When British Army nurse Claire Randall (Caitriona Balfe) went through the standing stones that transported her back in time from 1945 to 1743 right at the start of Outlander, she didn’t just get dumped in the past with her knowledge of history and modern(ish) views of feminism. Claire took her four years of direct, hands-on, World War II-honed battlefield surgical nursing skills and medical knowledge with her.

That knowledge has since allowed her to save friends and family from certain death. During S3, when Claire wound up back in the 1960s, she studied to be a surgeon, too. Her additional skills have stood her in good stead since her return to the 1700s. But it has also placed her in grave danger of accusations of witchcraft.

In S5, Claire’s medical practice will set her up for a horrific confrontation in the season finale when someone believes that what she is doing is in defiance of God’s will. “We see that she takes these big chances in exploring surgery that she would have done in the 20th century and also trying to develop medicines that she would have used in the 20th century. But that definitely is a very risky endeavour for Claire this season,” warns Caitriona.


Dr. Claire, medicine woman

Claire’s most useful modern medical tools in the 1700s are her knowledge of how sepsis works and how it can be prevented, her knowledge of painkillers like opium, and her all-round awareness of preventive medicine, particularly with regards to healthy nutrition and sanitation – Dr. Claire was a clean hands and face mask pioneer. She’s able to identify common infection diseases and has also been vaccinated against some of the major killers of the time, including smallpox.

The greatest tool in modern medicine is one that she doesn’t have access to, though. The use and mass manufacture of penicillin as an antibiotic was still in its early days during the 1940s, and in S5 episode 2 (during the 1700s), we’ll see Claire experimenting to make a supply for herself, which is a complicated task involving baking a suspicious amount of bread. Steve Kornacki and Alyson Evans, who wrote the episode, originally wanted to show Claire making her discovery as a quick aside during the episode’s title sequence. But they decided to rather give Claire’s lifesaving experiments the drama that they were due by having her show her assistant, Marsali (Lauren Lyle), to process and explain it to her instead.

Once she has penicillin, Claire will also have to figure out a way to reinvent the hypodermic needle – a task that becomes urgent in episode 9, and leads to her having an interesting chat with a baffled glassblower in episode 10.


Paging Dr Rawlings

To serve her larger community, Claire needs to get the word out about a number of health issues that can be tackled at home with proper sanitation, nutrition and certain other preventatives. We’ll see in episode 2 that she also needs to dispel current medical myths and dangerous courses of treatment, particularly in the widespread use of heavy metals like mercury and antimony, which are doing more harm than good.

With the position of women at the time, though, she cannot do this directly. Claire’s community is somewhat willing to accept her as a herbalist and healer and midwife, but not as a doctor. So, under the pseudonym Dr. Rawlings, Claire starts publishing household medical advice on fliers that will land up in the local newspaper by episode 4. With a larger audience, comes the danger of discovery, and that's particularly dangerous since Dr. Rawlings has been dispensing advice about how to prevent pregnancy.

Time travel purists might be clutching their pearls at the thought of backdating the discovery of penicillin over 150 years – Claire’s daughter, Bree (Sophie Alexandra Skelton) – certainly is. But a bigger problem is looming. Executive Producer Matthew B Roberts muses, “With something like penicillin, you kind of look at… what would this do in the long range? What Claire would be trying to do is protect her community – The Ridge – and not let it get out, not let the invention get away from her. If she kept control of it, who else would know how to make it or to use it? So, I think she feels like she can keep control of it. About her knowledge – the Dr. Rawlings of it all – that is probably, in a weird way, more dangerous than the penicillin… It’s the ideas that spread so quickly, I think, [that] are more of a challenge for her to keep contained. And as the season goes, that becomes an issue,” he warns.

Fun fact: Claire’s portable surgeon’s chest was specially made for S4 and 100% period accurate. “The medical box was researched extensively. We found references to a type of 18th-century, portable chest – a surgeon’s chest. We had three versions made bespoke for the show by a specialist antique company, Wetton and Grosch," says Outlander set decorator Stuart Bryce.

Watch Outlander S5 from Saturday, 25 July on M-Net (DStv 101) at 22:00

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