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A few days later, when Hassen returned to the hospital for his next shift, he wondered what had happened to the man with the weakened legs. He saw that his potassium had come back to a normal level and that he had been discharged. These days, financial pressures push doctors caring for hospitalized patients to narrow their focus to identifying life-threatening conditions and addressing those enough to stabilize the patient. Patients are then sent back to their primary-care doctors to determine the hows and whys behind the conditions that sent them to the hospital in the first place. Hassen accepted this reality, and yet to him the real pleasure of medicine wasn't just identifying and addressing the serious symptoms but figuring out the cause behind the cause of the symptom. This man's weakness was caused by low potassium. But what made his potassium low?
几天后，哈森回到医院准备下一次值班时，他想知道那名腿部虚弱的男子现在情况如何。他看到他体内的钾含量已恢复到正常水平，目前已经出院。如今，经济压力迫使看护住院病人的医生将重点缩小到识别危及生命的状况，并解决足以稳定病人的问题。之后，病人被送回自已的初级保健医生那里，以确定最初送他们去医院的情况背后的原因和方式。哈森接受了这个现实，然而对他来说，医学的真正乐趣不只是识别和解决严重的症状，而是找出症状背后的原因。这名男子的虚弱由体内钾含量低引起。但为何他的钾含量会低呢？
A Striking Resemblance
惊人的相似
Hassen reviewed the notes from the patient's overnight stay. In the emergency department, he had been weak, his heart racing, his blood pressure high and his potassium low. When electrolytes were repleted, his strength returned and his blood pressure dropped. But his heart continued to race. Heart rates are often high in the E.R.: Patients are scared and sometimes sick, often in pain. But this man's heart rate stayed high even as everything else got better. That struck Hassen as strange.
哈森回顾了病人住院那晚的记录。他在急诊室时一直很虚弱，他心跳加速，血压高而且钾含量低。补充电解质后，他的体力恢复，血压下降。但他的心跳仍在加快。患者在急诊室时心率都会很高：因为病人感到害怕，有时会恶心，而且通常处于痛苦中。但这个人的心率一直很高，即使其他情况都有所好转。这让哈森觉得很奇怪。
And so Hassen turned to the internet. He eventually found a case report that bore a striking resemblance to his patient: a young man with weak legs, low potassium and a high heart rate. That patient turned out to have something Hassen had never heard of: thyrotoxic periodic paralysis, muscle weakness where the low potassium was being caused by an excess of thyroid hormone.
于是哈森开始在互联网搜索。他最终发现了一个与其病人惊人相似的病例报告：一名年轻人，双腿无力，钾含量低，心率高。那名病人患有哈森从未听说过的疾病：甲状腺毒性周期性麻痹，症状为肌肉无力，而钾含量低由甲状腺激素过量所引起。
译文由可可原创，仅供学习交流使用，未经许可请勿转载。
