Also known as: Heart attack
Glen, a 73-year-old man, presents with an MI and severe bradycardia due to a broken pacemaker. He has end-stage heart failure from two prior massive MIs and deliberately broke his pacemaker because he wants to die. His case drives a major emotional storyline about end-of-life wishes and suffering.
Also known as: CHF
Glen has end-stage heart failure with ventricles barely pumping, requiring consideration of a biventricular pacemaker. His heart is described as 'way beyond repair' and he is told he has only months to live.
Also known as: Bile duct infection
Liam, a young autistic patient, presents with jaundice, fever, elevated liver enzymes, and dilated bile ducts. Initially suspected to be cholangitis from gallstones related to his ketogenic diet, but later discovered to be hypereosinophilic gastroenteritis from kava root supplements.
Also known as: Food poisoning
Shaun diagnoses this as the true cause of Liam's condition after noting uveitis and learning about kava root supplements. The immune flare-up created extensive biliary tree scarring and required emergency surgery to remove necrotic bowel segments and evacuate a phlegmon.
Also known as: Asperger's syndrome
Liam's autism is central to the episode, affecting his ability to tolerate medical procedures like MRI due to sensory sensitivities and stimming behaviors. Shaun connects with him as a fellow person with autism and helps manage his care by understanding his needs.
Also known as: Eye inflammation
Shaun identifies Liam's red eyes as uveitis, an immune-mediated inflammation that provides the key diagnostic clue linking to the hypereosinophilic gastroenteritis caused by kava root supplements.
Also known as: Cut
Liam presents with a 4.5 centimeter forehead laceration from a fall after getting off the bus at the wrong stop. This injury brings him to the hospital where his more serious condition is discovered.