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Compass CasesCompass Cases CASE ONE

Jordan’s Red Eye

Follow Jordan Chen’s red eye from a dorm room to a diagnosis and back, one person at a time. At each stop, meet the professional in the room, step into their shoes, and see the career behind the encounter.

Late at night, Jordan studies at his dorm desk, one hand at his temple; his left eye is red and inflamed, a bottle of Visine open on the books.
The night before · Jordan’s desk

Jordan Chen, a 20-year-old college sophomore, is three days into a red left eye. The drugstore drops have stopped helping, and midterms are close. He tells himself it’s pink eye and keeps studying. By morning, the whole care system will begin to move around him.

Comic panel: at the pharmacy counter, Jordan winces and holds up two boxes of Visine while the pharmacist looks over from a prescription in his hands.
18:20 a.m., the community pharmacyDirect clinical care

Raj stops the Visine sale and tells Jordan someone should look at that eye today.

Comic panel: Jordan sits on his dorm bed shielding his eyes in the dark while two EMTs arrive at the door.
29:47 a.m., the dormitory roomDirect clinical care

Marcus meets the campus EMS crew at the door: “He won’t open the curtains.”

Comic panel: in an exam room, the medical assistant dims the lights for Jordan, who sits on the table with his eyes lowered.
311:15 a.m., the urgent care clinicDirect clinical care

Diego rooms Jordan and, without being asked, reaches for the light switch: “We can fix that light, Jordan.”

Comic panel: Dr. Patel sits across from Jordan in her exam room, tablet in hand, asking about the redness.
411:32 a.m., the family doctor’s exam roomDirect clinical care

Dr. Patel starts with the question that opens the whole case: “Tell me about the redness. Is it more concentrated in one area?”

Comic panel: Jordan at the slit lamp while the ophthalmologist examines his eye with a focused beam of light.
53:15 p.m., the ophthalmology clinicDirect clinical care

At the slit lamp, Dr. Osei finally sees what no one else could: inflammation inside the eye itself.

Comic panel: the rheumatologist reviews an electronic health record showing HLA-B27 positive while Jordan listens.
6ten days later, the rheumatology clinicDirect clinical care

The HLA-B27 result is on the screen, Dr. Osei’s letter is on the desk, and Dr. Nakamura assembles the whole picture.

Comic panel: Jordan grimaces in a hospital bed while the hospitalist reviews his record at a bedside workstation.
7fourteen months later, inpatient medicineDirect clinical care

Jordan is admitted with a severe flare, and Dr. Kim works the timeline in the chart.

Comic strip: the medical laboratory scientist draws and runs Jordan’s HLA-B27 test, explains flow cytometry at her analyzers, and reviews the result that will steer his care.
8the clinical laboratoryExtended care team

One tube of blood becomes the HLA-B27 result that reorganizes Jordan’s next twenty years, and Priya runs the machines, and the judgment, behind it.

Comic panel: the radiologic technologist positions Jordan on the X-ray table, and in the next frame a radiologist reviews his sacroiliac images on twin monitors.
9the imaging suiteExtended care team

A few degrees of positioning decide whether early sacroiliitis shows at all: Keisha moves the machine, and the diagnosis moves with it.

Comic panel: the radiologist points a stylus at MRI and X-ray images of Jordan’s pelvis on twin monitors while Jordan watches.
10the reading roomExtended care team

On the STIR sequence, Dr. Park finds bilateral bone marrow edema at the sacroiliac joints: active inflammation, visible on MRI before the X-ray could prove it.

Comic panel: the genetic counselor talks with Jordan beneath a pedigree chart while his thought bubbles show HLA-B27 and whether to tell his sister and father.
11the genetics consultExtended care team

HLA-B27 runs in families, and Isabel helps Jordan think through what his result means for Anna, for his father, and someday for his own children.

Comic panel: the social worker sits with Jordan in her office, tablet in hand, while his thought bubbles show medical bills and whether to tell his parents.
12the social worker’s officeExtended care team

Elena’s opener names the two things nobody else has asked about: the costs, and how to tell his parents.

Comic strip: the specialty pharmacy technician explains prior authorization to Jordan by phone and video, works the appeals queue at her desk, and holds up the technical fixes that clear a denial.
13the specialty pharmacyExtended care team

A prior authorization stands between Jordan and his biologic, and Maya works the phones, the criteria, and the appeals queue until it clears.

Comic panel: the infusion nurse starts Jordan’s biologic infusion while he sits in a recliner at the infusion center.
14the infusion center, every six to eight weeksExtended care team

Two quiet hours in the chair, a biologic dripping in, and a nurse who notices everything.

Comic panel: Jenna, the nurse practitioner, sits with Jordan in a follow-up visit, asking how he is really doing.
15the three-month rheumatology follow-upExtended care team

Jenna, the nurse practitioner, runs the routine monitoring visit and asks the quieter questions the checklist doesn't: how are you sleeping, how is school, who knows.

Comic panel: a physical therapist holds a model spine and pelvis while talking with Jordan in a therapy room.
16the physical therapy studioExtended care team

Spine mobility first, then a tailored exercise plan: among the most evidence-supported treatments for AS.

Comic panel: the dietitian meets with Jordan, low-FODMAP and anti-inflammatory brochures on the side table, while his thought bubble shows an inflamed GI tract.
17the nutrition consultExtended care team

Sophia builds Jordan a plan for the GI symptoms that turn out to belong to the same disease story as his eye and his back.

Comic panel: Dr. Singh, the optometrist, examines Jordan at a slit lamp in an optical shop lined with eyeglass displays.
18a Saturday, the optical shopExtended care team

Dr. Singh, the optometrist, is open when nothing else is. Ten seconds at the slit lamp and he tells Jordan to see a doctor today.

Comic panel: the health informatics specialist works at twin monitors of EHR screens, a whiteboard of decision-support logic behind her.
19behind the EHRSystems, science & public health

Jordan never meets the informatics specialist whose decision-support rules surface the right data the moment a patient like him arrives; this is what invisible care looks like.

Comic panel: two years earlier, the biotech researcher presents an HLA-B27 assay-development plan to her lab team in a conference room.
20two years before the red eyeSystems, science & public health

In a biotech conference room, Dr. Chen pitches a faster, more accessible HLA-B27 assay; the test that could someday answer in hours is being argued into existence while Jordan is still healthy.

Comic panel: the clinical pharmacology consultant reviews Jordan’s rheumatology consult request, medication list, labs, and genetic report across his screens, weighing adalimumab.
21the consult nobody seesSystems, science & public health

One week after diagnosis, Dr. Santos weighs the biologic against Jordan’s whole chart, diagnosis, medications, labs, and genomics, so the therapy fits the person and the risks are named before the first dose.

Comic panel: at a patient advocacy nonprofit, the health writer builds a plain-language uveitis guide from clinical guidelines, expert interviews, and patient testimonials.
22two months after diagnosisSystems, science & public health

At a patient advocacy nonprofit, Sarah turns guidelines, interviews, and testimonials into the plain-language uveitis guide the next frightened twenty-year-old will find at 2 a.m.

Comic panel: at a health plan, the policy analyst audits the TNF-inhibitor prior-authorization criteria on screen and flags the NSAID-trial requirement that acute uveitis cannot wait out.
23the health plan’s criteria deskSystems, science & public health

Auditing the prior-authorization rules, the policy analyst finds the flaw Jordan just lived, a three-month NSAID-trial requirement that acute uveitis cannot safely wait out, and drafts the exception.

Comic panel: at the student health center, the public health administrator maps a cluster of campus uveitis cases on a whiteboard of flags, metrics, and workflows.
24the student health center, two weeks laterSystems, science & public health

Dr. Rivera thinks in populations: three campus uveitis diagnoses in six weeks is a system signal, and her whiteboard turns Jordan’s case into clinician education and better referral pathways.

Comic panel: Denise, the healthcare manager, reviews clinic operations dashboards and quality metrics in an administrative office.
25the urgent care operations officeSystems, science & public health

Denise, the healthcare manager, never meets Jordan, but the way she runs the clinic shapes every visit that happens inside it.

Comic panel: Dana, an insurance executive, presents a coverage-policy analysis to a steering committee in a boardroom.
26the health plan's strategic reviewSystems, science & public health

Dana, an insurance executive, weighs a coverage policy that will decide whether patients like Jordan get their biologic without weeks of delay.

Comic panel: James Park, a biopharma executive, reviews a patient-access strategy for an anti-TNF biologic on screens in a corporate office.
27two years before the red eye, a biopharmaceutical companySystems, science & public health

James Park, a biopharma executive, makes an access decision that ripples out to patients he will never meet, Jordan among them.

The whole ecosystem, at a glance

Every person you met, and a few Jordan never did, arranged by how close they stood to his care. Click any name to open their card, shadow them, hear from them, and ask your own question.

Jordan Chen, his left eye red and inflamed
JORDANour patient · 20

Filled dots are people you have already met. Click any name to open their card.

It took 31 people, and many more behind them, to get one college sophomore from a red eye to a diagnosis.

Your questions

Everything you asked along the way, gathered in one place. This is your record of engagement for this case.