The week's episode of the Good Doctor had some very complex cases. The first being a huge neurofibroma that was 200 pounds. Neurofibromas are small benign tumors that form from the cells and tissues that cover nerves. They normally are very small and pop up all over the body and can be in clusters (GARD). This patient had one that had managed to grow out of control and become 200 pounds. It was taking most of the blood and nutrients from his body. There actually was more blood in the tumor than in the actual patient. In the episode the man was from Louisiana and was getting the surgery done for free because the other doctors claimed the tumor to be inoperable. Scans showed that the tumor grew in a very short period of time and had arteries the size of a thumb. This meant that the doctors would have to embolize the arteries before surgery so the patient wouldn't bleed out. During the surgery, the man lost 8.5 liters of blood, and the human body only has about 5 liters in total. I did some research and there was a similar case to this at the University of Chicago Hospital. It was with a woman from Grand Rapids. Her tumor grew over a few short months, and the doctors believed it was because of radiation sparking the rapid growth of the neurofibroma. She experienced just as much blood loss (if not more) as the show portrayed (Manier). Overall, the show didn't change that much in the case. The show naturally made it more dramatic with the patient's blood pressure dropping in surgery, but the main facts of the case besides gender really stayed true to the original. This is extremely surprising to me because most shows are notorious for taking a case and twisting it to be extremely dramatic and inaccurate. The only problem I observed was at one point during the surgery, there was a doctor consulting on the vascular part of the tumor without eye or mouth protection with an open patient on the table. That's very unhygienic and would never happen in real life, but that was the only inaccuracy I saw in that case. The other case in the show was about a baby that had a subdural hematoma. The testing showed that the baby had to have been shaken extremely hard in order to have a brain bleed. The doctors assumed it was the mother and called Child Protective Services. This is the exact procedure doctors are required to take by law. They are supposed to protect the child before asking questions. It turns out that there was a vacuum delivery, and the blood breakdown caused the brain injury. It isn't uncommon for babies to have rough handling during birth. Doctors do their best to avoid hurting the baby, but it can happen. Overall, I was very pleased with this episode and its accuracy. I loved that the writers decided to stick with the details of the original case. 

This weeks Greys Anatomy was very interesting to say the least. The main story throughout the whole episode was about an 11-year-old girl with pancreatic issues. She needed a full pancreatectomy and islet transplantation. A pancreatectomy is the complete removal of the pancreas. An islet transplantation is a treatment for type 1 diabetes. Islet cells are cells that are meant to help regulate hormones that help digest food and create insulin. The insulin in the body helps regulate blood sugar (glucose) from food (NIDDK). This little girl was fighting for years to get her glucose levels low enough to get the surgery. She had spent so much time away from school because of her illness. The pre-surgery labs showed a large spike in her glucose, and this caused the surgery to be put off. The patient drank a juice box because she didn't want to go back to school because she had no friends. I know that school is scary, but I find it extremely hard to believe that someone would want to put off a surgery that they have waited for just because they were scared of school. Her mother wants to respect her wishes, but one of the doctors calls her irresponsible for not forcing her to get the surgery. This is completely out of line for a doctor, and a trend I have noticed in medical shows. The doctors always seem to yell at a patient and by the end of the episode everything is fine. In reality these doctors could be suspended from surgery if they were reported. I know that it's meant to happen for dramatic flair, but it is one of the most annoying parts of medical shows and a huge inaccuracy. By the end of the episode, the doctor convinces the little girl to have the life saving surgery. He was originally banned from seeing or speaking to the patient, but he broke the rules anyway. Greys Anatomy has a theme of rule breaking. No matter what the supervisor says, the doctors still seem to do whatever they so please. That is a huge inaccuracy because the people who are in charge have the most experience with surgery and are normally teachers. Overall, this episode was not very accurate as far as doctor patient relationships as well as treatment. 

The episode of Chicago Med was very exciting and had a couple different cases. The first case was about a patient that had come in with cystic fibrosis and had three serious inflections in the past month. He was going to get a lung transplant. However, the patient went into distress and they had to put in a chest tube. This is problematic because the patient had a total of four chest tubes. This caused extreme scarring and would weaken his lungs and not allow him to get the transplant. Chest tubes are very invasive. The surgeon cuts through the ribs and puts a tube into the chest wall to alleviate pressure on the lungs for a variety of reasons. CF patients will all have chest tubes at one point or another because of the stress put on their lungs during infections (Null). The sad part was that the doctors had no choice but to put in the chest tube because he wouldn't have survived long enough before his new lungs arrived. This choice was a no brainer for the doctors and would be made in real life too. While the chest tube damaged his lungs to the point where he couldn't get the transplant, he would've died before even getting the chance to say yes to the procedure. It was a choice made to keep the patient alive. The other part of the episode was about how a car crashed into the ambulance bay. The driver was trying to get to the hospital because he was feeling dizzy with chest pains. He passed out behind the wheel and struck a nurse going to an ambulance. The nurse was pinned under the car and he couldn't move because his lower body was pinned down. It took a long period of time and the patient was bleeding out, but they managed to get him out. They had to pinch his femoral artery in his leg because that could have made him bleed out in seconds and they had to wrap his pelvis. Doctors do this because the hips have to be set back properly and when they are out of place it is extremely painful, so to help relieve the pain, doctors wrap the hips in order to set them back in place before surgery ("Pelvic Fracture"). The driver was given a CT scan to access for internal bleeding, and they found a large tumor in his heart. The original prognosis was to put the patient on the donor list because the tumor was extensive and complicated. The doctors let the patient convince them to do surgery to try and resect the tumor. This is inaccurate because doctors come up with a diagnosis and treatment plan and stick to it. They do not deviate just because a patient claims that they trust the doctors and push them to do a surgery that could kill them. That goes against the oath doctors take to do no harm. In the end, they almost kill the patient and only manage not to by using unpublished research for surgical techniques. This is problematic because surgeons do not come up with a completely different surgery right on the fly. They can change what they need to do, but this doctor changed his whole treatment plan in the matter of an hour. Overall, this episode could have done better on its behind the scenes of doctor patient care. The cases were interesting, but not all of them were accurate.