Karen has an annoying itch which is affecting her work. Ayesha takes a huge risk for a young patient. Sid struggles to help a difficult patient with anxiety.
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Out of date, out of date,
out of date, out of date...
KNOCK AT DOOR Come in.
Gosh, last time I saw you, you were a spotty teenager.
-Yeah, I've grown up a bit.
I heard you got into law school. Very impressive.
Yeah, it will be, if I finish my degree.
What have you done?
One of my lecturers accidentally slammed a door on it.
Hairline fracture of the metacarpal bone.
Two weeks after the splint came off, it started to cramp up.
It's been like this ever since.
I can't dress myself, can't type properly.
I'm behind in my coursework.
If I can't get it sorted, I'll have to quit.
It's freezing in here!
Well, it's February.
Why are you wearing such a light blouse?
Cos they were supposed to have fixed the heating.
Oh, look, now see what you've done.
-You've put ideas in my head.
I was fine, and now I'm cold.
-No! No, Karen!
I said I was cold first!
Yeah, but you had it yesterday.
-Only in the afternoon.
-I'm not well.
It wasn't that long ago that I collapsed.
Hello, I have an appointment. Miller's the name.
Yes, you are with Dr Carmichael.
Sorry, we are running a bit late.
OK, thank you.
Oh, now, come on, that's not fair.
Possession, nine tenths of the law.
Mum quit her job so that she could help me,
but there's only so much she can do.
It's getting us both down.
I'm not surprised.
You are really strong.
It's not me. I have no control over it.
Apparently it's something called focal dystonia.
I've heard of it.
The neurons in my head are misfiring for some reason.
Makes the muscles go into spasm.
Leah, you need to see a doctor.
I've seen loads.
I need advice from someone I can trust.
So you came to see me?
You were always really kind to me, even when I got scared.
Well, you are the only patient I've ever sung to.
I can't believe I made you do that.
Neither can I.
-You were a bit of a hero to me.
-I am no hero.
All of my friends laughed when I said that I wanted to do law,
but I thought, "If Eesh can become a nurse..."
-You have to help me.
I don't trust anyone else.
-I'm thinking about my list.
A list for Jimmi's session.
I'm not sure I've chosen the best things.
Well, neither am I.
Anxiety and sleep disorder - they're quite important.
But there's also dyslexia, obviously.
You haven't got dyslexia.
And then there's losing both my parents,
not having a child, Derek - he was my first.
That did not go well. PCT...
That still hurts, you know. Redundancy is a horrible word.
Do we need pens?
Then there's the raw-food thing.
Now, I am aware that I went too far with that.
But you can get quite addicted when you start to believe in something.
-Are you all right?
-Oh, just, erm...
..Rob got this new washing powder on the cheap.
Ah, you should always use the liquid.
I've had genetic tests, brain scans - all normal.
And endless blood tests. You know what I'm like with needles.
Mm. Not only did you make me sing to you,
I had to use anaesthetic cream so you wouldn't know what was going on.
And you always did it.
The specialist suggested a therapeutic trial of Botox.
He says it could relax the muscles.
-But what if it goes wrong?
I've seen pictures on the internet.
I wouldn't pay too much attention to what you see on the internet.
It's probably not as bad as I think. Still...
Try to flatten your fingers for me, like this.
I can't. Part of me wishes they'd just knock me out and just do it.
I want to forget the whole thing ever happened.
-You sound desperate.
-I am desperate.
But I have to make a decision, and I can't. I'm too scared.
You shouldn't be. It's very safe.
Yeah. In fact, I've got some in the fridge.
I could do it now for you, if you like.
Yeah, it'll only take a minute.
That's not why I came.
Well, you might as well while you're here.
I don't know. I should ask my mum.
Sit down. How old are you?
OK, we've got the results of your blood tests,
and they've ruled out anaemia and thyroid problems.
Oh, right. So I've waited all this time to find out what I haven't got.
Sorry, but we had to make sure that there wasn't something else
-So what is it?
Well, I'm pretty sure I was right with my first instinct.
You're suffering from something called generalised anxiety disorder.
Are you having a laugh?
It is a specific, often long-term, condition.
I don't need a doctor to tell me I'm worried.
OK. Well, it does explain your dizziness, the stomach-aches,
-Whatever. Just make it go away.
OK. Well, there are a range of options for you.
There are self-help courses, cognitive behavioural therapy,
and mindfulness can be very effective.
I meant drugs.
Medication is a possibility,
but we do need to discuss all the options.
Yeah, you can tick all your little boxes in your own time.
Just give me a prescription.
Are you qualified to do this?
But, seeing as it's you, I thought we'd make an exception.
Ready? Can you feel that?
-Sing to me.
-Grand Old Duke Of York.
# Oh, the grand old Duke of York
# He had 10,000 men
# He marched them up to the top of the hill
# And he marched them down again. #
Should only take a couple of minutes to work.
How's your diet?
Just because I'm poor doesn't mean I've got a bad diet.
That's not what I was...
No matter how bad things have been, my kids have always eaten well.
Good. Do you do any exercise?
Yeah, plenty. Walking around, looking for work.
But if you mean do I go to some stupidly overpriced gym,
then the answer to that question is no.
Again, that's not what...
-OK, how much do you drink?
-Are you saying I'm an alcoholic?
-It's none of your business!
OK, is there anything specific in your life
-that is causing you anxiety?
-What are you, an idiot?
-I'm sorry, but everything in my life is stressful.
Well, then, it would probably help you to talk about it.
No, I don't think it would.
How could somebody like you possibly understand
what life is like for someone like me?
If you don't want to talk about it...
Will you just get me some pills?!
Why don't you try picking up the tray?
-How does it feel?
..a bit weak, but it's working.
How did that happen?
The toxin blocks the nerve impulses, which relaxes the muscles.
Wow. It's amazing.
There's only one problem.
I didn't actually inject your wrist with anything.
But I saw the syringe.
MMR vaccine, out of date. I squirted it into the cotton wool.
I never went near your wrist with anything.
That's not possible.
Even if I did inject you, it would
take a lot longer than a couple of minutes to work.
Why would you do something like that?!
Because it's in your mind, Leah.
Are you saying I'm mad?
No. It's psychosomatic.
It's not actually all that uncommon.
You lied to me.
Yeah. But for your own good.
I trusted you!
It will take at least a week before you start
-feeling the benefits of that medication, so...
But I still think you should consider mindfulness.
When I go to see the doctor, I don't expect to be fobbed of
-with some hippy-dippy rubbish.
-It's not rubbish.
Do you know how long I had to wait to see you?
Sitting in that filthy waiting room, listening to those two morons
babbling on about nothing, ignoring patients, wasting everyone's time.
-I'm sorry, but if...
-Yeah, you should be.
-Yeah. Who are you?
-I'm the practice manager.
-So, if you've got any complaints...
-Oh, yes, I've got loads.
OK. If you take a seat in reception, I'll be right with you.
-Five minutes. Promise.
What's up with her?
No idea. Whatever I said, she still complained.
OK. Leave her to me. I need you to go to the Campus.
-The locum's running late.
Can you just nip over there for 30 minutes?
I've arranged cover here. And don't worry about Mrs...
-I've dealt with worse.
Don't count on it.
I saw you open your hand.
When you bent over to pick up the box I dropped,
you leant on the bench for support.
And when you held on to it, I saw you completely open your fingers.
No, I didn't
That's how I knew it was psychosomatic.
-Why would I lie?
It's real. It has to be.
Yeah, for you, it is real.
That's why I had to trick you, so you'd be able to see the truth.
You injected something in my hand.
-You must have!
-I didn't touch you.
-How could you do this?!
There you go, the instructions are in the box.
Will you stop doing that?
-You've been doing it all morning.
Yeah, it's making me itchy.
The more I think about it, the itchier I get.
And the more I scratch, the worse it gets.
Then don't scratch.
Yeah, but you were just doing it again then.
-Did I? Oh!
-Have you got fleas?
No! I get allergies.
Will you stop going on about it?
I'm not the one who started itching.
You're making me scratch.
You two are disgusting.
It's bad enough having to watch them two scratching themselves
like a pair of manky dogs, but then the stupid doctor tells me
-there's nothing wrong with me.
-Did he actually say that?
Well, he said I needed to be more mindful.
As if I'm some filthy slob.
Ah, he was probably talking about mindfulness.
-This place is revolting.
Have you seen the carpets out there? God knows what is growing in them.
-Yeah, how old are they?
No wonder your receptionists can't stop scratching.
And the walls! Have they ever been painted?
Actually, I'm the temporary manager, but...
You know what? There is a notice out there for a patient participation
group next week. Maybe I should go along.
-You're certainly entitled to...
-Because this place is a disgrace!
I don't understand why she got so angry.
Are you kidding? I can't believe you were so stupid!
-Do you know how risky that was?
Yeah, but it worked.
-Are you sure?
-I think so.
You know you could have caused her long-term psychological damage?
She was fine when she left.
Yeah, but what if it actually stops her seeking the help
that she actually needs? Or triggers another psychosomatic episode?
-It was unbelievably irresponsible, Eesh.
To be honest, it does kind of put me in a difficult position.
Because by all rights, I should go and tell the partners.
-What? Don't be daft.
-It's not like I want to grass you up.
I've got a break in a bit. I'll go and see if she's OK.
-I don't think you...
-Sid! I said I'll sort it.
I've had a complaint.
-It is that Vicky woman?
-She used to be so nice.
-What's she on about now?
Actually, she's complained about the two of you.
Apparently, you're scratching.
Is there something wrong?
Well, it's Karen's fault. She keeps going on about how itchy she is.
-You started it!
-No, I didn't start it!
Just...try not to do it. Especially in front of the patients.
This is killing me.
I know. Me too.
What do you think you are playing at?
-You've done this!
It's all right.
-What you done to her?
I'm not lying.
You said that she gave you a shot of something, yeah?
-I just pretended to.
Oh, right. So you were lying then, but you're not lying now.
Are you even qualified to do something like that?
-I didn't do anything.
-Right, you said you saw a syringe, yeah?
-An out-of-date vaccine.
-Right, so you did inject her.
I didn't go anywhere near her.
You know, you are in so much trouble.
In fact, this whole practice is,
because I am going to sue the lot of you.
Leah, tell her, please.
I didn't see anything.
And you don't have any witnesses.
-I can prove it if...
-Don't you touch her!
I just want to tear the skin off my arm.
Maybe we could try meditation.
Are you joking? The thought of sitting still...
We need to somehow break the psychological urge to itch.
-I know - mango.
Yeah, it's full of vitamin C, which is a natural antihistamine.
-Yeah, no, it is.
It's got loads of anti-oxidants, B6, glutamine acid...
I am not taking dietary tips from you!
Everything all right, you two?
Oh, good, you're here. Ben wants to see you.
-There's been a complaint.
-What, about me?
OK. Give me the mango. Where is it?
In the fridge.
I was patient with her, I was thorough,
-and I didn't let her get to me...
-She was pretty mad.
Yeah, I know, but it wasn't my fault.
-That's not what she says.
-I never raised my voice.
And I was tempted.
It's our job to help people, no matter how difficult they are.
Yeah, I know, OK? I tried to help,
-and I couldn't get through to her.
Look, that stress-management programme I had in mind -
it would have been perfect for her.
-You've got a gap later on, right?
Maybe pop round and see her. Smooth her feathers?
-I'd really appreciate it.
Save us a lot of problems.
Right, yeah. Suppose I could.
Look, I wouldn't worry too much.
You should have heard what she said about Karen and Valerie.
-About the scratching?
And she said she was kept waiting for hours.
-Honestly, she wasn't.
-It was 25 minutes. I checked.
Dr Carmichael? Just wondering -
when was the surgery last painted?
It could do with a bit of freshening up.
And the carpet's a bit threadbare, too.
And you're paying for all this, are you?
I can actually feel it working.
Yeah, that's because it's all in the mind.
No, no, I can really feel it.
No, you've got to trick your mind into thinking the itching's gone.
-Do you know, I was starting to think this was something serious.
-You can't be here!
-No, seriously, don't shut the door.
-Mum will be back soon.
-You've got every right to hate me.
-I don't hate you.
And if you make a complaint and I lose my job, I deserve it.
I don't want you to lose your job.
Yeah, but if it stops you getting help,
I won't be able to forgive myself.
What is it I've got to do to make this right?
SHE BREATHES HEAVILY
-Oh, God, what is happening to me?
-Just try and relax, OK?
Take it easy. Breathe.
-Am I dying?
-No. No, no, you're going to be fine.
Is it me, or is it really hot in here now?
I know, they have got to sort out this heating.
It is ridiculous!
Look at this. It's a rash.
Yeah, it's just cos you've been scratching.
-No, it's a rash.
-You're putting ideas in my head again!
No, look, it's all on the inside of my elbows as well.
-No! Now I feel all itchy.
-No, I'm not listening to this.
-Valerie, this is serious!
La, la, la, la!
-How are you feeling?
-How do you think I'm feeling?!
Mrs Swan, you do know I'm trying to help you?
I'm sorry. Why do I keep shouting at you?
So are you still feeling dizzy?
Yeah, I've been feeling dizzy all day.
And I've got a banging headache.
I wish you would think about what I said. It will help.
How? Nothing's going to help!
-Oh, look, I'm sorry.
I keep picking fights with everyone.
Half my mates won't even speak to me any more.
That's because stress can take over your life.
-But there are things you can do about it.
-I doubt it.
Well, the medication, that's going to help for a start -
it'll take the edge off -
but you do need to find the root cause of your stress.
There's nothing I can do about that.
The mindfulness can help you cope with stress.
Yeah. Maybe for middle-class idiots who haven't got any real problems.
I'm sorry. I can't stop meself.
I understand. It's OK.
I've got absolutely no money, I'm up to my ears in debt...
What are you doing here, anyway? What do you want?
The practice manager asked me to come and see you.
-Oh, of course.
-And I was worried about you.
Yeah, it's because I was going to make a complaint, isn't it?
I wasn't actually going to do it,
but now I definitely will.
You of all people should know how hard it is
to get away from this place, to make it to uni, get a degree...
Becoming a nurse is the hardest thing I've ever done.
-It nearly killed me.
And I wouldn't have got this far if it wasn't for you.
Well, if you lie about what I did, that's my career over.
-It's my whole life. Is that what you want?
You know I didn't do anything to you.
How DID you get that puncture mark?
I pricked myself with a needle.
I panicked. I wasn't thinking.
Is that your mum? You have to tell her the truth.
I can't, you don't underst...
-What are you doing here?
-Tell her what you just said.
-I'm calling the police.
This is harassment! I've got a good mind to sue you.
You can't sue everyone. Stop!
I can't do this any more.
You two have got some serious explaining to do.
Karen, could you check if my test results are in for my 4.30?
It's Mrs Pattinson. I should be back in about 20 minutes.
OK. That was quick.
Yeah, I thought I'd be longer.
Should you rub mango on a rash?
-It's just that when I ate it, it really helped.
No idea. Sorry.
Well, that's rude.
-I think we should try it anyway.
-Right, I'll go and get it.
At first, it really was paralysed.
I had to give up my cleaning job to look after her.
And the lecturer who slammed the door on me
-said should we sue the university.
-He was right!
And then, one morning, I woke up, and my hand was fine.
Maybe it WAS psychosomatic.
Yeah, but by then, we'd seen all these doctors and lawyers.
I couldn't tell them all it was a lie.
Yeah, because we'd get done for fraud!
Not if she wasn't actually lying.
I'll have to give up uni, I won't get my degree.
You've got no idea how hard she's worked.
Actually, I do.
This is all my fault. I told her to keep pretending.
One thing led to another... I had no idea it would come to this.
It made Mum ill.
And if they find out that she's lied, that's it.
She'll never get to be a lawyer.
We have to do the right thing, no matter what it costs.
Are you sure this is right?
I don't care any more. I've got to do something.
Oh, that's good!
You know, Sid could have shown a bit of interest.
Oh, they don't care about us.
And after everything we've done for them!
-What are you doing?
-I've got it everywhere.
Oh, my God!
The thing about psychosomatic illnesses -
they're pretty much impossible to prove or disprove.
So if you really believed your hand was paralysed, then it was.
I didn't, though.
As far as I'm concerned, when you came to see me,
you couldn't fully open your fingers.
-But if they ask...
-Just listen to her!
Whatever happened in the surgery,
it must have triggered something in your mind,
and it released the muscle spasm.
You're saying I should lie?
A&E have a record of the injury.
So you were definitely injured and it was the university's fault.
-Only because the lecturer said...
Even if your hand is better now, or even if it was psychosomatic,
you should still get some money. It might not be as much...
Anything would help.
And who's to say when your hand started working again?
If someone asked me, I couldn't say for sure.
Here, sit down.
This keeps happening.
It's the worry.
I'm just going to get you some water.
Do you really think this could work?
Mum, you need to stop worrying about me,
and start thinking about yourself.
-Do you trust her?
Always have. Why?
Here you go.
What do you know about this mindfulness?
You know, at one point, I thought I'd actually got her to listen.
As if the words I was saying were actually going in on some level.
-Maybe it had.
-No. I was just kidding myself.
You don't know that.
She was just as stubborn and narrow-minded as ever.
-She's definitely going to make a complaint now.
And if it shames the partners into giving this place a lick of paint,
it's no bad thing.
-Did you tell him?
About my patient, the psychosomatic one.
-Are you all right?
I had an impossible patient.
I was sympathetic, took the abuse, went the extra mile,
did everything by the book, but nothing worked.
The thing is, I knew exactly what she needed.
It was clear as day. But do you think I could get her to listen?
Sorry, you were saying about your psychosomatic girl.
It's fine, I worked it all out. I went to her flat.
Even managed to sort out Mrs Swan's problems.
-Yeah, Leah's mum.
-She's been having panic attacks.
-Yeah, I know.
-I talked her into trying mindfulness.
Yeah. I'm on a serious roll today, Sid.
Sometimes it pays to take risks.
Not that I'd ever do anything like that again.
-Sorry, Zara. I'm having one of those days.
Sorry, could I ask your medical opinion about something?
If I said no, would it make a difference?
It's a personal matter.
Then see your GP, like everyone else.
I've got a rash, and it's on my wrists,
elbows, behind the backs of my knees. It itches like mad.
There is a flesh-eating bacteria going around.
Necrotising fasciitis. It could be that.
Best make that appointment, Karen, sooner rather than later.
No, just a fender-bender. PCs Atkinson and Kirkwood.
The Chuckle Brothers.
-I'm getting that rash that you got.
-I didn't sleep a wink.
I know, you look terrible.
Police! Stay where you are!
Police! Don't move!
-We really need your help.
-I've seen 20 patients already this morning,
-so, unless it's an emergency...
-No, it is an emergency!
We think we've got fleas.
Karen has an annoying itch which is affecting her work - can Valerie help find the solution before it gets worse for everyone? While Ayesha takes a huge risk for a young patient, Sid struggles to help a difficult patient with anxiety - but who will triumph?