The brilliant surgeon who realised too late he had deadly sepsis
ORThOPAeDIC surgeon Tony Fogg had rarely taken a day off sick in 27 years. As his wife Jane explains: ‘When you’ve got a clinic full of people waiting to see you, then you can’t just phone in and have a duvet day.
‘If he felt unwell, he got on with it and I was the same. Like most medical families, our medicine cabinet at home contained some paracetamol and, if you were lucky, a couple of plasters.’
Tony, a spinal surgeon at the Great Western hospital in Swindon, was a big character. Known by all as Foggy, he was full of joie de vivre, with a passion for fast cars, and at 64 was at the top of his game, relishing work in the department he had helped establish.
Jane, also 64, had happily given up a career in fashion to raise their children: Ben, now 37, Jack, 35, and Anna, 33.
‘Foggy was my soulmate and my best friend,’ she says. ‘We’d grown up together in the little Welsh coastal town of Porthcawl. After 40 years we still had a great marriage. We loved being together.’
At the beginning of March last year, Jane booked a mini break to the Netherlands to see a painting — the subject of a book, The Goldfinch by Donna Tartt, which they had both been reading.
‘Any excuse for a weekend away,’ she says with a laugh.
‘When Foggy came home from work on the Thursday evening feeling grotty, I said: “Oh man up, you’ve got a cold.” The next day, I woke up feeling rough, too, and I thought: “Well, that serves me right for being unsympathetic.” ’
At that point neither would have described their symptoms as worrying. ‘They were nothing more than a scratchy sore throat and prickly eyes,’ says Jane.
They pressed ahead with their trip, flying to The hague on Friday. ‘We walked around a museum, went out for supper. We felt fine,’ she says. ‘On Saturday, we were sneezing a lot, but not feverish, just a bit zonked and coldy.’
But by Saturday evening both were feeling very unwell. exhausted, achey, with coughs and chest pain, they were desperate to get home.
‘We flew back on Sunday,’ says Jane. ‘That evening, Foggy said: “I’m going to phone and cancel my clinic tomorrow.” That was unheard of for him. We thought we had ghastly flu — we went to bed early, thinking we’d feel better in a couple of days.’
In fact, Tony was developing the sepsis that would kill him.
Sepsis is where the immune system overreacts to an infection and attacks its own organs and tissues. It can occur as the result of a bacterial, fungal or viral infection, and can start as a result of something as trivial as a cut, bite or sting. If not spotted and treated quickly, it can rapidly lead to a sudden drop in blood pressure, organ failure and death, sometimes within a few hours.
every year sepsis kills 44,000 people in Britain — more than the combined figures for breast and prostate cancer and road accidents.
There is a worrying lack of awareness among the public and medical professionals, leading to thousands of needless deaths.
The Mail has been backing calls by charity the UK Sepsis Trust for a national awareness campaign.
health Secretary Jeremy hunt has pledged to act, and later today he is due to meet again with the charity and Melissa Mead, whose one-year-old son William died of sepsis after warning signs were missed by the NhS.
There are high hopes Mr hunt will soon announce a campaign — but every day of delay costs lives.
Part of the problem with sepsis is that the initial symptoms are vague and can be confused with other, more benign conditions.
‘Sepsis can arise from any type of infection so it’s often hard to diagnose,’ says Dr Ron Daniels, chief executive of the UK Sepsis Trust.
‘In its early stages, it can look and feel like a bad case of flu. The difference is that it’s likely to make you feel much worse.’
Through Monday, the Foggs stayed in bed, expecting the ‘flulike’ symptoms to pass. ‘At some point on Tuesday morning, Foggy said: “I’m not happy with the way I’m feeling, I’m going to phone Tim [the family GP],” ’ says Jane.
‘I think he may have stopped peeing which, being a doctor, he knew was a classic symptom of sepsis. But he didn’t share very much with me — he wouldn’t have wanted to worry me.’
The GP immediately called an ambulance, which arrived in minutes and the couple were rushed to the hospital where Foggy worked.
‘I felt pretty done in, but not so ill that I couldn’t put on make-up and blow dry my fringe while we waited for the ambulance,’ says Jane.
‘And we walked into A&e, chatting away. It all felt terribly relaxed because we were in Foggy’s hospital and everyone knew him.’
What happened next was ‘like being in a very bad film’, says Jane.
She waved goodbye to her husband as she was taken one way, he another. ‘I didn’t grasp the seriousness of the situation at all and I don’t know if Foggy did — or whether he was just trying to protect me. The next time I saw him he was unconscious.’
he was taken to intensive care and put on intravenous antibiotics and a ventilator machine. Jane found out later he’d been asked whether he wanted someone to call the children and he’d said: ‘Don’t be ridiculous! They’re all busy.’
‘That is my great consolation,’ she says. ‘he wasn’t worried, he wasn’t frightened. As far as he was concerned, they were going to get on top of the infection and he would get better.’
In another room in intensive care, Jane was given intravenous antibiotics and told they would be in hospital for about a week.
‘I felt terrible, but I clearly remember thinking: “A week. But we’ve got plans for the weekend!” even then, there was no sense of dread or panic.’
Blood tests showed Jane and Tony had swine flu and a streptococcus A infection — a common cause of throat infection and not normally a serious threat to health.
‘Foggy must have caught swine flu working in the hospital and then given it to me,’ says Jane.
But Tony had also caught a third, water-borne infection, possibly from something he’d eaten or drunk in The hague. The combination caused his immune system to go into overdrive as it tried to fight the three sources of infection.
Within hours of being admitted, his condition had deteriorated to the point that his colleagues had to tell Jane he was not responding to antibiotics and they might not be able to save him. ‘I’ll never forget it,’ she says. ‘Being told Tony’s life was hanging by a thread.’
The shock of those words still makes her cry. ‘I just said: “What? It can’t be!” I couldn’t believe it or take it in.’
In the early hours of Wednesday morning, Tony was moved to Papworth hospital in Cambridgeshire, a specialist centre for critical care. Their children gathered round their adored father and though still very unwell, Jane discharged herself to be with him, too.
‘It was Foggy lying there, but it wasn’t him,’ she says. ‘his skin was mottled and he was covered with tubes and wires. The worst part for me — for any mother — is seeing your children broken and there’s nothing you can do to help them. There was so much disbelief and shock that a healthy, vibrant man who was so full of energy could be reduced to this body on a table in such a short time.
‘We were told he was close to death, but we clung to the smallest glimmer of hope that he would pull through.’
Then on March 19, eight days after being admitted, Tony suffered a massive heart attack and died.
‘No one can prepare you for it,’ says Jane. ‘Just a week before we’d sat chatting in a bar in The hague and decided we had at least ten really good years ahead of us to travel the world before we started getting creaky.’
After Tony died, Jane received hundreds of letters from her husband’s grateful patients. ‘he made my daughter walk again,’ one wrote. ‘he transformed my life,’ said another. Did it help?
‘No,’ says Jane. ‘It made it worse. Foggy did so much good, he was still operating three times a week, making people’s lives better. Why did he have to die? There is just this awful, unbearable emptiness.’
She doesn’t torture herself with what might have been done to save her husband. ‘everyone did everything they could. They were fantastic. ‘The real problem was that we didn’t realise what was happening until it was too late.’
This is the point the UK Sepsis Trust and its supporters want to stress to families and healthcare professionals: think ‘sepsis’ and get medical help quickly.
As Dr Daniels is at pains to point out: ‘With sepsis, every hour counts.
‘even if you don’t have the key warning signs [see panel above], if you or your loved one has an infection and are getting steadily worse, and you just know something is wrong, have the courage of your convictions, contact your GP or NhS 111 and ask: could this be sepsis?’
The Great Western hospital had a huge memorial party for Tony, and the family held another.
‘We had community singing and an auction for the UK Sepsis Trust — someone paid £150 for a ball of string, just because they wanted to help.’
It’s the little things she misses. ‘When this happens, you don’t just lose the man you love, you lose everything you did together.
‘you no longer go to the pub for fish and chips. you no longer go to the cinema. I suddenly realised: Foggy’s gone and so has my life. I am lost without him.’