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RW Johnson Recounts his Amputation Ordeal

South Africa's Brave New WorldSouth AfricaRW JohnsonAlert! BOOK SA readers will recall the ordeal that RW Johnson went through in March when, swimming in a lagoon in KwaZulu Natal – just weeks before the launch of his latest book, South Africa’s Brave New World – he cut his leg and had to have it amputated.

Now Johnson has recounted his battle with necrotising fasciitis, the terrifyingly-named “flesh-eating disease” that almost cost him his life, in the London Review of Books:

In early March, while staying at our holiday cottage in Trafalgar on the KwaZulu-Natal south coast, I went swimming, as has been my habit for many years, in the idyllic Mpenjathi lagoon. The lagoon looks pretty much the way it did when Vasco da Gama first saw it; the lower south coast and Trafalgar in particular are unspoiled – we frequently get duikers as well as monkeys in our garden.

As I neared the shore I hit my foot painfully on a submerged rock; a quick inspection showed that several toes were bleeding. I waded ashore, got home quickly and showered. The bleeding soon stopped but the next day my whole foot was sore. I tried to ignore it but matters rapidly got worse and soon I was running a fever and felt so ill I was giddy and unsteady on my feet. Eventually I decided I had to see a doctor, but things were so bad that I fell repeatedly while trying to get to the car and had to half-crawl across the garage to get in. How I managed to drive the 12 kilometres to Port Edward remains a mystery – I was lurching all over the road. Arriving at the offices of Dr Chetty, whose board advertises him as a dokotela (Zulu for ‘doctor’) trained in Mysore, I found several other patients ahead of me but stumbled over to the receptionist’s desk and explained that I was seriously ill.

Dr Chetty was wonderful. He immediately laid me on a table, gave me a drip, and in no time at all an ambulance had been arranged to
take me to Margate Hospital. It turned out later – a great stroke of luck – that Dr Chetty had once before seen a patient suffering from what I had: necrotising fasciitis, caused by flesh-eating bacteria which rapidly invade and poison the body (the other man had died, as is normal with this disease). Almost certainly the reason the lagoon was polluted with such a deadly organism was to do with the dumping of raw sewage by communities living upriver.

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Image courtesy the Guardian and thanks to @TymonSmith for the tip

 

Recent comments:

  • <a href="http://helenmoffett.book.co.za" rel="nofollow">Helen</a>
    Helen
    August 5th, 2009 @00:03 #
     
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    What a nightmare. I am no great respecter of Johnson's views, but I suspect he and I would agree vociferously on the tyranny of private medical aids: am trying to get authorisation for surgery in just over a week, and already I am plotting a blog along the lines of Rustum's "meditation" on I-Burst...see http://rustumkozain.book.co.za/blog/2009/07/17/open-letter-to-iburst-sa/
    http://rustumkozain.book.co.za/blog/2009/07/18/more-anger-and-thoughts-on-iburst/
    http://rustumkozain.book.co.za/blog/2009/07/19/ethos-ego-respect-a-little-discourse-analysis/

    Wishing Johnson well with the rehabilitation process.

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  • <a href="http://fionasnyckers.book.co.za" rel="nofollow">Fiona</a>
    Fiona
    August 5th, 2009 @08:58 #
     
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    Johnson lives to annoy me another day - which is a very good thing. I too wish him all the best with rehab, recovery and adapting to the prosthesis. That's one of the most nightmarish stories I've ever heard.

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  • <a href="http://rustumkozain.book.co.za" rel="nofollow">Rustum Kozain</a>
    Rustum Kozain
    August 5th, 2009 @13:03 #
     
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    What a horrific tale. Politics aside, yes, much respect to Johnson for being able to write about it so soberly and stoically.

    Not to hijack this thread, but thanks for referencing 'Open Letter'; teh forums are still buzzing with complaints - connections and accounts. Some guy, who never got to use iBurst when he signed on in 2005 because it didn't work at his place and had cancelled his account almost immediately, has been facing a bill of R21 000. That's right. And that excludes legal fees, lost credit reputation, etc etc. He never used their service!

    More hijacking: Couscous goes under the knife on Friday, and then will take the long journey into the deep south, where she will join a family of two cats, a dog and two ducks with friends in Noordhoek.

    Mowbray Vets in Durban road have been good, caring and sympathetic. I recommend them unconditionally.

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  • <a href="http://helenmoffett.book.co.za" rel="nofollow">Helen</a>
    Helen
    August 5th, 2009 @15:44 #
     
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    Poor little Couscous! May she repair well, and recuperate in bliss in her new home. (I wish Johnson the same.)

    I also recommend Mowbray Vets very highly. Not quite unconditionally, cos every time Graham gives either of my girls an antibiotic injection, they utter an outraged yowl and I burst into tears. But somehow I don't think this is his fault, and I do trust them completely. Katya got to spay Meg and Lily (more maternal tears), and they were bouncing around only hours later.

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  • <a href="http://rustumkozain.book.co.za" rel="nofollow">Rustum Kozain</a>
    Rustum Kozain
    August 5th, 2009 @16:12 #
     
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    Well, Kati did call Couscous 'miracle cat' and I want to believe that that was special and that she does not call every other cat 'miracle cat'. Your cats, Helen, are of course not a subset of 'every other cat' at all..

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  • <a href="http://helenmoffett.book.co.za" rel="nofollow">Helen</a>
    Helen
    August 5th, 2009 @16:24 #
     
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    At risk of total hijack of v. serious post about poor R.W. Johnson's truly appalling ordeal, just want to confirm that Kati has never described either of my fluffies as miracle cats. Now jealous. Not really. V. v. glad Couscous is a miracle cat. They breed 'em tough in Obs.

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  • <a href="http://poetsprintery.book.co.za" rel="nofollow">Amitabh</a>
    Amitabh
    August 5th, 2009 @17:59 #
     
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    I believe that it has more to with Cellulitis or Erysipelas caused by Streptococcal bacterial infection. Necrotising Fasciitis is one of its complications.

    Such type of an infection is quite common considering that any wound would result into such an infection if not treated with the right antibiotics at the right time.

    Diabetes and old age contributes to such a galloping infection.

    Mr. Johnson's ordeal had been terrible, I wish him all the best in his rehabilitation and recovery.

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  • <a href="http://rustumkozain.book.co.za" rel="nofollow">Rustum Kozain</a>
    Rustum Kozain
    August 5th, 2009 @19:53 #
     
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    I was wondering Amitabh, Johnson does not mention washing in household first-aid antiseptics. He just mentions having a shower. Could Dettol have helped?

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  • <a href="http://liesljobson.bookslive.co.za" rel="nofollow">Liesl</a>
    Liesl
    August 5th, 2009 @20:23 #
     
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    As a beneficiary of first world medical care I am deeply grateful to the likes of Dr. Chetty who have intervened and saved my life on occasion. Too seldom are these good people properly recognised.

    This article is a sobering reflection on a potential outcome that makes me squeamish to consider.

    Strength and good heart for the recovery that lies ahead yet, RW.

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  • <a href="http://fionasnyckers.book.co.za" rel="nofollow">Fiona</a>
    Fiona
    August 5th, 2009 @21:15 #
     
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    More hijacking - Paddy and Sprite are going for their respective neutering and spaying in a couple of weeks and my nerves are all ajangle. Mind you, it's not a moment too soon in Paddy's case, judging by the swagger he's developing.

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  • <a href="http://poetsprintery.book.co.za" rel="nofollow">Amitabh</a>
    Amitabh
    August 5th, 2009 @21:47 #
     
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    My apologies, but couldnt understand about the mention of Dr. Chetty and his medical education from Mysore. The Medical School at Mysore is equivalent to any first world medical training centre. The Commonwealth Countries Medical training programme follows the same syllabus and protocol. Graduate and Post Graduate Medical Studies in India are recognised by General Medical Council UK and the WHO.

    Has there been a feeling that in spite of having studied in Mysore, he did very well.
    Obviously Mr. Johnson does not know about the Medical School in Mysore.

    Rustum -
    I believe that the wound got septic and the overall picture is of a rapid sepsis due to low immunity.
    It has nothing to do with the sea water.

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  • <a href="http://helenmoffett.book.co.za" rel="nofollow">Helen</a>
    Helen
    August 5th, 2009 @22:34 #
     
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    Huh. Comment death, for the 1st time in a long while. Trying again...so I can send sympathetic vibes to Fiona -- I was a wreck when my babies had their snips, wept copiously all over unfortunate (and very kind) vet just BOOKING their ops. And Fifi, please post pics of Paddy and Sprite so we can welcome them properly to the BookSA feline family.

    (Have joined forces with hijackers, but still want to ask Amitabh if one should immediately wash wounds like the one Johnston sustained with antiseptic, or if that just breeds superbugs??)

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  • <a href="http://rustumkozain.book.co.za" rel="nofollow">Rustum Kozain</a>
    Rustum Kozain
    August 5th, 2009 @23:12 #
     
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    Would a wash with Dettol have helped Amitabh? Johnson says that he showered but doesn't mention first-aid antispetics...

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  • <a href="http://poetsprintery.book.co.za" rel="nofollow">Amitabh</a>
    Amitabh
    August 6th, 2009 @13:55 #
     
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    It might help as it would clean the skin surface but the inflammation caused by the wound would progress
    Rustum, Helen - The progress of the wound to a frank sepsis would depend on various factors and from person to person.
    Non Steroid Anti Inflammatory drugs along with proper antibiotics are necessary to be given at the beginning of such a sepsis.

    There was a time at Zimbabwe, where I never gave routine antibiotics postoperatively to my orthopaedic patients.
    Now times have changed.
    I keep Ciprofloxacillin at my home all the time.

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  • <a href="http://fionasnyckers.book.co.za" rel="nofollow">Fiona</a>
    Fiona
    August 6th, 2009 @14:06 #
     
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    You're right Amitabh, I also detected a distinct sniffiness about the fact that Dr Chetty proclaimed his profession in Zulu (what else would you do when many of your patients are Zulu-speaking?) and that he studied at Mysore.

    Helen, thanks for your good wishes. I hope I won't be a complete wreck on the day (battle-hardened after all of Abby's many hair-raising procedures, see), but I know I'll be very glad when they're back home safe and sound. Will post pics soon.

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  • <a href="http://poetsprintery.book.co.za" rel="nofollow">Amitabh</a>
    Amitabh
    August 6th, 2009 @20:39 #
     
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    Mr. Johnson would have chosen to visit the neighbourhood doctor who has after his medical degree Pretoria written in brackets but unfortunately there was none.

    My sojourn in specialising in the University of Pretoria for many years has been due to this very mentality.
    LOL

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