Medical Diagnoses in The Good Doctor: A Comprehensive Review of Medical Conditions in Season 5
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Season 5 of The Good Doctor ups the ante with a blend of complex medical mysteries and deeply personal health battles. From the deceptive presentation of a Scleroderma patient testing the hospital's competence to the heart-wrenching reality of a young boy’s brain tumor, the season explores the cutting edge of medicine. The surgical team navigates everything from rare congenital defects to the unintended consequences of high-risk procedures.
Below is a comprehensive review of the specific medical diagnoses and treatments featured throughout Season 5.
Episode 1
Scleroderma
Salen Morrison presented with a confusing array of symptoms: shortness of breath, blurred vision, headaches, foamy urine, and swollen ankles. Initial imaging suggested kidney stones or renal-cell carcinoma. However, her erratic behavior and refusal to follow instructions hindered diagnosis. Diagnosis: The team discovered Salen was sabotaging her own care. She doubled her Ritalin dosage to cause heart irregularities and used makeup to hide Raynaud's syndrome on her fingers. The final diagnosis was Scleroderma, a condition she had known about for years. Her deception was a test of the doctors' competence as she prepared to buy the hospital.
Advanced Cervical Cancer and Tracheal Tumor
Sarah (Mother), Riley and Jackson (Sons). During a tonsillectomy for Riley, surgeons found a cancerous mass likely inhaled during birth. This prompted screening for the whole family. Diagnosis: Sarah was diagnosed with advanced cervical cancer due to missed screenings. Her other son, Jackson, had a tumor in his trachea. Treatment: Sarah underwent a radical hysterectomy, using a technique to preserve blood supply and prevent incontinence. Jackson was treated with an endoscopic mucosal tracheal resection for faster recovery.
Other Medical Diagnoses and Conditions Discussed
Kidney Stones: Suspected cause for foamy urine.
ADHD: Reason for Ritalin use.
Tonsillar Infection: Initial suspicion for throat mass.
Lymph Node Metastasis: Potential cancer spread requiring chemotherapy.
Infectious Abscess: Potential cause for kidney lesions.
Polycystic Kidney Disease: Proposed diagnosis for systemic symptoms.
Episode 2
Stage IV Malignant Melanoma
Madeline. A track athlete collapsed with dizziness and nausea, initially attributed to heat exhaustion. Her condition rapidly worsened to hypoxia. Diagnosis: Imaging revealed a malignant lung lesion and spread to lymph nodes. Biopsy confirmed Stage IV Malignant Melanoma. Treatment: Despite a grim prognosis, Dr. Rendón Osma proposed experimental Engineered T Cell therapy. Following tumor removal, the treatment showed promising results.
Methylmalonic Acidemia
Meggie. Newborn Meggie exhibited hypotonia and poor nutrition, leading to cyanosis. Her mother, serving time for poisoning her first child, was suspected of poisoning Meggie with antifreeze. Diagnosis: Dr. Murphy identified the toxin as propionic acid, naturally produced due to methylmalonic acidemia, a genetic metabolic disorder triggered by proteins in breast milk. Outcome: The diagnosis proved the mother’s innocence and allowed for correct metabolic treatment.
Other Medical Diagnoses and Conditions Discussed
Placenta Previa: Placenta covering the cervix.
Fetal Brachycardia: Slow fetal heart rate.
Postpartum Depression: Mood disorder after childbirth.
Gastritis: Stomach inflammation.
Heat Exhaustion: Overheating causing dizziness.
Ethylene Glycol Poisoning: Antifreeze poisoning mimicking metabolic issues.
Uterine Atony: Uterus failing to contract post-birth.
Episode 3
Severe Craniofacial Trauma
Bob. A cyclist suffered severe craniofacial trauma after crashing face-first into concrete. Injuries included multiple fractures and an orbital blowout. Treatment: Complications included hemorrhagic shock and infection. Surgeons created an osteomyocutaneous flap to fixate the midface and mandible, restoring vision and eating function.
Refractory Epilepsy
Jenna’s experimental implant for seizures lost software support. Diagnosis: Turning off the device revealed four distinct epileptogenic zones. Treatment: The team used motor mapping and intraoperative ECoG to guide the resection of seizure foci.
Other Medical Diagnoses and Conditions Discussed
Autism Spectrum Disorder (ASD): Neurodevelopmental condition affecting sensory processing.
ACL Injury: Orthopedic condition requiring repair.
Gastrointestinal Distress: Physical pain and bloating.
Acute Diarrhea: Severe reaction to dietary triggers.
Septic Shock: High risk from untreated infection.
ADHD: Neurodivergent diagnosis providing unique perspectives.
Episode 4
Visceral Myopathy
Holly suffered years of vomiting and hematochezia. Her father suspected visceral myopathy, which was confirmed after a bowel obstruction occurred. Treatment: Initial treatment with Rituximab failed, causing perforation. Dr. Murphy devised a plan using a PC tube as a pressure valve combined with medication to manually increase intestinal motility.
Idiopathic Pulmonary Fibrosis
Gina presented with shortness of breath and a non-functional left lung. Diagnosis: Idiopathic pulmonary fibrosis led to severe scarring and respiratory failure. Treatment: After a cadaver lung was rejected due to a lesion, her son donated a lobe of his lung for a rare living donor transplant.
Other Medical Diagnoses and Conditions Discussed
Inflammatory Bowel Disease: Chronic digestive inflammation.
Scleroderma: Autoimmune disorder causing systemic issues.
Cancerous Lesion: Malignancy in donor organ.
Severe Pulmonary Hypertension: High blood pressure in lung arteries.
Florid Respiratory Failure: Life-threatening drop in oxygen.
Bowel Perforation: Hole in the intestinal wall.
Episode 5
Fibromuscular Dysplasia
Rosa Castillo was admitted for acute kidney failure after a stent failed. Diagnosis: Surgeons found aneurysms throughout her major vessels, diagnosing Fibromuscular Dysplasia. Treatment: Doctors bypassed her renal artery using her own vein and planned future repairs for remaining aneurysms.
High-Grade Brain Tumor
While treating a jaw fracture, Mr. Song developed Cushing’s Triad, indicating brain pressure. Diagnosis: A necrotic brain tumor was invading the motor strip. Treatment: The patient fell into a coma due to herniation. Surgeons used 5-ALA, a fluorescent agent, to resect 98% of the tumor while sparing healthy tissue.
Other Medical Diagnoses and Conditions Discussed
Fungal Infection: Persistent infection.
Renal Artery Stenosis: Narrowing of kidney arteries.
Parasymphyseal Fracture: Jawbone break.
Sublingual Hematoma: Blood collection under the tongue.
Bradycardia and Hypotension: Slow heart rate and low blood pressure.
Brain Herniation: Displacement of brain tissue due to pressure.
Sociopathy: Personality disorder mentioned as a diagnosis.
Episode 6
Internal Carotid Artery Dissection
Brandon. A fall led to massive trauma and internal bleeding. Diagnosis: While in a coma, Dr. Murphy found a tiny tear in the internal carotid artery causing a clot. Treatment: A heparin drip was used despite bleeding risks. Ultimately, the patient progressed to brain death, but a valve repair allowed him to become an organ donor.
Optic Nerve Tumor
Nira. Routine screening revealed visual deficits. Diagnosis: Optic nerve tumor. Treatment: Surgery saved her life but resulted in the preservation of only 50% of her vision after cost concerns ruled out proton beam therapy.
Other Medical Diagnoses and Conditions Discussed
Bilateral Tibia-Fibula Fractures: Leg bone breaks.
Respiratory Failure: System inability to provide oxygen.
Brain Contusions: Bruising of brain tissue.
Ruptured Vena Cava: Tear in the primary vein requiring clamping.
Multi-Organ Failure: Dysfunction of vital systems.
Heart Valve Thrombosis: Clots on heart valves.
Episode 7
Malignant Carcinoma (Invasive Neck Lesion)
Sunil presented with symptoms suggesting Lewy Body Dementia. Diagnosis: Imaging revealed an ectopic parathyroid lesion which was actually a malignant carcinoma invading the carotid sheath. Treatment: Dr. Glassman performed a resection using a shunt bypass to maintain blood flow to the brain during tumor removal.
Congenital Heart Defect (Closing PDA)
Newborn (Alma's Baby). Following a car accident and emergency C-section, the newborn was hypoxic. Diagnosis: The patent ductus arteriosus (PDA) was closing prematurely. Outcome: The hospital's supply of PGE (Alprostadil) was expired, and the baby could not be resuscitated.
Other Medical Diagnoses and Conditions Discussed
Fractured Digits: Broken fingers.
Cardiac Tamponade: Fluid pressure on the heart.
Lewy Body Dementia: Progressive condition ruled out.
Blunt Chest Trauma: Non-penetrating thoracic injury.
Placental Abruption: Premature placenta separation.
Episode 8
Fat Embolism Syndrome
Unnamed Female. A patient presented with abscesses after a "Brazilian Butt Lift." Diagnosis: She developed Fat Embolism Syndrome, where injected fat entered the bloodstream. Treatment: A mechanical thrombectomy removed clots from the heart and brain, alongside debridement of the abscesses.
Open Comminuted Tib/Fib Fracture
Phil Hall. A drunk driver suffered a severe leg fracture with bone loss. Treatment: Surgeons performed a prophylactic fasciotomy to prevent compartment syndrome and stabilized the leg with an external fixator.
Other Medical Diagnoses and Conditions Discussed
Congenital Cardiac Condition: Heart defect in a newborn.
Acute Alcohol Intoxication: Elevated blood alcohol in trauma.
Compartment Syndrome: Pressure buildup threatening limb viability.
Venous Air Embolism: Air in the bloodstream.
Episode 9
Pancreatic Tumor and Kabuki Syndrome
Cody had Kabuki Syndrome. A panic attack led to a ruptured aortic aneurysm. Diagnosis: Chronic weakness was traced to a benign pancreatic tumor causing hypoglycemia. Treatment: Removal of the tumor stabilized his glucose levels, allowing him to walk.
Traumatic Tracheal Damage
Nelly required a trachea transplant to restore her voice. Complication: Carotid artery stenosis threatened graft survival. Treatment: Bone marrow stem cells were used to prevent rejection. Despite a massive hemorrhage, her clotting factors saved her, and the transplant succeeded.
Ossified Ligament of the Cervical Cord
Joe reported no pain after a fracture, indicating nerve damage. Diagnosis: An ossified ligament compressed his cervical cord. Treatment: Surgery to remove the ligament caused unavoidable cord damage, leaving him a paraplegic.
Other Medical Diagnoses and Conditions Discussed
Chronic Hypoglycemia: Low blood sugar causing fatigue.
Diplopia: Double vision.
Pituitary Tumor: Growth on the pituitary gland.
Adverse Reaction to Immunosuppressants: Systemic response to meds.
Episode 10
Liver Cancer with Paraneoplastic Syndrome
Ryan. A transplant recipient suffered seizures and fainting. Diagnosis: Metastatic liver cancer from the donor organ caused paraneoplastic syndrome. Treatment: Palliative resection and chemo-embolization extended his life.
Bladder Sarcoma in Pregnancy
Grace. A surrogate presented with a bladder sarcoma. Treatment: To save the pregnancy, surgeons performed an experimental cystoscopic surgery. When bleeding occurred, they used a specialized suture technique to remove the tumor from the uterine wall without a hysterectomy.
Other Medical Diagnoses and Conditions Discussed
Tracheal Transplant: Replacement of damaged airway.
Encephalitis: Brain inflammation ruled out.
Herpes Simplex Virus (HSV): Potential cause for brain symptoms.
Subserosal Fibroids: Growths on the uterus.
Episode 11
Pulmonary Artery Pseudo-aneurysm
Isla Liu. A trauma victim developed a pseudo-aneurysm in her pulmonary artery. Treatment: After embolization failed, Dr. Murphy performed an emergency stat thoracotomy to clamp the artery.
Multi-System Trauma (Liu Family)
Elaine and Bryan Liu. Elaine suffered an SSS tear in her brain and aortic valve damage. Bryan had a ruptured spleen. Treatment: Elaine required a dural flap, aortic pump, and tracheal reconstruction. Bryan underwent a below-knee amputation but had his arm saved via vascular reconstruction.
Other Medical Diagnoses and Conditions Discussed
Subdural Hematoma: Bleeding around the brain.
Bowel Obstruction: Blockage of intestines.
Hand Ischemia: Lack of blood supply to hand.
Brain Fluid Accumulation: Hydrocephalus requiring a shunt.
Critical Bradycardia: Dangerously slow heart rate.
Episode 12
Valley Fever (Coccidioidomycosis)
Mariel Torres presented with lung nodules initially suspected as cancer. Diagnosis: Biopsy revealed Valley Fever, a fungal infection. Rupture spread the fungus, causing a collapsed lung. Treatment: Amphotericin B and surgical removal of the nodule cured the infection.
Grade IV Ruptured Hemorrhoids
Brenna suffered from severe ruptured hemorrhoids. Treatment: Surgical removal was successful. She later experienced vaginismus, which was explained as a muscle spasm.
Other Medical Diagnoses and Conditions Discussed
Lung Cancer: Ruled out after biopsy.
Pneumothorax: Collapsed lung.
Renal Impairment: Kidney issues from systemic infection.
Episode 13
Major Depressive Disorder and Chronic Pain
Kayla Quinn suffered from treatment-resistant depression and chronic neuropathic pain. Treatment: An anterior cingulotomy using a Gamma knife successfully burned lesions in the cingulate cortex to eliminate pain.
Bony Marginal Erosion (Biohacking)
Trent. A "biohacker" had an infected magnet implant causing bony marginal erosion. Diagnosis: An LED implant in the other wrist caused irreversible joint damage. Treatment: Dr. Murphy performed an experimental arthroplasty with a custom implant to restore function.
Other Medical Diagnoses and Conditions Discussed
Severe Infection: Risk of spreading to bone.
Sepsis: Systemic risk from untreated infection.
Severe Arthritis: Consequence of implant stress.
Paralysis: Potential progression of nerve damage.
Episode 14
Accidental Psilocybin Ingestion
Hospital Staff. Staff experienced hallucinations and dilated pupils after a potluck. Diagnosis: Psilocybin ingestion from a spiked casserole. Treatment: IV fluids and observation.
Anomalous Left Coronary Artery
Jake Khan. A patient admitted for toe reattachment showed cardiac anomalies. Diagnosis: An anomalous left coronary artery posed a risk of cardiac arrest. Treatment: Dr. Murphy surgically relocated the artery to restore normal flow.
Wandering Spleen
Content Creator. Abdominal trauma caused the spleen to migrate. Diagnosis: Wandering spleen (Splenic Ectopia). Treatment: Emergency surgery to fix the organ in place.
Advanced Appendicitis
Dr. Alex Park developed abdominal pain while intoxicated. Diagnosis: Advanced appendicitis. Treatment: Dr. Jordan Allen performed a laparoscopic appendectomy.
Other Medical Diagnoses and Conditions Discussed
Traumatic Amputation: Loss of big toe.
Depressed Skull Fracture: Bone fragments pushed into brain.
Rectal Foreign Body: Object lodged in rectum.
Hypertensive Crisis: Critically high blood pressure.
Episode 15
Aortic Valve Stenosis and Bronchial Rupture
Joan. A polio survivor in an iron lung had aortic valve stenosis. Treatment: Valve replacement was successful, but the iron lung failed. A bronchial rupture occurred on a ventilator. Surgeons used kyphoplasties to stabilize her spine for a biphasic cuirass ventilator.
Periorbital Fractures (Dyslexia)
Kevin presented with facial fractures from "falling." Diagnosis: Injuries were from abuse due to struggles with dyslexia. Treatment: Reconstructive surgery and social advocacy for a new foster placement.
Other Medical Diagnoses and Conditions Discussed
Sleep Stage Impairment: Disrupted REM sleep.
Pneumothorax: Punctured lung from rib fracture.
Autism Spectrum Disorder (ASD): Sensory processing challenges.
Terminal Respiratory Failure: End-stage lung decline.
Episode 16
Third-Degree Burns
Dana Bradley. Initially diagnosed with second-degree burns, grafts failed due to necrosis. Diagnosis: Third-degree burns were confirmed by lack of reaction to pressure. Treatment: Deeper debridement and a free tissue flap reconstruction were successful.
Unstable Lumbar Fracture
Grant Ferlin. A firefighter suffered an intraperitoneal hemorrhage and unstable lumbar fracture. Treatment: During cage placement, a vessel tore. Surgeons performed a long segment fusion to save his life, ending his career.
Other Medical Diagnoses and Conditions Discussed
Ventricular Tachycardia: Heart arrhythmia during surgery.
Hypothermia: Low body temperature requiring rewarming.
Sepsis: Risk from necrotic burn tissue.
Compartment Syndrome: Pressure compromising circulation.
Episode 17
Multiple Angiomyolipomas
Lucho had tumors in his kidneys, heart, and brain. The brain tumor caused seizures by obstructing CSF. Diagnosis: Angiomyolipomas. Treatment: Renal tumors were removed first. A cerebral ventricular thrombus blocked access to the brain tumor. Dr. Murphy used photothermic laser light therapy to break the clot, allowing for successful tumor removal.
Other Medical Diagnoses and Conditions Discussed
Ventricular Tachycardia: Rapid heart rhythm.
Cerebral Edema: Brain swelling.
Brain Herniation: Displacement of brain tissue.
Renal Vein Hemorrhage: Bleeding during kidney surgery.
Episode 18
Stage IV Lung Cancer with Malignant Pleural Effusion
Yosel Wolke. Dr. Wolke's father had Stage IV lung cancer invading the chest wall, causing a malignant pleural effusion. Treatment: An embolization stopped bleeding. Talc was injected to scar the pleural cavity and stop fluid leakage, followed by immunotherapy.
Chronic Post-Stroke Paralysis
Steph Lewis. A stroke survivor suffered from recurrent pneumonia and lung compression from scar tissue. Treatment: Decortication expanded the lung but caused loss of finger movement. An electrode array was implanted to decode brainwaves into speech using AI.
Other Medical Diagnoses and Conditions Discussed
Brainstem Stroke: Cause of paralysis.
Pulmonary Scar Tissue: Restriction of lung expansion.
Hemothorax: Internal bleeding into chest.
Hypotension-Induced Neurological Injury: Loss of motor function.
🔖 Key Takeaways
🗝️ Surgical Innovation: Season 5 featured groundbreaking procedures, including engineered T-cell therapy for melanoma and AI-assisted speech restoration for a stroke victim.
🗝️ Diagnostic Challenges: The team faced deceptive patients (Scleroderma), masked conditions (Methylmalonic Acidemia), and rare infections like Valley Fever.
🗝️ Complex Trauma: Multiple episodes dealt with severe trauma, from craniofacial reconstruction to multi-organ failure in accident victims.
🗝️ Medical Ethics: The season navigated difficult ethical waters, such as the allocation of expired medication for a newborn and the balance between life-saving surgery and quality of life.
🗝️ Personal Health: The staff's own families were involved, with cases affecting Dr. Wolke's father and Dr. Park's son, highlighting the emotional weight of medical decisions.
Keywords: Medical Diagnoses The Good Doctor Season 5
Medical Diagnoses The Good Doctor Season 5
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