The six case studies presented within this chapter should be viewed as drawing attention to weaknesses in a system of detection first, followed perhaps by issues in containment and mitigation as a result. In looking at these events from a system perspective, we should be aware that the point at which a system fails is often a weakness due to failure in other parts of the system. A system is defined as “a dynamic order of parts and processes standing in mutual interaction with each other” (von Bertallanfy, 1968). Therefore it is necessary for all professionals reading this text to examine all of the parts and processes, especially the interactions among the parts.
The manner in which the case studies are presented in this chapter runs the risk of being categorized as anecdotal and, as such, dismissed by some purists. It is not practical for us to completely recreate or chronicle the accounts for the case studies presented here, and more elaborate and definitive references are easily retrieved from open sources. As such, references and websites are provided at the end of the chapter to allow additional, in-depth exploration of the described events.
Early detection of biologic events requires an innate ability to make sense of seemingly subtle and random events, often lacking scientific explanation. The practice of medicine is an example of the need to combine science, experience, and instinct in the development of a plan of action. Rarely do patients themselves progress in clinical presentation and disease etiology as the pages in a textbook might suggest. In 1973, Sacks wrote that
We need, in addition to conventional medicine, a medicine of a far profounder sort, based on the profoundest understanding of the organism and of the life. Empirical science is the key to one form of knowledge, the generalized knowledge that gives us power over nature; the key to wisdom however, is the knowledge of particulars.
We anticipate that the reader will filter and interpret this material within the context of his or her chosen vocation. Applying some of these lessons may allow future generations, regardless of their particular vocational path, to detect early on the emergence of a biologic event and conceivably achieve improved outcomes. Herd health and well-being may take precedence over individual rights and outcomes. No doubt this is a hard pill for some to swallow. However, improved outcomes portend a decrease in morbidity and mortality, minimization of social or economic impact, or perhaps even decreased international interest.
There is a growing consensus among social scientists that research pro-grams advance more effectively through the iterative or collaborative use of different research methods than through the use of any one method alone. Making the most of the synergies among research methods requires an understanding of the relative comparative advantages, trade-offs, and lim-itations of each method and an ability to translate between different meth-ods. The comparative advantages of case study methods include identify-ing new or omitted variables and hypotheses, examining intervening variables in individual cases to make inferences on which causal mecha-nisms may have been at work, developing historical explanations of partic-ular cases, attaining high levels of construct validity, and using contingent generalizations to model complex relationships such as path dependency and multiple interactions effects. Particularly important is the ability to identify new hypotheses, which case studies can do through a combination of deduction and induction.