A 55-year-old gravida 3, para 3, perimenopausal female presents with complaints of pelvic pressure, abnormal uterine bleeding, and urinary frequency. Her evaluation reveals uterine fibroids. A trial of hormonal treatment with iron supplementation failed to resolve her symptoms and the patient desires definitive treatment. A hysterectomy is planned. Her medical history is significant for chronic obstructive pulmonary disease (COPD) and a 25 pack-year history of cigarette smoking. Her surgical history included cholecystectomy and bilateral tubal ligation. Her medications include a long-acting muscarinic antagonist inhaler, norethindrone 5 mg daily, and oral iron supplement. She has no shortness of breath at rest, but reports a chronic cough and difficulty walking up more than one flight of stairs. She has no chest pain with activity and no family history of cardiovascular disease.

Statistics relating to troop mortality in the British Empire had been collected systematically from 1816, but the first serious analysis came in the late 1830s. Alexander Tulloch investigated the causes of sickness and mortality among soldiers, specifically concentrating on establishing the relationship between race and mortality. The reports of West India Regiment surgeons provided him with the largest and most comprehensive data available for any people of African descent. Although it was readily apparent that black soldiers generally had lower sickness and mortality rates than white troops in the West Indies, in Tulloch’s opinion the mortality of black troops should have been even lower. If the black soldier was naturally suited to a West Indian climate, then mortality should be closer to that of Africans in Africa or Europeans in Europe. They fact that it was higher meant, according to Tulloch, that Africans were unsuited to life beyond Africa. The importance of Tulloch’s publications on military mortality was that they appeared just as public interest in statistics exploded, and his research was circulated widely in military and medical publications, helping to shape ideas about black bodies far beyond military circles.