Also known as: Stroke
George presents with sudden onset arm and leg weakness, right facial droop, and trouble speaking due to a middle cerebral artery embolism. The team performs an interventional radiology procedure to remove the clot. His stroke was caused by Lupron (anti-androgen medication) he was taking to suppress deviant sexual urges toward children.
Also known as: Pedophilia
George reveals he has intrusive sexual urges toward children that he has never acted upon. He was taking Lupron to chemically suppress these urges and attempted self-castration when told he couldn't continue the medication. This drives the central ethical debate of the episode about whether to perform surgical castration.
Also known as: Self-inflicted genital injury
George returns to the hospital with severe self-inflicted lacerations to his scrotum in an attempted home castration. The injury becomes infected and leads to sepsis and DIC, creating a medical emergency that prevents the team from performing the castration he requested.
Also known as: Collapsed lung
Billy, a juvenile detention inmate with a severe facial deformity, presents with a collapsed lung requiring chest tube placement after being beaten.
Also known as: Eye socket fracture
Billy has a fractured eye orbit from assault that requires surgical repair. During the repair, he develops a retrobulbar hematoma causing oculocardiac reflex and cardiac arrest.
Also known as: Hole in the diaphragm
Billy's diaphragm is lacerated from assault, causing his stomach to herniate into his chest cavity. This requires emergency surgical repair.
Also known as: Forehead dent
Billy has a severe depression in his frontal bone from childhood abuse by his father with a baseball bat. This deformity has led to bullying and assault throughout his life. The team debates whether to repair it cosmetically, ultimately using a breast implant to fill the defect.
During Billy's orbital fracture repair, pressure on the orbit causes severe bradycardia and cardiac arrest requiring CPR and temporary pacing.
Also known as: Bleeding behind the eye
Billy develops bleeding behind the eye during his orbital surgery, triggering the oculocardiac reflex and cardiac arrest.
Also known as: DIC
George develops DIC from his sepsis, causing dangerous clotting and bleeding problems that prevent the surgical castration he requested.
Also known as: Blood infection
George develops sepsis from his infected genital wound, leading to life-threatening complications including DIC.
Also known as: Brain cancer
Dr. Glassman is undergoing radiation therapy for his brain cancer. Shaun administers a memory test showing deficits and takes away Glassman's driver's license, creating interpersonal conflict throughout the episode.
Also known as: Suicide attempt
George commits suicide by jumping from a hospital window after being told he must undergo psychiatric evaluation before surgical castration, unable to face continuing life with his intrusive thoughts.