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Joyce A. Shaw
Associate Professor of Biology
jshaw@endicott.edu
School of Arts and Sciences
Endicott College
Revolt on the Tuberculosis Ward 

Monique is a 30-year-old Haitian woman with advanced pulmonary tuberculosis who has been transferred from a tuberculosis sanatorium to a large general hospital in Port au Prince after developing a secondary infection with Bacteroides fragilis at the site of her chest tube insertion. The patients on the hospital ward were disgusted by the foul smell of her wound drainage and wanted her removed from the unit. In this directed case, students investigate the characteristics of Mycobacterium tuberculosis and Bacteroides fragilis and review the anatomy and physiology of the respiratory system to help determine whether to keep the chest tube in place or remove it. Using statistics from websites of the World Health Organization, students also must balance the different social, cultural, and medical conditions that exist in Haiti while they formulate a recommendation as to how to end the patient revolt on the tuberculosis unit.  Originally designed for use in a general microbiology course, the case could also be suitable for an upper-level pathophysiology or clinical microbiology course.


The Case of the Jamaican Fisherman 

Designed for a first- or second-semester Anatomy & Physiology course, this directed case study involves a 48-year-old Jamaican fisherman who suffered a cerebrovascular accident.  He was taken to a hospital, where he stayed for three days before he was discharged to his one-room home in a rural fishing village. His limited access to the healthcare system and his lack of understanding about his condition led him to spend the next month in bed. A physical therapist was the first clinician to see him at home. The case describes her findings and asks students to explain the anatomy, physiology, and cultural conditions that led to his present situation. The case consists of five sections that ask questions related to cultural competence, the nervous system, cardiovascular system, muscular system, and respiratory system. Sections can be used altogether, alone, or in any order or combination to help students apply their knowledge of body systems to this practical case.