Diagnosis is a 2019 documentary television series. The series follows Dr. Lisa Sanders as she attempts to help patients with rare illnesses and searches for a diagnosis and cure using wisdom of the crowd methods. The show is based on her column for The New York Times Magazine. It was released on August 16, 2019, on Netflix.
Author Lisa Sanders was born on July 24, 1956, in South Carolina. Sanders grew up loving the idea of mystery and became fond of Arthur Conan Doyle's fictional character, detective Sherlock Holmes. Sanders went to the College of William & Mary where she majored in English.
After her graduation in 1979, she was hired by ABC News as a journalist. During her 10-year career as a journalist, Sanders won an Emmy award for her reporting of Hurricane Hugo. She was repeatedly drawn to stories that focused around mysteries and medicine. After about 10 years of reporting, Sanders decided to pursue a career within the medical field.
She was accepted into the post-baccalaureate pre-medical program at Columbia University. After completing her pre-medical requirements, she was accepted into Yale Medical School. She completed her residency at Yale and became her class’s chief resident.
Sanders became an attending internal medicine physician for the Yale-New Haven Hospital. As her new career progressed, she joined Yale’s Department of Internal Medicine while also teaching primary care at the school of medicine.
In 2002, a friend of hers working at The New York Times sparked a conversation about what doctors could provide in a literature perspective. After more discussion, Sanders started writing a column for The New York Times called Diagnosis. The column would highlight medical mysteries that she would encounter with her own patients and those of her colleagues. She described the cases as mysteries, revealing the diagnosis in the following week's column.
The column was adapted for the 2004 TV series House M.D., for which Sanders served as a medical consultant for the show.
Her work also has resulted in a documentary series. A Netflix documentary series titled Diagnosis was released in August 2019. Produced by the New York Times, each episode follows Dr. Lisa Sanders as she seeks to diagnose patients with difficult symptoms.
In addition to writing a column for The New York Times, Sanders has written 4 books related to medicine.
Cast Lisa Sanders — physician, narrator, and columnist for The New York Times. Angel Parker — a 23-year-old nursing student from Las Vegas, Nevada. Her symptoms include episodes of severe muscle painthat render her immobile. Sadie Gonzalez — a 7-year-old girl from Queens, New York. She suffers from hundreds of seizures daily. Physicians initially suggest removing a large part of her brain (a hemispherectomy) as a form of treatment. Willie Reyes — a 46-year-old Army veteran from Vado, New Mexico. He suffers from frequent seizures that result in memory loss and mood swings. Kamiyah Morgan — a 6-year-old girl from Vermillion, South Dakota. She has frequent fainting episodes that can happen up to 300 times a day; these cause her to temporarily go limp and unresponsive. Lashay Hamblin — a 16-year-old high school student from South Jordan, Utah. She cannot keep down any foods or liquids but does not have bulimia. Matt Lee — a 20-year-old college student from Mt. Airy, Maryland. He suffers from frequent fainting spells that occur when he feels a sense of deja vu. These fainting spells also cause his heart to momentarily stop. Joe — a 61-year-old man from Wallingford, Connecticut. He was struck with a sudden and unexplained paralysis from his waist down, leaving him paraplegic. Ann — a 42-year-old patient from Wallingford, CT. She has intermittent paralysis affecting the right side of her body. She will regain mobility but the paralysis always occurs again.
Episodes
Episode 1: Detective Work Angel Parker is a 23-year-old nursing student. Her earliest memory of her illness dates to when she was 14, and woke in the middle of the night not able to move. Since then her illness has progressed into daily severe muscle pain episodes, where the pain will start at the bottom of her legs and grow its way up to jaw. These episodes render Angel immobile for hours, her pee is pitch black, and very frequently she has to be admitted to the hospital. Angel says that any increase in physical strain or exercise makes her symptoms worse but she still pursues athletic activities. Each time she is admitted, physicians have been unable to find a cause for her pain. She has been tested for Rheumatoid Arthritis, Lupus, Multiple Sclerosis, and Autoimmune diseases - all have had negative results. After a colleague sent Angel’s story to Dr. Lisa Sanders, she decided to take on the case and seek a solution. Dr. Sanders published Angel’s story in her column, Diagnosis, asking readers to help find a diagnosis for her symptoms. One big medical anomaly that physicians have recorded during Angel’s episodes is a rise in her Creatine Kinase levels. Creatine Kinase is muscle protein; Angel's highest CK level recorded during an episode was 57 thousand U/L in comparison to average levels of 22-198 U/L.
After Dr. Sanders published Angel’s story, she received thousands of responses on possible diagnosis based on the symptoms. The most common response was the possibility of a Metabolic Myopathy that translates to a metabolic muscle illness and are usually caused by the muscle's inability to breakdown nutrients. The muscles begin to break themselves down to yield energy. As Angel gets closer to possibly having a diagnosis, she starts to think about a possible future with children. She worries that if her disease is genetic, she wouldn't want to put her children at risk.
A medical student from Italy reaches out to Dr. Sanders. She describes her 4th- year thesis on metabolic gene testing that could be beneficial in narrowing down a diagnosis. Angel travels to Turin, Italy for blood and urine testing. The testing showed that Angel had a normal metabolic gene profile, which eliminated many possible metabolic disorders. The physicians in Italy submitted her genomes into a sequencing trial that could take up to two months to process but could hopefully result with a diagnosis. After the two months, Angel receives a call from the Physician with a complete result and a solid diagnosis of Carnitine Palmitoyltransferase II Deficiency.
Episode 2: Second Opinions Sadie Gonzalez is a 7 year old little girl from Queens, NY, with a severe brain disorder. Sadie suffers from very frequent seizures that have resulted in a slight speech and mobility impediment. Her mother recounts the first time Sadie had a seizure being the morning of the 29th of December, when Sadie was 6 years old. The seizures stopped for two months and in late February Sadies seizures started to violently progress into daily visible seizures that will affect different parts of her body at a time. At the time of recording the episode, Sadie was having a motor seizure almost every couple of minutes. Sadie was admitted into the Columbia Presbyterian where multiple MRI’s were done showing no signs of brain damage or brain tumors. These results along with her symptoms led some physicians to believe she had Rasmussen’s. Rasmussen’s Encephalitis, explained by Dr. Lisa Sanders, is characterized by the chronic inflammation caused by T-Lymph white blood cells to invade half of the brain and destroy it. The only sure treatment for Rasmussen’s is a hemispherectomy, where the corpus callosum is severed and separated the diseased side of the brain from the healthy side. This procedure can result in loss of vision in one eye, losing the ability to move one half of her body, or losing the ability to speak. If Sadie actually does have this disorder and undergoes the procedure, then half of the brain can spread into the second half, causing the brain to deteriorate.
The parents of Sadie reach out to Dr. Lisa Sanders in hopes of getting a second opinion, a different diagnosis, or a different treatment. Essentially looking for any route that could lead to a better life for Sadie that doesn't have to hinder her more than her disease hinders her now. Dr. Lisa Sanders put their story out onto her column and awaited for the responses. Many of the responses from the audience agreed with the diagnosis of Rasmussen’s, others suggested that the seizures could be controlled with electro stimulation therapy, and a third group suggested it was a neurologic version of Lyme Disease. She was tested for various diseases under different conditions and one specific test came back strongly positive, resulting in a diagnosis that led to a manageable treatment, and also a responsive neurostimulation device was implanted by a neurosurgeon.
Episode 3: The Wisdom of the Crowd Willie Reyes is a 46 year old Army Veteran who is slowly losing his memories as a result of frequent seizures. Willie’s wife recounts the first time he had a seizure when he was 44 and he just fell to the floor one day without any explanation. Since the first seizure, he has developed multiple brain lesions, progressive memory loss, hearing loss, and violent/emotional mood swings. Willie says that because of his memory loss he forgets a lot of things and constantly repeats himself, making him feel like a child. His biggest fear is waking up one day and completely forgetting about his family. His daughter reveals that, recently, he's been starting to forget major memories from her childhood, such as her birth. Dr. Lisa Sanders took a look at Willie’s MRI scans and noted a huge lesion at the base of his brain with finger-like deterioration rooting up from it. She has a theory that the deterioration reaching the memory region of his brain could be the reason for his memory loss and mood swings. His wife states that in June 2019, he had a biopsy done with a piece of brain matter and the results came back as having unspecified inflammation. Dr. Sanders says that one of the biggest reasons that his condition is hard to diagnose is because it has very similar symptoms to a lot of common brain disorders, with no response to steroids.