This case is based on a number of real life scenarios, but it has been modified to suit the students’ linguistic proficiency. A number of factual details have been left out, such as the success rate of kidney transplantation and John's slim probability of death in hospital. Also, difficult vocabulary (kidney dialysis machine) and complex grammatical structures have been removed or replaced. As long as the gist of the story remains, the teacher can modify the case at will, omitting details or even adding complications.