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Julia Zelixon pulled back the crisp green blanket covering Helen, her patient, and suppressed a gasp.

“I’ve never seen anything like this,” she whispered to another nurse, standing nearby. “Never.”

Julia had read about necrotizing fasciitis — better known as flesh-eating bacteria — in nursing school, but this ravaged abdomen was beyond any textbook description. From just below the ribs down to the left hip, an enormous patch of Helen’s flesh had been surgically removed to block the fast-moving infection. Only a white layer of gauze covered her crimson muscles, and black magic marker lines, drawn by nurses across Helen’s thighs, mapped the bacteria’s continued spread.

Julia, a first-year nurse, carefully cut the sutures that held one of Helen’s monitoring lines in place. She revealed nothing of the thoughts racing through her mind to the 55-year-old patient, who was staring straight up and trembling slightly.

“I’m sorry dear,” Julia said softly, her accent redolent of her native Russia. “Does it hurt?”

The other nurse in the room, Michele Jerard Pender, had seen too much in 20 years of nursing at Massachusetts General Hospital to be unnerved by Helen’s wounds. She didn’t miss a beat in her stream of advice about removing the monitoring line from a major artery: Be sure to block the opening with gauze and “hold it real solid for five minutes” to prevent a gusher of blood. It was a lesson M.J., as she is universally known, had learned the hard way, long ago.

M.J. and Julia had been thrown together for an extraordinary crash course in the ways of the Intensive Care Unit — Mass. General’s answer to the national shortage of veteran nurses. M.J. had just eight months to turn a trainee fresh out of school into a nurse ready to care for the most gravely ill patients at one of the nation’s leading hospitals.

Eager and ambitious and, at 35, more tested by life than most of her peers, Julia was, from the start, utterly sure she would succeed.