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The clinical case report is a literary tool that enables clinicians to depict and think medically about a sick person's situation. Composed for the most part as chronologies set out as observations, case reports are marked by various forms of literalism contrasted with more expressive forms of writing. In this way, they adopt literary framings and dramatic devices to help to convey the patient's overall situation and the physician's reaction to it. Encoding the clinically essential for the purposes of record, demonstration, and communication, the shape and emphases of case reports today build on, and contribute to, a long train of developments in medical theory, practice, and case description. My aim in this essay is not to suggest a single unbroken continuity between past and present case reports, but rather to explore the variety of textual representations deployed in their composition and to suggest that the plurality of past forms licenses renewed experimentation in the writing of clinical case reports today.