Shane is 20 years old, and is excited to have just joined the army. Growing up in northern Ontario, it was always one of Shane's dreams to see the world and serve his country. Shane joined just 6 months ago and is in training in preparation for an overseas mission. He is very healthy, aside from a prior splenectomy performed for a traumatic splenic rupture. However, on Saturday he is feeling slightly unwell, with some chills, headache and general fatigue. Despite it being his day off, he decides not to go into town with his friends. Later that day, his friends return, and Shane looks terrible: he is pale, obtunded, and has a rash on his feet. They call the base nurse, who urgently calls the doctor on-call, and a decision is made to transport him into town to the Emergency Room via ambulance. In the ER, Shane is seen by the triage nurse, who puts him in isolation precautions in a closely monitored setting. He is immediately attended by the ER physician, who notes complete unresponsiveness, a rigid neck, blood pressure of 70/pulse (i.e. no diastolic blood pressure was obtainable), HR 140/min, RR 28, and T 39.1 degrees celsius. A petechial rash is noted on his extremities, and his skin is mottled.