Medical Diagnoses in Chicago Med: A Comprehensive Review of Medical Conditions in Season 6
- Jan 28
- 11 min read
Season 6 of Chicago Med takes place against the backdrop of a global pandemic, forcing the Gaffney Chicago Medical Center team to adapt to a "new normal." From the isolation of the COVID-19 ward to the increased reliance on telemedicine, the season explores how the virus reshaped healthcare. Beyond the virus, the season delivers high-stakes trauma cases, exceedingly rare genetic anomalies, and complex psychiatric presentations that challenge the boundaries between physical and mental health.
Below is a detailed review of the primary medical cases and additional diagnoses presented throughout the season.
Episode 1
Auto-Brewery Syndrome
Anita Palmer, an air traffic controller, presented with unexplained falls and "loopy" behavior. Despite denying alcohol consumption, her blood alcohol level was 0.14. Diagnosis and Progression: Initial suspicions of hidden alcoholism were proven wrong when further research revealed auto-brewery syndrome. Yeast in her gut was fermenting carbohydrates into alcohol, triggered by ending a paleo diet. Treatment: The patient was instructed to eliminate simple carbohydrates to stop the internal fermentation.
Chemo-Induced Heart Failure
Kellie Lieu, a pediatric leukemia patient, presented with respiratory distress and leg swelling. Diagnosis and Progression: Dr. Manning diagnosed heart failure caused by cardiotoxicity from chemotherapy. With an ejection fraction of 15%, she could not tolerate further cancer treatment. Treatment: Despite the risks, the team surgically implanted a Left Ventricular Assist Device (LVAD) to provide mechanical support.
COVID-19 and Multi-Organ Failure
In the dedicated pandemic ward, patients Frederick MacNeal and Alvin Booker were treated for severe respiratory distress. Diagnosis and Progression: Mr. MacNeal’s condition progressed to multi-organ failure with oxygen saturation dropping to 85% despite maximum ventilation. Treatment: Due to limited resources and poor prognosis, ECMO was withheld. Mr. MacNeal passed away with nurse April Sexton by his side.
Other Medical Diagnoses and Conditions Discussed
Opioid Overdose: Treated with intubation and OG tube for aspiration pneumonitis.
Chemical Pneumonitis: Lung inflammation from aspirating stomach contents.
Diabetes: Chronic metabolic disorder requiring specific workplace protocols.
Zoom Fatigue: Mental exhaustion from excessive virtual communication.
Myelogenous Leukemia: Cancer of the blood requiring chemotherapy.
Gunshot Wound: Penetrating trauma treated with analgesics and imaging.
Alcohol Intoxication: Diagnosed via toxicology screens in disoriented patients.
Episode 2
Esophageal Perforation and Pneumocephalus
Jerome Kirk was admitted following a car accident with a pneumothorax and low blood pressure. Imaging revealed air trapped in his cranium (pneumocephalus). Diagnosis and Progression: Dr. Halstead correctly theorized the air originated from a microscopic esophageal hole caused by a previous cardiac ablation. The air compressed the brain, leading to unresponsiveness. Treatment: An emergency needle evacuation through the eye vented the trapped air, followed by surgical repair of the esophagus.
Eclampsia
Aisha Barnes, 37 weeks pregnant, presented with high blood pressure and severe headaches. Diagnosis and Progression: The condition escalated from preeclampsia to eclampsia when she suffered a seizure. Treatment: A magnesium drip was administered to prevent seizures, followed by an emergency delivery of a healthy baby.
Perforated Duodenal Ulcer
Susan presented with severe stomach pain and vomiting. Diagnosis and Progression: Endoscopy revealed a perforated ulcer caused by NSAID overuse for migraines. Treatment: Emergency surgery was performed to repair the duodenal wall.
Other Medical Diagnoses and Conditions Discussed
Leukemia: Cancer of blood-forming tissues.
Pneumothorax: Collapsed lung.
Pneumomediastinum: Air in the central chest compartment.
Cardiomyopathy: Heart muscle disease.
COVID-19: Infectious respiratory illness requiring monitoring.
Hypertension: High blood pressure.
Heart Failure: Chronic pump inefficiency.
Respiratory Failure: Inability to oxygenate blood.
H. Pylori Infection: Bacterial cause of ulcers.
Migraines: Severe recurring headaches.
Episode 3
Congestive Heart Failure and Pulseless V-Tach
Ruben Esquivel presented with fatigue, pulmonary edema, and a right-sided effusion. Diagnosis and Progression: His condition deteriorated into pulseless ventricular tachycardia during a clinical trial for a new heart medication. Treatment: Dr. Halstead performed an emergency stellate ganglion block to restore sinus rhythm, disqualifying the patient from the trial.
Factitious Symptom Presentation (Investigated as ALAD Porphyria)
Ms. Webb reported wine-colored urine and complex symptoms via telemedicine. Diagnosis and Progression: While ALAD porphyria was investigated, Dr. Manning determined the symptoms were mimicked to maintain contact due to profound loneliness. Treatment: Psychological support.
Traumatic Kidney Laceration
Megan, a paramedic, sustained a knife wound to the flank. Diagnosis and Progression: A laceration on the kidney's inferior pole led to hemorrhagic shock. Treatment: When embolization failed, emergency surgery was performed to save the kidney.
Other Medical Diagnoses and Conditions Discussed
Vitamin D Deficiency: Condition linked to lack of sunlight in a long-term abduction victim.
COVID-19: Pandemic requiring decontamination protocols.
Needle Phobia: Anxiety barrier to treatment.
Pleural Effusion: Fluid buildup outside lungs.
Gastric Ulcer: Potential cause of nausea.
Pulmonary Edema: Fluid in air sacs.
Ventricular Insufficiency: Weak heart pumping.
Hemorrhagic Shock: Critical blood loss.
Episode 4
Abdominal Carcinomatosis
Isabella presented with abdominal distension; scans revealed her abdomen was "full of cancer." Diagnosis and Progression: Invasive tumors had compromised the kidneys and liver. Treatment: Drs. Marcel and Manning performed an experimental ex-vivo surgery, removing the kidneys to debulk the cancer before re-implanting them.
Body Dysmorphic Disorder (BDD)
Dr. Todd Lowry passed out while performing surgery on himself to remove a lipoma. Diagnosis and Progression: Dr. Charles diagnosed BDD, noting the patient's obsession with physical perfection and control. Treatment: Psychiatric de-escalation and breathing exercises.
End-Stage Liver Failure
Auggie, a foster child, presented with fever and jaundice. Diagnosis and Progression: Progressive liver failure requiring a transplant. Treatment: Expedited search for biological relatives for donation.
Other Medical Diagnoses and Conditions Discussed
Heart Failure: Chronic condition requiring inotropes.
Diabetes: Metabolic disorder increasing risk.
COVID-19: Viral infection requiring isolation.
Acute Respiratory Failure: Lung function collapse.
Cytokine Storm: Immune system overreaction.
Ventricular Tachycardia: Rapid abnormal heart rhythm.
Lipoma: Benign fatty tumor.
Hypovolemia: Low blood volume.
Myocardial Infarction: Heart attack.
PTSD: Trauma-induced mental health condition.
Episode 5
Heart Failure (Post-COVID)
Mr. Booker returned with shortness of breath and fluid in the lungs. Diagnosis and Progression: Diagnosed with heart failure exacerbated by a previous COVID-19 infection. Treatment: Admitted to a clinical trial after fluid administration lowered creatinine levels.
Amyotrophic Lateral Sclerosis (ALS)
Phyllis Coleman and her husband were found unconscious from a benzodiazepine overdose. Diagnosis and Progression: The overdose was a suicide pact driven by Phyllis's fear of ALS progression. Treatment: Phyllis succumbed to the overdose; her husband later committed suicide in the ED.
Other Medical Diagnoses and Conditions Discussed
Pregnancy: Diagnosed via off-record lab work.
COVID-19: Viral infection causing long-term damage.
Gas Poisoning: Inhalation of toxic fumes.
Aspiration: Breathing in foreign substances.
Reduced Kidney Function: Indicated by high creatinine.
Pheochromocytoma: Adrenal gland tumor.
Ventricular Fibrillation: Cardiac arrhythmia.
Lidocaine Toxicity: Fatal cardiac arrest from injection.
Asystole: Flatline.
Dehydration: Fluid deficit.
Episode 6
Trigeminal Neuralgia
Eric Bowman suffered agonizing head pain triggered by minor stimuli like a breeze. Diagnosis and Progression: Dr. Choi identified trigeminal neuralgia, where an artery pulsates against a nerve. Treatment: Microvascular decompression surgery inserted a Teflon cushion between the artery and nerve, resolving the pain.
Malignant Stomach Cancer
Cindy Morales was impaled by rebar; surgery revealed a stomach mass. Diagnosis and Progression: Confirmed as a malignant tumor. Treatment: After initially refusing care due to trauma from her mother's death, she consented to tumor removal.
Other Medical Diagnoses and Conditions Discussed
End-Stage Liver Failure: Treated with transplant from a donor with amyloidosis.
Chemical Pregnancy: Early miscarriage of a fertilized egg.
Pelvic Fracture: Break in the base of the spine.
Concussion: TBI from a blow to the head.
Amyloidosis: Protein buildup in organs.
Heart Failure: Chronic pumping issue.
Leukemia: Blood cancer.
Episode 7
Metastatic Adenosquamous Carcinoma
Ron Kelton presented with respiratory distress; pneumonia treatment failed to lower procalcitonin levels. Diagnosis and Progression: A mass was identified as aggressive, undifferentiated adenosquamous carcinoma that had already metastasized. Treatment: Palliative care; prognosis of one year.
Hypothalamic Lesion
Vera Johnson, a heart failure trial participant, presented with severe hyponatremia and seizures. Diagnosis and Progression: A hypothalamic lesion was pressing on the pituitary gland, causing the electrolyte imbalance. Treatment: Surgical correction of the lesion.
Fregoli Delusion
Dr. Richard Cohen exhibited paranoia, believing strangers were a former colleague in disguise. Diagnosis and Progression: Diagnosed with Fregoli delusion triggered by a "cocktail" of nootropic supplements. Treatment: Stabilization with Haldol and Ativan.
Other Medical Diagnoses and Conditions Discussed
Heart Failure: Chronic condition in clinical trial.
Community-Acquired Pneumonia: Lung infection.
Sarcoidosis: Inflammatory disease with granulomas.
Sepsis: Systemic response to infection.
Bile Spillage: Complication of gallbladder surgery.
Brain Aneurysm: Weak spot in brain artery.
Cerebral Edema: Brain swelling.
Episode 8
Heart Failure
Carol Manning presented with elevated troponin and global dyskinesis. Diagnosis and Progression: Sudden onset heart failure with depressed ejection fraction. Treatment: Enrolled in an experimental clinical trial to reverse damage.
Pancreatic Abscess
Mr. Becker presented with abdominal pain and vomiting. Diagnosis and Progression: Pancreatitis progressed to a large abscess. Treatment: Emergency Video-Assisted Retroperitoneal Debridement (VARD).
Delusional Companion Syndrome
Tally Sanders claimed a doll was her injured baby. Diagnosis and Progression: Dr. Charles diagnosed Delusional Companion Syndrome stemmed from unresolved grief over her real child's death. Treatment: Therapeutic reenactment of the trauma to facilitate closure.
Other Medical Diagnoses and Conditions Discussed
Chemical Pregnancy: Early miscarriage.
Myocarditis: Heart muscle inflammation.
Medication-Induced Toxicity: Adverse drug effect.
Alzheimer’s Disease: Neurodegenerative disorder.
Stroke: Interruption of blood supply to brain.
C-3 Fracture: Neck vertebrae break.
SIRS: Systemic inflammatory response.
Sepsis: Life-threatening infection response.
Mesenteric Ischemia: Blood flow interruption to intestine.
Episode 9
VEXAS Syndrome
Hector Campos presented with fever, lung congestion, and inflamed ear cartilage. Diagnosis and Progression: After ruling out common infections and cancer, Dr. Archer diagnosed VEXAS syndrome, a rare autoinflammatory genetic mutation. Treatment: Targeted treatment following confirmation via genetic sequencing.
Subdural Hematoma and Factitious Disorder
Ramona Davis presented with a self-inflicted nail gun wound to the foot. Diagnosis and Progression: A fall caused a life-threatening subdural hematoma. Her behavior was identified as factitious disorder driven by an obsession with a doctor. Treatment: Craniotomy followed by a psychiatric hold.
Placenta Previa
Tionne Jefferson suffered a severe hemorrhage in public. Diagnosis and Progression: Placenta previa causing life-threatening bleeding. Treatment: Emergency C-section; infant diagnosed with spina bifida occulta.
Other Medical Diagnoses and Conditions Discussed
LVAD Complications: Issues with heart pump.
COVID-19: Viral respiratory concern.
Pneumonia: Lung infection.
Pulmonary Embolism (PE): Lung blood clot.
Cholecystitis: Gallbladder inflammation.
HIV-related Syndrome: Differential diagnosis.
Deep Vein Thrombosis (DVT): Leg blood clots.
Sarcoidosis: Inflammatory disease.
Peripheral Vasculitis: Blood vessel inflammation.
Malignancy: Cancerous growth.
Episode 10
PTSD Nightmares
Emily Norris presented with injuries initially attributed to domestic abuse. Diagnosis and Progression: Her husband was physically acting out combat terrors during sleep (PTSD nightmares). Treatment: Psychiatric referral for therapies including MDMA/ketamine.
Bullet Embolism and Ventricular-Septal Defect (VSD)
Arash Mehti’s gunshot wound projectile migrated to his heart. Diagnosis and Progression: A VSD (hole in the heart) posed a risk of the bullet causing a stroke. Treatment: Emergency open-heart surgery to remove the bullet lodged under a valve.
Refractory Cardiac Arrhythmias
Mary Daniels, a pregnant surrogate, suffered from resistant A-fib and V-fib. Diagnosis and Progression: Alcoholism history and pregnancy strain caused unstable rhythms. Treatment: High-risk tetracaine infusion followed by cardioversion.
Other Medical Diagnoses and Conditions Discussed
Shellfish Allergy: Immune reaction.
Nephrolithiasis: Kidney stones.
Bone Fracture: Arm break.
Lacerated Femoral Artery: Leg artery tear.
Battered Woman Syndrome: Pattern of abuse signs.
COVID-19: Infectious disease.
Episode 11
Hereditary Hemorrhagic Telangiectasia (HHT)
Montez Price coughed up blood after a chest impact. Diagnosis and Progression: CT revealed a pulmonary arteriovenous malformation (AVM) caused by HHT. Treatment: Surgery and embolization.
Occipital Lobe Tumor
Liam McIntyre experienced hallucinations of his deceased wife. Diagnosis and Progression: Initially suspected as Charles Bonnet Syndrome, an MRI confirmed an occipital lobe tumor. Treatment: Surgical removal.
Nutcracker Syndrome
Lisa Holtzman presented with 16 years of undiagnosed abdominal pain. Diagnosis and Progression: Compression of the left renal vein (Nutcracker Syndrome) and Loin Pain Hematuria Syndrome. Treatment: Kidney autotransplant to decompress the vein.
Other Medical Diagnoses and Conditions Discussed
Commotio Cordis: Rhythm disruption from blow.
Ventricular Tachycardia: Rapid heart rate.
Shoulder Dislocation: Joint injury.
Urinary Retention: Inability to empty bladder.
COVID-19: Viral infection.
Grand Mal Seizure: Violent muscle contractions.
Celiac Disease: Gluten reaction.
Pulseless Electrical Activity: Rhythm without pulse.
Episode 12
Thoracic Endometriosis
Michelle Forbes presented with chest pain and shortness of breath post-COVID. Diagnosis and Progression: Bronchoscopy revealed endometrial lesions in the lung airway. Treatment: Surgical resection of lung tissue to preserve fertility.
Organophosphate Poisoning
Ramona Davis presented with vomiting and pinpoint pupils. Diagnosis and Progression: Intentional ingestion of Malathion insecticide. Treatment: DuoDote injection (atropine and pralidoxime).
Traumatic Liver Laceration
Eddie Howard suffered an evisceration in a building collapse. Diagnosis and Progression: Severe liver laceration causing hemorrhage. Treatment: Emergency Pringle maneuver performed in the field.
Other Medical Diagnoses and Conditions Discussed
Heart Failure: Chronic cardiac decline.
Seizure: Electrical brain disturbance.
Cardiac Arrest Rhythms: PEA and V-fib.
Head Trauma: Skull/brain injury.
Pulmonary Embolism: Lung clot.
Cardiac Arrhythmia: Irregular heartbeat.
PTSD: Trauma response.
Episode 13
Traumatic Pseudoaneurysm
Jake Miller, 10, was struck by a car. Diagnosis and Progression: Multiple fractures and a brain vessel pseudoaneurysm. Treatment: Craniotomy for vessel reconstruction.
Bowel Obstruction
Elaine Watkins presented with abdominal pain and "hollow drum" sounds. Diagnosis and Progression: Obstruction caused by adhesions. Treatment: Surgical removal after conservative management failed.
Chronic Urinary Retention
Jerry Turner suffered from inability to urinate. Diagnosis and Progression: Chronic retention requiring long-term drainage. Treatment: Suprapubic (SP) tube insertion.
Other Medical Diagnoses and Conditions Discussed
Congestive Heart Failure: Treated with Digoxin.
Blunt Cardiac Injury: Heart damage from impact.
Premenstrual Syndrome (PMS): Differential diagnosis.
Indigestion: Minor GI disorder.
Infection and Stricture: Catheter risks.
Bowel Perforation: Obstruction complication.
Cognitive Deficits: Surgical risk.
Vagal Response: Heart rate drop during procedure.
Episode 14
Perforated Appendicitis and Delusional Disorder
Neil Dietrich refused care believing he was in a computer simulation. Diagnosis and Progression: Appendicitis progressed to perforation and sepsis. Treatment: Emergency appendectomy after intubation.
LVAD "Suck-down" Phenomenon
Carol presented with syncopal episodes. Diagnosis and Progression: Unsupervised inotrope ingestion improved heart function, causing the LVAD to suck in the ventricle wall. Treatment: LVAD removal and relisting for transplant.
Other Medical Diagnoses and Conditions Discussed
Hypertensive Emergency: Treated with hydralazine.
PTSD: Chronic trauma issue.
Gunshot Wound: Ballistic injury.
Iatrogenic Pneumothorax: Accidental lung collapse.
Sepsis: Systemic infection response.
Episode 15
Bilateral Pneumonia (Donor Damage)
James Barton developed distress days after a lung transplant. Diagnosis and Progression: Donor lungs had microscopic COVID-19 damage invisible during transplant. Treatment: Surgical salvage of functional tissue.
Cranial Hemangioblastoma
Mindy presented with intracranial hemorrhage from a known tumor. Diagnosis and Progression: Life-threatening intracranial pressure. Treatment: Emergency burr hole followed by tumor removal.
Acute Liver Failure and Tamponade
Carol presented with jaundice. Diagnosis and Progression: Trial meds interacted with Hepatitis C causing liver failure; a wire perforated her heart causing tamponade. Treatment: Emergency aspiration of the heart.
Other Medical Diagnoses and Conditions Discussed
Self-Harm: Factitious behavior.
PTSD: Psychological distress.
Respiratory Distress: Breathing difficulty.
Tachycardia: Rapid heart rate.
Long QT Interval: Rhythm disorder.
Supraventricular Tachycardia (SVT): Rapid heartbeat.
Episode 16
Intracardiac Myxoma
Carol Conte received a donor heart containing a tumor. Diagnosis and Progression: Benign myxoma in the left ventricle of the donor organ. Treatment: Ex-vivo tumor removal and warm perfusion before transplant.
Neurogenic Shock and Spinal Trauma
Dr. Ethan Choi suffered a GSW to the chest. Diagnosis and Progression: Bullet lodged at T6 caused cord hematoma and neurogenic shock. Treatment: Corpectomy to remove bone fragments and fuse the spine.
Other Medical Diagnoses and Conditions Discussed
Delusional Disorder: Belief in simulation theory leading to violence.
Sluggish Schizophrenia: Fake diagnosis used in Soviet era (investigated in patient Pavel Zorin).
Heart Failure: Cardiac decline.
Sarcoma: Malignant tumor.
Appendicitis: Appendix inflammation.
Hiatal Hernia: Stomach bulge.
Musophobia: Fear of rats.
Hemothorax: Blood in chest.
Concussion: Brain injury.
Spinal Shock: Loss of neurological activity.
CSF Leak: Fluid escape.
🔖 Key Takeaways
🗝️ The Shadow of COVID-19: Season 6 deeply integrates the pandemic, showcasing not just acute respiratory distress, but long-term complications like post-COVID heart failure and microscopic lung damage in transplant donors.
🗝️ Rare & "Zebra" Diagnoses: The medical team identifies exceptionally rare conditions such as VEXAS Syndrome, Auto-Brewery Syndrome, and Nutcracker Syndrome, emphasizing the importance of looking beyond common presentations.
🗝️ Mental Health Complexities: The season blurs the line between neurological and psychiatric conditions, exploring diagnoses like Fregoli Delusion, Body Dysmorphic Disorder, and the overlap between PTSD nightmares and physical injury.
🗝️ Experimental Surgery: From ex-vivo kidney surgeries to correcting heart defects in donor organs before implantation, the surgeons push the boundaries of what is possible in the OR.
Keywords: Medical Diagnoses Chicago Med Season 6
Medical Diagnoses Chicago Med Season 6
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