We researched online and found that over the past 300 years, 200 such cases were reported. The last reported case was of a 73-year-old man who died in his sleep, after going up in flames, in Wales, England, in 1995,” he says.

In the paediatric intensive care unit where Rahul is admitted, the authorities have placed a bucket of water and a fire extinguisher near the baby’s bed to tackle any emergency.

Terming it a ‘rarest of rare occurrence,’ Dr. Babu says, “It has been scientifically documented that concentrated combustion air excreted from the body could result in such episodes. In elderly persons, heavy drinking could lead to the body excreting alcohol-like substance which could get ignited.”

Rahul is now being treated with external application of ointment for his burns.

What struck me immediately was the matter-of-fact approach both the doctors treating the patient and the newspaper reporting the story took to diagnosing a case of “spontaneous human combustion”. What I also found quite odd was that having satisfied themselves that the boy was indeed spontaneously igniting (via some unexplained mechanism), the pediatric unit of the hospital chose to “research” the malady online (because whatever we read online is accurate, right?)

The term “spontaneous human combustion” is a misnomer, since there is no biochemical method by which humans spontaneously ignite. The spontaneous disintegration of a human into flames would also be a thermodynamically unfavorable reaction. A website claiming to describe the process by which a human “spontaneously” burns mentions that “the victim’s clothing is accidentally ignited by an external heat source”. This is as intrinsic a firestarter as being hit by lightning. Yet, we know, all too well, and all too tragically, that under the right circumstances and external flammable agent, humans do burn. In a very few rare cases, what has been called “spontaneous human combustion” (a phenomenon which no one has actually observed first-hand) is the melting of the fat of a deceased human like a candle through a wick-effect. Articles which propagate this phenomenon outline a series of events which are preconditions for this rare incineration: the flame burn victim must die for the body fat to start melting, the skin must be ruptured for the flammable fat to extrude the skin and mix with the clothes in the skin; and there must be a presence of flammable liquids or vapors to ignite the body. What bears repeating is that in these rare cases, the human is always deceased before the body burns.

When I read the report in The Hindu a few points stuck out apart from the bizarre decision of the doctors to consult online “sources”. The boy was burning up repeatedly and the boy was still alive. Therefore, based on the mountain of evidence, the simplest solutions were that the conditions of the house were such that the boy was either accidentally catching on fire or that someone was deliberately setting him on fire. The simplest solutions may be unpalatable, as they certainly are in this case, but they must be examined first before reaching for fantastic assumptions. Occam’s Razor, really should be a model for how we think.

Further, that a young boy accidentally caught on fire was formally possible. But logically, that possibility must decrease with repetition. We can suspect accidental burning if it happens once. But the possibility of this accident occurring, especially after it has happened once, should go down. As an analogy, a man can win a lottery once without suspicion, but if he wins four times in a row, though still possible, we begin to suspect that something else may be a part of the story. In this case, if someone was harming the baby, it would be possible to test this hypothesis by isolating him and keeping him under observation. The outcome could be that the baby did not burn, which would be good news, or that the baby did (and that would open up a new avenue of path-breaking research on a truly unique child).

Instead of waiting and taking the logical approach, the doctors rushed to the media and prescribed this approach to the parents:

Doctors say the parents will be trained to take care to prevent exposing the child to situations that could cause him to go up in flames. “We have to teach them to avoid sending the child out in the sun and specify the kinds of clothes he can wear when he grows up,” Dr. Babu says.

Why did the doctors not consider the possibility that someone was harming the baby? Assuming good faith on their part, perhaps, it was the simplicity of the parents and their displays of concern? Perhaps, it was the unwillingness to acknowledge that someone could do something as heinous? Nonetheless, children are harmed globally and sometimes even by their parents. Munchhausen Syndrome by Proxy is real and more prevalent than so called instances of spontaneous combustion. Indian culture would do well to acknowledge its possibility.

POSTSCRIPT: another friend pointed out a new story today that states the baby is “medically” normal and that the authorities are finally suspecting foul-play.