Medical Diagnoses in The Good Doctor: A Comprehensive Review of Medical Conditions in Season 2
- 4 days ago
- 12 min read
Season 2 of The Good Doctor continues to push the boundaries of medical drama, presenting a fascinating mix of rare congenital defects, high-stakes surgical innovations, and complex ethical dilemmas. From the quarantine-induced chaos of the emergency room to the personal health battles of Dr. Aaron Glassman, the medical accuracy and dramatic tension remain high.
Below is a comprehensive review of the specific medical diagnoses and treatments featured throughout Season 2.
Episode 1
Pulmonary Hypertension and Aortic Aneurysm
Melanie Arnott presented with pulmonary hypertension, a condition characterized by elevated lung blood pressure. This placed extreme strain on her heart, resulting in heart failure. Because her heart was structurally healthy but failing under pressure, Dr. Melendez proposed a "piggyback transplant" (heterotopic heart transplant), where a donor heart is inserted to support the existing one. Progression and Diagnosis: During surgical planning, the team discovered Melanie also suffered from an aortic aneurysm. This complication nearly canceled the procedure, as the aortic wall was as thin as "tissue paper," making it impossible to anchor a standard graft. Treatment: The team proceeded with a modified David procedure. Dr. Melendez resected the damaged segment and reconstructed the ascending aorta using a Teflon graft, allowing the donor heart to be plugged directly into the graft. The surgery was successful, resulting in the patient having two functional heartbeats.
Right Parietal Brain Tumor
Harry (Edward Austin Thomas), a homeless man, initially identified as "Harry," presented with severe paranoia, delusions, and disorganized thinking. Staff initially suspected schizophrenia due to the psychiatric nature of his symptoms. Progression and Diagnosis: Dr. Jared Kalu suspected bacterial meningitis due to a stiff neck, but a lumbar puncture was negative. Dr. Shaun Murphy eventually identified the condition as "kaleidoscopic disintegration" and, drawing insights from Dr. Glassman’s own condition, realized the symptoms were caused by a right parietal brain tumor. Treatment: The patient underwent successful surgery to remove the tumor. The procedure cured his neurological condition, restoring his identity as Edward Austin Thomas and allowing him to reunite with his family.
Brain Cancer (Glioma)
Former hospital president Dr. Aaron Glassman was diagnosed with brain cancer, specifically a glioma. Treatment: He stepped down from his position to undergo a comprehensive treatment plan under Dr. Marina Blaize. This involved brain surgery to remove the tumor, followed by radiation and chemotherapy, with a focus on minimizing brain swelling and maintaining cognitive function.
Other Medical Diagnoses and Conditions Discussed
Disseminated Intravascular Coagulation (DIC): Systemic activation of blood-clotting mechanisms leading to clotting and bleeding.
Ulcerative Tinea Pedis: Severe fungal infection of the feet resulting in open sores.
Chlamydia: Bacterial infection typically treated with antibiotics.
Schizophrenia: Chronic mental disorder involving a breakdown of thought, emotion, and behavior.
Bacterial Meningitis: Inflammation of the brain's protective membranes, often presenting with a stiff neck.
Kaleidoscopic Disintegration: Rare neurological condition causing severe cognitive confusion.
Episode 2
Stage III Pancreatic Cancer
Paul presented with apparent acid reflux, but frequent burping and minor jaundice led Dr. Murphy to suspect a severe condition. A pancreatic protocol CT scan and labs confirmed Stage III pancreatic cancer, involving local nodes and partial encasement of the superior mesenteric artery. Diagnosis and Treatment: Although the case was borderline, the team proceeded with a Whipple surgery. This complex resection involved removing the head of the pancreas and reconstructing the anatomy. Unfortunately, Paul suffered a gastroduodenal artery rupture—a fatal complication—and passed away during the operation.
Female Genital Mutilation (FGM) and Clitoral Reconstruction
Mara (Asha), a young woman sought "vaginal rejuvenation" to correct scarring. Dr. Lim discovered the patient was a victim of Female Genital Mutilation (FGM) performed at age two. Diagnosis and Treatment: A labiaplasty was initially performed, revealing viable nerves buried under scar tissue. Exposure of these nerves caused immense pain. Dr. Lim proposed and performed a clitoral reconstruction using a tissue graft from the patient's cheek to sheath the nerves, rejecting the parents' request for total ablation.
Other Medical Diagnoses and Conditions Discussed
Acid Reflux: Stomach acid backflowing into the esophagus.
Influenza (The Flu): Common communicable respiratory infection.
Brain Tumor: Abnormal mass of cells within the brain.
Disseminated Intravascular Coagulation (DIC): Critical condition of overactive clotting mechanisms.
Gastroduodenal Artery Rupture: Bursting of a major abdominal artery.
Episode 3
Severe Endometriosis and Invasive Polyploid Mass
Gina presented for a minor procedure to resolve infertility caused by endometriosis. However, surgery revealed lesions covering her ovary, bowel, bladder, and uterus were far more severe than expected. Diagnosis and Treatment: The procedure converted to a "crash lap" (open surgery). The team performed an orthotopic neobladder reconstruction using intestinal tissue. A critical polyploid mass invaded the uterine arteries, necessitating a full hysterectomy to save her life.
Epidural Abscess presenting as Ischemic Priapism
Alex Leon presented with ischemic priapism, initially suspected to be drug-induced. Diagnosis and Treatment: Dr. Murphy noted a foot drop, indicating neurological impairment. This led to a diagnosis of an epidural abscess with pelvic extension. The patient was treated with a Winter’s procedure to restore circulation, followed by surgery to drain the infection, preventing paralysis.
Other Medical Diagnoses and Conditions Discussed
Malignancy: Condition requiring post-operative chemotherapy and radiation.
Myocardial Infarction (M.I.): Heart attack due to blocked blood supply.
Compound Femur Fracture: Severe bone break piercing the skin.
Masseter Muscle Spasm: Involuntary contraction causing lockjaw.
Pulmonary Aspiration: Inhalation of foreign material into the lungs.
Post-Operative Hallucination: Delirium occurring during surgical recovery.
Episode 4
Fragile X Syndrome
Mac was admitted for a shoulder injury caused by a picket fence splinter. The primary medical focus was his Fragile X Syndrome, a genetic disorder causing intellectual disability and behavioral issues. Treatment: While the shoulder was surgically repaired, the team recommended Mac be placed in a residential facility due to the physical danger his aggressive outbursts posed to his mother.
Cervical Fractures (Broken Neck)
Kitty Kwon, a free solo climber, fell 150 feet, sustaining cervical fractures, calcaneus fractures, and tibial pilon fractures. Treatment: The team debated between a vertebral fusion (safer, but restricts motion) and an Odontoid Screw Procedure (risky, but preserves motion). Ultimately, due to her history of reckless behavior, she was treated with a spinal fusion to prioritize the preservation of life.
Post-operative Delirium
Following brain surgery, Dr. Glassman experienced hallucinations of his deceased daughter. Treatment: Initially suspected to be ICU psychosis or sleep deprivation, the condition was managed with Haldol after the delirium became agitated.
Other Medical Diagnoses and Conditions Discussed
Internal Bleeding: Acute complication from trauma.
Calcaneus Fractures: Heel bone fractures.
Tibial Pilon Fractures: Fractures of the distal tibia.
Concussion: Traumatic brain injury.
Shattered Femur: Severe leg bone injury.
Ruptured Spleen: Internal organ injury.
Cerebral Ischemia: Insufficient blood flow to the brain.
Episode 5
Crohn’s Disease and Enterovesical Fistula
Wade presented with fizzy urine. A contrast cystogram revealed a fistula connecting the bladder to the intestine, caused by Crohn's disease. Treatment: The team determined Wade required a reversal of his gastric bypass to preserve intestinal length. Complications involving a strangulated bowel necessitated emergency surgery.
Anorexia Nervosa and Mitral Regurgitation
Louisa DeLeon suffered a syncopal episode due to proximal ventricular tachycardia. Her heart failure (mitral regurgitation) was a complication of long-term anorexia nervosa. Treatment: Too weak for valve repair, Louisa underwent experimental Deep Brain Stimulation (DBS). Electrodes were placed in the nucleus accumbens to reduce anxiety around eating, allowing her to regain strength for future heart surgery.
Other Medical Diagnoses and Conditions Discussed
Gallbladder Disease: Often requiring cholecystectomy.
Emphysematous Cystitis: Bladder infection with gas in the bladder wall.
Bladder Cancer: Malignancy in bladder tissues.
Kidney Stones: Mineral deposits causing pain.
Deep Vein Thrombosis (DVT): Blood clot in a deep vein.
Partial Bowel Obstruction: Blockage preventing normal digestive flow.
Episode 6
Necrotizing Fasciitis
Jas Kohl. What began as paronychia (nail infection) rapidly progressed to severe pain and necrosis. Dr. Murphy diagnosed necrotizing fasciitis, a flesh-eating bacterial infection. Treatment: Despite debridement and hyperbaric oxygen therapy, the infection migrated to the bone. Jas became septic, requiring the amputation of her arm to save her life.
Foreign Body Aspiration
Riley presented with chronic epistaxis (nosebleeds) and respiratory distress, initially attributed to psychological issues. Diagnosis and Treatment: An imaging scan revealed a shadow on the bronchus. Exploratory surgery uncovered a LEGO piece inhaled years prior, encased in a granuloma. Removal of the object resolved the condition.
Other Medical Diagnoses and Conditions Discussed
Tendonitis: Inflammation of tendons.
Arthritis: Joint inflammation.
MRSA: Drug-resistant bacterial infection.
Carcinoid Tumor: Slow-growing cancer in the bronchus.
Sepsis: Life-threatening systemic reaction to infection.
Episode 7
Stage 4 Ovarian Cancer and Diaphragm Perforation
Kayla had Stage 4 ovarian cancer. A metastatic lesion displacing her diaphragm made her a candidate for HIPEC (heated intraperitoneal chemotherapy). Treatment: During the procedure, she suffered cardiopulmonary collapse due to a diaphragm perforation. Surgeons repaired the hole, allowing her to complete the treatment.
Traumatic Renal Rupture and Unilateral Renal Agenesis
Santiago suffered a ruptured kidney from a nail gun injury. Dr. Murphy discovered unilateral renal agenesis, meaning Santiago was born with only one kidney, which was now destroyed. Treatment: Complicated by hypercoagulability, Santiago was stabilized via a living donor kidney transplant from his brother.
Other Medical Diagnoses and Conditions Discussed
Anorexia: Psychiatric disorder.
Arterial Circulatory Collapse: Failure of arterial blood flow.
Extensive Vein Thrombosis: Blood clots within veins.
High Blood Pressure: Chronic elevated arterial pressure.
Protein-losing Nephropathy: Kidney disorder involving protein loss.
Cardiopulmonary Collapse: Failure of heart and lungs.
Episode 8
Diastematomyelia
Finn presented with a stiff neck and weak reflexes. An MRI revealed diastematomyelia, a rare congenital split of the spinal cord. Treatment: The split cords had become tethered during puberty. Surgeons used a laser to cut adhesions and remove the dividing septum to prevent paraplegia.
Paraneoplastic Syndrome
Dawn Williams presented with a ruptured Fallopian tube due to an ectopic pregnancy, alongside impulsive behavioral changes (affairs, spending). Diagnosis and Treatment: Dr. Murphy linked her behavior to involuntary muscle spasms. An MRI confirmed a thoracic tumor causing paraneoplastic syndrome, which lowered inhibitions. Resection of the tumor was performed to restore her baseline personality.
Other Medical Diagnoses and Conditions Discussed
Hip Dislocation: Displacement of the femur head.
Ectopic Pregnancy: Implantation outside the uterus.
Polio: Viral infection causing paralysis.
Whooping Cough: Pertussis.
Radiation-Induced Memory Loss: Cognitive complication of therapy.
Measles: Contagious viral disease.
Episode 9
MCA Embolism and DIC
George Reynolds presented with a Middle Cerebral Artery (MCA) embolism, triggered by anti-androgen injections used to suppress pedophilic urges. Treatment: After an initial embolectomy, George attempted self-castration, leading to sepsis and Disseminated Intravascular Coagulation (DIC). He refused life-saving treatment and died.
Lacerated Diaphragm and Frontal Bone Defect
Billy presented with a collapsed lung and fractured eye orbit. Investigation revealed a lacerated diaphragm allowing the stomach into the chest. Treatment: Surgeons repaired the diaphragm with mesh. Simultaneously, Dr. Murphy used a breast implant to correct a pre-existing frontal bone defect ("dent") in Billy's forehead.
Other Medical Diagnoses and Conditions Discussed
Prostate Cancer: Potential indication for anti-androgens.
Collapsed Lung: Pneumothorax requiring chest tube.
Fractured Eye Orbit: Trauma to the eye socket.
Testicular Ischemia: Restriction of blood flow to testes.
Retrobulbar Hematoma: Blood collection behind the eye.
Oculocardiac Reflex: Heart rate drop due to orbital pressure.
Episode 10
Airborne Malaysian Respiratory Virus (SARS-like)
A highly contagious respiratory virus originating from Malaysia caused an outbreak. Symptoms included vesicular rash, high fever, and rapid ARDS. Treatment: The ER was quarantined. Treatment involved antivirals, oxygen, steroids, and nitric oxide.
Sigmoid Volvulus
Santa Pete suffered a sigmoid volvulus (twisted bowel). Treatment: Due to quarantine restrictions, the team performed an improvised "combat-style" surgery in the ER to treat the perforated bowel.
Leukemia-Induced Myocardial Infarction
Chris, a leukemia patient, suffered a heart attack caused by excess blast white cells. Treatment: Combined leukapheresis, chemotherapy, and radiation were used to clear the blockage.
Other Medical Diagnoses and Conditions Discussed
Viral Pneumonia: Lung inflammation.
Diverticulitis: Inflammation of digestive pouches.
Peripheral Nerve Injury: Damage requiring nerve study.
Asthma: Chronic airway inflammation.
Hypoglycemic Shock: Critical drop in blood sugar.
Episode 11
Meningitis and CSF Leak
Dr. Glassman feared cancer recurrence due to memory loss. Diagnosis and Treatment: Imaging revealed meningitis caused by a CSF leak from previous surgery. Immediate repair was required.
Preeclampsia and Placental Abruption
Trapped in quarantine, Viola developed preeclampsia and subsequently suffered a placental abruption. Treatment: Dr. Murphy improvised a Bakri tamponade using a saline-filled balloon to stop the uterine hemorrhage.
Severe Respiratory Virus (Lungs)
Dr. Audrey Lim was infected by the Malaysian virus and entered respiratory failure. Treatment: She was placed on ECMO (extracorporeal membrane oxygenation) to bypass her lungs and allow them to heal.
Torn Inferior Mesenteric Artery (IMA)
Santa Pete suffered a torn IMA and internal hemorrhaging. Treatment: Surgeons improvised a repair using a saphenous vein graft within the quarantine zone.
Other Medical Diagnoses and Conditions Discussed
Immunocompromised State: Susceptibility to infection.
Pulmonary Edema: Fluid accumulation in lungs.
Hypotensive Crisis: Dangerously low blood pressure.
IV Catheter Embolism: Catheter fragment in bloodstream.
Meconium Aspiration: Newborn inhaling stool/fluid.
Episode 12
Malaysian Virus Outbreak Aftermath
The hospital underwent review following the outbreak. Issues addressed included the non-consensual dosing of Haldol and violations of DNR orders.
CSF Leak (Secondary to Brain Tumor)
Following his CSF leak repair, Dr. Aaron Glassman faced the risk of a subdural hematoma if the skull base repair did not heal. Treatment: A strict recovery period was mandated before beginning aggressive chemotherapy.
Other Medical Diagnoses and Conditions Discussed
Subdural Hematoma: Bleeding between brain and skull.
Autism Spectrum Disorder: Developmental diagnosis affecting sensory processing.
Bipolar Disorder: Chronic mental health condition.
Episode 13
Brain Arteriovenous Malformation (AVM)
Lana Moore presented with a grade two AVM and microbleeds. Treatment: Because the AVM was near Broca’s area, the team performed awake brain surgery to map her speech center and safely resect the malformation.
Mechanical Heart Failure and Aortic Narrowing
Sunny Lee's mechanical heart appeared to malfunction. Diagnosis and Treatment: An angiogram revealed the device was fine, but the aorta had narrowed. Surgeons replaced the constricted section with a graft.
Other Medical Diagnoses and Conditions Discussed
Cancer: Treated with PCV chemotherapy.
Hypotension: Low blood pressure.
Valvular Stenosis: Narrowing of heart valves.
Episode 14
Aortic Dissection and Total Face Transplant
Karin Tindle (Donor) / Molly (Recipient). Karin suffered brain death following an aortic dissection. She became a donor for Molly, who had severe facial disfigurement. Treatment: Molly underwent a total face transplant. The 48-hour surgery involved distraction osteogenesis and the complex reconnection of nerves and vessels. A torn donor artery was repaired with interrupted sutures.
Other Medical Diagnoses and Conditions Discussed
Distraction Osteogenesis: Procedure to realign bone.
Head Trauma: Injury resulting in low GCS.
Pseudoaneurysm: Vascular injury.
Brain Edema: Swelling causing increased ICP.
Brain Death: Irreversible loss of brain stem reflexes.
Episode 15
Congenital Heart Defects and Omphalocele
Persephone ("Percy"). A newborn presented with bowel protrusion and a "Swiss cheese" heart septum. Treatment: Dr. Murphy utilized a PTFE disc with a stem to plug the heart defects. The abdominal wall was separated to accommodate the bowel. A "check valve" was created in the heart wall to manage pulmonary pressure.
Chordoma vs. Benign Notochord Cell Tumor
Minesh Goyal. An incidental tumor was found on the sacral nerve. It was either a benign tumor or a malignant chordoma. Treatment: Minesh opted for high-risk surgical excision rather than monitoring. The surgery was successful but required the removal of the S1 nerve root.
Other Medical Diagnoses and Conditions Discussed
Hernia: Organ pushing through muscle.
Piggyback Heart Transplant: Heterotopic transplant.
Infantile Hypertrophic Pyloric Stenosis: Thickening of the pylorus.
Bowel Atresia: Malformation of the intestine.
Episode 16
Sparganosis
Sadie Barnes was diagnosed with a malignant meningioma. Diagnosis and Treatment: Dr. Murphy noted a high eosinophil count and linked it to her food habits. The "tumor" was actually a parasitic worm (sparganosis). It was surgically removed, curing her.
Spontaneous Tumor Regression
Clarence had a metastatic sarcoma. Diagnosis and Treatment: The tumor inexplicably shrank (spontaneous regression). A spinal fusion was performed to stabilize his vertebrae and treat pain.
Other Medical Diagnoses and Conditions Discussed
High Altitude Headaches: Caused by thin air.
Malignant Meningioma: Aggressive brain tumor.
Cyanide Poisoning: Identified by scent of bitter almonds.
Episode 17
Giant Neurofibroma
Kenny Grimm had a massive 200-pound neurofibroma. Treatment: During resection, Post-Embolization Syndrome (PES) caused distributive shock. Dr. Murphy clamped the aorta in intervals to manage the cytokine storm, allowing for successful removal.
Vacuum-Assisted Delivery Induced Subdural Hematoma
An infant presented with a subdural bleed, raising suspicion of abuse. Diagnosis: Pathological analysis confirmed the bleed occurred at birth due to vacuum-assisted delivery and had re-bled, clearing the mother of abuse allegations.
Other Medical Diagnoses and Conditions Discussed
Aneurysm/AVM: Ruled out as causes for bleed.
Non-Accidental Trauma: Shaken baby syndrome (ruled out).
Distributive Shock: Systemic inflammatory response.
Episode 18
Tertiary Syphilis and Aortic Arch Aneurysm
Zack Cordell presented with erratic behavior and a closed head injury. Diagnosis and Treatment: Dr. Murphy diagnosed tertiary syphilis causing an aortic arch aneurysm. The aneurysm was surgically repaired.
Traumatic Hemothorax and Splenic Laceration
Dr. Shaun Murphy after being assaulted by Zack Cordell, collapsed with internal bleeding. Diagnosis and Treatment: He suffered a rib fracture, left hemothorax, and splenic laceration. A chest tube was inserted to stabilize him.
Factitious Behavior
Ida mimicked symptoms by dumping slushies into her surgical drain. Diagnosis: Factitious behavior (simulated illness) driven by loneliness.
Other Medical Diagnoses and Conditions Discussed
Epidural Hematoma: Blood collection between skull and brain.
Guillain-Barré Syndrome: Immune system attacking nerves.
Rhabdomyolysis: Muscle tissue breakdown.
Botulism: Rare illness causing paralysis.
🔖 Key Takeaways
🗝️ Surgical Innovation: The season highlighted creative surgical solutions, such as the "piggyback" heart transplant and the use of a cheek graft for clitoral reconstruction.
🗝️ Diagnostic Complexity: Several cases, such as the parasitic worm masquerading as a tumor and the paraneoplastic syndrome causing behavioral changes, emphasized the importance of differential diagnosis.
🗝️ Medical Ethics: The show tackled difficult ethical questions, including informed consent in minors (FGM case), the allocation of organs (face transplant), and treating patients during a quarantine.
🗝️ Impact of Trauma: Physical trauma was a recurring theme, from the "Swiss cheese" heart requiring a mechanical plug to the life-threatening injuries sustained by Dr. Shaun Murphy himself.
🗝️ Rare Conditions: Viewers were introduced to rare medical phenomena like kaleidoscopic disintegration, spontaneous tumor regression, and diastematomyelia.
Keywords: Medical Diagnoses The Good Doctor Season 2
Medical Diagnoses The Good Doctor Season 2
