Close call 失之毫厘，差以千厘

It is not easy to be a medical doctor; worse if one is a specialist.

As my other colleague said, s specialist is the last bastion for a patient with medical problem. If the diagnosis is missed, the suffering can be catastrophic sometimes.

I had a patient recently. I thought she had immune encephalitis initially. But by a stroke of luck, I happened to add a lab test to screen for remote possibility of MELAS, a neurometabolic/genetic disorder -> and it turned out to  positive. Further investigations point towards MELAS. 

Treatment for immune encephalitis and MELAS is different all together; worse of all, the latter is a neurodegenerative disease, shorten lifespan...

最近有位患者因为脑部疾病入院治疗。起初我以为是免疫性的脑炎，不过因为这是患者的第二次发病，我在检验时，额外检验患者的乳酸指数；结果误打误撞的发现她的乳酸指数蛮高的。后续的检验都指向线粒体疾病的可能性。最终，患者被转移去公立医院继续就医。

回想起来，如果我没有检验患者的乳酸指数，那便不可能诊断出线粒体病症，治疗方针便是个错位，无法对症下药。

有时医者的职责很大，容不得丝毫的疏忽。