Season 8, Episode 18

Also known as: COPD

Frequent flyer patient who was admitted 10 times for COPD exacerbations in six months and recently died despite multiple intubations and interventions. Her case prompts discussion about patient responsibility and the limits of medical intervention.

Also known as: GBM, terminal brain cancer

Mark Greene's recurrent inoperable brain tumor is driving his declining physical function and his pivotal decision to discontinue chemotherapy treatment. He experiences hand tremors affecting his ability to perform procedures and ultimately decides to stop his second cycle of vincristine.

Also known as: MS

Patient with severe multiple sclerosis who presents with choking episode and respiratory distress. Her case involves family conflict over DNR orders, with her son initially wanting full resuscitation against the sister's legal directive, leading to intubation that is later reversed per advance directive.

Also known as: Perforated eardrum

Minor case involving a patient hit by a ball resulting in eardrum perforation, used for comic relief when Pratt initially examines the wrong body part.

Also known as: Narcotic overdose

28-year-old patient found down with agonal respirations and pinpoint pupils requiring Narcan and intubation. He becomes agitated and violent upon waking, assaulting staff before passing out again with facial trauma.

Also known as: Newborn heroin withdrawal

Premature infant born at approximately 28 weeks to drug-using mother Shane, presenting with low Apgar scores and requiring resuscitation. Baby exposed in utero to heroin, cocaine, and alcohol, resulting in premature delivery with significant complications and expected withdrawal syndrome.

Also known as: Abruption

Pregnant patient at approximately 28 weeks presents with severe abdominal pain and premature labor, suspected placental abruption requiring emergency obstetric intervention and resulting in premature delivery.

Also known as: Heroin addiction

Patient Shane demonstrates active polysubstance abuse during pregnancy including heroin, cocaine, and alcohol, never seeking prenatal care and endangering her fetus. Greene confronts her about the devastating consequences to her newborn.

Also known as: DKA

Homeless diabetic frequent flyer who presents with foot pain but develops acute DKA with blood sugar over 700, respiratory failure requiring intubation. Case used to teach Pratt about the importance of thorough history-taking and recognizing chronic disease complications.

Also known as: Prostate cancer

Patient presenting with urinary retention and back pain found to have extremely elevated PSA (600) and metastatic prostate cancer on exam. His negligent primary care physician missed the diagnosis for two years. Greene delivers the devastating terminal diagnosis, drawing parallels to his own condition.

Also known as: Enlarged prostate

Patient's presenting complaint of urinary retention initially attributed to BPH and alpha-blocker medication, but workup reveals underlying metastatic cancer.

Also known as: Fungal lung infection

Egyptologist from Art Institute who presents with syncopal episode, found to have aspergilloma (fungal infection) acquired during recent excavation work in Egypt, humorously referred to as 'curse of the mummy.'

Also known as: Face injury

Patient who passed out and sustained midface fractures with blood in airway requiring difficult fiberoptic intubation by Greene.

Also known as: Cut

Young girl with wooden splinter under fingernail from mythology class project, treated by Greene in his final patient encounter as he decides to leave clinical practice.