I'm getting close to calling The Good Doctor, my FAVORITE medical drama out right now! On this episode, I critique Dr. Sean more ...

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Real Doctor Reacts to THE GOOD DOCTOR #4 | Medical Drama Review

what's up guys we've done three reviews of the good doctor already but we haven't even seen season two yet so let's start it up season 2 episode 1 dr. Shawn I'm coming for you the patient is pulmonary hypertension the only treatment is medication which reduces the lung blood pressure but not enough her heart's failing due to the extra string so pulmonary hypertension is exactly what it sounds like pulmonary meaning lungs hypertension meaning high blood pressure but it gets really tricky when you have high blood pressure within the lungs because then it puts a lot of strain on your heart to be able to beat against that pressure within the lungs oftentimes once medication fails the last approach becomes surgical intervention which is what I expect to happen here when I say surgical intervention means a transplant what about a fix isn't it just a transplant nope there's nothing inherently wrong with Melanie's heart it's healthy just needs a little bit of help so we're gonna leave her current heart inside and slot in another one to support it well it's still a transplant you tricked this man I obviously don't take surgical cases like this this is outside of my wheelhouse but it is interesting to hear that this is even a possibility you can have two hearts beating simultaneously to give it a little extra support you probably would have to be on blood thinning medication immunosuppressive medications because you have more turbulent blood flow you have another organ inside of you that your body will probably react to unless you have immunosuppressive medication and I could see a huge challenge coming up here do you live in a tent I lived in a tent - it wasn't very good so I moved to a bus you should move to a bus it will be much less likely to develop all sort of tinea pedis tinea pedis or Pettis as he says it is a fungal infection of the feet when it becomes very severe you can have ulcerative fungal infection where you actually have breakages in the skin and you can get infections on top of the fungal infection you already have present it's basically like the worst form of athlete's foot treatment for this usually requires oral antifungal medication because topical would not have the enough strength to cover it just keep it dry and clean and we'll give you some rather we continue to discuss this inside we are discussing things with the patient that are potentially sensitive we don't weigh the patient he's actually really right here even though the fact he's usually bad at picking up social cues you should not talk about sensitive issues in front of other people with a patient like this even if it's as simple as putting up two little curtains to give them some privacy or at least a sense of privacy will make the conversation go a lot smoother and allow the patients to take in the information without feeling like all eyes on them good job Sean excuse me please [Music] scuse me please thank you for keeping me waiting we doctors are busy important people hold on a second is that dr. Cuddy from house is this like a crossover event that's happening right now look dr. plays I am like any other patient entitled to have say my own treatment but unlike any other patient I have spent my entire adult life digging into people's brains so if you think I'm gonna sit around and watch you're mistaken well if you think you can operate on yourself I'd happily add you to the list of potential surgeons today you're gonna be waiting and waiting and waiting the test test test you've had them all before I want them again my versions actually really important what she's doing here is that she's not letting herself be bullied into making medical decisions based on just what he wants she's letting her own clinical experience her knowledge guide her to make the best decisions for his health very often this happens when you have a powerful patient a VIP patient someone very wealthy but they say oh I want the absolute best care I want all the tests when in reality that's not in their best interest and it takes someone with a lot of guts to stand up to that so I applaud dr. Blais / dr. Cuddy what's your name Harry these are my mates those pills are for people with chlamydia Harry no they're all the same see I I know better that's why I had to hide out in the street next door to mr. googly eyes why are doctors involved in this and not security staff like if I'm going to any kind of event they usually bring security with us because there's a lot of medical equipment here there's medications why are the doctors getting involved come on Joe get some diesel security dudes and gals and up and they're just I trust him disorganized thinking paranoia and delusions I think you have schizophrenia Harry okay this is my first time I'm gonna call BS on dr. Shawn as a surgeon perhaps you can look at someone and figure out the problem right away because it's a problem of plumbing Anatomy what have you he can look at a scan you can't treat humans with mental issues like that say this patient is just high on methamphetamine and he's having all of this disorganized psychotic thinking is that schizophrenia no it's not so dr. Shawn pumped those brakes and let a non-surgical doctor take over here that's an abscess that smells very bad so the reason why abscess II smell bad is because you have an infection that already smells bad but then you have all these inflammatory cells that go in to fight off the infection and what your body does is it walls off that infection and it essentially creates a bubble of pus and pus never smells good because of the dead bacteria the only treatment Ind incision and drainage cut that bad boy open let it drain out get the infection out and then you could start thinking about antibiotics and all that but you have to drain it this would give me at least 10 more years should give you 10 more years yes Elliot I understand your concerns dr. meléndez is one of the best cardiac surgeons around dr. Andrews told us all about you and he convinced me to come here for surgery instead you spoke to dr. Andrews and they both already spent half the morning raving to the press well it's that's very kind you spoke to the press he spoke to the patient my patient as I explained Elliot Melanie the press attention is a necessary element for funding this surgery there's a fine line with doing this type of press and exposure and I understand that line very well because I try and balance my professional life as well as my life as a social media person very diligently to put it nicely sometimes medical systems forget about that line they forget about that the major mission that we're involved in is helping humans and while yes we want to get a better surgical center so we can help more people we want to create funding for a hospital notoriety for a hospital the question needs to be asked is at what cost do we discuss this with our patient are they on board with having this type of press happening is this fair to them are we taking advantage of them and only until you answer those questions only then you can go ahead and do all this press and notoriety for your hospital ah my god is he having meningitis it's stiff it's definite could be an early indicator of bacterial meningitis many possible explanations for stiff neck most of which are much more likely than bacterial meningitis has invaded the meninges of his brain it could be exacerbating his paranoia so bacterial meningitis is inflammation of the meninges the soft flow of padding that's found between your brain and the skull this is quite dangerous because the area inside your skull is very limited so that if you increase pressure you could actually harm the brain and do damage to the brain on top of that that infection can spread from the meninges to the actual brain to your blood and cause you to become septic it's a very dangerous condition that needs to be treated urgently the way you diagnose it is you go into the spinal cord through a lumbar puncture and you see and you study the the spinal tap so you see if there's white blood cells there if there's bacteria in there you do a culture if there's blood and it basically points you to if there is a meningitis what could be the possible cause of it and then right away you got to start being as proactive as possible starting all the treatments and backing down once you have the guidance as to what the likely cause of the meningitis is hey not only hasn't they already can you ISM to ours beating into that yeah that's so good so I've talked about aortic aneurisms on this channel in the past but basically what happens is the aorta is the major blood vessels that comes out from the heart that allows it to bring blood to the rest of the body if you have an aneurysm you basically have a weakness within the wall that allows ballooning of the last layer of the artery which means what if you have more pressure meaning two hearts beating at the same time you could actually rupture the aorta and what happens you bleed out internally and you die perhaps they can fix the aortic aneurysm first and then do the procedure I don't know how critical this patient is right now it was my medical opinion that he could have bacterial meningitis and if you're right then I owe you an apology but if you're wrong then I will be on the phone to Denver and I will make your life infinitely more complicated than you think you're making mine why is this such a manipulative situation for God's sakes there's a patient's life at stake who could have bacterial meningitis you're saying if the doctors wrong by playing it safe you're gonna give them a bad review I feel that one of two things is gonna occur one it's gonna be viral or aseptic meningitis which can happen or two by bringing him in and doing all of these things they're gonna find out that he has another issue that had he not brought him in he would have passed let's see if my prediction is right mary has kaleidoscopic disintegration he does know he has a brain tumor [Music] this is why you said patients to the ER because in the ER with all those symptoms in addition to getting a spinal tap they would have done a head CT and likely done it with contrast to see what's going on inside the brain and would have seen something like a brain tumor but I don't know what kaleidoscopic disintegration means even if he's right with the brain tumor this is a guessing game that's not how medicine is practiced kind of a shame to see this because in season one they were so medically accurate and making these diagnoses and how it happens but here just because he's finding some symptoms and he's getting these wild theories did you do a drug screen did you see if he's anemic did you see if he has a major thyroid tumor causing excess thyroid hormone and that's why he's bouncing around all over the place there's a lot of things that need to be ruled out Sean have you seen Harry he lives in it we need to find here you don't know so those who are diagnosed with autism sometimes have a condition where if there's over stimulation whether it's light sounds even stress they can sometimes be overwhelmed like this I totally sympathize with Sean what's happening here because he's trying to do the best for his patient but clearly it's a struggle you have a neurological condition too but yours can be cured I appreciate the sentimental value here but he doesn't know that what if it's a malignant tumor you just need some surgery and you can be Edward Austin Thomas again you just need some surgery just some surgery nice someone pay attention to the monitors on the show she's flatlining there they haven't even made the incision yet and she's already flatlining Edward has a right parietal brain tumor find dr. Lim you can have a war number two that's not an emergency operation when you need surgery you can go one of two routes you can go planned or you can go emergent surgery for example if you come in with a level one trauma where you got shot or cut inside your abdomen and you need to find the source to bleed and shut that off that's emergent surgery you're not going to get a lot of pre testing done to make sure the patient's capable to get through that surgery because they'll die otherwise so you want to just do as best as you can in the given moment but in this scenario this is not urgent this patient has lived for a while with this tumor and been fine perhaps it's best to do some pre-surgical testing figure out if we can optimize them medically meaning get them on some medications lower their blood sugar control their blood pressure clean them up now we just have to wait to see who wakes up and Werner Harry see that is realistic there are certain tumors depending on where they're found inside your brain that can totally change certain aspects of the way you behave for example the frontal lobe is what's most important for decision-making and control over your urges so it's not uncommon for a patient who has a frontal lobe tumor to start acting differently becoming more risk tolerant meaning that they're gambling more they're having more sexual relations unprotected cheating on their spouses and then no one knows what's going on only until they get properly examined so they find out that has this tumor the whole time it's just like playing surgeon simulator just drop it it's a little good heart check out this playlist of me running around the streets answering people's questions curbside consults tile click it and I'll see you on this one being happy and healthy [Music]

Dr.

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