By the time Michelle Marineau saw her patient, James*, there was little she could do to help him. His big toe had been removed, a complication from years of uncontrolled type 2 diabetes, but the amputation site had stubbornly refused to heal. An infection had eaten away flesh and left tendon and bone exposed, streaks of off-white against the angry, red, weeping wound. Several of his other toes had developed gangrene, turning black and slowly dropping off.
Marineau, a nurse practitioner and wound care specialist on Oahu, Hawaii, had seen many patients like James before and decided that he, like over 70,000 other people with diabetes in the US each year, needed to have his foot amputated in order to save his life.
Seeing his father’s distress at the looming procedure, James’s son proposed a different solution: maggots.