Field Fever Doctors

Lassa fever.

Starts with fever, general weakness and malaise,

then headache, sore throat,

muscle pain, chest pain,

nausea, vomiting, diarrhoea, cough

and abdominal pain.

Ah! Um...plague.

Um...bubonic, pneumonic and septicaemic.

Er...

Ah! Our old friend, leptospirosis.

Also known as field fever, rat catcher's yellows

and pretibial fever.

If the infection causes the patient to turn yellow,

have kidney failure and bleeding, then it's Weil's disease.

If it causes bleeding from the lungs,

then it's severe pulmonary-haemorrhage syndrome.

Dr Elizabeth Briscoe.

Excuse me?

Dr Elizabeth Briscoe, clinical lead,

emergency medicine, St Philomena's Hospital, Letherbridge.

And you are...?

Um...Remy Briscoe, your...your...your son.

And in your own right?

Medical student in my final undergraduate year.

Good. Pleased to meet you.

-Ow!

-Be firm. It impresses people.

And that's who you're going to be talking to, people.

Which is why you're spending the afternoon with a GP.

It's not easy being different.

We have to learn how not to be.

Yes, Mother.

Good. Now, chop-chop, off and get dressed.

HE SIGHS

-Cheese and onion?

-Oh, yeah. Love and marriage, horse and carriage.

No wonder the kitchen stinks.

-Don't you miss her, Sidney?

-What?

I'm talking about the tall specimen,

takes, like, 55 minutes in the bathroom each morning.

Always some kind of culinary criticism for what I'm trying to eat.

Yeah. I do miss having meals together.

One of us would cook, and then...

Is Heston about?

Yeah. He's still in his room.

Right. Well, um...he's got a visitor.

It's got to be worth building bridges, hasn't it?

Has it?

You've spent a lot of time together. Good times.

Got to be worth a try.

-Maybe you're right.

-Of course I am.

CLASSICAL MUSIC

Diseases of the male organs.

Ah! Remy Briscoe. Medical student. Final undergraduate year.

-Right.

-I'm here to see a Dr Heston Carter.

-Has somebody...?

-Ah, yes, somebody's gone to get him.

OK.

-Remy!

-Ah! Yes! Dr Carter!

Good to see you. Nice tie. Let me show you around.

Here you are. I thought you were in your room.

No, I was just going out for some lunch.

Well, I made you a coffee.

Before lunch?

Right. Yeah. Never before lunch or bed.

Well, unless you want to stay awake.

-I can go all night.

-Well, why wait till night, Vere?

What did you have in mind, Sharma?

Remember that we have a session booked later, so...

Any chance of fitting me in before?

No. I'm wall to wall.

You might get a cancellation.

You know how long people wait for an appointment with me.

And the reception area.

Dr Sid Vere, Remy Briscoe.

He's not much older than you.

I don't know about that.

-Pleased to meet you.

-Likewise.

-Dr Megan Sharma.

-Yes, we've, er...we've met.

Our consultant psychiatrist.

No need to look so worried.

No, no, no, no, I-I'm not.

OK. Well, I'm off to lunch, so maybe see you in the afternoon.

Yes.

-Remy?

-Right. Huh!

-So, how's your mother?

-Yes, she's fine, thank you. She sends her love.

Wonderful. Please, have a seat.

You're going to have to sign a confidentiality agreement...

My lips are sealed.

..if you're to sit in on a consultation.

Oh, right. Yes, I see.

-I just can't wait to see the way everything works.

-Good.

Right, confidentiality agreement.

And the important thing is to let me do the talking.

-Of course.

-And once the patient leaves,

we discuss the treatment and the diagnosis. OK?

-Absolutely.

-Good.

Right, confidentiality agreement.

Print your name and sign there.

-You waiting for someone?

-No.

So, what you doing tonight, then?

Nothing. Why?

No reason. Just asking.

I don't know. Just staying in, have some dinner.

Emma said she might be doing her lasagne.

Beef or lamb?

I don't know. Why don't you ask her?

I don't think so.

Is it all worth it?

There's nothing like a bit of home cooking, is there?

I've got house calls.

So, as I say, we'll be in touch when the test results come back.

Should be a week at the most.

Fine. Thank you very much.

-Bye-bye.

-Bye.

-As I said, let me do the talking.

-Yes, of course. Sorry.

Right. Male, 59.

Shooting pains in the legs, stiffness of the knee,

pins and needles, all down the right-hand side. Thoughts?

OK. I ordered a blood test. Why do you think I did that?

-Infection?

-Possible.

Clotting?

There wasn't much evidence of swelling.

Claudication through atherosclerosis?

It didn't seem to get better with rest.

RLS, AKA Willis-Ekbom Disease?

Well, Restless Legs Syndrome. Didn't seem to get worse at night.

Something else neurological?

Right, think about Mr James' history.

He mentioned a broken pelvis.

Ah, yes! Um...femoral-nerve lesion.

Possible. Well done.

Weakness is typically acute or sub-acute,

in contrast to that caused by myopathy,

-in which the onset is often gradual and usually bilateral.

-That's right.

Numbness in the medial side of the leg and calf may occur.

Involvement of the lateral cutaneous branch of the nerve

may also produce painful paraesthesia of the thigh,

-meralgia paraesthetica.

-It may do.

-Mild pain near the inguinal ligament may...

-Remy?

-Yes?

-You can stop.

Ah. Right. Yes. Sorry. Excited.

-Knowing the answer.

-Well, it's one possible answer.

And well done for getting that, by the way.

Next time, let's make it a little more difficult.

-What do you think?

-Definitely.

Yes. It's important to put the patient at their ease

-and try and get the full picture.

-Exactly.

-And that's what I'm here to learn.

-And learn you shall.

But...let me do the talking.

I will. Promise.

Good.

Ayesha?

So you've had a bad stomach for a while, aches and pains.

-You've been sick a few times.

-Yes.

Loss of appetite, dizziness, diarrhoea.

Oooh!

Sorry. Sorry. Huh!

-Dizziness, a persistent cough, headaches?

-Yes, Doctor.

Right, OK. I need to ask my student to step outside.

Remy?

Ah! Right! Yes! Sorry.

REMY CHUCKLES

Good luck.

He's young.

-Ah!

-Hello again.

-Hi.

Are you locked out?

No. Dr Carter's testing me. My diagnostic skills.

Oh. How's that going?

Good. I, er...I think I know what's wrong.

That's a good start. You seem confident.

Yeah. At diagnosis.

So, that's your strength?

Yeah. Talking to patients, I'm not so good at.

I don't know how you do it.

Well, listening, mainly.

Letting people know that whatever they want to tell you, it's OK.

-Right.

-Be brave.

So, as I say, we'll be in touch as soon as the test results come back.

Everything's going to be fine. Nothing to worry about.

How do you know it's going to be fine?

-Well, it's minor, isn't it?

-Is it?

We haven't discussed it yet. You shouldn't put ideas into the patients' heads!

-But surely you should tell them.

-I should tell them because I know them!

You haven't met them before.

Right, let's carry on. I'm going to be Mrs Rainham.

You sit there, OK?

I've got headaches, nausea, loss of appetite.

Right. A-hem-hem-hem!

-So, you've had a bad stomach?

-Yes.

Aching, painful and you're nauseous?

I feel sick every now and then, yeah.

Dizziness? Cough and headaches?

-Yes.

-And diarrhoea?

Why are you pulling that silly face?

Oh. Right. Um...sorry.

Can I just ask, have you noticed passing anything?

Well, I passed a garage on the way here.

No, sorry, when you've been to the lavatory.

Have you noticed anything?

-Like what?

-Like segments.

-Grapefruit segments?

-No, of tapeworm?

Tapeworm?! You think I've got tapeworm?

Well, haven't you? Hasn't she?

Stay in character. How have I got tapeworm?

By eating undercooked pork or beef, usually.

-Is it serious?

-Not usually, but it could be.

One tapeworm can grow long enough to block the digestive system.

Or it could be a larval infection.

The tapeworms burrow through your intestine wall and enter your bloodstream.

Remy, you're supposed to be reassuring me.

And how do you propose to treat it?

If it's an adult tapeworm infection?

Niclosamide or praziquantel.

And if it's larvae?

Referral for further assessment and treatment

and maybe albendazole.

Or surgery, if it's blocking the digestive system.

It's not blocking the digestive system!

OK, the important thing is not to be overly optimistic

or overly pessimistic.

-You have to strike the right balance.

-Yes.

Good. Well done. You're doing fine.

Thank you. So are you.

I really do like it.

Thanks, love.

I mean it.

So do I.

Is everything all right?

Yeah. Fine.

-I didn't ruin things?

-No.

How about at work?

Work's fine.

But you've just reminded me, I'd better get back to it.

Well, at least give me a hug.

It was nice, wasn't it, the other day?

-Yeah.

-Oooh!

-What's wrong with your wrist?

-Nothing, honestly.

Show me.

BREN SIGHS

-BREN WINCES

-Sorry.

I know you've got house calls. It'll be all right, I'm sure.

-Mum!

-What?

Don't tell me how to do my job, OK?

OK, then.

There?

I've been shearing.

-Busy time of the year?

-Too busy to get ill.

Trouble is, I can't seem to shake it off.

How long have you been feeling like this?

Three, four weeks.

A long time to wait to see a doctor.

I've had the livestock buildings to clean out.

Stagging, notching, tagging.

Tails sheared to stop fly strike.

When did you first notice blood in your urine?

About the same. Three, four weeks.

The same time you started feeling a bit shaky?

Yeah. Shivering.

And you can hardly put central heating on in the summer.

No. I'd have to get central heating first.

Right. Well, your temperature is a little high.

I think it might be a urine infection,

so I'm going to prescribe antibiotics.

If it doesn't start feeling better in about three days...

Does he have to be in here? Or does he want stagging, too?

-Stagging?

-Castrating.

To stop the young rams fighting.

-Remy?

-Yes.

Maybe you should wait outside.

HE SIGHS

-HE SIGHS

-You all right?

It's just so frustrating!

-What is?

-I've got a diagnosis, but he doesn't want to hear it.

Well, that's because Heston's the doctor.

Yeah, but I'm the one who knows what's wrong.

Then you should keep trying to find a way to say so.

-You think so?

-Yeah, if you know you're right.

You'd hate yourself for saying nothing.

See, that's the difference.

You fix people, I just know what's wrong with them.

No, the difference is that you're young.

I'm not that young.

I know my mind. I know what I want.

Maybe the two of us could talk about it sometime.

Yeah, we could.

Right.

-Is that the patient?

-Yeah.

-Mr Groom?

-What?

-So, you've been feeling a bit shaky?

-You know I have.

-A little shivery.

-I've just said so to Dr Carter, haven't I?

MR GROOM COUGHS

-Is it wheezy?

-What?

-Your cough?

-Why?

Breathy, like you can feel it down in your lungs?

-It might be. Why?

-Have you come into contact with any rodents lately?

-No.

-No rats?

-No!

-Mice?

-No!

-Voles?

-No!

Voles? Why do you ask?

Mr Groom, I am terribly sorry.

So, there's nothing in it, then, what the boy said? This Hatna...

-Hantavirus.

-Remy.

-Sorry.

-Because you said it was urinary.

-A urinary infection.

So, that's what it is, then, right?

-It's most likely a UTI.

-Most likely?

Well, we can't be certain.

So, it could be this Hanta... What is it?

-Hantavirus.

-It's very unlikely.

It's incredibly rare.

Even with the smoking? What was it you said about the smoking?

-Hantavirus infections occur through...

-Remy, please!

No, let him finish.

So if you were clearing a barn full of voles and smoking whilst you were doing it,

you'd be actively breathing in the spores.

Plus, the villi in smokers' lungs,

they can't remove the contaminated particles.

Um...he's right.

I was smoking while I were doing it.

-Plus, it can lead to HFRS.

-Remy?

Sorry. Haemorrhagic Fever with Renal Syndrome.

Death can occur in days. No vaccines exist.

-Remy!

-Sorry. Look, treatment?

The only treatment is antibiotics

and mechanical ventilators to stop the build-up of fluid in the lungs.

Do you have any of these mechanical ventilators?

You don't need a mechanical ventilator.

-But what if I did?

-Well, you'd have to go to St Phil's.

-Right, then.

-But you don't need one.

No? Death occurring in days?!

Mr Groom? Bill?

-WHISPERS:

-Idiot!

It could be sprained.

What happened? You were fine on Monday.

What a time for an old war wound to flare up.

What war wound? Since when have you had a bad wrist?

Since a while ago.

What made it flare up again?

Moving boxes.

-Hiya!

-In here!

-WHISPERS:

-Did someone do this to you?

-No.

-You've told her, then?

Well, that was a waste of time.

-Of everybody's time.

-Look, I'm sorry.

We've taken a few samples, sent them away for tests.

The results should take a few days.

-We'll call you when they come through.

-Yeah, you do that.

In the meantime, start on the antibiotics Dr Carter prescribed.

Pharmacy is open.

Brilliant(!)

Hantavirus? Absolutely stunning(!)

-Elizabeth?

-What's wrong with a UTI? But no!

It has to be mice, or rats, or voles.

Voles, for pity's sake!

And you really think you're going to be a doctor?

-Pathetic!

-It was me.

-What?

-I came up with the possible Hantavirus diagnosis.

Really? Most doctors would just prescribe antibiotics,

-tell them to come back if it doesn't clear up.

-And I have.

But when I heard about the voles,

I thought, better safe than sorry.

Anyway, we should be going. You'll keep us informed?

-Is that really necessary?

-He is my patient.

If he still wants to see you.

-Why did you do that?

-Everyone makes mistakes.

That's not an excuse, but everybody does.

And when you do, you have to stand up for yourself.

I know.

Let's go.

Remy?

I still don't get it, why you didn't tell me that Ike was hitting you.

Because you were right. You said he was bad news.

-So?

-I thought you'd say, "I told you so".

I probably would, but it still wouldn't have stopped me helping you.

Then that was my own stupid fault.

Mum, you did not deserve this.

I wouldn't have taken your help, anyway.

Even if you'd offered. You know what I was like.

Where is he now?

Long gone.

-Well, that's something, I guess.

-Yeah.

But...we've got other problems.

What other problems?

Mum?

We're being evicted.

AYESHA SIGHS

-Who is it?

-It's me.

Who's "me"?

Me. Open up.

Well, you could be anyone.

I could be, yeah.

How badly do you want to come in?

Very.

So badly you'd break the door down?

You know, I do have the keys.

I'm the fire warden.

A fire warden? Now, if you'd said fireman, then...

What, like, with a hose?

And a helmet and, er...?

I can't think of anything else.

Yellow trousers, wellingtons.

-No, it's not working.

-No. And neither are you, now.

-Dr Vere!

-As the fire warden, I do have to check all the entrances.

-Yeah, well, that is your job.

-Mm.

And you do it really well.

Thank you, Dr Sharma.

And in this case, I'm afraid I am going to have to seal off the area.

"Fight Sandersbrook's plans to demolish affordable housing and replace it with luxury flats."

The place has got defects, apparently.

It's going to be demolished.

But the ones which are privately owned are mysteriously all right.

Amb said I could stay.

But we came out of the refuge to an eviction notice.

-So, leaflets?

-Well, what else can we do?

Flaming pharmacy's backed up!

Who's meant to run the farm in the meantime?

That's hardly my concern.

Who's meant to feed the sheep? The dogs?

I could....maybe? If you told me how to.

You told me I was going to die.

No, I said it could be a possibility.

Remy, hush up.

-Do you know him?

-I do.

-How?

-He's my son.

Ah! Never mentioned that before, did you?

Covering up for each other's mistakes now, are we?

I haven't made a mistake.

Well, his mistakes, then.

I want to make a complaint.

Well, you'll have to talk to the Patient Advisory Liaison Service.

And where's that, then?

It's closed now. You'll need to e-mail.

-I don't have a computer.

-Come back tomorrow, then.

I probably won't have to. I'll probably still be here, waiting!

Excuse me, I have other patients to attend to.

This is all your fault!

Huh?

HE COUGHS

CRASH

People need to know what's going on.

-By reading these?

-It's better than nothing.

-Is it?

-If you don't want it, give it here.

You need to think bigger. Get organised, start a petition.

Is anyone really going to care?

Yeah, they will. We'll make them.

-How?

-By getting all over social media,

showing them that we won't be bullied.

-We could get a campaign going.

-Too right.

No development company's going to push us around.

-Thanks, love.

-Shut up. What did you think I'd do?

You're my mum, aren't you?

Did your mother say what it was?

No. There wasn't time.

He's stable. He's on the ventilator.

What happened?

We've had the test results, it's Hantavirus.

And it looks like it's well on the way to becoming HFRS.

Seems you were right, Heston.

Tell her. Go on.

-It was me.

-What?

It was me who made the Hantavirus diagnosis.

-Then why didn't you say so?

-Because you said it was ridiculous.

And you couldn't stand up for yourself just once?

-Elizabeth, come on.

-No, Heston!

You, of all people, know how hard it is, and you became a surgeon.

I don't want to become a surgeon.

-And even if he did end up as a GP...

-Heaven forbid(!)

..at least he'd be doing something!

I don't want to be a GP either!

What do you want to do? Because I would love to know.

-Elizabeth!

-I...I would really love to know.

I want to work with animals.

Be a vet?

If I can.

SHE SIGHS

Many years ago, your mother told me

that I didn't have it in me to be a doctor.

And if I'd listened to her, I would have given up.

I'm not giving up.

I want to work with animals.

And there's nothing I can do to change your mind?

Change it? You've made it up for me.

Right. Well, in that case...

Ahhhh!

Yes. Sorry. Huh!

No, no, don't apologise.

Good luck.

I mean, you...you were so confident!

What...what brought that on?

Honestly? Um...

I overheard that student ask you out.

Remy?

SHE LAUGHS

Wow!

He just wanted someone to talk to.

I remember being that age, seizing the moment.

Well, you certainly did just now.

Yeah, I certainly did.

And it felt good.

It felt right.

You're joking. It's so far from right.

Did feel good, though, didn't it?

And it's all thanks to my therapist.

Er...I have just used up one of your sessions, though.

Hm?

Well, I'm a private client now, so I should probably pay you, right?

Pay me?

No...! I-I-I didn't mean for...

Hm! Sorry.

I meant for the session. For the...for the therapy.

Er...see you, see you.

HE SIGHS

Beverley Lomax is a key witness to the robbery

at Rattigan's Jewellers of June 16th.

He just trashed our place again, Gary.

Stole my money, wet the sofa. Got us arguing again.

I'd had enough.

I couldn't just turn my back on him, Bev.

You may feel braver, but you're not.

You're still the same old you.

So motivational. Thanks, Al(!)

You know what? I don't think I'm cut out for this.