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Abstract
Frank and Joe are 24-year-old fraternal twins who share similar interests, including cycling. The brothers decide to attempt their first long-distance bicycling trip, retracing the journey of early American explorers Lewis and Clark to the Northwest. Along the way, serious problems arise. Students review normal physiology of organ systems as well as changes that occur during physical exertion to piece together an understanding of the medical condition of one of the cyclists. The pivotal point in the case is learning that seemingly harmless and legally available substances can lead to potentially fatal outcomes, affecting organ systems already taxed beyond normal limits. This case is designed for use in a human biology course after students have learned about the integumentary, respiratory, cardiovascular, neuromuscular, and urinary systems.