Medical Diagnoses in Grey's Anatomy: A Comprehensive Review of Medical Conditions in Season 9
- Oct 21
- 17 min read
Season 9 of Grey's Anatomy was a season of profound loss, resilience, and rebuilding. Picking up in the devastating aftermath of the plane crash, the surgeons grappled with life-altering injuries, unimaginable grief, and the psychological trauma that would redefine their lives and careers. The season's medical storylines were deeply intertwined with this recovery, focusing on cutting-edge procedures to repair the irreparable, from nerve grafts to save a surgeon's hand to the agonizing decision of a life-saving amputation. As the hospital faced bankruptcy and an uncertain future, the doctors tackled bizarre medical mysteries, complex ethical dilemmas, and a terrifying superstorm that put their skills to the ultimate test.
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Episode 1: "Going, Going, Gone"
Post-Traumatic Neurological Failure (Dr. Mark Sloan)
The season opened with the emotionally devastating case of Dr. Mark Sloan, who was in a state of irreversible decline following the plane crash. As per his living will, life support was to be discontinued after 30 days with no signs of recovery. The medical intervention was purely palliative. After being sedated with morphine for comfort care, his life support was withdrawn, and he passed away.
Other Conditions Mentioned:
Hungry Bone Syndrome: A potential complication of parathyroid surgery causing hypocalcemia.
Iatrogenic Pericardium Injury: A surgeon poked holes in a patient's pericardium during a bypass, preventing them from coming off the pump.
Ripped Cecum: A severe complication during an appendectomy.
Status Post Leg Amputation: A reference to Arizona Robbins's injury from the plane crash.
Episode 2: "Remember the Time"
Reactive Psychosis
Dr. Cristina Yang was diagnosed with reactive psychosis as a result of the extreme exhaustion and trauma from being stranded for four days after the crash. She was unresponsive, silent, and occasionally violent. Resisting the use of antipsychotics, Owen Hunt took a leave of absence to provide support at home, allowing her to process the traumatic memories of her survival.
Traumatic Median Nerve Damage
Dr. Derek Shepherd's surgical career was in jeopardy due to significant nerve damage in his hand, a result of the crash. Rejecting a conservative repair that offered only 80% function, he opted for a high-risk nerve graft using his own anterior interosseous nerve, performed by Dr. Callie Torres, in the hope of a full recovery.
Osteomyelitis and Septic Shock Leading to Amputation
Dr. Arizona Robbins developed a severe infection in her crushed leg, leading to osteomyelitis (bone infection). She adamantly refused amputation. However, her condition rapidly deteriorated into septic shock, with a fever of 104°F and a high serum lactate. To save her life, Dr. Callie Torres had to break her promise and order the urgent amputation.
Meningioma Invading the Sagittal Sinus
A 44-year-old patient had a Meningioma located against the sagittal sinus. During surgical excision, the patient suffered a life-threatening air embolus, followed by acute hypertension and a venous infarction, and subsequently coded on the table.
Short-Bowel Syndrome
A pediatric patient, Stuart, required an intestinal transplant for short-bowel syndrome. The surgery was successful.
Other Conditions Mentioned:
Air embolus and Venous infarction: Life-threatening complications during the meningioma surgery.
Septic Shock: The life-threatening crisis that necessitated Arizona's amputation.
Final surge of energy: A temporary improvement in health often seen in terminally ill patients.
Episode 3: "Love the One You're With"
Severe Lower Extremity Trauma
Emery (16), a solo sailor, was rescued after her boat's mast crushed her leg. The injury was severe, with the foot nearly severed and no pulse. Dr. Torres opted for limb salvage over amputation, a choice that required a series of major operations over several months to restore blood flow and achieve near-full function.
Advanced Heart Failure
Mr. Patel was suffering from an enlarged heart and required a ventricular reduction surgery. Dr. Yang argued for a less risky LVAD, but Dr. Thomas, the surgeon, countered that it was merely a "band-aid." He successfully performed the high-risk reduction, suturing the myocardium with a double layer of vicryl to give the patient a chance at life without waiting for a transplant.
Other Featured Surgical Conditions
Roxie Meyers, a patient who lost 117 pounds, underwent elective excess skin removal and repair of an umbilical hernia.
Other Conditions Mentioned:
Mitral Regurgitation: A cardiac condition requiring mitral annuloplasty.
Juvenile Rheumatoid Arthritis (J.R.A.): A chronic pediatric autoimmune disease.
Episode 4: "I Saw Her Standing There"
Giant Scrotal Lymphedema
Bryan presented with giant scrotal lymphedema, a condition he had avoided treating for months. The surgery involved removing the massive excess lymphatic tissue to reduce the scrotum by 98%. The procedure was successful.
Complex Retroperitoneal Tumor
Mr. Mays was diagnosed with a massive retroperitoneal tumor that was adherent to his aorta and intertwined with multiple critical vessels. Dr. Grey used the Mattox maneuver, a trauma technique, to mobilize the kidney and gain "perfect visualization" to resect the tumor successfully.
Patent Ductus Arteriosus (PDA)
Janet, a patient with both a PDA and blocked arteries, underwent a unique two-part surgery. Dr. Thomas first repaired the PDA via a side approach, then flipped the patient over to open the blocked arteries from the front.
Other Conditions Mentioned:
Amputation/Residual Limb Care: Monitoring the healing of an amputated limb.
Arterial Puncture: A complication during central line practice.
Small Bowel Obstruction: A case that resolved before surgery.
Episode 5: "Beautiful Doom"
Complete Vascular Ring and Giant Aneurysm
Katy, a young patient, had a massive aneurysm, the size of an apple, caused by a congenital heart defect known as a Complete Vascular Ring. During surgery to repair the aneurysm, it blew. Dr. Thomas skillfully cut out the aneurysm and interposed a graft in under 30 minutes, saving her life. A second surgery was later performed to correct the underlying vascular ring.
Multiple Crush Injuries and Hepatic Laceration
Melissa, a cyclist, was pinned under a car and suffered multiple crush injuries and massive internal bleeding. Dr. Grey performed damage control surgery, packing the liver. After Melissa was stabilized, Dr. Grey took her back to the OR and located and clamped a tiny tear in the external iliac artery, successfully stopping the bleed and saving her life.
Other Conditions Mentioned:
Gastropericardial Fistula: An abnormal connection between the stomach and the pericardium.
Ventricular Fibrillation (V-fib): A cardiac arrhythmia that led to a surgeon collapsing mid-operation.
Gallstones: A patient was diagnosed with an unusually large quantity of gallstones.
Episode 6: "Second Opinion"
Cyclic Vomiting Syndrome (CVS)
A frequent patient known as "Santa Claus" was routinely dismissed as an alcoholic. Intern Jo Wilson, however, discovered his severe vomiting episodes were triggered by migraines. The final diagnosis was Cyclic Vomiting Syndrome (CVS), a condition characterized by recurring episodes of extreme nausea and vomiting. While incurable, treating his migraines helped lessen the CVS symptoms.
Hepatocellular Carcinoma Secondary to Anabolic Steroid Abuse
Brian Danziger (17) was diagnosed with cancer after presenting with jaundice, hair loss, and high blood pressure. He confessed to taking anabolic steroids for two years. Pathologists confirmed hepatocellular carcinoma in a hemorrhaging mass on his liver. Surgeons successfully removed all of the cancer.
Lemierre's Disease
Jamie (13) presented with a persistent sore throat and neck swelling three days after an appendectomy. Dr. Robbins suspected the rare and often overlooked Lemierre's Disease, a diagnosis supported by a pulmonary infiltrate and shoulder pain.
Other Conditions Mentioned:
Migraines: The trigger for the patient with CVS.
Aortic Dissection with an Aortobronchial Fistula: A failed stent had torn through both the aorta and a bronchus.
Myxoma: A large cardiac mass in a pregnant patient's right ventricle.
Episode 7: "I Was Made for Lovin' You"
End-Stage Liver Disease and Valvular Heart Disease
Graham Cunningham (65) was diagnosed with both end-stage liver disease (ESLD) and valvular heart disease. He required both a valve replacement and a liver transplant, but either surgery alone would have been fatal. The team planned to perform both procedures in one session. The valve replacement was successful, but his body rejected the transplanted liver. His prognosis was dire.
Mesio-Orbital Frontal Lobe Tumor
Mr. Freeman was admitted after a fall, but his inappropriate and impulsive behavior led Dr. Grey to suspect a neurological cause. She noted a grasping reflex, a frontal release sign, and correctly suspected a frontal lobe tumor. A CT scan confirmed a mesio-orbital frontal lobe tumor, which Dr. Shepherd deemed operable.
Other Conditions Mentioned:
Wilms' tumor: A diagnosis for a six-year-old patient.
Nerve damage (Hand Injury): Derek Shepherd's dying nerve prompted research into advanced surgical repairs.
Transplant rejection: The patient's new liver appeared "patchy" and failed.
Episode 8: "Love Turns You Upside Down"
Neonatal Cardiac and Respiratory Conditions
Multiple critical neonatal cases required complex interventions.
Rhys Rutstein was born with a single-ventricle defect. After his condition deteriorated, he was moved to the top of the transplant list and successfully received a heart transplant.
Samantha Morgan, a three-month-old with idiopathic neonatal cardiomyopathy, lost the available donor heart to Rhys and continued to decline while waiting.
An infant born with a Congenital Diaphragmatic Hernia (CDH) struggled to oxygenate and was placed on ECMO to rest his heart and lungs.
Pacemaker Lead Dislodgement
Mrs. Crossley, who had just received a pacemaker for complete heart block, returned after passing out during a coughing spasm. It was diagnosed that the coughing had knocked the ventricular lead from her pacemaker loose. She required a follow-up surgery to reposition the lead.
Other Conditions Mentioned:
Congenital Diaphragmatic Hernia (CDH): A defect where abdominal organs herniate into the chest.
Cardiac Tamponading: A life-threatening complication from a suspected leaking central shunt.
Single-ventricle defect: A congenital condition where the heart has only one functioning ventricle.
Episode 9: "Run, Baby, Run"
Gastroparesis
A patient known as Lefkowitz was diagnosed with gastroparesis, preventing him from properly digesting food. The treatment was the implantation of a gastric neurostimulator, a device that "zaps" the stomach to help it push food down. The procedure was complicated by pre-existing adhesions but was ultimately successful.
Median Nerve Injury Requiring Sural Nerve Grafting
Dr. Derek Shepherd underwent a nerve graft to repair severe damage to his median nerve from the plane crash. The procedure involved harvesting the sural nerve from the leg of his sister, Lizzie, as a donor. To get enough nerve material, Lizzie agreed to have the nerve harvested from both of her legs.
Other Conditions Mentioned:
Gastric neurostimulator: The device implanted to treat gastroparesis.
Sural nerve graft: The procedure used to repair Derek's median nerve.
Unstable Uterus / High-Risk Pregnancy: A diagnosis leading to concern about a potential miscarriage.
Episode 10: "Things We Said Today"
Primary Aortoduodenal Fistula
Adele Webber was rushed into emergency surgery. A CT scan revealed a massive aortic aneurysm that had torn into her duodenum, a rare condition known as a primary aortoduodenal fistula. Her Alzheimer's disease had likely masked the symptoms, allowing the fistula to develop. During the challenging repair, the atherosclerotic plaque in the aneurysm fractured. Following a crucial suggestion from Dr. Webber, Dr. Bailey divided the renal vein to get above the fracture and successfully repaired the aorta with a graft. Despite the successful surgery, Adele died shortly afterward from a heart attack.
Other Conditions Mentioned:
Alzheimer's Disease: The underlying condition that complicated Adele's diagnosis.
Atherosclerotic plaque: The buildup in the aneurysm that fractured during surgery.
Degloving injury: A severe soft tissue injury on a trauma patient's arm.
Episode 11: "The End is the Beginning is the End"
Crouzon Syndrome
James Leggett (16) had Crouzon syndrome, a genetic disorder causing premature fusion of skull bones. After five previous operations, Dr. Avery recommended a risky monobloc advancement, moving the entire midface forward in one block to give him a "more normal appearance." The five-hour surgery was successful.
Gastric Bezoar secondary to Trichotillomania
Taylor (19) was diagnosed with a bezoar, a giant hairball in her stomach, after presenting with nausea and abdominal distension. The underlying cause was trichotillomania, a condition compelling her to pull out and eat her hair. The bezoar was surgically removed, and she was set up with a therapist.
Traumatic Diaphragmatic Injury
Leonard Olsen (67) was injured when his wife fell on him from a stripper pole. Scans revealed a rib had punctured his diaphragm, requiring surgical repair.
Other Conditions Mentioned:
Crouzon syndrome: The genetic disorder causing craniofacial abnormalities.
Monobloc advancement: The high-risk procedure to correct James's midface.
Trichotillomania: The hair-pulling disorder that led to the bezoar.
Vaginal Infection: A painful consequence of sand exposure during a beach romance.
Episode 12: "Walking on a Dream"
Acoustic Neuroma
Jimmy presented with headaches, dizziness, and hearing loss caused by an acoustic neuroma that had grown while he waited for Dr. Shepherd to recover from his hand injury. The surgery to remove the tumor, which was encasing the facial nerve, carried a high risk of permanent deafness and facial paralysis. Although monitoring indicated a loss of facial function during the operation, he ultimately recovered with both his hearing and facial symmetry intact.
Acute Liver Failure
Brie, a pregnant woman, was admitted with severe abdominal pain and progressed rapidly to acute liver failure. She was moved to the top of the UNOS list. After the first donor liver was damaged during recovery, a second was secured, and the life-saving transplant proceeded.
Endomyocardial Fibrosis (EMF)
Nyah, a child from the African exchange program, was diagnosed with Endomyocardial Fibrosis (EMF), a rare condition where the heart appeared "floppy." The treatment was a highly specialized endocardial stripping of the left ventricle and papillary muscle, which was successful.
Phantom Limb Syndrome
Dr. Arizona Robbins was suffering from Phantom Limb Syndrome, feeling excruciating pain where her amputated leg once was. When the pain flared during a surgery, Dr. Hunt ordered Dr. Karev to stab her prosthetic limb with a scalpel—a shocking anecdotal remedy that provided immediate relief.
Other Conditions Mentioned:
Pericarditis: The initial diagnosis for Nyah.
Pentalogy of Cantrell: A rare, severe congenital syndrome.
Patellar Dislocation: An acute kneecap injury.
Episode 13: "Bad Blood"
Aortic Transection Complicated by Religious Refusal of Blood Transfusion
Rich Campion, a teenager, was diagnosed with an aortic transection after a skateboarding accident. The case was critically complicated because he was a Jehovah’s Witness and could not receive blood transfusions. Surgeons attempted a "bloodless surgery," modifying the plan to an endovascular repair and using a cell saver machine. Despite these measures, he lost more than half his blood volume, went into V-fib, and died.
Deep Neck Laceration and Carotid Artery Repair
A logger suffered a deep neck laceration from a chainsaw, affecting his carotid artery. The injury was too messy for a primary repair. A shunt was placed to maintain blood flow, and a piece of saphenous vein from his leg was used to patch the carotid.
Slipped Capital Femoral Epiphysis
Simmi (13), a competitive gymnast, required a double hip replacement. Post-operatively, she refused to move due to depression. Doctors warned this risked clots and contractures. She was eventually motivated to begin rehabilitation by Dr. Torres.
Other Conditions Mentioned:
Bloodless surgery: The challenging protocol for the Jehovah's Witness patient.
Endovascular repair: The percutaneous technique used to minimize blood loss.
Suicide Risk / Severe Depression: The post-op hip replacement patient's emotional state.
Episode 14: "The Face of Change"
Gender-Affirming Surgery (Top Surgery)
Brian Weston, a young transgender man, underwent gender-affirming chest reconstruction surgery. The procedure was highly significant for him, as he explained that living in his pre-transition body felt like "dying inside." The surgery was completed successfully.
Polytrauma and Tension Pneumothorax
A 10-year-old hit-and-run victim was brought to the closed ER. He had a locked airway, low oxygen saturation, and internal hemorrhage. During resuscitation, his trachea deviated, indicating a tension pneumothorax, which was treated with needle decompression. He ultimately underwent a lung resection and splenectomy and survived.
Gastroschisis
Maya Noel, a 13-day-old infant, was diagnosed with gastroschisis, a defect where her intestines were outside her body. The treatment was a staged silo repair, gradually compressing the organs back into the abdomen over time. The episode featured the final stage of her closure.
Other Conditions Mentioned:
Sub-Q Emphysema: Air under the skin, a sign of severe internal injury.
Pneumopericardium: Air in the sac around the heart.
Gastroschisis: The congenital defect where intestines are outside the body.
Episode 15: "Hard Bargain"
Volvulus and Hemoperitoneum in a Neonate
A newborn presented with vomiting and a distended abdomen, diagnosed as a Volvulus—a twisting of the bowels. During surgery, a hematoma on the liver ruptured, causing a hemoperitoneum. Instead of a risky repair, the team opted for conservative management, packing the liver and administering clotting agents. The bleeding stopped on its own, and the baby was expected to be fine.
Progressive Cancer Requiring Genome Mapping
A.J., a patient with aggressive, spreading cancer, was proposed for genome mapping by Dr. Bailey. This technique aimed to identify the tumor's specific DNA sequence to find targeted drug therapies. The hospital administration rejected the proposal due to cost. Frustrated, Dr. Bailey advised the parents to take their son to another hospital.
Other Conditions Mentioned:
Arteriovenous Malformation (A.V.M.): A neurosurgical case requiring hypothermic arrest.
"Parachute" device: Implanted in a heart to block off damage from a heart attack.
Hematoma on the liver: The complication that ruptured during the volvulus surgery.
Episode 16: "This Is Why We Fight"
End-Stage Renal Disease Complicated by Septic Shock
Melissa Keyser (28) was admitted in septic shock from complications of her ongoing dialysis. She had exhausted all viable veins for vascular access. The innovative treatment was to surgically create an artificial artery to restore her ability to remain on dialysis while she waited for a kidney.
Pediatric Tumor (Mass)
Bobby Brinn, a young boy, underwent surgery to remove a tumor he had personified as an "evil little man" named "Phil." The surgery used a Morcellator to fragment and remove the tissue.
Post-Surgical Adhesions
Andy required his fifth surgery in two years to clear life-threatening adhesions (scar tissue). The treatment involved placing novel adhesion barriers to keep the internal tissues separated while they healed.
Other Conditions Mentioned:
Epilepsy: A drastic surgical treatment involving severing the connection between brain hemispheres was mentioned.
Viral glioblastoma: The "Shepherd method" for treating this was mentioned.
Scaffold-free cartilage fabrication: An advanced research area Dr. Torres was an expert in.
Episode 17: "Transplant Wasteland"
Amyotrophic Lateral Sclerosis (A.L.S.) and Donation after Cardiac Death (D.C.D.)
Bradley Parker (31), a former resident with end-stage A.L.S., chose to undergo Donation after Cardiac Death (D.C.D.). This involved disconnecting his ventilator, allowing his heart to stop, and providing a five-minute window for organ recovery. His decision facilitated several life-saving transplants.
Complex Cardiopulmonary Transplantations (Domino Procedure)
In a rare "domino transplant," Mr. Schulz received a donor heart and lungs for his pulmonary hypertension. Subsequently, Mr. Schulz’s original heart, which was still 80% functional, was transplanted into Mr. Crump, who had severe cardiac failure.
Other Conditions Mentioned:
Amyotrophic Lateral Sclerosis (A.L.S.): The 100% fatal neurodegenerative disease.
Donation after Cardiac Death (D.C.D.): The process Bradley Parker chose.
Pulmonary Hypertension: The condition necessitating Mr. Schulz's heart-lung transplant.
Episode 18: "Idle Hands"
Nonresectable Late-Stage Gallbladder Cancer
Madeline Skurski, a teacher, was diagnosed with what was thought to be gallstones. During a laparoscopic procedure, Dr. Grey discovered a hard, calcified mass. The final diagnosis was nonresectable late-stage gallbladder cancer that had spread to the liver and was encasing the hepatic artery. Her prognosis was grim.
Other Noteworthy Cases
A 16-year-old ATV collision victim, Susie Kramer, sustained an open depressed skull fracture. A hematoma was removed from Broca's area, putting her at risk for long-term speech and motor deficits. The episode also highlighted the Lotus Valve, a noninvasive device for aortic valve defects.
Other Conditions Mentioned:
Absorbed twin / Fetal Malformations: Unusual congenital anomalies discussed as risks during a pregnancy.
Congenital cystic adenomatoid malformation (CCAM): A serious fetal lung lesion.
Lotus Valve: The new, noninvasive technology for aortic valve repair.
Episode 19: "Can't Fight This Feeling"
Kawasaki Disease
Parker Hedges, a young boy with a persistent high fever and rash, was misdiagnosed with a virus and then strep throat. His mother's intuition led to further investigation. The final diagnosis was Kawasaki disease, a serious condition that can cause heart damage. An echocardiogram showed fluid around his heart. He received immediate Intravenous Immunoglobulin (IVIG) within the crucial ten-day window to prevent permanent heart damage.
Traumatic Brain Injury Presenting as Capgras Syndrome
Rachel Dawson, a patient in a gas tanker pileup, sustained a closed head injury and developed a hematoma in her temporal lobe. This manifested as Capgras syndrome: she failed to recognize her own son, reacting with fear and confusion. The treatment was surgical evacuation of the hematoma.
Other Conditions Mentioned:
Kawasaki disease: The serious illness causing inflammation in blood vessels.
Capgras syndrome: The delusional misidentification syndrome caused by the brain hematoma.
Aortic Transection: A severe cardiovascular trauma requiring dual-circuit bypass.
Prolapsed Cord: An obstetrical emergency where the umbilical cord presents before the baby.
Episode 20: "She's Killing Me"
Severe Post-Operative Septic Infections
A cluster of aggressive post-operative septic infections occurred in three of Dr. Bailey's patients. Joyce Basche, who had received a dialysis graft, developed a huge abscess, crashed, and died. Two other patients, Kathy Dong and Seth Lepik, also developed severe infections. The investigation, which briefly focused on an intern, ultimately turned to Dr. Bailey as the common link between all three patients.
Other Conditions Mentioned:
Dialysis Graft: The vascular access required for hemodialysis.
Post-Operative Infection: Characterized by fever, redness, and swelling at a surgical site.
Genetic Markers for Alzheimer's Disease: Testing to identify hereditary risk.
Episode 21: "Sleeping Monster"
Methicillin-Resistant Staphylococcus Aureus (MRSA) USA600 Outbreak
The CDC identified the virulent post-op infection as MRSA USA600. After two patient deaths, the investigation focused heavily on Dr. Bailey. The source was complex: Dr. Bailey was found to be an asymptomatic carrier of MRSA USA600, and she transmitted it to her patients through defective surgical gloves that had microscopic tears. The third patient, Seth Lepik, succumbed to the infection when an abscess eroded into his innominate vein.
Other Conditions Mentioned:
MRSA USA600: The aggressive, antibiotic-resistant staph strain.
Defective surgical gloves: The mechanism of transmission for the MRSA.
Hypoplastic Left Heart Syndrome (HLHS): A severe congenital heart defect.
Abscess Eroding into the Innominate Vein: The fatal progression of the MRSA infection.
Episode 22: "Do You Believe in Magic"
Severe Abdominal Trauma and Abdominal Compartment Syndrome
Kayla Wayne, a magician's assistant, sustained a severe open wound to her abdomen from a chainsaw. The trauma shredded her kidney, injured her large intestine, and caused massive bleeding, leading to a profound metabolic collapse. After damage control surgery, she developed Abdominal Compartment Syndrome (ACS), with her intra-abdominal pressure skyrocketing. She required immediate surgical decompression.
Gastric Rupture Due to Liquid Nitrogen Ingestion
Kimmy, celebrating her 21st birthday, ingested a cocktail made with liquid nitrogen, which essentially blew out her stomach. The final diagnosis was a Gastric Rupture. The treatment was a Roux-en-Y, completely removing her stomach and reattaching her intestine directly to her esophagus.
Moyamoya Disease
Iris Kane (7) was admitted for Moyamoya disease, a condition causing the narrowing of blood vessels in the brain, which had manifested as TIAs. The treatment was an omental flap surgery, where healthy tissue containing vessels from her abdomen was surgically placed on her brain to improve blood supply.
Coma Following Inferior Myocardial Infarction
Paul was in a coma following a cardiac arrest from a post-op inferior M.I. Dr. Bailey suggested a novel approach: administering zolpidem, a GABA agonist. Though a sleeping pill, studies indicated it could potentially reverse the coma effect in certain brains.
Other Conditions Mentioned:
Abdominal Compartment Syndrome (ACS): The life-threatening pressure buildup in Kayla's abdomen.
Moyamoya Disease: The rare condition causing choked-off blood vessels in the brain.
Transient Ischemic Attacks (T.I.A.s): Mini-strokes experienced by the patient with Moyamoya.
Episode 23: "Readiness Is All"
Temporal Bone Fracture Complicated by Basilar Artery Thrombus
Jason Myers was admitted with a temporal bone fracture and an epidural hemorrhage. After nine days unconscious, a CT angio revealed a thrombus blocking his basilar artery. A precarious procedure to place a pipeline stent was successful, restoring blood flow, and Jason woke up coherent.
Congenital Craniofacial Anomaly
A baby was born with a severe encephalocele and facial cleft—"his brain on his face." The treatment was an extensive reconstruction involving a calvarial graft from the parietal bone to rebuild his face.
Traumatic Impalement on Rebar
Leon, a construction worker, fell four stories and was impaled on three bars of rebar. The removal was complicated by the risk of an explosion from sparks in the oxygen-rich OR. Using a dangerous manual ventilation technique, the rebar was cut, and the final injuries were surprisingly minor.
Other Conditions Mentioned:
Thrombus: A blood clot blocking the basilar artery.
Pipeline stent: The device used to restore blood flow to the brain.
Encephalocele and Facial Cleft: The severe congenital anomalies.
Hypoxia: A risk during the rebar removal due to the manual ventilation.
Episode 24: "Perfect Storm"
Disseminated Intravascular Coagulation (DIC) Secondary to Ruptured Spleen
During a hospital-wide power outage caused by a superstorm, Dr. Meredith Grey required an emergency C-section due to the baby's dangerous face presentation (mento-posterior). Following the delivery, she began bleeding excessively. On the operating table, she self-diagnosed Disseminated Intravascular Coagulation (DIC), hypothesizing the cause was an internal injury from a fall the previous day. Before losing consciousness, she instructed a junior resident, Dr. Shane Ross, to perform a midline laparotomy. Dr. Bailey arrived and confirmed a ruptured spleen was the source of the massive bleeding. A splenectomy was performed in the dark, and Meredith survived.
Other Conditions Mentioned:
Face presentation (mento-posterior): The dangerous fetal position necessitating the C-section.
Disseminated Intravascular Coagulation (DIC): The life-threatening clotting disorder Meredith developed.
Ruptured Spleen: The source of Meredith's massive internal hemorrhage.
Myocardial Infarction (M.I.): A patient who fixed the hospital generator was to be worked up for a heart attack.
🔖 Key Takeaways
The Aftermath of the Crash: The season was dominated by the physical and psychological fallout of the plane crash. This included Mark Sloan's tragic death, Arizona's amputation and struggle with Phantom Limb Syndrome, Derek's high-risk nerve graft surgery to save his hand, and Cristina's reactive psychosis.
Financial Crisis and the New Hospital: The hospital's impending bankruptcy and subsequent purchase by the surviving doctors (transforming it into Grey Sloan Memorial Hospital) created a new dynamic, where financial constraints directly impacted patient care and surgical decisions, such as denying funding for genome mapping.
Diagnostic Challenges and Rare Diseases: The season featured several "medical mystery" cases that tested the attendings and new interns. Notable diagnoses included Cyclic Vomiting Syndrome masquerading as alcoholism, the rare parasitic infection Gnathostomiasis, and the often-overlooked Lemierre's Disease.
Pushing Surgical Boundaries: Despite personal and professional turmoil, the surgeons continued to innovate. Key procedures included a complex ventricular reduction surgery, the use of the Mattox maneuver in a non-trauma setting to resect a retroperitoneal tumor, and the successful treatment of Moyamoya disease with an omental flap.
The Superstorm Finale: The season culminated in a massive storm that caused a hospital-wide power outage. This crisis led to a dramatic in-the-dark C-section for Meredith, who then suffered a ruptured spleen and DIC, forcing a junior resident to perform a life-saving splenectomy with limited resources.
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