On the morning of Wednesday, May 22, 2024, Conservative MP Craig Mackinlay returned to the House of Commons to rapturous applause.

Normally, applause is forbidden in the chamber, but Speaker of the House Sir Lindsay Hoyle (Labour) allowed it for the MP who defied death, even though he now has artificial arms and legs.

Sepsis drama

The Telegraph has his story — and incredible photographs — in ‘Tory MP Craig Mackinlay: I lost my arms and legs to sepsis’ (purple emphases mine).

First of all, many will wonder how he got sepsis. It is still a mystery:

The cause of the sepsis remains unclear. A test carried out by a specialist lab in Manchester detected pneumococcus, the bacteria that causes pneumonia. “It’s the only thing they can put it [the sepsis] down to. Sepsis is your body going berserk. It’s an autoimmune response going over the top. It’s not the disease but your body’s overreaction to it. It makes platelets explode and causes clots and it’s the clots that cause the blockage in your arms and legs, and your extremities.”

The drama began on September 28, 2023. The Mackinlay family — Craig, wife Kati and daughter Olivia — were ready to jet off to Turkey for holiday. Everything had seemed relatively normal on the 27th, until nightfall:

… there was nothing untoward to foretell the horrors to come. Parliament was in recess and Mr Mackinlay had decided to skip the annual Tory conference in favour of a rare family holiday in Turkey. Their bags were packed and Mr Mackinlay took himself off to bed earlier than normal – “I had felt a little bit unwell during the day, just a bit off colour and anyway we had an early flight to catch the next day.” In the night, however, he was “violently sick” and “in the morning I was worse”.

On the 28th, his life changed dramatically:

… Mr Mackinlay, the Conservative MP for South Thanet, went into septic shock, his kidney and liver packed in and blood clots began forming in his extremities. His limbs turned black, his toes and fingers became – as he puts it – “desiccated” and then curled up so they looked as if they belonged to a “mummified pharaoh” or “peat bog man”.

Mackinlay’s wife Kati is a pharmacist and comes from a family of doctors. Even then, she had a hard time getting paramedics to take him to hospital in Kent:

… an ambulance … came in “reasonable time”. She had tried to take her husband’s pulse, but had been unable to find one. Mr Mackinlay’s arms were turning white. It was by now 8.30 in the morning.

“The paramedics were reluctant to take me in. They thought I should go and see my GP. I could have gone back to sleep. And I would have died I suppose,” recalls Mr Mackinlay. But Mrs Mackinlay had intervened, insistent her husband be transported to Medway Maritime Hospital, Kent’s largest general hospital. The ambulance crew could find no obvious signs of concern other than a low blood sugar count that they thought might be a symptom of undiagnosed diabetes.

“After a bit of remonstration they agreed [to take me],” recalls Mr Mackinlay. “No doubt at all Kati saved my life. If we had got there two hours later I would have been dead.” He describes it as a “goldilocks time”. If the ambulance had come any earlier, he wouldn’t have gone to hospital in the first place; any later and it would have been well… too late.

Ninety minutes later, Mackinlay’s condition worsened in a most bizarre way:

By 10am – a little over an hour after he reached the hospital – his condition had changed dramatically. “I was in the triage area and I was all perfectly OK and lucid,” he says, “and then I went literally a bright blue as the sepsis shock started.” He learnt later this was an effect of DIC, a condition which stands for disseminated intravascular coagulation, and which can be brought on by sepsis. DIC causes clotting, blocking the flow of blood to many parts of the body including vital organs and limbs. It can also perversely cause bleeding.

Most of us think of sepsis as something people can get a hospital to treat before it becomes serious, as it comes in stages.

Not so, in Mackinlay’s case. He was given a 5% chance of survival:

“They [the hospital] realised something was very seriously wrong. I was whisked away very quickly, sedated, ventilator, the whole lot. That’s the last I remember,” he says. “So I was in an induced coma for 16 days, I had a lot of organ failure. Dialysis, liver problems. My wife was told ‘he is one of the illest people we have ever seen in the hospital’ and prepare for the worst.” To put it in perspective, Medway treats about 400,000 patients a year.

“The weird thing is with sepsis you usually get a few days. You usually feel progressively worse and if you can spot it you save yourself. But mine was so rapid and so severe there was no warning at all.”

Meanwhile, the issue of amputation divided Kati and the hospital team:

Mrs Mackinlay was fighting his corner. “Medway were proposing some very, very radical surgery,” he says, “Up to here and up to here.” Mr Mackinlay is showing me where the surgeons wanted to perform the amputations before spelling it out: “Up to the crotch and up to the armpits” …

Refusing to accept the Medway amputation plan, she contacted St Thomas’ Hospital in London, near Parliament:

Mrs Mackinlay, seeking a second opinion, contacted St Thomas’, the London hospital just a few hundred yards from the Palace of Westminster on the other side of the Thames. The specialists there agreed to take her husband in.

“I couldn’t be moved immediately because my platelet level was so low that if I had an internal bleed I’d have bled to death so I had to wait a little bit.”

On Oct 16, Mr Mackinlay was transferred to St Thomas’ Hospital intensive care unit – “I was lucid but the cocktail of drugs means I don’t really remember” – before being moved 10 days later to the high dependency unit (HDU).

There a sensible surgeon assessed Mackinlay’s limbs in an effort to try and save what he could:

The surgeon at St Thomas’ Hospital – Edmund Fitzgerald O’Connor – had decided to play a waiting game. “He wanted to see how my arms and legs developed because by then they were black like plastic. I suppose it’s most akin to… ” Mr Mackinlay pauses in search of the right comparison. Eventually he says: “Frostbite, severe frostbite. You have lost circulation. That’s gone in your arms and legs. It’s like your phone. They were as hard as your phone. Like plastic up to my elbows and half way up to my knees. The surgeon said ‘let’s see what’s dead and what’s not because we want to save as much length as we can’.”

Mackinlay stayed in the high dependency unit (HDU) for six weeks. His wife visited him every day and her parents looked after their daughter.

He got sicker:

Through November, Mr Mackinlay says he was “on a fairly regular fever,” and adds with some understatement, “because you have this gangrenous material bringing your whole body down a bit. I was on a cocktail of antibiotics permanently as your arms and legs are withering and dying. Or are dead.”

The day before his amputations, Kati made a video of her husband, in which he explained his condition:

On the eve of the amputations, Mrs Mackinlay recorded a video that the family have shared with The Telegraph. It’s painful, deeply uncomfortable viewing. In it Mr Mackinlay is lying on his hospital bed, a tube running out of his nose and his arms and legs black.

“The reality is I probably shouldn’t have survived this far because the damage that was done by this sepsis was so severe,” he says, looking into the camera, “You don’t often see people in my condition who survive so that’s a big thanks to what they’ve done to keep me alive. It has caused the complete death of my hands and my feet.

“The reason I am doing the video today is of course this is the last time that these old things which have served me well for 57 years will be attached to me. They are gnarled, dry and desiccated. It will be like saying goodbye to old friends.

“Tomorrow we are on the start of proper rehabilitation where these useless hands will be gone, sad as it is to see them go. It will be a new life, a different life. The grim reaper has let me survive but he’s taken his payment in four of my limbs.”

On December 1, Mackinlay was ready for surgery, his amputations duly performed in one day:

… surgeons performed the quadruple amputation over five hours. “They did it all in one hit, on one day. Now I could see over that month that these limbs were finished. The blackness was increasing and the fingers were like something out of Peat Bog Man. Or some pharoah dug out of the desert. They were all desiccated, clenched and drying. They are part of you but they don’t look like part of you. Like a sort of pharaoh’s finger getting smaller and more dry by the day. The legs were gradually getting worse. Over time the right foot was just curling inwards. Just dead stuff attached to it.”

One might wonder about his status as an MP and how much his constituents knew at the time:

The amputations have been a well-kept secret in Westminster. Back in December, a little over a fortnight after the operation, Mr Mackinlay sent out an open letter to constituents, apologising for not having been in touch for “some time” and adding by way of explanation that he had had sepsis and undergone what he called “extreme surgery” as a consequence. He didn’t elaborate.

He had a lot of famous political visitors, nothing new for St Thomas’, which is the first port of call for most MPs who are ill. Boris Johnson was hospitalised there for coronavirus in 2020:

Friends from Parliament popped in. Rishi Sunak, and his predecessors as prime minister, Boris Johnson and Liz Truss, paid him visits. The European Research Group, made up of Eurosceptic Tories, even held a meeting at his bedside. Sir Iain Duncan Smith, Mark Francois and Sir Bernard Jenkin were among the attendees. Constituency work resumed from his bedside. The Speaker, Sir Lindsay Hoyle, was a regular visitor. Mr Mackinlay will contest the next election, in contrast to so many colleagues leaving politics.

UPDATE, May 24: One of my readers, dearieme, wrote in to say Guido Fawkes has reported that Mackinlay will NOT be contesting the next election as July 4 is too soon; he had envisaged an autumn campaign. Guido notes in red:

Sunak’s election claims another casualty…

I could not agree more. He was a credit to the Commons.

He has been remarkably stoic throughout:

Five months on from amputation day, Mr Mackinlay is in reflective mood. “It wasn’t as dreadfully shocking as you think it might be. I could see it for myself. People can’t believe how cheerful I have been. I have not had much to be cheerful about but that’s my nature. There’s not much you can do about it so there’s not much point in getting upset about it.

“You come round and because of the general anaesthetic you think no time has elapsed and they can’t have done it. I looked down at this shortage of limbs and, yeah, they had done it.

“It wasn’t a surprise and I wasn’t as sad about it as you might expect yourself to be. I had been lying in a hospital bed for over a month and you knew it was coming and it was just a matter of when. I had been pretty sick, carrying this gangrenous dead flesh that’s causing general infections. I just wasn’t well at all.”

After the amputations came more surgical and post-op procedures:

Before the start of this interview, Mrs Mackinlay administers a lip balm to alleviate the discomfort of dried skin around the mouth.

… he has undergone a number of procedures. On Jan 6, surgeons took “a very big lump” out of the top of his thigh and grafted it onto his left arm where there had been too much dead tissue and not enough living skin to keep the bone covered. There was a distinct fear the whole of the arm might have to be removed. The procedure took 11 hours. For the next week, he had to “lay very still” with a “bear hugger” system enveloping his damaged arm to keep it warm.

Since those darkest days, it’s been all about Mr Mackinlay’s recovery. He was covered in dressings, including a vacuum dressing that “goes into a machine that sucks out anything that keeps leaking and bleeding”.

On Dec 27, he was transferred out of HDU to a surgical ward that specialises in limb loss. On Jan 15, the MP had his first leg cast, for his left leg. His right leg still had complications from the sepsis scarring that made him appear like a burns victim. “I have a photo of my leg and it looks like a doner kebab going round,” says Mr Mackinlay, “It was in a dreadful state.”

The right artificial leg came at the end of January. “I left St Thomas’ on Feb 20 on my feet with a frame. But upright. That wasn’t bad going.” Mrs Mackinlay, making a home video of his first time walking out the ward, is so jubilant you can hear her cheering, proud of her husband as he edges his way through the door.

For the next three months, Mr Mackinlay’s home was a 12-bed specialist amputee unit run by St Thomas’ Hospital in south London. In a little over a week, the MP was “walking under my own steam” and just 88 days after having his limbs removed. “I did my first 30 steps without a frame or a crutch and they were very surprised,” he says. But it’s not been plain sailing. He acknowledges the ups and downs, not least the skin that keeps breaking on his legs …

Mackinlay did not return home until April 2024:

By mid-April, Mr Mackinlay was able to come home. If one good thing has come out of this catastrophe it is that he has been forced to spend so much more time at home with his daughter. “Being an MP you’re never here. You realise how much you lose and how much you devote to this job. Perhaps you lose sight of what’s really important in life. I think I probably had,” he says. “I’ve spent more time with Olivia than ever. I’m taking her to school. It’s rather nice.”

A chartered accountant by profession, he had been working 80 to 90 hours a week, burning “the candle at both ends”.

The prosthetics have been a challenge. The NHS have provided the ‘legs’ and ‘feet’. Although they came without moveable ankles, he is to get new ones with that essential feature:

Rehab has not been straightforward but Mr Mackinlay is determined not to go back into the wheelchair that sits in his living room but remains unused for the past month. “It is surprising how hard walking is,” he says, “These first edition ones [artificial limbs] have no ankles that move. Going up and down stairs is really hard; slopes are really hard.” New limbs with ankles are due on the NHS.

Mackinlay takes strong issue with the ‘arms’ and ‘hands’ that the NHS gave him. He has since paid £100,000 for a bionic type of artificial hand:

“The arms,” he says, “are a different story. They [the NHS] will not pay for them. You have to wait an indefinite amount of time for the multifunctional arms. Maybe two years. If you want to get back to normal life you have to buy them yourself.”

He holds up his current hands. “These are what the NHS provides you with, which frankly I find unbelievable if not insulting – that in 2024 that is the best they can come up with. In medieval times they could have come up with that. William the Conqueror would have recognised them.” He laughs, but almost cries. “They’re good for breaking windows or pub fights. I can’t see much else.”

The next option up on the NHS are “body powered hooks” that he puts a mid-1800s date on for suitability. “It is frustrating that multifunctional ones are available but you can’t have them.” To brush his teeth, for example, he removes the hands and presses the toothbrush between his stumps.

Overall, his biggest challenge is taking care of himself after defecating:

If he writes his autobiography, its working title is “It all comes down to having a poo” in reference to the most basic of problems when you’ve lost your limbs. “If you can do that you are well on your way.” He’s hoping the new hands, delivered in time for his return to Parliament, will do the trick. Fingers, so to speak, crossed.

Now that he is back in the Commons, he intends to make sepsis more of a parliamentary issue:

Mr Mackinlay will campaign going forward to make sure “sepsis is embedded” so that “even if one person” spots it early “and doesn’t go through this, that will be a job well done”. His second is to try to improve the NHS service to multi-limb loss people which he says is “not geared up to this kind of complication”. A physio told him there are about half a dozen cases like his each year across the UK. “There’s a reason for that. Usually this level of sepsis you die,” he says.

The system is “unfair” because insurance covers limbs lost in a car crash for example, while the military and assorted charities will pay for the care of veterans. “But if you get sepsis, you are on your own. You are reliant on the NHS. You are disadvantaged compared to people who lost limbs in other ways.”

As for the NHS, Mackinlay highly praises the care he received but points out areas for reform with regard to administration:

At the end of October, when first disclosing he had been struck down with sepsis, he declared in a post on X, formerly known as Twitter: “Treatment has been exemplary by all NHS staff and I can’t thank them enough.”

He owes the NHS his life and he knows it. But his time in hospital and in rehab has also got him thinking.

“I have seen so much of the NHS that needs serious reform,” he says. “I’ve spent eight months under NHS care which is far longer than anyone would ever want to. I’ll have advice at some point going forward for ministers.”

Appointments, for example, are made without checking a patient is available; his wheelchair, which he doesn’t wish to use anyway, is unsuitable for someone without functioning arms. The NHS, he recognises, is short of specialist staff. The team looking after him in Medway’s specialist prosthetic unit is “great” although the experience hasn’t mellowed his politics, nor has he had a religious experience.

But he is all too aware that without the NHS he wouldn’t even be alive to talk about it. “I can’t imagine there’s many countries in the world where I would have survived this.”

Return to Parliament

When Craig Mackinlay returned to the Commons yesterday morning, I did not recognise him, as he had changed that dramatically:

His suit and shirt hang a little large too, a sign of the stone and half to two stones he has lost in weight in the past eight months.

He has to dress casually for the foreseable future:

… his black work shoes won’t fit over his artificial foot … In the place of his shoes are New Balance trainers. It wasn’t easy getting his suit back on. His rubber stumps can’t tackle buttons or zips and the trousers don’t fit easily over an artificial leg that’s bulky at the knee.

On Wednesday, Guido Fawkes’s sketch writer Simon Carr wrote about Mackinlay’s entrance that morning:

The clapping started as soon as he crossed the bar. He stood there on the floor of the House looking round the room, over to the Speaker, and then up into the galleries, acknowledging the applause and the applauders. They were all on their feet – MPs, public, even some of the journalists – a universal standing ovation. Not even [the first female Speaker of the House] Betty Boothroyd got one of those. Your sketch writer is uneasy at public displays of affection in the Chamber and to tell the truth certain parts of it got a little blurred, around at the sight of his three-year-old daughter in a sky-blue summer dress alert in her mother’s lap, clapping the NHS staff when they had their turn. She will be a strong candidate for Best Little Girl in the World when the judging takes place.

Craig took it all without humility or arrogance, with great balance, and some humour. He apologised for being the cause of so much rule breaking. Such as clapping. And the trainers he wore because “shoes wouldn’t go over the plastic feet, and the jacket wouldn’t go over the bionic arm.” He thanked the Speaker for coming to visit him in hospital. “The rest of the hospital thought I must be dreadfully ill because they said, ‘That guy’s got the funeral director in already.’” (Much laughter)

“The other person I’d like to thank is the Prime Minister. He’s been with me throughout. He hasn’t advertised it but he’s been to see me multiple times. And that shows me the true depth” of his character.

Also, his wife who visited him “every single day of those many months.” And the NHS staff in the public gallery “who took me from close to death to where I am today,” finishing with: “I’m not sure I’m entirely happy with the two surgeons who took this lot off.” (Much more laughter)

Therein was the spirit of England many of us thought had been extinguished by Covid and lockdown and its long consequences. He is a living symbol for a post-election Conservative Party – he has faced a life-threatening disease, endured excruciating, life-preserving surgery with patience, resilience, and courage to come back in altered form, stronger – and considerably more popular – than before …

Whether [the general election comes in] June, July or December, all Tories have to rely on is the Mackinlay Spirit. May it serve them as well as it has served him.

Mackinlay re-emerged during Science questions, appropriately enough, as Science Minister Julia Lopez observed:

Please allow me to say welcome back to my hon. Friend the Member for South Thanet (Craig Mackinlay). What an appropriate way for the new bionic MP to walk in: on science questions.

Guido has a brief video of the moment:

Just before PMQs started, Mr Speaker said:

Before we begin Prime Minister’s questions, I am sure the whole House would like to join me in welcoming back our colleague and friend, the inspirational hon. Member for South Thanet (Craig Mackinlay).

Craig, it is so good to have you back among us. You are the man of the moment. I met your daughter, whose birthday is tomorrow. I say to you and your family that you are an inspiration to the people in this country who have suffered with sepsis. You have shown us the way forward. Thank you for everything—[Applause.] That is the only time I allow clapping.

All the party leaders welcomed Mackinlay, a strong Brexiteer, back into the fold after such a long, arduous and death-defying eight months.

It is always a joy to see MPs put politics aside and act with compassion and empathy.

I wish Craig Mackinlay and his family all the best with regard to their family life and, for him personally, his health.