 A deleted scene from early on within the episode , in which Scully questions her doctor about her ultrasound scans , was cut from the final broadcast as writer Frank Spotnitz felt it was too " confusing " for the viewers to place doubt on the actions of the doctor so early . Fellow series writer John Shiban said that the scene was not " subtle " enough to convey the right level of suspicion . Spotnitz has described " Per Manum " as being " a real paranoia episode " , concerning " the way you perceive connections between people , what are they saying , and is it suspicious or not " . 
