My patient was a Native American.  "I have been fasting and praying for 2 days" he told me that first day of June, when I walked in to introduce myself. I told him I was an Infectious Disease (ID) doctor and would be part of the team to care for him over the next month. I was covering for my colleague on a trip to his home country.  He had repeatedly refused amputation of his leg and pleaded with me for help to save it.  His story began years ago. He had diabetes a long time. Admitted about 4 weeks earlier for a diabetic foot ulcer #DFU that spread #infection through the left foot he had surgery to remove the worst of the infection. He lost 4th and 5th toes and the outer part of  left foot.  Sorry for graphic images . ID was consulted and antibiotics guided by subsequent bone cultures were started. Wound care saw him daily. The wound did not heal.  Arteriography showed blocked arteries and angioplasty to open up the leg arteries was performed. Twice .  The wound still did not