Of Medicine and Mushrooms http://nyti.ms/ZeeXSA from NEW YORK TIMES
我是被這文章的標題吸引進來的，霉菌能教我們醫師們什麼？
Defining mushrooms from Encyclopedia of Life
All mushrooms are fungi, but not all fungi are mushrooms.
作者這位年輕的住院醫師說到一天在醫院的停車場附近樹叢，看到一堆野生的mushrooms，被它們的美麗外觀所吸引，從不了解它們，認為可能吃一小口就可能產生fulminant liver failure（醫學院教的）或是有些品種就是可以吃的 (edible)，逐漸找書來看、上網學習。
在幾個月的學習後，他有一次就挖下了一些他認為可以吃的mushrooms，把它們煮來吃，後來也是沒事，他的信心愈來愈大了。逐漸能辨識的品種愈來愈多。作者說，這學習mushrooms，就像學習人的疾病一樣，從醫學生紙上談兵，到後來實戰經驗在住院病人上學習，做疾病的鑑別診斷。
作者說到他有一次急診值班，一位18個月的嬰兒因為發燒來掛急診，媽媽說，應該是感冒吧，但是作者用觀察mushrooms一樣，仔細看嬰兒，發現有呼吸窘迫，鼻翼凹陷、胸膛肋骨上的肌肉也凹陷，他覺得這不是感冒，經過檢查後，是嚴重肺炎，就送到ICU治療了。
But when I approached the infant to examine him more closely, I noted his nostrils flaring and the muscles between his ribs contracting into subtle channels across his chest with each inhalation. He was working hard to breathe.
Each medical case, like each mushroom, is a diagnostic puzzle.
當醫師診斷疾病，要看氣候，地區，而會有不同的疾病流行。當一個野外食物專家，也要從當地的氣候，地區，雨量，以及周圍的植物型態來知道附近會有什麼mushrooms（兩者區別的過程真的有點相同）。
LEARNING to diagnose diseases or identify mushrooms also means learning ecology. Just as an experienced forager knows which mushrooms to expect based on region, climate, season and recent rainfall patterns, the sort of tree overhead and forest duff underfoot, a physician understands that diseases have an ecological context of season and geography. Doctors expect Lyme disease in the summer and influenza in the winter, and, as with foraging, knowing what to look for helps us to see it. A fruity whiff in the forest tells of nearby black trumpet mushrooms, which are often smelled before they are seen, just as the slight movements of a child’s nostrils tell of more serious problems hidden inside the lungs.
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Jonathan Reisman is an internist and pediatrician at Massachusetts General Hospital, and the president of the World Health and Education Network.
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