My most memorable patient was a 55-year-old man that I cared for while I was working at a homeless shelter in downtown Charleston, S.C. The patient had a large venous stasis ulcer on his left ankle with another smaller ulcer just below it.
I had just started working at the shelter, so I did not know how scarce supplies could be. When I first saw the ulcers, I thought I would wash them with basic soap and water. For three weeks I used this method, but after no change I finally decided to give up. The wound sites were not looking any better, so I sent the patient to the county hospital ED.
When the patient returned to the shelter, he told me that the ED physician said it was possible that he might lose his foot. We sent him to the Medical University of South Carolina Vascular Surgery Unit, also in Charleston. But they suggested the same thing, because the patient was homeless and did not have any insurance.
The supervising physician I worked with said that there was not much hope, but suggested that I try applying an Unna boot once a week. That’s exactly what I did every Monday for one full year, and the patient did not lose his foot. My supervising physician was surprised at my persistence and the positive outcome.