Editor's note: This story includes a graphic image of Stacy Young after her accident.
While talking to a friend at a picnic the weekend before July Fourth, Stacy Young heard a sudden whoosh, followed by a loud thump.
"I saw color flying at my face, and my head flipped back," she said. "I fought like hell to get up, then everything went dark."
Young, who lives outside of Reading, was among the thousands each year who are treated in the emergency room for a fireworks injury. Hers, at a birthday party in Chester County 17 years ago, was especially gruesome, as it was caused by a professional-grade firework that was unsafely fired from more than 100 yards away.
Young, 39, lost one eye, sustained severe damage to the second, and suffered a cracked skull in five places. She has had a half-dozen surgeries over the last 16 years. The most recent took place in August at the University of Pennsylvania's Scheie Eye Institute.
In 2002, the man who set off the firework pleaded guilty to aggravated assault and served 10 months in prison.
Though that was an extreme case, even ordinary sparklers, which burn at up to 2,000 degrees, can cause severe injuries. These handheld pyrotechnics accounted for 900 out of more than 7,500 fireworks-related injuries that required emergency care during the month surrounding Independence Day last year, the U.S. Consumer Product Safety Commission says.
Burns are the most common fireworks injuries, generally accounting for two-thirds of the total each year. Often they're classified as third degree, meaning that both the outer and inner layers of skin are destroyed and skin grafts are needed, said Randall W. Culp, a professor of orthopedic, hand, and microsurgery at Thomas Jefferson University Hospital.
Culp has been on call during the July holiday for a dozen years in a row, and in addition to burns, he sees other injuries that remind him of his service in the Navy during the first Gulf War.
"It's almost like a war zone," Culp said.
A common mistake people make is to light M-80s, cherry bombs, and other explosives while holding them, he said. The device goes off too soon, and the thumb and index finger are blown off.
Culp tries to salvage the digits with bone grafts, when possible. If the thumb is beyond saving, he can fashion a new one from the patient's big toe, a complicated procedure that involves attaching arteries, veins, tendons, and nerves.
While hand and finger injuries are the most common year after year, eye injuries also are a regular presence in federal statistics.
In Young's case, the firework was launched from a tube that had fallen sideways by accident, according to the Chester County District Attorney's office. She was flown by helicopter to the Hospital of the University of Pennsylvania, where surgeons successfully rebuilt her skull and removed the remnants of her left eye. She was fitted with an artificial eye to replace it.
The first surgery to stabilize her right eye took place in early 2001. The force of the explosion had damaged her optic nerve and ruptured the spongy network of blood vessels beneath the retina, leading to the growth of scar tissue that clouded her remaining vision, said Albert M. Maguire, a professor of ophthalmology at Penn's Perelman School of Medicine.
"From her perspective, it was like she was wearing a pair of glasses and then gradually there were more and more scratches, and it started to become opaque," Maguire said of the scar tissue.
He performed a delicate surgery to peel off the scar tissue, and it went well enough that Young, though legally blind, was able to function independently for years.
However, in the last several years, the lingering impact of the injury clouded her vision once again, this time from the front side of the eye. Upon returning to Penn's Scheie Institute for an exam, she learned she suffered from a cataract, an affliction that strikes most people much later in life.
Cataract removal is a routine surgery, but hers was not, said Maguire and Penn colleague Stephen Orlin, an associate professor of ophthalmology. She had suffered damage to her zonules, the stringlike fibers that hold the lens in place. Not only was her lens cloudy, but also it drifted back and forth.
Last August, Maguire removed the old lens. Then, Orlin sewed a new one to the white of her eye, using sutures thinner than a strand of human hair.
It was a success, her physicians said. Young is still classified as legally blind in her one eye, and her vision is especially poor when looking straight ahead. But it's stable.
At that level of vision, "you can cook, clean, take care of yourself, and do daily household chores," Maguire said.
It was a good outcome, considering the severity of the injury, said Orlin.
"It's the worst fireworks injury that I've ever seen," Orlin said. "It's almost analogous to a blast injury from a weapon."
Still on Young's medical plate: recurring migraine headaches, which she keeps in check with a type of medicine designed for epilepsy.
"This is something that will haunt me for the rest of my life," she said. "If you want to enjoy the celebration of fireworks, go see a show by those who are professionally trained."