The caller got straight to the point. “Hello Nurse Clark,” he began. “My name is Jesse.* I don’t know whether or not you remember me, but I’ll always remember you.”

To wound care specialist Amanda Clark, this was welcome news. Of course she remembered him—already paraplegic from a bullet to the spine, he’d been admitted a year ago with foot wounds so severe they threatened to take both legs. In fact, before turning to Hopkins, he refused treatment at two other hospitals because physicians there wanted to amputate. Perhaps it seemed pointless to perform heroics on a paraplegic’s legs?

But Jesse was adamant about keeping them. “He made it clear he would leave this world with all the parts he came with,” remembers Clark. “I knew that if we succeeded, he would comply with even the most demanding home dressing instructions. That got me on a different page.”

Clark cleaned Jesse’s wounds by debriding as much of the dead tissue as she could at the bedside. Amazingly, despite exposed bone and tendons, Jesse still had blood flow to his feet—which, Clark says, greatly increased his chances for recovery.

With this promising report, Clark called in podiatrist John Murphy. “Collaboration between wound care nursing and podiatry is critical to maintain continuity of care from inpatient to outpatient,” says Clark. “We use each other’s expertise to get the right outcome.” Murphy agreed to take Jesse into the operating room and follow him for as long as necessary on an outpatient basis.

In the OR, he used the vacuum-assisted closure device to treat the wounds, some as long as 12 centimeters. He was then able to close them with skin grafts because the surrounding tissue had been saved from infection.

“He was dramatically better even after just a few days,” says Clark. Jesse recovered from surgery and began his outpatient commitment. For months afterward, he and his grandfather faithfully made the two-hour roundtrip every two weeks for follow-up appointments with Murphy—just as Clark had predicted he would. A year later, Jesse has made a full recovery.

“My experience with [Clark and Murphy] restored my faith in doctors and nurses,” he says. “They’re not arrogant, but kind. They were willing to try for the conclusion I wanted. That made my ordeal so much better.”

*name has been changed

-From Hopkins Nurse, Spring 2006

PHOTO: Wound care nurse Amanda Clark, center, and podiatrist John Murphy, right, teamed up to save their patient’s legs from dangerous foot wounds. Today, he’s grateful to be fully healed.