Medical Diagnoses in Chicago Med: A Comprehensive Review of Medical Conditions in Season 11
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Season 11 of Chicago Med has pushed the boundaries of emergency medicine, featuring high-stakes structural collapses, rare congenital anomalies, and complex ethical dilemmas regarding organ donation and psychiatric care. From the discovery of "superfetation" to the management of familial prion disease, the ED staff at Gaffney Chicago Medical Center faced a relentless series of physiological and psychological challenges.
Below is a comprehensive, episode-by-episode breakdown of the medical diagnoses, treatments, and clinical outcomes presented throughout the first half of the season.
Episode 1
Traumatic Impalement, Splenic Rupture, and Aortic Hematoma
Shay and Sierra. Following a structural collapse at a rave, two sisters arrived at the ED physically joined by a traumatic impalement; Sierra’s fractured forearm bone had punctured Shay’s abdomen. A FAST scan revealed free fluid in Shay's abdomen, indicating a splenic rupture. To save them, surgeons performed a complex separation involving the amputation of Sierra’s non-viable arm and a splenectomy for Shay. The case was further complicated when Shay developed a massive aortic hematoma and entered V-fib. She was resuscitated after 18 minutes of cardiac massage.
Familial Prion Disease
Dr. Lenox. A major medical storyline was introduced involving Dr. Lenox, who tested positive for familial prion disease, a terminal condition that killed her mother. While currently asymptomatic, the disease is characterized by an unpredictable progression that remains fatal within a year of symptom onset. With no cure available, treatment is currently limited to psychological management of grief and denial.
Other Medical Diagnoses and Conditions Discussed
Full-Thickness Burns (90%): Required immediate intubation and chest escharotomy for respiratory distress.
Deep Extremity Burns: Necessitated early surgical debridement to prevent necrosis.
Traumatic Forearm Fracture: Involved vascular compromise requiring amputation.
Traumatic Brain Injury: Resulting from structural collapse debris.
Crush Injury: Characterized by multiple fractures and soft tissue damage.
MDMA Intoxication: Stimulant ingestion causing distorted pain perception.
Acute Renal Failure: Secondary complication of severe burn trauma.
Delayed Intra-abdominal Hemorrhage: Manifested hours after initial blunt force trauma.
Episode 2
Soft-Tissue Infection Secondary to Leg-Lengthening Surgery
Miles Weller. A patient presenting with fever and leg pain was found to have hidden a leg-lengthening surgery from his fiancée. The titanium rods and gear systems used in the procedure created crevices that harbored a severe soft-tissue infection on both tibias. To prevent sepsis while preserving bone growth, surgeons replaced the complex hardware with standard intramedullary (IM) nails.
Bowel Obstruction and Cocaine Toxicity
Jasper. A "drug mule" presented with severe abdominal pain caused by body packing. A CT scan revealed 59 bags of cocaine, with 41 causing an obstruction at the ileocecal valve. When a packet ruptured, causing tachycardia and rising temperature, doctors performed an emergency laparotomy to remove the drugs.
H. Pylori Infection and Gastric Cancer
May and Jeremy. A pregnant woman and her partner presented with gastrointestinal distress. While the woman was treated for a standard H. pylori infection, her partner’s symptoms were caused by gastric cancer triggered by the bacteria. Diagnostic imaging revealed ascites, leading to a transition from antibiotic treatment to oncology care.
Other Medical Diagnoses and Conditions Discussed
Pregnancy: Monitored via prenatal labs and ultrasound.
Psychological Denial: Defense mechanism against mortality.
Morning Sickness: Differential diagnosis for GI distress.
Sympathy Indigestion (Couvade Syndrome): Partner experiencing physical pregnancy symptoms.
Gallstones: Ruled out via ultrasound.
Ascites: Fluid accumulation indicating advanced disease.
Gunshot Wound: Trauma requiring immediate stabilization.
Episode 3
Horseshoe Kidney and Traumatic Renal Failure
Owen. A gunshot victim was discovered to have a horseshoe kidney, a congenital malformation where the kidneys are fused. With the right side obliterated and the left side non-functional due to perfusion issues, the patient required dialysis. He eventually received a successful transplant from his pregnant mother.
Dissociative Fugue State and Trench Foot
Lieutenant Daniel Hazouri. A patient found in the river with amnesia and trench foot was diagnosed with a dissociative fugue state. It was estimated he walked 1,000 miles to escape a traumatic memory. Treatment involved EMDR therapy utilizing the sound of his own diastolic heart murmur to trigger memory reconsolidation.
Other Medical Diagnoses and Conditions Discussed
Body Packing: Ingested drug balloons causing vomiting.
Scalp Laceration/TBI: GCS score of 3 following a crash.
Brain Death: Irreversible loss of brain stem reflexes.
Diastolic Heart Murmur: Abnormal heart sound disqualifying for aviation.
Amnesia: Memory loss with normal CT results.
Malignancy: Disqualifying factor for organ donation.
Preeclampsia: Hypertension risk during surgery.
Fetal Decelerations: Heart rate drop due to maternal positioning.
Episode 4
Harm OCD
Lionel Blake. A patient intentionally amputated his hand due to Harm OCD, believing it would prevent him from hurting others. Doctors used fMRI technology to show the patient his caudate nucleus was malfunctioning—processing thoughts with fear rather than pleasure—to convince him to accept reattachment surgery.
Immune Deficiency Disorder and Sepsis
Cora Cooper. A "bubble kid" with severe immune deficiency developed sepsis. Treatment required a stem cell transplant. A DNA test revealed an IVF embryo mix-up, leading to the discovery of her biological mother, who served as the donor.
Lacerated Spleen (Traumatic Internal Hemorrhage)
Faye Carter. A domestic violence victim presented with a lacerated spleen initially attributed to a fall. The blunt trauma caused a slow hemorrhage, which was treated via splenic artery embolization.
Other Medical Diagnoses and Conditions Discussed
Bipolar Disorder: Target for fMRI diagnostic research.
Depression: Potential for neuroimaging diagnosis.
Schizophrenia: Complex disorder targeted for machine-led diagnosis.
Body Integrity Identity Disorder: Desire for amputation of healthy limbs.
Superficial Partial Thickness Burns: Treated with Silvadene.
Methamphetamine Addiction: Substance use disorder affecting behavior.
Episode 5
Prosopometamorphopsia (PMO)
Lucas Early. A foster child claimed doctors were "monsters" due to prosopometamorphopsia ("Demon Face Syndrome"), a visual perception disorder where faces appear distorted in real life but normal in 2D images. The condition was triggered by pediatric migraines caused by stress and sleep deprivation. Treatment involved green-tinted glasses.
Sepsis secondary to Endometritis
Jenny Roselle. A student presented with sepsis and an enlarged uterus. It was discovered she had secretly delivered a stillborn baby, leading to endometritis and retained placenta. She required emergency surgery and IV Zosyn.
Ventricular Fibrillation (V-fib)
Mr. Crowley. An elderly patient suffered cardiac arrest in the treatment room. He was successfully resuscitated from V-fib using a defibrillator, epinephrine, and amiodarone.
Other Medical Diagnoses and Conditions Discussed
Increased Nuchal Translucency: Ultrasound marker for genetic abnormalities.
Early-Onset Schizophrenia: Ruled out differential for agitation.
Myocardial Infarction: Cause of death in ED.
Cataracts: Lens clouding in elderly patient.
Pelvic Inflammatory Disease: Differential for uterine symptoms.
Miscarriage: Spontaneous pregnancy loss.
Pediatric Migraine: Stress-induced headaches.
Stillbirth: In utero fetal death.
Dementia: "Rage phase" behavioral changes.
Episode 6
Arsenic Poisoning and Pulmonary Embolism
Jabo. A patient with severe anemia and recurrent health issues was diagnosed with arsenic poisoning from contaminated well water. The toxicity contributed to an acute pulmonary embolism. Treatment included heparin, clot ablation, and DMSA chelating agents.
Intracranial Cyst
Lexi Caplan. A child suffering anaphylaxis from hornet stings underwent a CT scan that incidentally revealed a life-threatening intracranial cyst. Immediate surgery was performed to remove the lesion.
Subdural Hematoma (Alzheimer’s)
Bert. A patient with advanced Alzheimer's presented with a subdural hematoma. Despite the condition being reversible, the medical team adhered to his advanced directive (DNR) and provided palliative care only.
Other Medical Diagnoses and Conditions Discussed
Foreign Body in Eye: Plastic lodged in ocular area.
Asystole: Cardiac arrest from anaphylaxis.
Radial Artery Laceration: Vascular injury from fall.
Amputation Complications: Issues with prosthetic fit.
Severe Anemia: Hemoglobin level of 5.8.
Hepatitis: Screened via hepatic panel.
Lung Cancer: Historical condition linked to arsenic.
Episode 7
Gastric Adenocarcinoma and Cytoreduction with HIPEC
Jeremy Lockhart. A patient with terminal gastric cancer opted for cytoreduction with HIPEC (heated chemotherapy). The high-risk surgery to remove the tumor and circulate heated drugs was complicated by a power failure during the procedure.
Vitamin A Toxicity
Angelica Larson. A gymnast suffered dizziness and a broken ankle due to vitamin A toxicity. The cause was traced to excessive use of topical products (glitter, gels) containing high doses of retinol. Treatment involved cessation of the products.
Other Medical Diagnoses and Conditions Discussed
ICD Malfunction: Electrical injury causing inappropriate shocks.
Narcolepsy: Management during pregnancy.
Pregnancy-Related Insomnia: Sleep disturbance.
Acute Alcohol Intoxication: BAC of 0.275.
Soft Tissue Trauma: Defensive wounds from violence.
Traumatic Brain Injury: Concussion protocol utilized.
Domestic Violence Trauma: Systemic signs of abuse.
Episode 8
Invasive Abdominal Tumor
Jeremy Lockhart. Continuing from the previous episode, surgeons manually controlled a massive hemorrhage from the splenic artery during a power outage. The patient survived the surgery and awoke with full cognitive function despite risks of stroke.
Traumatic Hemothorax
Faye Carter. A domestic violence victim developed a hemothorax after a fall re-injured her ribs. Doctors performed a makeshift chest tube insertion using a knife and bike pump hose in a non-sterile environment to stabilize her lung.
Dilated Cardiomyopathy and Beta-Blocker Toxicity
Linda Myers. A transplant candidate with dilated cardiomyopathy overdosed on beta-blockers. Although stabilized, she was denied a donor heart due to the active suicide attempt and history of depression.
Other Medical Diagnoses and Conditions Discussed
Insomnia: Pregnancy symptom.
Alcohol Intoxication: Severe impairment.
Memory Consolidation: Leakage during storage transfer.
Hypothermia/Acidosis: Hemorrhage complications.
Cerebrovascular Accident: Ruled out post-op.
Parasomnia: Anxiety-induced nightmares.
Cocaine-Induced Cardiac Damage: Historical factor.
Clinical Depression: Treated with SSRIs.
Sepsis: Risk of non-sterile intervention.
Panic Attack: Burnout symptom.
Epistaxis: Stress-induced nosebleed.
Episode 9
Hypopituitarism (Misdiagnosed as Depression)
Sebastian Hendricks. A patient treated for years for resistant depression was found to have a damaged pituitary gland via fMRI and hormone testing. The injury, caused by sports trauma, resulted in low testosterone and symptoms mimicking depression. Treatment involved hormone replacement and removal of a deep brain stimulation device.
Other Medical Diagnoses and Conditions Discussed
Panic Attacks/Epistaxis: Stress responses.
Hypertension: Elevated blood pressure.
Improper Medication Metabolism: Toxic drug accumulation.
Humerus Fracture: Trauma from crash.
Active Labor: Imminent delivery.
Tibia Fracture: Lower leg break.
Neurogenic Shock: Spinal cord injury complication.
Fetal Decelerations: Distress during labor.
C5 Fracture Dislocation: Cord compression.
Parkinson’s Disease: DBS indication.
Tetraplegia: Paralysis from cervical injury.
Substance Use Disorder: Addiction recovery.
Episode 10
Superfetation and CPAM
Olivia. A surrogate mother was diagnosed with superfetation (becoming pregnant while already pregnant). The younger fetus had a Congenital Pulmonary Airway Malformation (CPAM) causing heart failure. An attempted shunt procedure failed, leading to the loss of the younger fetus to save the older one.
Ultra-Rapid Codeine Metabolism
Kristen Thompson. A college athlete overdosed on therapeutic cough syrup due to being an ultra-rapid metabolizer. Her body converted codeine to morphine at a dangerous rate. She was treated with Narcan.
Avascular Necrosis (AVN)
Ruth Williams. A dementia patient with a hip fracture was found to have avascular necrosis. A hip replacement was mandated by the court to prevent bedridden complications, despite family objections.
Other Medical Diagnoses and Conditions Discussed
ACL Tear: Knee ligament rupture.
Rectal Foreign Body: Required extraction.
Bronchitis: Treated with codeine.
Twin-to-Twin Transfusion Syndrome: Differential for size disparity.
Selective Fetal Growth Restriction: Differential diagnosis.
Episode 11
Arteriovenous Malformation (AVM)
Suzie Mankiewicz. A patient presenting with blurry vision and seizures was diagnosed with a grade 4 Arteriovenous Malformation (AVM) deep in the brain. She opted for high-risk resection surgery but did not survive.
Amniotic Bands
Lyra. An ultrasound revealed amniotic bands constricting the umbilical cord of a pregnant breast cancer survivor. Fetal surgery was successfully performed to release the constriction and restore nutrient flow.
Progressive Cervical Myelopathy
Alex Tompkins. A bull rider treated for a chest wound was incidentally diagnosed with cervical myelopathy (spinal cord compression). He refused spinal fusion surgery to continue his career, accepting the risk of paralysis.
Other Medical Diagnoses and Conditions Discussed
Deep Traumatic Wound: Required surgical exploration.
Cataracts: Ruled out for vision issues.
Open Pneumothorax: Sucking chest wound.
ER-Positive Breast Cancer: Hormonal sensitivity.
Pulmonary Laceration: Lung tear.
Infected Piercing: Localized infection.
Serotonin Syndrome: Medication complication.
Tonic-Clonic Seizure: Neurological event.
Tension Pneumothorax: Air pressure emergency.
🔖 Key Takeaways
🗝️ Trauma Innovation: The season highlighted extreme field medicine, from separating conjoined trauma victims to utilizing makeshift equipment (bike pumps and tequila) for chest tubes.
🗝️ Genetic & Congenital Rarities: The show explored medical anomalies such as superfetation (double pregnancy), horseshoe kidneys, and ultra-rapid drug metabolism.
🗝️ Diagnostic Technology: Advanced imaging, specifically fMRI, played a crucial role in re-diagnosing psychiatric conditions as physiological issues (e.g., Harm OCD and pituitary damage).
🗝️ Ethical Dilemmas: The episodes frequently addressed complex ethics, including overriding DNRs, organ donation from pregnant mothers, and court-mandated surgeries for dementia patients.
Keywords: Medical Diagnoses Chicago Med Season 11
Medical Diagnoses Chicago Med Season 11
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