Diagnosis (2019–…): Season 1, Episode 6 - Déjà Vu - full transcript

[Lisa] We've all experienced déjà vu.

It's that strange sensation
where you suddenly

feel like you've been here before.

Like you've had this experience before.

But what if every time

you have déjà vu, it was a signal?

A signal that you're about to pass out,

your heart is about to stop,

and your doctors have no idea why.

Every doctor's worst nightmare

and the thing
that keeps doctors up at night



is the concern
that they've missed something.

And the greatest worry is what if,

like this next patient, that missed clue

could mean the difference
between life or death?

[man] It's duckpin bowling,

so it's different than regular bowling.

-[man] Nana.
-What?

I don't remember how to play.

[Nana] Come on, Matt.

-[Matt] How is that possible?
-You're trying to hit that net.

[Matt] I know.

You probably look at me now
and I seem just like a normal 20-year-old.

[Matt] Oh, my goodness.

[Matt] I used to be a very athletic kid,



but now if I strain myself too much...

there's consequences.

[Nana] Well, his heart stops.
This is like... Yeah, you've got to get--

[woman 1] Can you get help?

[Nana] All we do
is watch him do this over and over.

[woman 2] He has a heartbeat.
-[overlapping conversation]

[woman 1] Does he have seizures?

-[Nana] We don't know.
-[woman 2] His heart stops beating.

[Matt] About a year ago,

I was like, "Man, I feel light-headed,"

and I kept saying I had déjà vu.

I fainted and blacked out,

and then I realized I had blacked out,
so I went to the hospital.

They hooked me up to a bunch of monitors,

and they couldn't pick up anything.

And then two weeks later,

I had another episode, but...

this time I flatlined.

Uh,
I work with Dr. Calkins and Dr. Brinker.

I'm here to talk to you
a little bit about it.

So, any symptoms you have,
we want you to let us know.

[Matt] When it starts coming on,

I can feel this weird sensation
in my head.

It's like a tingling.

After that, I feel a light-headedness.

I get very, very hot and sweaty

like I'm running five miles straight
without a break.

You feel like you want to puke
a lot of the times.

[doctor] And is it associated

with any activity,
or does it happen at random times?

[Matt] Just random.

I get a lot of bad heart palpitations,

I start to feel the loss
of control of my thoughts,

and then the déjà vu moment occurs,

where some memories that I know
don't exist pop into my head.

When I first flatlined,
I was hallucinating The Flintstones,

and...

I felt like I'd been there before.

But every time déjà vu happens,

I feel my eyes roll in the back of my head
and then I pass out.

I don't really have any control over it,

and if I flatlined last time,

I could flatline again anytime,

and it could be much longer
or it could be permanent.

[Lisa] Matt is perfect for crowdsourcing

because he has
a real life-threatening condition.

This is someone who needs a diagnosis

because he lives in constant fear
that it's going to happen again,

his heart will stop again,

and he's really just put his life on hold
until he gets an answer.

I know he feels limited

to staying at home

because he has no control over
where this happens.

[satnav]
Starting route to Johns Hopkins Hospital.

[Lisa] He's afraid that he might just
pass out in the middle of the street,

when he's driving, riding a bicycle.

I mean, times when it would be
really dangerous to lose consciousness.

[satnav]
You have reached your destination.

[woman] Take your shirt off
and put this gown on.

[Matt] Yeah.

At this point,
I have been going to doctors

near my home for a year
without really any diagnosis.

Basically,

they hooked up a temporary pacemaker,

but decided to take it out

because it increases the chance
of getting an infection,

and if my heart flatlining
wouldn't kill me,

then the infection would kill me.

So now they sent me to Johns Hopkins.

I look forward to hopefully getting
some more information

and getting closer to coming up
with a diagnosis and treatment.

-[Matt] Thank you.
-I'll see you shortly.

I'll just do your vitals
and everything real fast.

[Matt] Okay.

Before all this happened, I used to be
a very social and happy kind of dude.

Last year, I was just a typical kid
going to college.

I was just 18 years old

and already planned out
what I wanted to do.

I wanted to do anything
with computers or technology,

but at the end of the first week,
I had my first heart episode,

so I had to drop out, obviously.

I wanted to go back, but...

they advised me not to have
anything too crazy or too stressful

because if that's a trigger,

they don't want me to trigger
my heart failing again.

[man] You can lean back now.

[Matt] It was a big disappointment.

Pretty frustrating 'cause I'd just started
my life as an adult

and it's already ending within a week.
[laughs]

-[buzzing]
-I'll shave you, okay?

[Matt] Yeah.

[Lisa] Now that Matt's at Johns Hopkins,

he'll have some of the top specialists
in the world looking at his case.

First, his cardiologist
is testing his heart

to see what kind of role it's playing
in these episodes.

[doctor] Okay, so we're getting prepped
and all set to go?

[man] Yeah.

[Lisa] Right now the only thing
we can say definitively

is that Matt's main symptoms,
what we call syncope,

is the medical term for fainting spells
caused by reduced blood flow to the brain.

The question is why.

His episodes could be triggered
by the nerves that drive his heart,

or by something
that's happening in his brain.

It's really a case of heart versus head,

and that's what his doctors
are trying to figure out.

[doctor]
What happened with the last episode?

Um, I did pass out, but I have
an episode at least once a week now.

It went from six months
to, like, two months to now weekly.

[Dr Calkins] So that's one more
piece to the puzzle

to add to our data gathering.

For a patient like this,

you just have to always be willing
to consider new diagnoses,

keep your eyes open,
keep collecting information.

Right now our presumptive diagnosis
is an atypical form of syncope.

First, we're doing the tilt table test

because the typical scenario is,

you're singing in the choir under
hot lights and you're standing still.

Blood pools in your legs and your feet.

You vasodilate because it's warm,

and your blood pressure starts to drop.

[man] Are you light-headed or dizzy?

[Matt] A little bit.

[Dr Calkins] After the tilt table test,

we also wanted to put a link monitor in,
so if he had further episodes

then we would get information
about when he's passing out,

what's his heart rate really doing.

You're gonna get some numbing medicine
now, so a pinch and burn.

One, two, three.

You shouldn't feel anything sharp,
but you might feel a little pinch.

Sorry. A little bit of pressure, okay?

It's in there.

-It's finished.
-[Matt] All done?

-Yep.
-Sweet.

[Lisa] The hope is that these tests
will give an answer

to why Matt's heart stops.

He needs to find that clue
because every time his heart stops,

he could die.

Hey, Dad.

I know you usually try to approach things
with a sense of humor

and not get stressed out or whatever,

but, I mean,
your life's been a little bit...

at a bit of a standstill.

You don't know if you can get
on a plane to come down here,

you know, for holidays. We don't know.

Yeah, or, um...

Nana and them just went on vacation
to an amusement park,

but I can't get on any rides
just in case I do have a heart problem.

[Larry sighs]

It's worrisome that nobody knows
what's going on.

Have you and your mom been talking
much lately,

or is everything okay on that front?

-I mean, we talked yesterday, but, um--
-Okay.

I don't know. She was just talking
a bunch of BS, so I was like,

"That's a bunch of BS,"
and then she got mad.

Okay.

[Matt]
This year has been stressful as it is,

and on top of that, my family situation

is a unique experience itself.

My dad lives in Mississippi,

so it's just hard for me to see him.

-All right. I'll talk to you soon, okay?
-Yep.

-All right. Bye.
-Bye.

And then me and my mother fight a lot,

so I moved into my nana's
just because it's a better environment.

Here's where I'm missing
my two front teeth.

-That's a very cute picture.
-Baseball's fun, too, and I liked it.

As a kid,
I had a very confusing upbringing.

My parents were already split
before I was born,

so I didn't talk to my dad

until probably 11 or 12 years old.

Mostly because of my mom,

but she has her own problems, that's why.

Mom is not very good
at choosing guys she dates.

My mom had me as a teen,
so I don't think Mom ever...

grew up.

She still acts like a teenager.

Like, when my health condition started,

my mom was kinda lacking
in taking me to my appointments.

She would get me there, but either late,

and she wouldn't be
writing down information

or taking down information, so...

it stressed me out a lot.

Eventually, my grandma

and grandpa just kind of picked up

and said, "We'll make sure
everything is getting done correctly."

[mother] My relationship with my son...

it's a tricky relationship still, but...

I feel like I've just always been
the scapegoat for him to kinda...

You know, like the punching bag per se.

My son's literally...
His heart's stopping.

They're telling me I can't help him.

I wish he would let me be involved, but...

you try to be strong and you try not
freak out and you try not to break down,

you know, but all that happens.

At this point, it's been over a year
since the first episode,

and we have no answers.

[video call ringtone]

Hello.

[Lisa] Hi, Matt.

You look so young.

I'm trying to figure out
how to start your story.

So each of these episodes
leaves you pretty wiped out?

Yeah, like, and if it's strong enough,
it's almost like being paralyzed.

Can you feel it coming on?

It feels like déjà vu,
and I say it every time.

I say, "I have a weird feeling in my head.
I need someone to change my thoughts.

Talk about anything."

And if they do talk about it
and I start focusing on that,

then it kinda goes away.

Has it ever happened
that somebody tries to distract you,

but you're not distractible
and you have an episode anyway?

Yeah, that happened last week.

Do you take any medicines?

No.

Um, let me ask you some boring questions.

-Okay.
-Do you smoke?

-No.
-Do you drink alcohol?

Um... No, not much anymore.

Once high school kinda ended, it was like,

"This isn't really fun anymore.
I'm not a kid."

Smoke pot?

Um...

I'm not going to arrest you.

I mean, I do,
but not as much as I, like, used to.

Where are you in getting care?

I have a loop recorder in,
so they're monitoring me,

and we did the tilt table test

that could provide answers
to what's going on with me.

Dr. Calkins is very persistent.

All right. I am going to look over
your records and try to write something.

-Okay.
-So, thanks so much, Matt.

-Bye.
-Bye-bye.

[Lisa] Even though we're still waiting
for the results of the tests

from Johns Hopkins, I'm eager
to put this out before the crowd now

because Matt has gone over a year
without a diagnosis.

"Matt had been having spells like these
for over a year.

The first time it happened,
he was on the floor

playing tug-of-war with his puppy.

He had the same creepy déjà vu feeling,
the same cold sweat, the same nausea.

His arms and legs jerked a few times,

and then he was still.

What do you think is going on?"

My name's Matthew. I'm 20 years old.

I'd keep blacking out
and my heart would keep...

My name is Bernd Reisbeck.
I live in Spain since ten years.

I'm German, and after eight years,
I've become a cardiologist

an invasive cardiologist.

I'm a hospital pediatrician.

I live in Dallas, Texas.

I am a retired cardiologist.

I am a neurologist
at the University of Vermont.

I thought that he could be deficient
in magnesium.

All of his symptoms and the pattern
that was demonstrated

are classic vasovagal syncope.

[woman] This particular article,

I said, "Oh, there's my son-in-law."

It was an exact description. I mean,
you could have just changed the names.

I would think that that's
a low blood pressure event

due to dehydration, but I'm a lawyer.

I said to myself, "Okay, maybe we're not
thinking about the event correctly."

The event we're thinking of
as the loss of consciousness.

But maybe the event
is actually the preceding feeling.

It seemed to have to do
with Matt's anxiety.

It made me think about
a particular localization

for seizures in the brain.

There are areas of the brain
that can affect the heart.

The temporal lobe
deals a lot with memory,

so that's why the déjà vu symptoms

are specified to temporal lobe epilepsy.

I think that first episode

was caused by staying up late
playing video games,

and then drinking energy drinks.

[Lisa] The response to Matt's story

was pretty huge.
You know, hundreds of people wrote in,

but there were two suggestions
that I'm most interested in.

Vasovagal syncope

and temporal lobe epilepsy.

With vasovagal syncope, the nervous system

sends an inappropriate message
to the heart to slow down,

and sometimes so much
that it actually stops.

That's what Matt was being tested for
in his tilt table test,

and I'm looking forward
to hearing the results of that.

And then temporal lobe epilepsy
is this weird sort of seizure

that is often preceded
by strange thoughts or feelings.

People might smell something,

or, absolutely classic,
they might have this sensation of déjà vu.

What were the ones that struck you
as particularly interesting?

The temporal lobe epilepsy... thing. Um...

That seems pretty close.

I mean, the temporal lobe epilepsy,

that to me seems
the easiest thing to treat

and the easiest thing to have.

Like they said, I would get
on the medication and that was it,

and the problem was solved.

And then vasovagal.

How do you feel about that as a diagnosis?

I mean, with all...

With the numbers
of how many people were saying

they believe as a doctor that that's it,

-it could most likely be it.
-All right.

Tomorrow, Dr. Calkins is giving me results
of my tilt table test.

Great. It will be interesting
to hear what he has to say.

-Yeah.
-The uncertainty is hard for doctors

as well as patients.

-Yes.
-All right.

We'll be in touch.

Okay.

[Lisa] Matt's next appointment
at Johns Hopkins

could give us some critical information.

He's gonna see a neurologist there

who's gonna give them the results
of an EEG he had,

and that might confirm
the crowd's suggestion

that this was temporal lobe epilepsy.

Can I see your insurance card

-so I can scan it?
-Yep.

[Lisa] And he'll get the results
of his tilt table test,

which will tell us
if he has vasovagal syncope.

[woman] You're gonna go down
the hallway to the left.

Okay.

[Lisa] And they'll check his link monitor
to see if it's picked up any activity.

So hopefully, Matt starts
getting some answers,

and we'll find out is it his heart?

Is it his head?

Matthew, I'm Dr. Bergey.
Dr. Calkins contacted me.

I am an epileptologist,

which is a fancy word
for someone who's a seizure specialist.

Much of what I do is treating people

who have unexplained loss of consciousness
or alteration of consciousness

and trying to figure it out what it is
and what it isn't, okay?

You had an EEG back in September,
I saw, right?

-Yeah.
-Well...

we didn't see evidence
of a seizure disorder

on the EEG, okay?

Medicine is not an exact science.

There are certain types of seizures,
frontal lobe seizures

and seizures that are coming
deep within the temporal lobe,

where sometimes a very mild aura
might not show up on the EEG.

Sometimes you see people
with a seizure disorder

and there's no question.

Other times, there's no question
that it isn't a seizure disorder.

-You're in that middle ground.
-Yeah.

And I think that middle ground
is somewhat...

confounded by the fact that there is
some cardiac component to it.

It's possible this could be
a seizure disorder,

but we haven't established that diagnosis.

-Okay. Good.
-Thank you.

Pleasure meeting you.

Most patients who have seizures

don't have cardiac manifestations,
other than the rapid heartbeat

that you would expect might be associated
with a motor activity,

but there is a small subset of patients
who have temporal lobe or focal seizures

who may have slowing of their heartbeat

or a pause in their heartbeat
as a manifestation of their seizures.

Having the loop recorder in is priceless
because this allows

Dr. Calkins to have a direct correlation
with his symptoms.

Good to see you again.

Happy Memorial Day.

Thanks.

Well, you survived the tilt table test
and the link monitor.

Okay, so here we go.

We're going to take a look at the monitor,
and we'll see if it has any secrets.

Move it around
until this thing turns green. Okay.

You have nice signals, which is nice.

The thing is working well. So it says...

You have no news. Nothing happened...
has happened on your monitor.

Nothing.

Okay, no news.

Right now we have no information

because we haven't caught
the fox in the hen house.

We won't know what's happening
with his heart rate during an episode

unless he has another episode.

Okay, let me fire up the computer.

I'm just looking
at the tilt table test report.

The tilt table test was negative,
so we have to keep searching.

And so my thought would be
to see you again in about six weeks.

[Matt] That appointment

was kind of the lead
to some sort of answers,

but now we're kinda at a place
where there is zero answers.

[Lisa] Matt's cardiologist couldn't prove
that he had vasovagal syncope,

and the neurologist didn't think
that there was a lot of evidence

that he had temporal lobe epilepsy.

For people who are desperate,
every step can be a false hope,

and that can be devastating.

At this point, nobody's been able
to give Matt an answer.

This is one of those things
that keeps doctors up late at night.

What if we missed something?

Because it's possible

that there is something in his history
that we've overlooked,

and so now I really have to go back
through all of his records

with a different point of view.

[phone vibrating]

[continues vibrating]

Hey, Mom.

Hey, what's up?

Um, not much.

The tests didn't give any results, so...

we're gonna look at some more videos

and see what more ideas we can look into
to figure out what's going on.

Okay. Um, can you wait for me?
'Cause I'd like to be a part of that.

Um...

Yeah.

Okay. I'll see you shortly.

[call ends]

[Matt] This one is interesting.

-I live in--
-All right. Hold on. [laughs]

Sorry. It just--

-What's wrong with you?
-I don't know.

It just made me laugh.
All right. Let's go.

[woman] My son-in-law was really pushing
the doctors for a more definitive answer

than just, "Oh, maybe it's vasovagal."

You have to be persistent, obviously.

-Mm-hmm.
-That's why I'm there every two weeks.

[Crystal] Okay.

So they did a test

called a bubble test,

where they see if there's air that maybe
passes through a hole in the heart,

and it actually showed
there was a substantial hole

between the chambers in the heart.

That's the first I've heard of it.

Can't remember her name,
but the girl doctor I saw before,

she was like,
"You should get that checked out,"

-and she's the one who sent me--
-[Crystal] Dr. Thomas?

-The one we had, or after that?
-No, you weren't there.

The doctor that I saw before

had me do the bubble test.

-Had that done to me.
-No.

You weren't there.

I feel like
if there was a hole in my heart...

-Yeah.
- ...it would've been discovered.

I tend to agree with you.

[Crystal] Not necessarily, though,
'cause the tests they do don't...

She's right on that. They don't.

Okay, I'm not gonna be involved
if you're gonna do that.

I'm serious. I will literally...

You haven't had any bubble tests
or anything to run a line of air,

-so you need to--
-You weren't there.

No, I know. I get your chart thing,
though.

Mom, I don't-- Just knock it off.

Okay, Matt can film. I'm serious.
I'm gonna go ahead and...

I'm not gonna deal with this.

You can do it, Matt. You know it all.

Stop talking.

You're making it more annoying.

[Crystal] I am done.

He has all the answers, so he's good.

All right. Good luck, Matt.

[Matt] I get very irritated with her

because she talks like she's...

been a big part of it, but she...

I mean,
the only time she's involved, it seems...

when it's very convenient for her.

Well, she's got a lot of issues too.

It's not mine to deal with.

She goes to counseling. She always has.

-She is.
-So...

Take your meds or whatever.
Get yourself together.

If I'm doing it, and I'm, like,

younger than you and your son.

[sighing]

[monitor beeping]

[Nana] Yesterday, Matt called to ask me
if I wanted to go have coffee with him,

so I picked him up.

He got in the car

and we were just discussing
Starbucks, 7/11,

going back and forth,
and then he just said,

"I think I'm having an episode," and that
was it, and then he put his head down.

[Nana] Are you okay?

It seemed like this was
the worst one of them all.

He was drenched in sweat,

and then he passed out.

There was no pulse.
I felt his pulse. There was nothing.

And I tried to tape it,

but I got the very end of it,
him just coming out of it.

You need some air?

When he came to,
he hung his head out the window,

and he started vomiting really bad,
and he never did that before.

[vomiting]

And I called his physician, and he said,
"Get to the closest emergency room."

When they looked at the loop recorder,
they saw a six-second pause in his heart,

which doesn't seem a long time.
It's long for me.

It was terrible.

[woman] Can you just tell me
what happened yesterday?

Uh, I just woke up,
and it was, like, a normal day...

Well, not really a normal day.
I've been stressed out lately,

and the person involved in the stress,
like, was invading my dreams,

so I woke up stressed.

And then I showered, got in her car.

We were on our way to get coffee.

I guess I was just, like,
so stressed that...

I got light-headed and then passed out.

When I woke up, I was already stressed out
that I was at the doctor's

and, like, things were...

just being done extremely slow.

I was just getting, like, frustrated...

and just annoyed,

so I got stressed out again
and then passed out again.

[woman] Just yesterday?

Yeah. I had two episodes yesterday.

[Lisa] This is Matt's first episode
in four months,

and it seems like the only variable,
at least that we can see,

is his stress level.

I'm just ready to go home.

[Lisa] This could be
that missing clue we need

to make everything start making sense.

As doctors, we sometimes

delve so deep in our search for a disease
that we overlook

the actual patient sitting
right in front of us.

And so now I really want to go back

to something that the crowd suggested
really early on

that I think bears reconsidering.

I saw there was a lot of
psychological issues, like anxiety,

and I thought,
"Maybe it's coming from that"

because it didn't say
that it was treated at any point.

Maybe that could be a possibility.

[man] My theory is that,

if he gets his anxiety under control
and he learns that he's not going to die,

he may stop having the extreme anxiety
that's causing him to faint.

[woman] It seemed that Matt's symptoms

could be delayed if he talked to somebody,
and that was very interesting to me

because it seemed like there might be
something psychological going on there.

[Crystal] When Matt was little,
Matt went through this big ordeal.

His father took him down to California,
took him out of everything he knew.

[Matt] I don't know too much of the story
'cause I was four years old.

My mom says one thing,
my nana says another thing.

[Nana] What happened was
my daughter wrote to Matt's dad

saying that she was living in a car,
she was homeless,

she didn't have anywhere to go
and her and Matt were on the streets,

so could he please come and get Matthew

for a couple months,
until she got on her feet.

[Matt] I was with my mom and then,
all of a sudden, I was with my dad.

[Crystal] When it's time
for Matthew to come home,

Matthew doesn't come home.

I get served with papers
suing me for custody.

[Nana]
Matt's dad's story is that he tried to,

um, set up a time to bring him back
and Crystal never was available,

so she was served papers saying
they were gonna go for temporary custody,

and she didn't respond,
so they won by default.

I know that was traumatic for him because
he didn't really know his dad at the time.

I think he felt he was, like,

getting sent away with strangers.

I made a mistake by going down there

because I thought, "If physical custody
is what you have to have,

I'm gonna get possession of him."

So I flew to California,

and I was gonna snatch him, take him
to the hotel and fly home with him.

It didn't work
because they found me and they...

they followed us, and they kind of
cut the car off and took Matthew,

so that was traumatic for Matthew.

'Cause Matthew thought
he was possibly going home,

and he thought I was there to get him
and everything was going to be okay,

and instead, he crawled underneath
the dashboard of my car

and was trying to hide from the police
'cause he didn't want to go with his dad.

So that was very...

And they physically took him away
screaming and crying. It was really bad.

So...

It was traumatic for Matthew.

[Matt]
The more I really think about this stuff,

it's very interesting 'cause...

I can remember my first déjà vu moment,
hallucinating The Flintstones,

thinking, "Man, this seems so familiar."

[Crystal] Matt did watch The Flintstones
when he was younger.

That was right after his dad had taken him
and I got him home.

Yep, we watched Flintstones. Um...

Yeah, that's weird.
I never even actually thought of that.

[Matt] I don't know. It just seems like
this isn't déjà vu.

This is, like,
your brain giving you a message, like...

"Hey, man. You dealt with this
when you were six or seven.

You never processed it."

So all the traumatic things
that I've seen as a kid

could not be a heart or brain problem.

It could just be so much trauma
and being stressed out,

probably since I was
four or five years old,

dealing with all that
all the way up until I moved in here.

[video call ringtone]

[Matt] So what made you think
that stress can affect you physically?

Have you heard the expression
that someone died of a broken heart?

Yeah, yeah.

There's not just that one. There's others,
too, that have to do with the heart,

so there seems to be some kind of...
at least a cultural awareness

of mental conditions of all kinds,
like stressful situations or whatever,

affecting your heart.

Things that made me think,

"Oh, this could be more psychological"
is that...

the article I wrote that
when you talk to somebody,

you can avoid
having these fainting spells.

I think the talking aspect

made me think there might be
something psychological going on.

I feel I could empathize
with the fact that it's very scary

and probably, like, terrifying
to not know what's going on with you.

I thought it would be very useful
and hopefully productive for you,

like, emotionally to...

like, see a therapist,
to see a psychiatrist, yeah.

[Matt] Yeah. Yeah, definitely.

Thank you for talking

and providing information
and your input on this.

Thank you.

-Bye.
-Bye.

[Lisa] We know
that Matt had a lot of trauma in his life.

Trauma alone is not responsible
for these episodes that happen to Matt,

but it could set an environment

where these episodes
are more likely to happen.

So I think the next step for Matt

is really to do what the crowd suggested:

to meet with a psychologist

or somebody who can help him
deal with his trauma,

and maybe that will reduce
the frequency of his episodes.

-[woman] Nice to meet you.
-[Matt] You too.

Have a seat, Matt.

How are ya?

-Pretty good.
-Yeah?

-It's a nice office.
-[laughs]

So, obviously,
I have your medical records,

and from what I understand,
anxiety's been a part of it.

What causes you to feel anxious?
What are some situations?

Just because of environments I grew up in.

There wasn't anyone to guide me
on what was right or wrong.

My mom kept my dad out of my life.

I didn't see him
until I was, like, 12 years old.

-Yeah.
-And then she let me see him,

so after that,
I just saw him, like, every summer.

And how frequently
do you see your mom now?

Um...

-Pretty much never.
-Okay.

I do think that we can begin to help you
work through some of that.

-You've never had that opportunity.
-Yeah.

So what I might recommend,

um, is that we get started
with some of the behavioral strategies -

the relaxation
and the cognitive behavioral therapy -

and see how you do with it.

-What do you think?
-I like that.

Now, how this relates to the syncope,
I don't...

Um, I don't... I don't know.

Like, clearly, you're getting stressed out

by some of the symptoms
that precede the actual syncope.

All of those are anxiety thoughts.

I think that it will
certainly help with that.

Whether or not it can, uh,

reduces or eliminates those episodes,
I guess we have to wait to see,

but, regardless, I think that
these psychological interventions

are gonna significantly improve
your quality of life.

I'm really hopeful about that.

Thank you.

[Dr. Gould] I think people forget
that the mind and the body are connected.

It's certainly possible
that the syncope is related

to anxiety in some way.

I can't say that it's causal -
the anxiety causes these by any means -

but it's certainly related.

Rock star. [laughs]

-I'm really proud of you, okay?
-Thank you.

Yeah, you'll do great.

[Lisa] At this point, we don't really know
whether going to therapy

is gonna help him
reduce the frequency of these episodes,

but if it does,
that would be a great thing.

It wouldn't be a true diagnosis,

but it will help him
until he gets a diagnosis.

[dog barking]

Come on. Good boy!

Good boy!

I've been going through therapy
for a few months.

Thinking about what's happened,

not just throughout, like,

this past year journey, just all along,
I kinda realized...

that there was...

there was so much that I was holding in
that I needed to let go.

Come on.

I don't really talk to my mom lately,

but I'm gonna head over and catch up
with her at some point.

With my mom, I guess it's like

I still have a little bit of worry
in the back of my head.

But other than that,
life's actually, like, progressing...

for once.

I'm just gonna continue to keep doing
what is necessary, what I'm doing now.

Good boy.

[video call ringtone]

-[Lisa] Hi. How are you?
-I'm good.

I'm actually, like, going out
and wanting to hang out with people

and, like, leave my house.

I can just, like,
be normal and just function.

It seems like you're doing so much better
with respect to your stress.

Yeah. Like, it's totally eliminated
the small heart palpitations.

Like, I don't have those at all.

I just feel like
when my stress is under control,

whether it's vasovagal or it's seizures
that are triggered by it,

if it's under control, then those become
a problem that won't matter anymore.

It would be fantastic if managing stress

could manage all of this.

I think that having the crowd...

think about you
and think about your problem,

-opened it up.
-Yeah, definitely. 100%.

-Take it easy, Matt.
-Okay. You, too.

-All right. Bye-bye.
-Bye.

Yeah, the crowd just felt, like,

just a huge support, and they were
just as eager to get me fixed

as everyone else was.

[Lisa]
I think the importance of the crowd,

in Matt's case in particular,

is that it opened up the possibilities
of what he could have.

As a doctor, I don't believe
that stress did all of this.

I think that he has some kind of epilepsy

that is exquisitely sensitive
to his anxiety and trauma.

-[woman] 8.13 change. It'll be right out.
-[Matt] Thank you.

Yes.

[Lisa] I think that his taking on
the problem of his anxiety

I think was very brave and very tough,

and I think that it's going
to be important in his life,

and I think it's also been important
in reducing his episodes of syncope.

[Nana] If we didn't do this project,
we probably wouldn't be any closer

to starting to really get what's going on

because doctors didn't have an answer.
No answers.

They were going to do pacemaker.
That would have been it, pacemaker...

for a 19-year-old.

[Matt]
Right now we're going to see my mom.

It's been...

It's been a few months
since I've seen her.

[dog barking]

-Hey, Mom.
-Hey.

[dog barking]

[Crystal] Come on.

-[dog barking]
-Hey, hey.

[Crystal] What did you do
for your birthday? Anything fun?

I had a nice dinner,
hung out with my friends.

Well, that's good.

What else have you been up to,
other than the doctor and serious stuff?

Anything fun? Anything exciting?

I was hanging out.

[Crystal] I just worry
'cause last time we saw each other,

I just was very scared
and worried about you,

but that's okay. I'm your mom. I get it.

I mean, I didn't have the slightest clue
of what was going on.

-I just was passing out.
-Yeah.

So it was just kind of freaky and...

something that threw me off guard.

Me and you are a lot alike
and I, obviously, you know,

have anxiety, and I didn't want that
to pass to you guys, and growing up,

-unfortunately, it did with you.
-Yeah.

How's the counseling and stuff?

I think I realized I complained about

bad things that I went through,
but I also had negative aspects myself.

I just want you to take your time

and get your stuff done
and situated and...

You know? I think from my end, I would
like to hear more updates, I guess, and...

Come over for dinner.
it won't kill ya every once in a while.

[chuckles]

-Yeah, sure.
-Aw!

[Crystal chuckles]

And now you've got some good stuff going.

Yeah.

Proud of ya.

-I'm happy with where we're at.
-Yeah.

-Me too.
-Good. [laughs]

Normally, you would have
argued that with me. [laughs]

-Not really.
-So that's good.

I am so proud of him actually, you know,
to be going to get the therapy he needs.

That's just as good, in my opinion,
as a diagnosis per se.

As long as his heart's not stopping
completely all the time like it was,

I think that's just as good.
It's just a more, um...

We have more answers.

I couldn't be more grateful
for the feedback that we got

because we didn't know
where to start, you know?

People showing how much they cared

just from reading your story
was, like, amazing to me.

[Lisa] Putting Matt's case to the crowd
showed that when you make a diagnosis,

sometimes you're diagnosing
the superficial,

what appears to be the problem,

and you have to dig deeper
to find out what's really the problem.

Now it's time for me to move on
to my next patient, or in this case,

patients.

[woman] This is one of the first steps
to getting dressed on his own.

[Lisa] Both suffer from forms of paralysis

that have really eliminated
their ability to live normal lives.

[woman] The right side of my body
can give out with no warning.

[man] I never thought I'd not walk.

It's something I did my whole life.

I'm athletic.

[Lisa] Joe's paralysis has been
progressive, and his family is terrified.

[woman] If it's moving up,
is it going to take over

his heart area?

[Lisa] Ann has seen over 30 doctors,
so she really needs the crowd to help.

[woman] I went to see

this neuromuscular person, and she's like,
"It's all in your head."

[Ann] My doctor told me
it's just psychosomatic.

I don't wanna to have to justify myself...

to somebody else.

I'm tired of it.