SCP-7303 : H is for "Health"

The following instance of SCP-7303 was recorded at a GP surgery in Stockerly, Manchester, United Kingdom. Patient Andrew Whitfield, 36, had attended an appointment with Dr. Henry Dockery MBBS MRCGP, for a follow-up examination of a laceration on his left hand. Toward the end of the appointment, the following interaction took place:

Now, Andrew, there's one more thing I want to look at before I go. Could you take your shirt off, please?

I can, but… what does this have to do with my hand?

How has your breathing been recently?

[Whitfield removes his shirt. Dockery walks behind him and places the chest piece of a stethoscope against Whitfield's back. He begins to listen to the patient's breathing.]

Fine? I've not noticed anything.

Any breathlessness? Coughing?

No more than usual. What's-

Shush, one moment… right, I want you to keep breathing normally, I'm going to give you a light tap on the back.

[Dockery clenches his fist, and punches Whitfield between the shoulder blades.]

Owh!

Okay, I'm all done here. Andrew, I'd like you to get some tests done before you leave. I'll send the details through to one of our nurses; if you speak to reception, they'll look after you.

Is it anything to worry about?

[Dockery smiles.]

Let's get those tests done first.

Appointment: 002

Stockerly GP Surgery

The following is a transcript of Whitfield's follow-up appointment with Dockery for test results, held several weeks after their last interaction.

Now, Andrew — I wish I didn't have to say this. I have bad news.

I… okay. Wh- what's the news?

You have cancer.

Cancer? I- I need to call my wife.

[Whitfield fumbles in his jacket pocket for his mobile phone, and begins to rise from his chair. Dockery does not acknowledge this.]

You have a very rare form of cancer. Asymptomatic lung cancer, to be precise. It's just as dangerous as your common forms of cancer but lacks many of the tell-tale symptoms. We're lucky to have caught it.

[Whitfield pauses.]

What does that mean? How is this different from normal cancer?

[He places his phone back in his pocket, and lowers himself back into the chair.]

Let me explain. I had my suspicions when I noticed the lack of blood you were coughing up when you came in for your appointment. That's a classic sign of asymptomatic lung cancer. With symptomatic lung cancer, you'd be coughing up blood, wheezing, feeling breathless. By contrast, the asymptomatic variant is very hard to spot. As the name implies, it can only be diagnosed by a lack of symptoms. I have experience in this field, I've previously trained as an oncologist — another doctor might not have spotted you were so sick.

So if there's no symptoms can I just go-

No! Good heavens no. There is an aggressive, expanding cancer within your body.

But if there's no-

If you walk out that door now, you will die. You will die, Andrew. This is serious.

[Whitfield stares at Dockery in stunned silence.]

You should go call your wife now.

Appointment: 003

Stockerly GP Surgery

Following the initial diagnosis, Dockery and Whitfield met to discuss treatment options for the SCP-7303 diagnosis.

Andrew! Come in, please take a seat.

Morning Henry. How are you?

It's Doctor Dockery, please. Now, what are we here to discuss today…

[Dockery begins to type on his computer keyboard.]

My, um, my cancer, Doctor.

Yes! Your cancer.

[Dockery swivels on his office chair, turning to face Whitfield. The latter sniffles.]

So, with normal cancer, the regular variety, you'd have tumorous growths throughout your body. Growing like weeds. One of the primary methods of treatment would be surgery, physically excising the cancer from your body. Plucking it out.

O-okay.

But we can't do that with your cancer. As it is asymptomatic there are no tumours. So, we need to explore other options.

[Whitfield's sniffle has progressed to a silent cry.]

Now, now. Don't be despondent; we can fight this thing. As we can't rely on surgery, our best bet will be a combination of chemotherapy and radiotherapy. For the former, we'll inject you with a variety of anti-cancer drugs, and with the latter, we'll expose your body to large amounts of radiation in a controlled manner. We need to start quickly before the cancer spreads. These treatments come with side effects, however: hair loss, nausea, vomiting, fatigue.

[Whitfield's crying intensifies.]

Let me get you some material to read in the waiting room.

Appointment: 007

Stockerly GP Surgery

Whitfield meets with Dockery to receive an update on the status of his "asymptomatic lung cancer". The former is joined by his wife, Helen Whitfield (denoted in transcript as H-Whitfield).

Andrew, good to see you.

[Andrew and Helen Whitfield enter Dockery's office.]

Doctor, this is my wife, Hel-

[He pauses mid-sentence, before exiting the room at speed. He makes his way toward the surgery's toilets, and proceeds to vomit profusely.]

He's struggled with the treatment recently, that's the third-

We should wait until the patient is here before discussing this.

Oh… I understand.

[Dockery turns to his computer and proceeds to check his emails. Helen Whitfield stands idly by the office door in silence. After four minutes, Andrew Whitfield returns.]

Shall we start that again? Helen, lovely to meet you. Andrew's told me so much about you.

[Helen Whitfield guides her husband over to the office chairs. They both sit.]

Helen was telling me all about your treatment. She said it's been difficult recently?

[Whitfield fiddles with a bandage on his arm, placed over the entry point for the chemotherapy intravenous drip.]

I've expended my sick leave at work. We have savings but… it's been a stressful time.

I can imagine.

[Silence.]

Now, your cancer. When asymptomatic cancers progress into the late stages, they can in fact begin to develop symptoms. Well, we're seeing some of these symptoms in you. Hair loss. Nausea and vomiting. Fatigue. Textbook examples of stage 3 asymptomatic lung.

[The Whitfields grasp each other's hands.]

There's something else we need to discuss too. I have your most recent test results here, and your urine samples came up clean. No blood, no protein, or leukocytes.

Okay, so there's some good news.

Please let me finish. I've also noticed Andrew, the colour of your skin. There's a distinct lack of yellow colouration. The same for your sclera, they're white as snow.

What does this mean? Those sound like positive things. Right, Andrew?

[She turns to her husband and caresses his arm.]

Oh Helen, he warned me this might happen.

The cancer. It's spread. Andrew now has asymptomatic liver and asymptomatic kidney cancer. I'll arrange with the hospital to increase treatment dosages.

[Helen stands from her chair, and hugs her husband, kissing his cheek as she does.]

You can beat this. I know you can.

I truly wish I had better news for you.

Appointment: 012

Stockerly GP Surgery

The following appointment took place several months into Whitfield's treatment. He has undergone several rounds of chemotherapy, overseen by Dr Dockery.

So the latest test results are back, and I've looked them over. I'm sorry, the cancer has progressed further.

[Whitfield places his head in his hands. His palms rest against the bandana covering his head, bald as a result of the treatment.]

Okay.

We're not giving up yet. There are several options available to us that we should-

I want to stop.

Excuse me?

I want to stop treatment. If this is it… if this is it, I want to go out on my own terms. Not like this.

Andrew, we still have a chance here. You have a chance!

It's not worth it. To me, it's not worth it. These last few months have been pain. Everything hurts. If I have little time left, I want to enjoy it. And I can't enjoy this.

[Dockery is silent.]

You'd give up?

I-

You've come so far, fought so hard, and you'd call it quits just before the finish line?

I think you're overstepping-

I am. Because I don't want you to make a mistake. Your wife — have you discussed this with her?

No not-

Because how will she feel? How will your children feel? Knowing that you wouldn't fight for a future with them?

[Whitfield does not respond.]

I know you, Andrew. We've been on this journey together. You're not this selfish. You wouldn't throw this all away.

I-

I know what I'm doing here. Yes, your cancer has progressed, but you can fight it back. You just need to try harder. Do you not trust me?

That's not what it is, I just want to enjoy-

Enjoy your life? There's only one way to do that.

[Whitfield is silent.]

Shall we keep going?

[Whitfield nods.]

Good. We have an appointment booked for this Tuesday. Shall I keep that in the diary?

My daughter has a school event that day, would we be able to switch to-

I have no other availability that week, unfortunately. We wouldn't want to delay treatment, would we?

…no. You're right.

Great! I'll see you then.

[Whitfield stands, and begins to make his way to the room's exit.]

One last thing, Andrew!

[Whitfield pauses, and turns to face Dockery.]

You're making the right decision.

Thanks. I do trust you.

You should. Of the two of us in this room, I'm the doctor. We'll get you all fixed up.

Appointment: N/A

North Manchester General Hospital

Following successive rounds of chemotherapy, Whitfield collapsed, unconscious, suffering from severe treatment-related toxicity. He was taken to North Manchester General Hospital for treatment. Three days after his admission, Whitfield was visited by Dr. Dockery:

[Whitfield lays unconscious in a hospital bed. He has not regained consciousness since his admission. A nasogastric feeding tube, an IV, a heart rate monitor, and a respirator have been fitted to him. He is surrounded by machines, which beep intermittently.]

[Dockery enters the room. He approaches the bed and looks down, surveying Whitfield.]

I promise you.

[He pauses, kneeling down to locate his mouth next to Whitfield's ear.]

I promise you I did everything I could.

[Dockery stands in silence over Whitfield for five minutes.]

[He exits the room.]

Four hours after Dockery's visit, Whitfield passed away.

Current Foundation estimations stand at 82.1% of medical professionals worldwide experiencing SCP-7303 over the course of their careers. Due to the impact active intervention in SCP-7303 instances would have on medical services, and the level of Foundation resources required for proactive containment, the Ethics Committee has deemed the occurrence of SCP-7303 an acceptable deviation from normality.

Ȝ is for "Ȝesundheit"

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I is for "Incision"