TED2003
Sherwin Nuland: How electroshock therapy changed me
Sherwin Nuland: Kako su me elektrošok terapije promijenile
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Kirurg i pisac Sherwin Nuland govori o razvoju elektrošok terapije kao lijeku za tešku, po život opasnu depresiju -- uključujući i njegovu vlastitu. Ovo je motivirajući i iskren govor o oslobođenju, iskupljenju i drugim prilikama.
Sherwin Nuland - Doctor
A practicing surgeon for three decades, Sherwin Nuland witnessed life and death in every variety. Then he turned to writing, exploring what there is to people beyond just anatomy. Full bio
A practicing surgeon for three decades, Sherwin Nuland witnessed life and death in every variety. Then he turned to writing, exploring what there is to people beyond just anatomy. Full bio
Double-click the English transcript below to play the video.
00:26
I'd like to do pretty much what I did the first time,
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Volio bih učiniti otprilike isto što sam učinio i prvi put,
00:28
which is to choose a light-hearted theme.
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što je bilo izabrati laganu temu.
00:31
Last time, I talked about death and dying.
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Prošli put, govorio sam o smrti i umiranju.
00:34
This time, I'm going to talk about mental illness.
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Ovaj put, govorit ću o psihičkim bolestima.
00:39
But it has to be technological,
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Ali mora biti tehnološko,
00:40
so I'll talk about electroshock therapy. (Laughter)
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tako da ću pričati o terapiji elektrošokovima. (Smijeh)
00:45
You know, ever since man had any notion
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Znate, otkad je čovjek primjetio
00:48
that some of his other people, his colleagues,
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da bi neki od njegovih ljudi, njegovih kolega,
00:52
could be different, could be strange, could be severely depressed
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mogli biti drugačiji, mogli biti čudni, mogli biti strašno depresivni
00:56
or what we now recognize as schizophrenia,
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ili imati ono što danas prepoznajemo kao shizofreniju,
01:00
he was certain that this kind of illness
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bio je siguran da su ovakve vrste bolesti
01:03
had to come from evil spirits getting into the body.
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morale doći od zlih duhova koji su ušli u tijelo.
01:06
So, the way of treating these diseases
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Tako da je način liječenja ovakvih bolesti
01:08
in early times was to, in some way or other,
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u ranim vremenima bio, na jedan način ili drugi,
01:11
exorcise those evil spirits, and this is still going on, as you know.
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istjerivanje tih zlih duhova, a to se još nastavlja, kao što znate.
01:16
But it wasn't enough to use the priests.
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Ali nije bilo dovoljno koristiti svećenike.
01:18
When medicine became somewhat scientific, in about 450 BC,
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Kada je medicina postala donekle znanstvena, otprilike 450 g. pr. Kr.,
01:23
with Hippocrates and those boys,
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sa Hipokratom i ostalim dečkima,
01:25
they tried to look for herbs, plants
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pokušali su potražiti bilje, biljke
01:29
that would literally shake the bad spirits out.
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koje bi doslovno istresle van zle duhove.
01:32
So, they found certain plants that could cause convulsions.
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Tako su pronašli određene biljke koje bi mogle uzrokovati grčeve.
01:35
And the herbals, the botanical books of up to the late Middle Ages,
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I knjige botanike do kasnog srednjeg vijeka,
01:41
the Renaissance are filled with prescriptions
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renesanse pune su recepata
01:45
for causing convulsions to shake the evil spirits out.
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za uzrokovanje grčeva koji će istresti zle duhove.
01:50
Finally, in about the sixteenth century,
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Konačno u otprilike šesnaestom stoljeću,
01:54
a physician whose name was Theophrastus Bombastus Aureolus von Hohenheim,
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liječnik čije je ime bilo Theophrastus Bombastus Aureolus von Hohenheim,
02:00
called Paracelsus, a name probably familiar to some people here --
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zvan Paracelsus, ime vjerojatno poznato nekim ljudima ovdje –
02:04
(Laughter) -- good, old Paracelsus
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(Smijeh)—dobri stari Paracelsus
02:09
found that he could predict the degree of convulsion
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otkrio je da može predvidjeti stupanj grčenja
02:13
by using a measured amount of camphor to produce the convulsion.
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korištenjem izmjerene količine kamfora za uzrokovanje grčeva.
02:17
Can you imagine going to your closet, pulling out a mothball, and
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Možete li zamisliti da odlazite u svoj ormar, uzimate kuglice protiv moljaca,
02:20
chewing on it if you're feeling depressed?
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i žvačete ih ako se osjećate depresivno?
02:23
It's better than Prozac, but I wouldn't recommend it.
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Bolje je od Prozaca, ali ne bih vam to preporučio.
02:26
So what we see in the seventeenth, eighteenth century
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Ono što vidimo u sedamnaestom, osamnaestom stoljeću jest
02:29
is the continued search for medications other than camphor that'll do the trick.
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neprestana potraga za lijekovima osim kamfora koji će postići taj cilj.
02:34
Well, along comes Benjamin Franklin,
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Zatim dolazi Benjamin Franklin,
02:36
and he comes close to convulsing himself
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koji i sam dolazi blizu grčeva
02:38
with a bolt of electricity off the end of his kite.
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zbog groma na drugom kraju uzice njegovgo zmaja.
02:42
And so people begin thinking in terms of electricity to produce convulsions.
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I tako su ljudi počeli koristiti elekricitet za uzrokovanje grčeva.
02:47
And then, we fast-forward to about 1932,
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Zatim ubrzavamo do otprilike 1932.,
02:51
when three Italian psychiatrists, who were largely treating depression,
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kada trojica talijanskih psihijatara, koji su većinom liječili depresiju,
02:57
began to notice among their patients, who were also epileptics,
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primjećuju da kod njihovih pacijenata, koji su također i epileptičari,
03:00
that if they had an epileptic -- a series of epileptic fits,
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ako imaju epilepsiju – seriju epileptičnih napadaja,
03:03
a lot of them in a row -- the depression would very frequently lift.
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puno njih zaredom – depresija bi vrlo često nestala.
03:07
Not only would it lift, but it might never return.
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Ne samo da bi nestala, nego se možda ne bi ni vratila.
03:11
So they got very interested in producing convulsions,
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Tako da su se jako zainteresirali za uzrokovanje grčenja,
03:16
measured types of convulsions.
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izmjerenih vrsta grčeva.
03:18
And they thought, "Well, we've got electricity, we'll plug somebody into the wall.
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I mislili su, „Imamo elektricitet, uključit ćemo nekoga u struju.
03:21
That always makes hair stand up and people shake a lot."
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To uvijek podiže kosu i ljudi se puno tresu.“
03:24
So, they tried it on a few pigs, and none of the pigs were killed.
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Pokušali su to na nekoliko svinja i nijedna svinja nije ubijena.
03:28
So, they went to the police and they said,
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Potom su otišli u policiju i rekli:
03:30
"We know that at the Rome railroad station,
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„Znamo da na rimskoj željezničkoj stanici,
03:33
there are all these lost souls wandering around,
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postoje sve te izgubljene duše koje lutaju uokolo,
03:35
muttering gibberish. Can you bring one of them to us?"
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mrmljaju besmislice. Možete li nam dovesti jednoga od njih?“
03:39
Someone who is, as the Italians say, "cagoots."
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Nekoga tko je, kako Talijani kažu, „lud kao bundeva".
03:42
So they found this "cagoots" guy,
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Tako da su pronašli tog „ludog kao bundeva“ tipa,
03:44
a 39-year-old man who was really hopelessly schizophrenic,
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39-godišnjeg čovjeka koji je doista bio beznadan šizofreničar,
03:47
who was known, had been known for months,
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poznat da mjesecima
03:50
to be literally defecating on himself,
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doslovno prazni crijeva po sebi,
03:54
talking nothing that made any sense,
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da priča besmislice,
03:56
and they brought him into the hospital.
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i odveli su ga u bolnicu.
03:58
So these three psychiatrists, after about two or three weeks of observation,
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Tako su ga ta tri psihijatra, nakon otprilike dva ili tri tjedna promatranja,
04:02
laid him down on a table,
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polegli na stol
04:04
connected his temples to a very small source of current.
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i spojili njegove sljepoočnice na sasvim mali izvor struje.
04:09
They thought, "Well, we'll try 55 volts, two-tenths of a second.
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Mislili su: „Pokušat ćemo s 55 volti, dvije desetine sekunde.
04:13
That's not going to do anything terrible to him."
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To čovjeku neće napraviti ništa strašno."
04:16
So they did that.
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Učinili su to.
04:17
Well, I have the following from a firsthand observer,
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Ovo što ću vam reći doznao sam od promatrača iz prve ruke,
04:21
who told me this about 35 years ago,
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koji mi je to ispričao prije 35 godina,
04:24
when I was thinking about these things
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kada sam razmišljao o ovim stvarima
04:26
for some research project of mine.
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za jedan moj istraživački projekt.
04:29
He said, "This fellow" -- remember, he wasn't even put to sleep --
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Rekao mi je, „Ovaj momak“ – zapamtite, nije bio čak ni uspavan –
04:33
"after this major grand mal convulsion,
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„nakon ovog velikog grčenja,
04:35
sat right up, looked at these three fellas and said,
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sjeo je, pogledao te momke i rekao,
04:38
'What the fuck are you assholes trying to do?' "
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'Koji vrag vi gadovi pokušavate napraviti?'"
04:42
(Laughter)
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(Smijeh)
04:50
If I could only say that in Italian.
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Kad bih barem to mogao reći na talijanskom.
04:53
Well, they were happy as could be, because he
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Oni su bili jako sretni, jer nije izgovorio jednu smislenu riječ
04:56
hadn't said a rational word in the weeks of observation.
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tijekom tjedana promatranja.
05:00
So they plugged him in again,
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Tako da su ga ponovno uštekali,
05:05
and this time they used 110 volts for half a second.
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i ovaj put su koristili 110 volti po pola sekunde.
05:09
And to their amazement, after it was over,
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I na njihovo oduševljenje, nakon što je završilo,
05:12
he began speaking like he was perfectly well.
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počeo je pričati kao da je bio savršeno zdrav.
05:15
He relapsed a little bit, they gave him a series of treatments,
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Malo je povraćao, dali su mu seriju tretmana,
05:18
and he was essentially cured.
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i bio je u biti izliječen.
05:19
But of course, having schizophrenia,
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Ali naravno, jer je imao šizofreniju,
05:22
within a few months, it returned.
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nakon par mjeseci, ona se vratila.
05:24
But they wrote a paper about this,
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Međutim, napisali su o tome rad
05:26
and everybody in the Western world began using electricity
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i svi su u Zapadnom svijetu počeli koristiti elektricitet
05:31
to convulse people who were either schizophrenic or severely depressed.
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da potresu ljude koji su ili šizofreničari ili jako depresivni.
05:35
It didn't work very well on the schizophrenics,
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Nije imalo preveliko djelovanje na šizofreničare,
05:37
but it was pretty clear in the '30s and by the middle of the '40s
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ali je bilo prilično jasno u tridesetima i do sredine četrdesetih
05:40
that electroconvulsive therapy was very, very effective
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da je elektrošok terapija vrlo, vrlo učinkovita
05:46
in the treatment of depression.
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u liječenju depresije.
05:48
And of course, in those days, there were no antidepressant drugs,
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A naravno u tim danima nisu postojali antidepresivi,
05:51
and it became very, very popular.
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stoga je postala vrlo, vrlo popularna.
05:54
They would anesthetize people,
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Anestezirali bi ljude
05:56
convulse them, but the real difficulty was
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i potresli ih, ali stvarna poteškoća bila je
05:59
that there was no way to paralyze muscles.
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u tome da nije postojao način da se paraliziraju mišići.
06:01
So people would have a real grand mal seizure.
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Tako da bi ljudi imali veliki napadaj.
06:04
Bones were broken. Especially in old, fragile people,
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Kosti bi se lomile. Osobito u starih, lomljivih ljudi,
06:07
you couldn't use it.
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metoda se nije mogla koristiti.
06:09
And then in the 1950s, late 1950s, the so-called muscle relaxants
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Zatim su u 1950-ima, kasnim 1950-ima, farmakolozi proizveli
06:14
were developed by pharmacologists,
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takozvane mišićne relaksante,
06:16
and it got so that you could induce a complete convulsion,
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i došlo je do toga da se moglo inducirati potpuno grčenje,
06:20
an electroencephalographic convulsion -- you could see it on the brain waves --
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elektroenefalografičnu grčenje – moglo ga se vidjeti u moždanim valovima –
06:23
without causing any convulsion in the body except a little bit of twitching of the toes.
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bez uzrokovanja grčeva u tijelu osim malih trzaja u nožnim prstima.
06:28
So again, it was very, very popular and very, very useful.
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Tako da je metoda ponovno bila vrlo, vrlo popularna i vrlo, vrlo korisna.
06:34
Well, you know, in the middle '60s,
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Dakle, kao što znate, u ranim 60-ima
06:36
the first antidepressants came out. Tofranil was the first.
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izašli su prvi antidepresivi. Tofranil je bio prvi.
06:40
In the late '70s, early '80s, there were others,
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U kasnim 70-ima, ranim 80-ima, postojali su ostali
06:44
and they were very effective.
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i bili su vrlo učinkoviti.
06:45
And patients' rights groups seemed to get very upset
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I grupe za prava pacijenata činile su se uznemirenima
06:48
about the kinds of things that they would witness.
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kakvim stvarima su svjedočili.
06:51
And so the whole idea of electroconvulsive, electroshock therapy disappeared,
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I tako je cijela ideja elektrokonvulzivne, elektrošok terapije nestala,
06:57
but has had a renaissance in the last 10 years.
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ali je doživjela svoj preporod u zadnjih 10 godina.
07:01
And the reason that it has had a renaissance
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I razlog zašto je doživjela preporod jest taj
07:04
is that probably about 10 percent of the people, severe depressives,
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da je vjerojatno oko 10 posto ljudi, jako depresivnih,
07:10
do not respond, regardless of what is done for them.
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nije reagiralo, bez obzira što se je učinilo.
07:15
Now, why am I telling you this story at this meeting?
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A sad, zašto vam pričam ovu priču na ovom sastanku?
07:19
I'm telling you this story, because actually ever since
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Pričam vam ovu priču zato što zapravo još otkad
07:22
Richard called me and asked me to talk about
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me je Richard nazvao i zamolio da pričam o ovome
07:24
-- as he asked all of his speakers --
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-- kako je pitao sve svoje govornike --
07:26
to talk about something that would be new to this audience,
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da pričam o nečemu što će biti novo publici,
07:29
that we had never talked about, never written about,
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o čemu nikada nismo pričali, nikad nismo pisali,
07:32
I've been planning this moment.
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planirao sam ovaj trenutak.
07:35
This reason really is that I am a man who, almost 30 years ago,
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Taj razlog je zapravo to što sam ja čovjek kojemu je,prije skoro 30 godina,
07:40
had his life saved by two long courses of electroshock therapy.
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život spašen pomoću dvije dugačke terapije elektrošokovima.
07:48
And let me tell you this story.
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I dopustite mi da vam ispričam ovu priču.
07:52
I was, in the 1960s, in a marriage. To use the word bad
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Bio sam oženjen 1960-ih.
07:58
would be perhaps the understatement of the year.
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Koristiti riječ loše bilo bi podcjenjivanje.
08:01
It was dreadful.
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Bilo je očajno.
08:03
There are, I'm sure, enough divorced people in this room
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Siguran sam, dosta razvedenih ljudi u ovoj sobi
08:06
to know about the hostility, the anger, who knows what.
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poznaje to neprijateljstvo, bijes, tko zna što.
08:12
Being someone who had had a very difficult childhood,
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A kako sam imao jako teško djetinjstvo,
08:17
a very difficult adolescence --
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jako tešku adolescenciju --
08:18
it had to do with not quite poverty but close.
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radi se o ne baš siromaštvu, ali bilo je blisko tome.
08:22
It had to do with being brought up in a family where no one spoke English,
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Radi se o odgajanju u obitelji gdje nitko ne priča engleski,
08:25
no one could read or write English.
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nitko nije mogao čitati ili pisati engleski.
08:27
It had to do with death and disease and lots of other things.
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Radi se o smrti i bolesti i još mnogo drugih stvari.
08:31
I was a little prone to depression.
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Malo sam bio sklon depresiji.
08:33
So, as things got worse, as we really began to hate each other,
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I kako su stvari postajale gore, kako smo se stvarno počinjali mrziti,
08:37
I became progressively depressed over a period of a couple of years,
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postao sam progresivno depresivan u periodu od nekoliko godina,
08:41
trying to save this marriage,
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pokušavajući spasiti taj brak
08:43
which was inevitably not to be saved.
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koji se nije mogao spasiti.
08:47
Finally, I would schedule -- all my major surgical cases,
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Na kraju zakazivao bih -- sve svoje kirurške operacije,
08:53
I was scheduling them for 12, one o'clock in the afternoon,
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zakazivao sam ih u 12, jedan sat poslije podne
08:57
because I couldn't get out of bed before about 11 o'clock.
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zato što se nisam mogao ustati iz kreveta prije otprilike 11 sati.
09:01
And anybody who's been depressed here knows what that's like.
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I svi ovdje koji su bili depresivni znaju kako je to.
09:04
I couldn't even pull the covers off myself.
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Nisam mogao ni pokrivače pomaknuti.
09:08
Well, you're in a university medical center,
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A u sveučilišnom medicinskom centru
09:10
where everybody knows everybody, and it's perfectly clear to my colleagues,
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gdje svi znaju svakoga mojim kolegama sve je postalo kristalno jasno
09:13
so my referrals began to decrease.
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tako da je moj status počeo opadati.
09:15
As my referrals began to decrease,
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Kako mi je dobar glas počeo opadati
09:18
I clearly became increasingly depressed
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očigledno sam postao još više depresivan,
09:22
until I thought, my God, I can't work anymore.
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sve dok nisam pomislio, moj Bože ne mogu više raditi.
09:24
And, in fact, it didn't make any difference
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I zapravo se ništa nije promijenilo
09:26
because I didn't have any patients anymore.
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jer više nisam ni imao pacijente.
09:28
So, with the advice of my physician,
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Tako sam se uz savjet svoga liječnika,
09:32
I had myself admitted to the acute care psychiatric unit of our university hospital.
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prijavio u psihijatrijsku jedinicu akutne brige u našoj sveučilišnoj bolnici.
09:37
And my colleagues, who had known me since medical school
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I moji kolege, koji me poznaju još od medicinske škole
09:40
in that place, said, "Don't worry, chap. Six weeks,
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u tom mjestu, rekli su: „Ne brini, stari. Šest tjedana
09:42
you're back in the operating room. Everything's going to be great."
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i vraćaš se u operacijsku salu. Sve će biti u redu.“
09:46
Well, you know what bovine stercus is?
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Pa znate što je goveđi izmet?
09:50
That proved to be a lot of bovine stercus.
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Ispostavilo se da je to gomila goveđeg izmeta.
09:56
I know some people who got tenure in that place with lies like that.
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Znam ljude koji ostaju za stalno u tom mjestu s istim takvim lažima.
10:01
(Laughter)
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(Smijeh)
10:07
So I was one of their failures.
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Ja sam bio jedan od njihovih promašaja.
10:10
But it wasn't that simple. Because by the time
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Ali nije bilo tako jednostavno.
10:12
I got out of that unit, I was not functional at all.
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Jer kada sam izašao iz jedinice, nisam mogao nikako funkcionirati.
10:17
I could hardly see five feet in front of myself.
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Jedva sam mogao vidjeti pet metara ispred sebe.
10:19
I shuffled when I walked. I was bowed over.
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Šepao sam dok sam hodao. Bio sam pognut.
10:22
I rarely bathed. I sometimes didn't shave. It was dreadful.
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Rijetko sam se kupao. Nekada se nisam brijao. Bio sam grozan.
10:27
And it was clear -- not to me,
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I bilo je jasno -- ne meni
10:30
because nothing was clear to me at that time anymore --
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jer mi ništa nije bilo jasno tada --
10:33
that I would need long-term hospitalization
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da mi treba duža hospitalizacija
10:37
in that awful place called a mental hospital.
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u tom groznom mjestu koje se zove psihijatrijska bolnica.
10:41
So I was admitted, in 1973, in the spring of 1973,
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Primljen sam 1973.godine, u proljeće 1973.,
10:47
to the Institute of Living, which used to be called the Hartford Retreat.
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u Institut življenja koji se prije zvao Hartford Retreat.
10:50
It was founded in the eighteenth century,
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Osnovana je u osamnaestom stoljeću,
10:52
the largest psychiatric hospital in the state of
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najveća psihijatrijska bolnica
10:56
Connecticut, other than the huge public hospitals
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u državi Connecticut, među ostalim velikim bolnicama
10:58
that existed at that time.
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u to vrijeme.
11:01
And they tried everything they had.
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I probali su sve što su imali.
11:02
They tried the usual psychotherapy.
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Probali su uobičajenu psihoterapiju.
11:04
They tried every medication available in those days.
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Iskušali su svaki lijek dostupan tih dana.
11:07
And they did have Tofranil and other things -- Mellaril, who knows what.
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A imali su Tofranil i druge stvari – Mellaril, tko zna što.
11:11
Nothing happened except that I got jaundiced from one of these things.
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Ništa se nije dogodilo osim što sam dobio žuticu od jedne od tih stvari.
11:15
And finally, because I was well known in Connecticut,
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I konačno, kako sam bio dobro poznat u Connecticutu,
11:21
they decided they better have a meeting of the senior staff.
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odlučili su da je bolje da se starije osoblje sastane.
11:25
All the senior staff got together, and I later found out what happened.
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I starije osoblje se sastalo, a ja sam kasnije doznao što se dogodilo.
11:31
They put all their heads together and they decided
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Razmišljali su zajedno i zaključili
11:35
that there was nothing that could be done
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da ne postoji ništa što bi se moglo učini
11:37
for this surgeon who had essentially separated himself from the world,
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za tog kirurga koji se doslovno odvojio od ovog svijeta,
11:41
who by that time had become so overwhelmed,
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koji je s vremenom postao poražen,
11:45
not just with depression and feelings
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ne samo zbog depresije i osjećaja
11:48
of worthlessness and inadequacy,
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bezvrijednosti i neprilagođenosti,
11:50
but with obsessional thinking,
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već i opsesivnim razmišljanjem,
11:53
obsessional thinking about coincidences.
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opsesivnim razmišljanjem o slučajnostima.
11:55
And there were particular numbers that every time I saw them,
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I postojali su određeni brojevi koji bi me, kada bi ih vidio,
11:58
just got me dreadfully upset -- all kinds of ritualistic observances,
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grozno uznemirili -- različiti načini rituala,
12:04
just awful, awful stuff.
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jednostavno grozna, grozna stvar.
12:06
Remember when you were a kid, and you had to step on every line?
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Sjećate se kada ste bili djeca i morali ste stati na svaku liniju?
12:09
Well, I was a grown man who had all of these rituals,
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E ja sam bio odrastao čovjek koji je imao sve te rituale,
12:13
and it got so there was a throbbing, there was a ferocious fear in my head.
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i došlo je do straha, došlo je do ogromnog straha u mojoj glavi.
12:17
You've seen this painting by Edvard Munch,
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Vidjeli ste sliku Edvarda Muncha,
12:19
The Scream. Every moment was a scream.
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Vrisak. Svaki trenutak je bio vrisak.
12:24
It was impossible. So they decided there was no therapy,
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Bilo je nemoguće. Pa su odlučili da nema tretmana,
12:27
there was no treatment. But there was one treatment,
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nema tretmana. Ali postojao je jedan tretman
12:30
which actually had been pioneered at the Hartford hospital in the early 1940s,
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koji se zapravo počeo primjenjivati u Hartfordskoj bolnici u ranim 1940-ima
12:35
and you can imagine what it was. It was pre-frontal lobotomy.
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i možete pretpostaviti što je to bilo. Bila je to prefrontalna lobotomija.
12:43
So they decided -- I didn't know this, again,
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I odlučili su -- nisam to znao, ponavljam,
12:45
I found this out later --
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saznao sam to kasnije --
12:46
that the only thing that could be done was
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da je jedina stvar koja se može učiniti
12:48
for this 43-year-old man to have a pre-frontal
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za ovog 43-godišnjaka prefrontalna
12:52
lobotomy.
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lobotomija.
12:55
Well, as in all hospitals, there was a resident
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Kao u svakoj bolnici, određenom je stažistu
12:58
assigned to my case. He was 27 years old,
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bio dodijeljen moj slučaj. Imao je 27 godina
13:01
and he would meet with me two or three times a week.
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i posjećivao me dva-tri puta tjedno.
13:03
And of course, I had been there, what, three or four months at the time.
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I naravno, ja sam bio tamo, koliko, već tri-četiri mjeseca tada.
13:07
And he asked to meet with the senior staff, and they agreed to meet with him
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Tražio je da se sastane sa starijim osobljem, i složili su se
13:10
because he was very well thought of in that place.
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da se sastanu s njim jer je bio na dobrom glasu u tom mjestu.
13:12
They thought he had a really extraordinary future.
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Mislili su da ima odličnu budućnost.
13:16
And he dug in his heels and said,
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Bio je tvrdoglav i rekao:
13:17
"No. I know this man better than any of you. I have met with him over and over again.
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„Ne. Znam ovog čovjeka bolje od vas. Susreo sam se s njim mnogo puta.
13:21
You've just seen him from time to time. You've read reports and so forth.
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A vi ga vidite s vremena na vrijeme. Pročitali ste izvještaje i slično.
13:25
I really honestly believe that the basic problem here is pure depression,
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Stvarno iskreno vjerujem da je osnovni problem ovdje jednostavno depresija,
13:30
and all of the obsessional thinking comes out of it.
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i sva opsesivna razmišljanja proizlaze iz toga.
13:33
And you know, of course, what'll happen if you do a pre-frontal lobotomy.
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A znate, naravno, što će se dogoditi ako napravite prefrontalnu lobotomiju.
13:36
Any of the results along the spectrum,
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Sav spektar rezultata,
13:40
from pretty bad to terrible, terrible, terrible
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od poprilično lošeg do groznog, groznog,
13:42
is going to happen. If he does the best he can,
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grozno će se dogoditi. Ako rezultati budu dobri,
13:46
he will have no further obsessions,
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neće više imati opsesije, vjerojatno ni depresiju više,
13:48
probably no depression, but his affect will be dulled,
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ali njegov učinak će biti otupljen,
13:51
he will never go back to surgery,
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nikada se neće vratiti operacijama,
13:53
he will never be the loving father that he was to his two children,
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neće nikada biti onakav otac kakav je bio prema svojoj djeci,
13:57
his life will be changed. If he has the usual result,
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njegov život će se promijeniti. Ako rezultati ispadnu normalni,
14:00
he will end up like 'One Flew Over the Cuckoo's Nest.'
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završit će kao „Let iznad kukavičjeg gnijezda.“
14:03
And you know about that, just essentially in a stupor the rest of his life."
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A znate kako to izgleda, jednostavno u mrtvilu do kraja svog života.”
14:08
Well, he said, "Can't we try a course of electroshock therapy?"
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Rekao je: „Zar ne možemo pokušati serijom tretmana elektrošokovima?“
14:14
And you know why they agreed? They agreed to humor him.
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Znate zašto su pristali? Samo da ga umire.
14:17
They just thought, "Well, we'll give a course of 10.
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Mislili su: „Dat ćemo mu seriju od 10
14:21
And so we'll lose a little time. Big deal. It doesn't make any difference."
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i izgubit ćemo malo vremena. Velika stvar. Neće biti nikakve razlike.“
14:25
So they gave the course of 10,
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I dali su mi seriju od 10,
14:26
and the first -- the usual course, incidentally, was six to eight
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a prva -- obična serija, slučajno je bila šest do osam
14:30
and still is six to eight.
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i još uvijek je šest do osam.
14:32
Plugged me into the wires, put me to sleep, gave me the muscle relaxant.
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Uključili su me u žice, uspavali me, uzrokovali opuštanje mišića.
14:36
Six didn't work. Seven didn't work.
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Šest nije uspjelo. Sedam nije uspjelo.
14:38
Eight didn't work. At nine, I noticed --
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Osam nije uspjelo. Na devetom, uočio sam --
14:41
and it's wonderful that I could notice anything
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i to je bilo čudesno da sam mogao primjetiti išta
14:44
-- I noticed a change. And at 10, I noticed a real change.
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-- uočio sam promjenu. I pri deset primijetio sam pravu promjenu.
14:48
And he went back to them, and they agreed to do another 10.
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Otišao je natrag k njima, pristali su na još 10.
14:51
Again, not a single one of them
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Ponovo, nijedan od njih
14:53
-- I think there are about seven or eight of them --
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-- mislim da ih je bilo sedam ili osam --
14:55
thought this would do any good. They thought this was a temporary change.
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nije mislio da će to poboljšati išta. Mislili su da je to bila privremena promjena.
14:57
But, lo and behold, by 16, by 17,
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Ali evo i gle, kod šesnaeste, kod sedamnaeste,
15:01
there were demonstrable differences in the way I felt.
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vidjela se očigledna promjena u načinu kako se osjećam.
15:05
By 18 and 19, I was sleeping through the night.
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Kod osamnaeste i devetnaeste, spavao sam čitavu noć.
15:08
And by 20, I had the sense, I really had the sense
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I kod dvadesete imao sam osjećaj, imao sam stvaran osjećaj
15:12
that I could overcome this,
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da mogu prebroditi ovo,
15:15
that I was now strong enough that by an act of will,
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da sam sada dovoljno jak da mogu samom voljom,
15:18
I could blow the obsessional thinking away.
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mogu maknuti ta opsesivna razmišljanja,
15:20
I could blow the depression away.
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mogu maknuti depresiju.
15:23
And I've never forgotten -- I never will forget
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I nikada nisam zaboravio -- i nikada ni neću
15:26
-- standing in the kitchen of the unit,
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-- stajao sam u kuhinji tog odjela,
15:29
it was a Sunday morning in January of 1974,
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bila je nedjelja ujutro, siječanj 1974.,
15:33
standing in the kitchen by myself and thinking, "I've got the strength now to do this."
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stajao sam u kuhinji sam i razmišljao: „Sada imam snage da učinim ovo.“
15:39
It was as though those tightly coiled wires in my head had been disconnected
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Kao da su se pokvarene žice u mojoj glavi isključile
15:44
and I could think clearly.
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i mogao sam pravilno razmišljati.
15:46
But I need a formula. I need some thing to say to myself
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Ali trebam formulu. Trebam nešto što ću si reći
15:51
when I begin thinking obsessionally, obsessively.
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kada počnem opsesivno razmišljati, opsesivno.
15:55
Well, the Gilbert and Sullivan fans in this room
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Fanovi Gilberta i Sullivana u ovoj sobi
16:00
will remember "Ruddigore," and they will remember Mad Margaret,
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sjetit će se „Ruddigore“ i sjetit će se Mad Margret,
16:03
and they will remember that she was married
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i sjetit će se da je ona bila udana za momka
16:05
to a fellow named Sir Despard Murgatroyd.
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zvanog sir Despard Murgatroyd.
16:09
And she used to go nuts, every five minutes or so in the play,
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A ona bi poludjela otprilike svakih 5 minuta u predstavi,
16:13
and he said to her, "We must have a word to bring you back to reality,
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i on joj je rekao, „Moramo imati neku riječ kojom ćemo te vraćati u stvarnost,
16:16
and the word, my dear, will be 'Basingstoke.'"
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a riječ, draga moja, bit će: 'Basingstoke.'“
16:20
So every time she got a little nuts,
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I svaki put kada bi malo poludjela,
16:22
he would say, "Basingstoke!" And she would say,
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on bi izgovorio riječ: „ Basingstoke!“ a ona bi odgovorila:
16:24
"Basingstoke, it is." And she would be fine for a little while.
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„Da, Basingstoke.“ I bila bi dobro neko vrijeme.
16:28
Well, you know, I'm from the Bronx. I can't say "Basingstoke."
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Znate, ja sam iz Bronxa. Ne mogu reći: „Basingstoke.“
16:32
But I had something better. And it was very simple.
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Ali imao sam nešto bolje. I bilo je dosta jednostavno.
16:36
It was, "Ah, fuck it!"
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Bilo je: „Ah, jebiga.“
16:39
(Laughter) Much better than "Basingstoke,"
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(Smijeh) Mnogo bolje nego „Basingstoke,“
16:44
at least for me. And it worked -- my God, it worked.
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bar za mene. I radilo je -- moj Bože, radilo je.
16:48
Every time I would begin thinking obsessionally --
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Svaki put kada bi opsesivno razmišljao --
16:50
again, once more, after 20 shock treatments
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ponovno, još jednom nakon dvadeset terapija elektrošokom --
16:54
-- I would say, "Ah, fuck it."
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-- rekao bih: „Ah, jebiga.“
16:58
And things got better and better,
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I stvari su postajale bolje i bolje,
17:00
and within three or four months,
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i za tri – četiri mjeseca,
17:03
I was discharged from that hospital, and I joined a group of surgeons
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otpušten sam iz te bolnice, pridružio sam se grupi kirurga
17:06
where I could work with other people in the community,
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gdje mogu raditi s drugim ljudima u zajednici,
17:10
not in New Haven, but fairly close by.
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ne u New Havenu, ali poprilično blizu.
17:13
I stayed there for three years.
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Ostao sam tamo tri godine.
17:15
At the end of three years, I went back to New Haven,
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I nakon tri godine vratio sam se u New Haven,
17:19
had remarried by that time.
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ponovo sam se oženio za to vrijeme.
17:23
I brought my wife with me, actually, to make sure I could get through this.
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Poveo sam svoju ženu sa mnom kako bih bio siguran da to mogu proći.
17:29
My children came back to live with us.
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Moja djeca su došla živjeti s nama.
17:35
We had two more children after that.
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Imali smo još dvoje djece nakon toga.
17:38
Resuscitated the career, even better than it had been before.
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Karijera mi je bila oživljena, čak bolja nego prije.
17:43
Went right back into the university
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Vratio sam se odmah na sveučilište
17:47
and began to write books.
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i počeo pisati knjige.
17:50
Well, you know, it's been a wonderful life.
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Bio je to prekrasan život.
17:53
It's been, as I said, close to 30 years.
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I prošlo je, kako sam rekao, skoro pa 30 godina.
17:57
I stopped doing surgery about six years ago
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Prestao sam operirati prije šest godina
18:00
and became a full-time writer, as many people know.
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i sada pišem puno radno vrijeme, kao što mnogi znaju.
18:04
But it's been very exciting. It's been very happy.
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Jako mi je je zanimljivo. Sretan sam.
18:07
Every once in a while, I have to say, "Ah, fuck it."
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Ponekad moram reći „Ah, jebiga.“
18:09
Every once in a while, I get somewhat depressed and a little obsessional.
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Ponekad postanem malo depresivan i malo opsesivan.
18:12
So, I'm not free of all of this. But it's worked. It's always worked.
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Nisam oslobođen svega toga. Ali funkcionira. Uvijek je funkcioniralo.
18:22
Why have I chosen, after never, ever talking about this, to talk about it now?
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Zašto sam odabrao,a nikada nikada nisam govorio o tome, sada govoriti?
18:30
Well, those of you who know some of these books
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Pa, oni koji znaju neke od mojih knjiga
18:33
know that one is about death and dying,
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znaju da je jedna o smrti i umiranju,
18:36
one is about the human body and the human spirit,
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jedna je o ljudskom tijelu i ljudskom duhu,
18:38
one is about the way mystical thoughts are constantly in our minds,
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jedna je o načinu na koju su mistične misli neprestano u našim umovima,
18:43
and they have always to do with my own personal experiences.
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i uvijek su povezane s našim osobnim doživljajem.
18:48
One might think reading these books
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Netko može pomisliti čitajući ove knjige
18:51
-- and I've gotten thousands of letters about them
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-- a dobio sam tisuće pisama o njima
18:54
by people who do think this --
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od ljudi koji to misle --
18:56
that based on my life's history as I've portrayed in the books,
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s obzirom na vlastitu životnu povijest koju sam prikazao u knjigama,
18:59
my early life's history, I am someone who has overcome adversity.
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povijest mog ranijeg života - da sam ja netko tko je nadišao probleme.
19:04
That I am someone who has drunk, drank, drunk
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Da sam netko tko je pio, pio i popio
19:09
of the bitter dregs of near-disaster in childhood
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gorke ostatke bliske katastrofe u djetinjstvu
19:16
and emerged not just unscathed but strengthened.
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i izašao iz toga ne samo neozlijeđen već i ojačan.
19:21
I really have it figured out, so that I can advise people about
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Da sam nekako sve shvatio, kako bih mogao savjetovati ljude o
19:24
death and dying, so that I can talk about mysticism and the human spirit.
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smrti i umiranju, kako bih mogao pričati o misticizmu i ljudskom duhu.
19:29
And I've always felt guilty about that.
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I uvijek sam se osjećao krivim zbog toga,
19:31
I've always felt that somehow I was an impostor
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uvijek sam osjećao da sam nekako prevarant
19:34
because my readers don't know what I have just told you.
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jer moji čitatelji ne znaju ovo što sam sada vama rekao.
19:39
It's known by some people in New Haven, obviously,
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Za to znaju neki ljudi u New Havenu, očigledno,
19:42
but it is not generally known.
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ali to nije općenito poznato.
19:44
So one of the reasons that I have come here to talk about this today
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Jedan od razloga zašto sam došao ovdje
19:49
is to -- frankly, selfishly --
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kako bih ispričao ovo danas jest kako bih -- iskreno, sebično --
19:54
unburden myself and let it be known
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lišio se tereta i dao na znanje
19:57
that this is not an untroubled mind that has written all of these books.
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da nije um bez problema koji je napisao sve te knjige.
20:03
But more importantly, I think,
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Još važnije, mislim,
20:06
is the fact that a very significant proportion
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jest činjenica da je određen dio vas
20:08
of people in this audience are under 30,
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u ovoj publici mlađi od 30 godina,
20:12
and there are many, of course, who are well over 30.
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naravno, tu su i oni koji su stariji od 30 godina.
20:18
For people under 30, and it looks to me like almost all of you
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Za ljude mlađe od 30, i čini mi se za skoro sve vas
20:21
-- I would say all of you --
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-- rekao bih svi vi --
20:22
are either on the cusp of a magnificent and exciting career
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ili ste na početku velike i zanimljive karijere
20:27
or right into a magnificent and exciting career:
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ili ste trenutno u velikoj i zanimljivoj karijeri:
20:31
anything can happen to you. Things change.
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svašta vam se može dogoditi. Stvari se mijenjaju.
20:35
Accidents happen. Something from childhood comes back to haunt you.
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Nesreće se događaju. Nešto iz djetinjstva se vrati i progoni vas.
20:39
You can be thrown off the track.
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Možete biti zbačeni s puta.
20:41
I hope it happens to none of you,
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Nadam se da se to neće dogoditi nijednome od vas,
20:42
but it will probably happen to a small percentage of you.
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ali dogodit će se malom broju vas.
20:47
To those to whom it doesn't happen, there will be adversities.
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Onima kojima se to ne dogodi, bit će nevolja.
20:52
If I, with the bleakness of spirit,
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Ako sam ja, s oslabljenim duhom,
20:56
with no spirit, that I had in the 1970s
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bez duha kakav sam bio u 1970-ima,
21:01
and no possibility of recovery,
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bez mogućnosti oporavka,
21:03
as far as that group of very experienced psychiatrists thought,
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bar je grupa jako iskusnih psihijatara tako mislila,
21:07
if I can find my way back from this,
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ako sam se ja mogao vratiti iz toga,
21:09
believe me, anybody can find their way back
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vjerujte mi, svatko može pronaći izlazak
21:13
from any adversity that exists in their lives.
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iz bilo kojeg problema koji postoji u njihovom životu.
21:18
And for those who are older, who have lived through
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A za one koji su stariji, koji su preživjeli
21:19
perhaps not something as bad as this,
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možda nešto ne tako loše kao što je ovo,
21:22
but who have lived through difficult times,
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ali koji su proživjeli teška vremena,
21:25
perhaps where they lost everything, as I did,
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možda su izgubili sve, kao ja,
21:27
and started out all over again, some of these things will seem very familiar.
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i počeli od početka, neke od ovih stvari bit će im poznate.
21:34
There is recovery.
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Postoji oporavak.
21:39
There is redemption. And there is resurrection.
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Postoji iskupljenje. Postoji uskrsnuće.
21:47
There are resurrection themes in every society that has ever been studied,
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Postoje teme uskrsnuća u svakome društvu koje je bilo istraživano
21:51
and it is because not just only do we fantasize
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i ne samo zato što maštamo
21:54
about the possibility of resurrection and recovery,
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o mogućnosti uskrsnuća i oporavka
21:57
but it actually happens. And it happens a lot.
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već se to stvarno događa. I događa se često.
22:01
Perhaps the most popular resurrection theme,
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Vjerojatno je najpoznatiji motiv uskrsnuća,
22:05
outside of specifically religious ones,
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izvan onih posebno religioznih,
22:08
is the one about the phoenix, the ancient story of the phoenix,
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onaj o feniksu, drevna priča o feniksu
22:12
who, every 500 years, resurrects itself from its own ashes
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koji svakih 500 godina uskrsne iz svog pepela
22:19
to go on to live a life that is
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kako bi nastavio živjeti život koji je
22:22
even more beautiful than it was before. Richard,
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čak i ljepši od prijašnjega. Richarde,
22:25
thanks very much.
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hvala vam puno.
ABOUT THE SPEAKER
Sherwin Nuland - DoctorA practicing surgeon for three decades, Sherwin Nuland witnessed life and death in every variety. Then he turned to writing, exploring what there is to people beyond just anatomy.
Why you should listen
Sherwin Nuland was a practicing surgeon for 30 years and treated more than 10,000 patients -- then became an author and speaker on topics no smaller than life and death, our minds, our morality, aging and the human spirit.
His 1994 book How We Die: Reflections of Life's Final Chapter demythologizes the process of dying. Through stories of real patients and his own family, he examines the seven most common causes of death: old age, cancer, AIDS, Alzheimer's, accidents, heart disease and stroke, and their effects. The book, one of more than a dozen he wrote, won the National Book Award, was a finalist for the Pultizer Prize, and spent 34 weeks on the New York Times best-seller list. Other books include How We Live, The Art of Aging: A Doctor's Prescription for Well-Being; and The Soul of Medicine: Tales from the Bedside.
Sherwin Nuland | Speaker | TED.com