评论
打印
The skin is the human body's largest organ and one of the most powerful predictors of our health.
皮肤是人身体上面积最大的器官，并且是人类最强大的健康晴雨表之一。
This is erythema migrans, a hallmark feature of Lyme disease, a tick-borne illness present in over 80 countries and estimated to affect 476,000 people in the United States each year.
这是游走性红斑，莱姆病的标志性特征，是一种出现在80多个国家的蜱传播疾病，并且预计每年会影响美国的十四万六千人。
Dermatologists like me are doctors of the skin trained to diagnose and treat skin disease.
像我一样的皮肤科医生接受培训去进行诊断和治疗皮肤病。
And this is how we're trained to see erythema migrans, as a bullseye-shaped rash that ranges from red to pink.
这是我们被训练如何判断游走性红斑的，就像是牛眼形状的粉色到红色的皮疹。
But this is not at all what it looks like in dark skin.
但在深色的皮肤上，完全不是这个样子。
As you can see here, there are hues of violet, of magenta, and even dark brown.
就像你能看到的一样，它是很多种深浅不一的紫罗兰色，洋红色，甚至是深棕色。
If we were to rely only on dermatology textbooks to teach us how to identify skin disease, we would frequently misdiagnose it in patients of color.
如果我们只依赖皮肤科的教科书来教我们如何识别皮肤疾病，我们就会经常对有色人种患者诊断失误。
And this is a huge problem because Lyme disease needs to be treated.
因为莱姆病需要被治疗，这便成了一个大问题。
Left untreated, Lyme disease has significant health ramifications including arthritis and even nerve damage.
如果不去治疗，莱姆病将对身体健康产生巨大影响，包括关节炎，甚至是神经损伤。
And what's more, as we've seen an increase in the incidence of Lyme disease, a phenomenon attributed in part to climate change,
另外，我们可以看到莱姆病传播增长地非常快，这个现象部分归因于气候变化，
as we continue to see and experience the effects of climate change, we may see more people infected with Lyme disease, making it even more important that we're able to accurately diagnose it.
因为我们持续目睹和经历气候变化所造成的影响，我们可能会看到更多人感染莱姆病，让我们能够准确诊断它变得更加重要。
Now, this story of erythema migrans is emblematic of a larger issue.
现在，游走性红斑的故事其实是象征另一个更大问题的缩影。
In the United States, 47 percent of graduating dermatology residents report feeling uncomfortable diagnosing skin disease in patients with dark skin.
在美国47%即将毕业的皮肤科住院医师称，当他们为深肤色患者诊断皮肤疾病时感觉不自在。
47 percent. I just want that to sink in for a second.
47%，我想让我们为此沉思一下。
This is a staggering statistic, and this means that the people who have just undergone their most intensive training to become doctors of the skin don't feel comfortable diagnosing and treating all patients.
这是一个令人震惊的数据，这意味着那些才刚刚受了大量培训，最终成为皮肤科医生的人们在诊断和治疗病人时，并不完全适应。
And even so, they graduate from residency, and they're eligible to become board-certified dermatologists, qualified to care for all people.
即使这样，他们通过住院医师实习期，也有资格成为通过认证的皮肤科执业医师，被准许去治疗所有人。
Now, I wonder, could this be why we still see and experience health care disparities in all aspects of medicine, including dermatology?
现在我很想知道，这是不是我们为什么仍在医学领域各个方面看到、经历到卫生保健差异的原因，其中包括皮肤科？
I believe there's a connection between the fact that almost half of dermatology residents feel uncomfortable diagnosing and treating certain patients and the poorer health outcomes of those same patients.
我相信与下列事实有关：近一半的皮肤科住院医师对诊断和治疗特定群体的病人感到不自在，而且这一群体的病人通常健康预后较差。
