Over its 19 years on the air, Shonda Rhimes’ “Grey’s Anatomy” has taught us a lot—not only about hospitals being hotbeds of workplace romance and randiness, but also about some very rare, credulity-straining medical conditions.
In honor of the premiere of the Shondaland flagship’s 20th season, we’re taking a look back at five of the most jaw-dropping cases that the surgeons at Seattle Grace Hospital have faced over the years. And to get notes on how to convincingly audition for and play a patient on a hospital drama, we spoke with Matthew Kaufman, MD, an emergency room doctor in the New York City area.
Jaw-dropping (and bodice-ripping!) case: Woman experiencing spontaneous orgasms
“Yesterday” (Season 2, Episode 18)
Notes from the chart: College student Pamela Calva (Arlene Ture) arrives at Seattle Grace complaining of…orgasms. She’s been experiencing them spontaneously for months, which led to her getting into a small car accident. OB/GYN Dr. Addison Montgomery (Kate Walsh) operates on Pamela to put an end to her unpredictable arousals. Though the cause of the condition is never explained in the episode, showrunner Krista Vernoff later attributed it to a tumor on the patient’s pudendal artery.
How to play the part: “I think you want to do this as panic,” Kaufman says. “You’re crying…but then that gives way to intermittent moans. Is there another way to do this than play it silly?”
Jaw-dropping case: Man and woman impaled on the same pole
“Into You Like a Train” (Season 2, Episode 6)
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Notes from the chart: The surgeons at Seattle Grace find themselves overwhelmed with patients following a massive train crash. Among the injured are Bonnie Crasnoff (Monica Keena) and Tom Maynard (Bruce A. Young), two strangers who have been impaled on the same metal rod. The pair maintain their sense of humor even as the doctors explain that one of them is likely to die once they remove the pole. Since Tom has a higher chance of survival, Bonnie agrees to be extracted first, which indeed kills her.
How to play the part: “Sometimes when a patient comes to the ER in very serious condition, they can be almost freakishly calm,” Kaufman says. “It’s not outlandish if you play this with comfort and humanity for the person you’re impaled with.”
Jaw-dropping case: Man with a fish in his urethra
“Desire” (Season 3, Episode 21)
Notes from the chart: In this memorable episode, Larry Jennings (Mitch Pileggi), the chairman of the hospital’s board of directors, returns from a trip to the Amazon with extremely swollen genitals, having not peed in days. When an X-ray reveals what looks like a tiny skeleton lodged in his penis, the doctors determine that it’s a candiru fish, a rare parasitic species that’s attracted to streams of urine.
How to play the part: Kaufman says that if someone hasn’t been able to relieve themselves in days, “you want to play it with a lot of discomfort. And then, the panic sets in when you find out about the parasite. The question of dignity comes up, too; you have to decide if you want to intermittently try to maintain an air of dignity while doctors discuss your genitals.”
Jaw-dropping case: Boy stuck in a block of cement
“Freedom: Part 1” and “Freedom: Part 2” (Season 4, Episodes 16 and 17)
Notes from the chart: In this installment, a teenager named Andy Langston (James Immekus) shows up in the ER encased in a block of concrete. Turns out that he jumped into a vat of wet cement on a dare from his friends. The case is severe enough to cause even the stoic Dr. Bailey (Chandra Wilson) to lose her cool. The doctors initially butt heads over which part of Andy’s body to focus on, but eventually join forces to operate on him. Because nothing is ever easy at Seattle Grace, the patient’s heart stops beating as soon as he’s freed from the cement; thankfully, he survives the ordeal in the end.
How to play the part: “This is panic mixed with extreme pain,” Kaufman explains. “You can’t move, and that’s panic-inducing, but the cement is also burning him as it dries. You want to convey that you’re incrementally more panicked and hyperventilating and losing control.”
Jaw-dropping case: Teenager with a hairball in his stomach
“The End Is the Beginning Is the End” (Season 9, Episode 11)
Notes from the chart: Taylor Lanz (Tara Shayne) comes to the hospital complaining of abdominal pain; and though her parents believe that their daughter is pregnant, she receives a negative test. That’s when Meredith (Ellen Pompeo)—who herself is secretly pregnant—notices that Taylor has a habit of chewing on her own hair, a condition known as trichotillomania. During surgery, the doctors extract an enormous hairball from her stomach.
How to play the part: “Often people have a sense of what they’ve done wrong, but they don’t want to tell you because they’re ashamed,” Kaufman says. “You want to convey some sheepishness. You want to be quiet and withdrawn, and then slowly forthcoming about the habit.”