Also known as: Protein intolerance
A six-year-old boy presents with abdominal pain and double vision, later developing cerebral edema. The diagnosis is made when it's discovered he trades away protein-rich lunches and had symptoms after consuming a protein shake. The rare genetic enzyme deficiency prevents him from properly metabolizing protein, leading to ammonia buildup and brain swelling. He is treated with dialysis to clear ammonia instead of undergoing emergency brain surgery.
Also known as: Brain swelling
Peter develops dangerous brain swelling as a complication of his undiagnosed urea cycle disorder. His intracranial pressure rises despite medication, and a craniectomy is nearly performed before dialysis successfully reduces the swelling by clearing excess ammonia from his system.
An 80-year-old woman on multiple medications is discovered to have undiagnosed Whipple disease causing her arthritis, weight loss, fatigue, and bowel inflammation. Years of steroid treatment for presumed arthritis actually worsened the condition, leading to bowel perforation. Despite correct diagnosis during surgery, she develops fatal cardiac tamponade as a complication of the long-standing untreated disease.
Also known as: Perforated intestine
Gloria develops a life-threatening perforation in her colon caused by years of undiagnosed Whipple disease compounded by steroid treatment. The perforation leads to acute abdominal pain and requires emergency surgery, during which the underlying Whipple disease is discovered.
Also known as: Blood around the heart
During surgery for bowel perforation, Gloria develops cardiac tamponade (fluid accumulation around the heart) as a complication of her long-standing undiagnosed Whipple disease. Despite attempts at pericardiocentesis and CPR, she does not survive.
Also known as: Too many medications
Gloria is on numerous medications prescribed over time to treat symptoms that were actually side effects of other medications or manifestations of her underlying Whipple disease. The polypharmacy causes syncope and arrhythmia, masking the true diagnosis until it's too late.
Peter experiences separation anxiety following his mother's abandonment three months prior, initially suspected as a possible cause of his abdominal complaints. He feels safe only at the hospital where his father works and fears his father might also leave him.
Also known as: Early dementia
Dr. Kravitz, a retired geriatrician, has early mild cognitive impairment affecting his short-term memory while long-term memories remain intact. He relies on his wife Gloria for memory support. This is a supporting element in the episode's focus on geriatric care.