Medical Diagnoses in Grey's Anatomy: A Comprehensive Review of Medical Conditions in Season 18
- 28 nov
- 8 Min. de lectura
Season 16 of Grey’s Anatomy brought significant changes to the hospital's roster and tackled pressing real-world healthcare issues. From the "medical divorce" required to afford life-saving surgery to the devastating impact of the broken foster care system on mental health, the writers didn't shy away from social commentary. Medically, the season featured rare toxicities, complex pediatric reconstructions, and the dramatic conclusion to the mystery of Richard Webber's deteriorating health.
Below is a comprehensive, episode-by-episode review of the medical cases, diagnoses, and treatments presented in Season 16.
Content ⁉️
Episode 1
Tethered Spinal Cord with Syrinx
Nadi. A patient injured in a bicycle crash presented with hypotension and variable temperature sensation. Imaging revealed thoracic compression fractures and a tethered spinal cord with a syrinx (a cyst within the spinal cord). Diagnosis: The tethered cord was likely congenital but exacerbated by the trauma. Treatment: A complex dual-approach surgery was performed to repair the fractures and release the tethered cord.
Cardiac Tamponade and Polytrauma
Father Christopher. An 82-year-old priest struck by the bicycle suffered cardiac tamponade, leading to Pulseless Electrical Activity (PEA). Treatment: Immediate thoracotomy to relieve the tamponade, followed by lung resection and repair of liver and spleen lacerations.
Parkinson's Disease (Cellular Therapy)
David Hamilton. Dr. Hamilton, a neurosurgeon with Parkinson's Disease, proposed a clinical trial for experimental cellular therapy. The treatment involves converting skin cells into dopamine-producing brain cells for injection into the brain.
Other Medical Conditions Discussed
Hemothorax: Blood in the chest cavity managed with a chest tube.
Autonomic Nervous System Damage: Suspected due to temperature fluctuations.
Episode 2
Chronic Kidney Disease and Racial Bias in GFR
Rashida Flowers. A Black woman with Chronic Kidney Disease (CKD) was denied a transplant because her eGFR was calculated using a race-based multiplier that overestimated her kidney function. Complication: During a catheter insertion for dialysis, she developed Superior Vena Cava (SVC) Syndrome. Resolution: Dr. Ndugu successfully challenged the biased eGFR criteria, getting her listed for a transplant.
Pulmonary Fibrosis (Burn Pits)
Noah Young. A veteran presented with coughing and low oxygen. He was diagnosed with Pulmonary Fibrosis attributed to exposure to burn pits in Iraq. He refused further treatment, highlighting the struggle veterans face in getting care for service-related conditions.
Other Medical Conditions Discussed
Thrombosed AV Fistula: A clogged dialysis access point.
Intestinal Obstruction (Foreign Body): Caused by a swallowed crystal.
Episode 3
Uterine Transplant
Tovah Freedman. A patient with Uterine Factor Infertility (due to prior hysterectomy) received a uterine transplant from a deceased donor. Complication: A clot was detected in the vascular anastomosis during surgery, requiring removal with a Fogarty catheter.
Medically Urgent Kidney Transplant (Mobile OR)
Rashida Flowers. Rashida (from Ep 2) required an urgent kidney transplant. Due to an HVAC failure in the hospital, the surgery was performed in a mobile operating room truck to prevent infection.
Other Medical Conditions Discussed
Hydrostatic Pelvic Injury: Severe trauma from a jet ski accident causing rectal perforation.
Heat Exhaustion: Affecting patients during the HVAC failure.
Episode 4
Advanced Pulmonary Fibrosis and Lung Cancer
Roy Davis. A veteran with burn pit-associated pulmonary fibrosis was found to have early-stage lung cancer. Treatment: Due to poor lung function, he underwent a high-risk segmentectomy instead of a lobectomy. Tragically, the tissue was too scarred to hold sutures, leading to hemorrhage and death.
Neurotoxicity from Immunosuppressants
Tovah (Uterine Transplant Recipient). Tovah developed seizures. Workup ruled out stroke or tumor, pinpointing neurotoxicity from her anti-rejection meds. The protocol was switched to save the transplanted uterus.
Constrictive Pericarditis
Farouk. A teenager presented with heart failure symptoms. He was diagnosed with Constrictive Pericarditis (a calcified sac compressing the heart), likely secondary to childhood tuberculosis.
Other Medical Conditions Discussed
Shoulder Dystocia: An obstetric emergency.
Cholecystitis: Routine gallbladder surgeries for resident training.
Episode 5
Parkinson's Cell Therapy Research
David Hamilton. The research team faced challenges keeping injected cells alive. They discovered that using a frozen needle improved cell viability to 92%, a critical breakthrough for the FDA trial.
Pericardiectomy
Farouk. Farouk underwent a pericardiectomy to remove the calcified pericardium constricting his heart. Complication: After removal, the heart swelled rapidly, requiring epinephrine to stabilize before closure.
Myocardial Injury from Electrocution
Vic Hughes. A firefighter suffered electrocution, leading to Ventricular Fibrillation. She was defibrillated and monitored for myocardial injury.
Other Medical Conditions Discussed
Rhabdomyolysis: Muscle breakdown checked after electrocution.
Full Thickness Burns: Facial burns from an explosion.
Episode 6
Perforated Appendicitis in Pregnancy
Ashley Wright. A pregnant patient’s appendicitis was displaced by the uterus, leading to perforation and abscess. Complication: During the appendectomy, fetal distress necessitated an emergency C-section, followed by an emergent hysterectomy to control massive bleeding.
Dilated Cardiomyopathy (ECMO)
Farouk. Farouk’s condition deteriorated to Dilated Cardiomyopathy, requiring ECMO support while waiting for a heart transplant.
Pulmonary Fibrosis (Terminal)
Noah. The veteran’s fibrosis progressed to a pneumothorax. He transitioned to palliative care as he was "drowning" in his own lungs.
Other Medical Conditions Discussed
Arteriovenous Malformation (AVM): A tangle of blood vessels mentioned.
Episode 7
Pheochromocytoma in Solitary Adrenal Gland
Brian Williams. A patient with only one adrenal gland (having donated a kidney) was diagnosed with a pheochromocytoma (tumor) on the remaining gland. Dr. Grey performed a partial adrenalectomy to save the gland and avoid adrenal insufficiency.
Congenitally Corrected Transposition of the Great Arteries (CCTGA)
Jeremy. An actor fell during a play, suffering an open femur fracture. His underlying CCTGA caused cardiac arrest. Bystanders used EpiPens to restart his heart before he received an external fixator and pacemaker.
Other Medical Conditions Discussed
Sprained Ankle: Sustained by Dr. Hamilton due to Parkinson's progression.
Episode 8
Parkinson's Surgery (Delayed)
David Hamilton. Dr. Hamilton was prepped for the experimental brain injection but developed a perforated bowel requiring emergency surgery, delaying the FDA-approved window.
End-Stage Heart Failure (Donor Transport Crash)
Farouk. A donor heart was found for Farouk. However, the transport vehicle crashed, endangering the organ's viability.
Fatal Surgical Error (Webber Method)
Devon Gomez. During an ileostomy takedown for ulcerative colitis, a resident operating without direct supervision (under the "Webber Method") accidentally avulsed the Inferior Mesenteric Artery (IMA) from the aorta. The patient bled to death.
Other Medical Conditions Discussed
Sleeve Gastrectomy: Bariatric surgery mentioned.
Episode 9
Heart Transplant with "Bruised" Organ
Farouk. The donor heart involved in the crash was "bruised." Despite the risk, Dr. Ndugu proceeded with the transplant, which was successful.
L1 Burst Fracture and Open Femur Fracture
Dr. Owen Hunt. Injured in the transport crash, Dr. Hunt suffered an L1 burst fracture with retropulsion into the spinal canal and an open femur fracture. Surgeons performed simultaneous spinal stabilization and femoral fixation to save his ability to walk.
Bowel Obstruction and Sepsis
David Hamilton. Hamilton’s bowel perforation progressed to sepsis, nearly killing him and jeopardizing the Parkinson's trial.
Other Medical Conditions Discussed
Vagus Nerve Hyperactivity: Explaining symptoms like nausea and tunnel vision.
Episode 10
Endometriosis Mimicking Back Pain
Francesca Lyons. A patient with chronic back pain was found to have endometriosis lesions on the uterosacral ligament, explaining why previous epidurals failed.
Spinal Disc Herniation Misdiagnosed as Osteoarthritis
Lila Hanley. A teacher with leg numbness was initially dismissed as having osteoarthritis due to her weight. A resident identified foot drop, leading to the correct diagnosis of a herniated disc.
Other Medical Conditions Discussed
Ventral Hernia: Scheduled repair.
Episode 11
Parkinson's Cell Therapy Surgery
David Hamilton. The experimental surgery proceeded. Robotic arms injected stem cells into specific brain targets to restore dopamine levels.
Primary Sclerosing Cholangitis (Liver Transplant)
Arthur Kyat. A patient with Primary Sclerosing Cholangitis received an orthotopic liver transplant from a donor who died on black ice.
CSF Leak
Dr. Owen Hunt. Recovering from his accident, Owen developed a Cerebrospinal Fluid (CSF) leak, requiring a dural patch repair.
Other Medical Conditions Discussed
Placenta Previa: Obstetric complication mentioned.
Episode 12
Parkinson's Surgery Complications
David Hamilton. Post-surgery, the team managed the fallout of Hamilton's bowel obstruction, framing it as a lesson in the need for rigorous pre-op screening for highly motivated research subjects.
Other Medical Conditions Discussed
Asthma/Diabetes: Discussed as genetic conditions.
Episode 13
Diaphragmatic Rupture from Python Constriction
Ivan. A man constricted by his pet python suffered a diaphragmatic rupture, causing abdominal organs to herniate into the chest. Diagnosis: A CT scan prevented a fatal chest tube insertion (which would have pierced the herniated organs). Treatment: Emergency surgery revealed liver hemorrhage and DIC, requiring damage control packing.
Other Medical Conditions Discussed
Aortocaval Compression Syndrome: Discussed in pregnancy.
Episode 14
Critical Aortic Stenosis (Ross-Konno Procedure)
Fernanda. A teen with congenital aortic valve disease presented with critical stenosis. Treatment: The standard Ross procedure was insufficient due to a narrow outflow tract. Dr. Pierce performed a Ross-Konno procedure, enlarging the ventricle to fit the pulmonary valve in the aortic position.
Other Medical Conditions Discussed
Aortic Dissection: Mentioned in a decompensating patient.
Episode 15
Xenotransplantation (Pig Kidney)
Mason Taylor. In a medical first for the show, surgeons performed a xenotransplant on a brain-dead donor. A genetically modified pig kidney was attached to the femoral vessels in the groin to monitor for rejection. The organ successfully produced urine.
Other Medical Conditions Discussed
Tension Pneumothorax: Trauma complication.
Episode 16
Uterine Transplant Thrombosis
Tovah. The uterine transplant recipient (Ep 3) became pregnant but developed clots in the uterine vessels. Despite a vascular bypass using a saphenous vein, the pregnancy was lost, though the uterus was saved.
Traumatic Amputation (Ex-Vivo Perfusion)
Colin Renfield. A patient with a severed arm was too unstable for reattachment. Dr. Hunt used ex-vivo limb perfusion to keep the arm alive outside the body until the patient could withstand surgery.
Burnout
Dr. Miranda Bailey. The season addressed physician burnout as a systemic medical diagnosis, characterized by physical depletion and enlarged amygdalas.
Other Medical Conditions Discussed
Fetal Decelerations: Sign of distress in the uterine transplant pregnancy.
Episode 17
Synovial Sarcoma with Small Bowel Obstruction
Simon Clark. A patient with metastatic sarcoma developed a bowel obstruction from a tumor. Resection was impossible due to vascular involvement. He received a palliative ileostomy to survive long enough to meet his unborn child.
Ruptured Abdominal Aortic Aneurysm (AAA)
Margot Talbert. A patient lied about having IBS to hide her pain. She suffered a ruptured AAA, requiring emergency open repair.
Other Medical Conditions Discussed
Cannabis Intoxication: Dr. Webber accidentally ingested cannabis.
Episode 18
Ruptured Spleen (Trauma)
Alice Tom. An elderly assault victim presented with facial fractures. She deteriorated rapidly due to a ruptured spleen, requiring an immediate exploratory laparotomy in the trauma bay.
Other Medical Conditions Discussed
Chondrosarcoma: Persistent cancer diagnosis mentioned.
Episode 19
Ex-Vivo Auto-Transplantation for Pancreatic Tumor
Cora. A patient with a massive pancreatic tumor wrapping around vital vessels was deemed inoperable. Innovation: Surgeons removed her liver, pancreas, and intestines en bloc (ex-vivo), excised the tumor on a back table, and then auto-transplanted the organs back into her body.
ECMO for Terminal Lung Cancer
Simon Clark. Simon (from Ep 17) was placed on ECMO as a bridge to allow him to meet his son, accepting the risk of clots for the chance to say goodbye.
Physician-Assisted Death (Pulmonary Fibrosis)
Rosie. A veteran with terminal fibrosis sought medical aid in dying. Dr. Hunt illegally provided medication, sparking an ethics investigation.
Other Medical Conditions Discussed
Blood Shortage: A critical lack of blood products impacted surgeries.
Episode 20
Catastrophic Hemorrhage and Blood Shortage
Cora. The ex-vivo patient (Ep 19) suffered massive bleeding and DIC. Due to a severe hospital blood shortage, she could not be resuscitated and died.
Placental Abruption
Kristen (Simon’s Wife). Kristen suffered a placental abruption. She required an emergency C-section and hysterectomy. Her dying husband, Simon, donated his matching blood to save her before he passed away.
Other Medical Conditions Discussed
Coagulopathy: Impaired clotting requiring plasma.
🔖 Key Takeaways
🗝️ The Frontiers of Transplant: Season 18 pushed boundaries with xenotransplantation (pig-to-human) and uterine transplants, exploring the future of organ availability.
🗝️ Ex-Vivo Surgery: The concept of removing organs to repair them outside the body was featured twice (limb perfusion and auto-transplant), showcasing high-risk, high-reward techniques.
🗝️ Systemic Bias: The storyline involving the race-based GFR correction factor highlighted how systemic racism is embedded in medical algorithms, affecting transplant eligibility.
🗝️ Veterans' Health: Through the arc of the burn pit victims, the show shed light on the struggle for recognition and treatment of military toxic exposure injuries like pulmonary fibrosis.
🗝️ Physician Burnout: The season explicitly diagnosed the toll of the pandemic and high-stress environment on healthcare workers as a medical condition itself.
Keywords: Grey's Anatomy Season 18
Grey's Anatomy Season 18
