Chasing Hope

That day, doctors set Jacqui's fractured bones, drilling in pins, metal rods and plates. They cut open her hand to wash out dead tissue and dirt with a hard water spray.

On Wednesday, surgeons began the process known as debridement. They went to work with scissors and a long blade, slicing through Jacqui's dead skin until they reached flesh that bled.

Surgeons covered her burns with autografts — thin strips of healthy skin shaved off unburned parts of her body. They passed the skin through a machine that punched small holes in the grafts, allowing doctors to stretch them and cover a wider area.

The grafts left aching wounds. Doctors waited until the wounds healed to harvest more skin. Meanwhile, doctors used homografts — stored sheets of cadaver skin, which work like a temporary dressing, buying time until the body rejects it.

Surgeons delayed debriding Jacqui's head, hoping to salvage as much of her face as possible. Her eyelids were destroyed, but her eyeballs survived. Days later, her eyes were sewn shut. If left uncovered, they would have dried out, and she could have lost all vision.

Dr. Dwayne Roberts, a 30-year-old ophthalmology resident, watched one of Jacqui's early surgeries. The young doctor had never seen such a severe case.

Around the operating table, doctors worked quickly and quietly.

"We're not going to save this girl," Roberts thought.

Hanging On
Amadeo and Rosalia watched Jacqui wheeled off to surgery after surgery. Doctors took turns working on different body parts.

Rosalia didn't think Jacqui could survive. She took sedatives and prayed.

"I asked so much of God. I begged him," she said.

Amadeo said he didn't have any doubt his daughter would live. He slept in a chair by her bed.

He and Rosalia spoke little. They sat apart in the waiting room and eventually rented separate apartments, but each parent kept up a one-sided dialogue with Jacqui.

After a few days, Jacqui sometimes responded to questions. To say yes, she moved a foot up and down; to say no, she swayed her foot from side to side.

Amadeo and Rosalia wanted to touch their daughter, but they didn't know where — her body was an unending wound. Patients need contact, Goodheart said. It's like a shot of morphine.

One day, nurses told Rosalia and Amadeo to remove their gloves and massage Jacqui's feet. Rosalia wanted to kiss her daughter.

"Go ahead and kiss her toes," Goodheart told her.

Rosalia, the nurse said, bent her lips to Jacqui's feet and held them, not letting go.

Face and Fingers
Amadeo and Rosalia watched Jacqui's ears disappearing and her fingers growing thinner.

Goodheart remembers Jacqui's lips getting looser as she cleaned her patient's face with wet gauze pads.

"Then one day," Goodheart said, "they're in my hands."

After her lips, Jacqui's right ear came off, Goodheart said. Her left ear and her nose fell off, too.

Jacqui battled infections and high fevers. Surgeons chipped at dead skull bone with a drill and harvested more skin.

On Oct. 10, three weeks after the accident, there was good news: Jacqui's doctors decided she could breathe on her own. She could barely speak.

"Hola, Mamita," Jacqui whispered hoarsely to her mother.

Early on, doctors had amputated parts of her fingers. They left as much as they could, hoping some bone would survive.

Amadeo kept signing the medical releases. He said he didn't know how much doctors planned to amputate. In the operating room, surgeons used scissors to snip the soft, dead bone to between the knuckle and the first joint.