TED2003
Sherwin Nuland: How electroshock therapy changed me
Šervin Nuland (Sherwin Nuland) o terapiji elektrošokovima
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Hirurg i pisac Šervin Nuland razmatra razvoj terapije elektrošokovima kao leku za tešku, po život opasnu depresiju - uključujući i svoju sopstvenu. Ovo je dirljiv i iskren govor o oslobađanju, iskupljivanju i drugoj šansi.
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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Želeo bih da uradim isto što i prvi put,
00:28
which is to choose a light-hearted theme.
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a to je da izaberem neku vedru temu.
00:31
Last time, I talked about death and dying.
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Prošli put sam govorio o smrti i umiranju.
00:34
This time, I'm going to talk about mental illness.
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Ovaj put ću govoriti o mentalnim bolestima.
00:39
But it has to be technological,
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Ali pošto mora biti u skladu sa tehnologijom,
00:40
so I'll talk about electroshock therapy. (Laughter)
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govoriću o terapiji elektrošokovima.
(Smeh)
(Smeh)
00:45
You know, ever since man had any notion
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Znate, otkad je čovek primetio
00:48
that some of his other people, his colleagues,
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da neko od njegovih bližnjih,
njegovih kolega,
njegovih kolega,
00:52
could be different, could be strange, could be severely depressed
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može biti drugačiji, može biti čudan,
može biti ozbiljno depresivan
može biti ozbiljno depresivan
00:56
or what we now recognize as schizophrenia,
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ili ono što danas prepoznajemo
kao šizofreniju,
kao šizofreniju,
01:00
he was certain that this kind of illness
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bio je siguran da je ova vrsta bolesti
01:03
had to come from evil spirits getting into the body.
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morala da dolazi od zlih duhova
koji zaposedaju telo.
koji zaposedaju telo.
01:06
So, the way of treating these diseases
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Pa, način da se leče ove bolesti
01:08
in early times was to, in some way or other,
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u ranijim vemenima je bio,
na jedan ili drugi način,
na jedan ili drugi način,
01:11
exorcise those evil spirits, and this is still going on, as you know.
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isterivanje ovih zlih duhova,
a ovo se i dalje dešava, kao što znate.
a ovo se i dalje dešava, kao što znate.
01:16
But it wasn't enough to use the priests.
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Ali nije dovoljno samo prisustvo sveštenika.
01:18
When medicine became somewhat scientific, in about 450 BC,
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Kada je medicina postala koliko-toliko naučna,
otprilike oko 450. godine p.n.e.,
otprilike oko 450. godine p.n.e.,
01:23
with Hippocrates and those boys,
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sa Hipokratom i tim momcima,
01:25
they tried to look for herbs, plants
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oni su pokušavali da nađu lekovito bilje,
biljke
biljke
01:29
that would literally shake the bad spirits out.
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koje bi bukvalno otresle loše duhove van.
01:32
So, they found certain plants that could cause convulsions.
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Tako da su našli određene biljke
koje izazivaju konvulzije.
koje izazivaju konvulzije.
01:35
And the herbals, the botanical books of up to the late Middle Ages,
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A knjige lekovitog bilja, botaničke knjige
sve do kasnog srednjeg veka,
sve do kasnog srednjeg veka,
01:41
the Renaissance are filled with prescriptions
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renesanse su pune recepata
01:45
for causing convulsions to shake the evil spirits out.
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za izazivanje konvulzija koji bi
istresli zle duhove.
istresli zle duhove.
01:50
Finally, in about the sixteenth century,
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Konačno, otprilike u 16. veku,
01:54
a physician whose name was Theophrastus Bombastus Aureolus von Hohenheim,
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lekar čije je ime Teofrastus Bombastus
Aureolus fon Hoenajm,
Aureolus fon Hoenajm,
02:00
called Paracelsus, a name probably familiar to some people here --
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zvani Paracelzus, ovo ime je
verovatno poznato nekima od vas -
verovatno poznato nekima od vas -
02:04
(Laughter) -- good, old Paracelsus
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(Smeh) - dobri, stari Paracelzus
02:09
found that he could predict the degree of convulsion
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je otkrio da može predvideti
stepen konvulzija
stepen konvulzija
02:13
by using a measured amount of camphor to produce the convulsion.
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koristeći izmerenu količinu kamfora
da bi proizveo konvulzije.
da bi proizveo konvulzije.
02:17
Can you imagine going to your closet, pulling out a mothball, and
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Možete li da zamislite da odete do vašeg ormara,
uzmete kuglicu protiv moljaca
uzmete kuglicu protiv moljaca
02:20
chewing on it if you're feeling depressed?
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i žvaćete je ukoliko ste depresivni?
02:23
It's better than Prozac, but I wouldn't recommend it.
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Bolje je od prozaka, ali ga ja ne bih preporučio.
02:26
So what we see in the seventeenth, eighteenth century
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Ono što vidimo je da se u 17., 18. veku
02:29
is the continued search for medications other than camphor that'll do the trick.
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konstantno traže lekovi osim kamfora
koji će da urade šta treba.
koji će da urade šta treba.
02:34
Well, along comes Benjamin Franklin,
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Zatim dolazi Bendžamin Franklin
02:36
and he comes close to convulsing himself
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i biva blizu da i sebi izazove konvulzije
02:38
with a bolt of electricity off the end of his kite.
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munjom elektriciteta sa kraja njegovog zmaja.
02:42
And so people begin thinking in terms of electricity to produce convulsions.
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Tako su ljudi počeli da razmišljaju o
električnoj struji zarad proizvodnje konvulzija.
električnoj struji zarad proizvodnje konvulzija.
02:47
And then, we fast-forward to about 1932,
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Zatim idemo u 1932. godinu,
02:51
when three Italian psychiatrists, who were largely treating depression,
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kada su 3 italijanska psihijatra,
koji su mahom lečili depresiju,
koji su mahom lečili depresiju,
02:57
began to notice among their patients, who were also epileptics,
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primetili među svojim pacijentima,
koji su takođe epileptičari,
koji su takođe epileptičari,
03:00
that if they had an epileptic -- a series of epileptic fits,
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da ako imaju seriju epileptičnih napada,
03:03
a lot of them in a row -- the depression would very frequently lift.
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dosta njih zaredom -
depresija će vrlo često prestati.
depresija će vrlo često prestati.
03:07
Not only would it lift, but it might never return.
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Ne samo da će prestati,
već se možda nikad neće ni vratiti.
već se možda nikad neće ni vratiti.
03:11
So they got very interested in producing convulsions,
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Zato su postali veoma zainteresovani
za stvaranje konvulzija,
za stvaranje konvulzija,
03:16
measured types of convulsions.
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izmerene tipove konvulzija.
03:18
And they thought, "Well, we've got electricity, we'll plug somebody into the wall.
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Pomislili su: "Pa, imamo struju,
samo ćemo priključiti nekoga za zid.
samo ćemo priključiti nekoga za zid.
03:21
That always makes hair stand up and people shake a lot."
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To uvek diže kosu na glavi i ljudi se mnogo tresu."
03:24
So, they tried it on a few pigs, and none of the pigs were killed.
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To su pokušali na nekoliko svinja
i nijedna svinja nije ubijena.
i nijedna svinja nije ubijena.
03:28
So, they went to the police and they said,
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Tako da su otišli do policije i rekli:
03:30
"We know that at the Rome railroad station,
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"Znamo da su na železničkoj stanici u Rimu
03:33
there are all these lost souls wandering around,
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sve te izgubljene duše koje tumaraju okolo,
03:35
muttering gibberish. Can you bring one of them to us?"
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mrmljajući besmislice.
Možete li da nam dovedete jednog?"
Možete li da nam dovedete jednog?"
03:39
Someone who is, as the Italians say, "cagoots."
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Nekoga ko je, što bi Italijani rekli "tikva".
03:42
So they found this "cagoots" guy,
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Te su našli tog "tikva" lika,
03:44
a 39-year-old man who was really hopelessly schizophrenic,
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39-godišnjeg čoveka koji je
beznadežni šizofreničar,
beznadežni šizofreničar,
03:47
who was known, had been known for months,
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koji je mesecima bio poznat
po tome što je
po tome što je
03:50
to be literally defecating on himself,
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bukvalno vršio nuždu po sebi,
03:54
talking nothing that made any sense,
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nije govorio ništa što ima smisla
03:56
and they brought him into the hospital.
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i doveli su ga u bolnicu.
03:58
So these three psychiatrists, after about two or three weeks of observation,
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Ova 3 psihijatra su ga, nakon 2-3 nedelje posmatranja,
04:02
laid him down on a table,
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postavili na sto,
04:04
connected his temples to a very small source of current.
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povezali njegove slepoočnice na mali izvor struje.
04:09
They thought, "Well, we'll try 55 volts, two-tenths of a second.
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Mislili su: "Pokušaćemo sa 55 volti,
2 desetine sekunde.
2 desetine sekunde.
04:13
That's not going to do anything terrible to him."
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To mu neće učiniti ništa strašno."
04:16
So they did that.
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Pa su to i učinili.
04:17
Well, I have the following from a firsthand observer,
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Sledeće sam čuo od neposrednog posmatrača
04:21
who told me this about 35 years ago,
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koji mi je ovo rekao pre 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 neki moj projekat.
04:29
He said, "This fellow" -- remember, he wasn't even put to sleep --
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Rekao je: "Ovaj momak" - zapamtite,
on nije bio uopšte uspavan -
on nije bio uopšte uspavan -
04:33
"after this major grand mal convulsion,
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"nakon ove glavne, zle konvulzije,
04:35
sat right up, looked at these three fellas and said,
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je ustao, pogledao ovu trojicu i rekao:
04:38
'What the fuck are you assholes trying to do?' "
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"Šta kog đavola pokušavate da uradite?""
04:42
(Laughter)
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(Smeh)
04:50
If I could only say that in Italian.
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Kad bih samo mogao to da kažem
na italijanskom.
na italijanskom.
04:53
Well, they were happy as could be, because he
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Oni su bili presrećni jer on
04:56
hadn't said a rational word in the weeks of observation.
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nije rekao racionalnu reč
svih nedelja posmatranja.
svih nedelja posmatranja.
05:00
So they plugged him in again,
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Te su ga priključili ponovo,
05:05
and this time they used 110 volts for half a second.
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ali su ovaj put koristili 110 volti pola sekunde.
05:09
And to their amazement, after it was over,
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I na njihovo zaprepašćenje,
kada je bilo gotovo,
kada je bilo gotovo,
05:12
he began speaking like he was perfectly well.
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on je počeo da govori
kao da je savršeno zdrav.
kao da je savršeno zdrav.
05:15
He relapsed a little bit, they gave him a series of treatments,
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Malo je popustio, pa su
mu dali seriju tretmana
mu dali seriju tretmana
05:18
and he was essentially cured.
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i on je bio u suštini izlečen.
05:19
But of course, having schizophrenia,
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Ali naravno, pošto je imao šizofreniju,
05:22
within a few months, it returned.
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ona se nakon par meseci vratila.
05:24
But they wrote a paper about this,
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Ali su napisali rad o ovome
05:26
and everybody in the Western world began using electricity
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i svako u zapadnom svetu je počeo
da koristi električnu struju
da koristi električnu struju
05:31
to convulse people who were either schizophrenic or severely depressed.
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za izazivanje konvulzija kod ljudi
koji su ili šizofeničari ili ozbiljno depresivni.
koji su ili šizofeničari ili ozbiljno depresivni.
05:35
It didn't work very well on the schizophrenics,
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Ovo nije bilo uspešno kod šizofreničara,
05:37
but it was pretty clear in the '30s and by the middle of the '40s
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ali je bilo jasno u '30-im i do sredine '40-ih
05:40
that electroconvulsive therapy was very, very effective
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da je terapija elektrokonvulzijama vrlo efikasna
05:46
in the treatment of depression.
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u lečenju depresije.
05:48
And of course, in those days, there were no antidepressant drugs,
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I naravno, u tom vremenu nije bilo antidepresiva,
05:51
and it became very, very popular.
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pa je ovo postalo veoma popularno.
05:54
They would anesthetize people,
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Oni bi davali ljudima anesteziju,
05:56
convulse them, but the real difficulty was
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izazivali konvulzije, ali prava poteškoća je bila
05:59
that there was no way to paralyze muscles.
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to što nije postojao način
da se paralizuju mišići.
da se paralizuju mišići.
06:01
So people would have a real grand mal seizure.
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Zato su ljudi imali stvarno veliki napad.
06:04
Bones were broken. Especially in old, fragile people,
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Kosti su lomljene. Posebno kod starih,
krhkih ljudi
krhkih ljudi
06:07
you couldn't use it.
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niste mogli ovo da koristite.
06:09
And then in the 1950s, late 1950s, the so-called muscle relaxants
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Zatim u kasnim 1950-im,
takozvane lekove za opuštanje mišića
takozvane lekove za opuštanje mišića
06:14
were developed by pharmacologists,
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su napravili farmaceuti
06:16
and it got so that you could induce a complete convulsion,
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i došlo je do toga da je mogla da se
izazove potpuna konvulzija,
izazove potpuna konvulzija,
06:20
an electroencephalographic convulsion -- you could see it on the brain waves --
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elektroencefalografska konvulzija -
što možete videti na osnovu moždanih talasa -
što možete videti na osnovu moždanih talasa -
06:23
without causing any convulsion in the body except a little bit of twitching of the toes.
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bez izazivanja konvulzija u telu
izuzev malog peckanja u prstima.
izuzev malog peckanja u prstima.
06:28
So again, it was very, very popular and very, very useful.
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Opet, to je bilo veoma popularno
i veoma korisno.
i veoma korisno.
06:34
Well, you know, in the middle '60s,
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Pa, znate, sredinom1960-ih,
06:36
the first antidepressants came out. Tofranil was the first.
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proizvedeni su prvi antidepresivi.
Tofranil je bio prvi.
Tofranil je bio prvi.
06:40
In the late '70s, early '80s, there were others,
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Kasnih 1970-ih, ranih 1980-ih,
postojali su i drugi
postojali su i drugi
06:44
and they were very effective.
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i bili su vrlo efikasni.
06:45
And patients' rights groups seemed to get very upset
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A grupe za zaštitu prava pacijenata
su se veoma uznemirile
su se veoma uznemirile
06:48
about the kinds of things that they would witness.
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zbog stvari kojima su prisustvovale.
06:51
And so the whole idea of electroconvulsive, electroshock therapy disappeared,
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Tako je cela ideja elektrokonvulzivne,
elektrošok terapije nestala,
elektrošok terapije nestala,
06:57
but has had a renaissance in the last 10 years.
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ali je doživela preporod
u poslednjih 10 godina.
u poslednjih 10 godina.
07:01
And the reason that it has had a renaissance
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A razlog za ovaj preporod
07:04
is that probably about 10 percent of the people, severe depressives,
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je to što oko 10 posto ljudi,
ozbiljno depresivnih,
ozbiljno depresivnih,
07:10
do not respond, regardless of what is done for them.
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ne reaguju, bez obzira kako ih tretiraju.
07:15
Now, why am I telling you this story at this meeting?
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Zašto vam govorim ovo na ovom sastanku?
07:19
I'm telling you this story, because actually ever since
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Govorim vam ovu priču jer me je Ričard pozvao
07:22
Richard called me and asked me to talk about
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i pitao da govorim o
07:24
-- as he asked all of his speakers --
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- kao što je pitao sve svoje govornike -
07:26
to talk about something that would be new to this audience,
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da govorim o nečemu što bi bilo
novo za ovu publiku,
novo za ovu publiku,
07:29
that we had never talked about, never written about,
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o čemu dosad nismo pričali, nismo pisali,
07:32
I've been planning this moment.
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isplanirao sam ovaj trenutak.
07:35
This reason really is that I am a man who, almost 30 years ago,
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Razlog je zapravo taj što sam ja čovek kom je,
pre skoro 30 godina,
pre skoro 30 godina,
07:40
had his life saved by two long courses of electroshock therapy.
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spašen život sa 2 duga tretmana terapije elektrošokom.
07:48
And let me tell you this story.
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Dozvolite mi da vam ispričam tu priču.
07:52
I was, in the 1960s, in a marriage. To use the word bad
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Bio sam 1960-ih u braku.
Nazvati ga lošim
Nazvati ga lošim
07:58
would be perhaps the understatement of the year.
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bi verovatno bilo premalo rečeno.
08:01
It was dreadful.
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Bio je užasan.
08:03
There are, I'm sure, enough divorced people in this room
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Ima, siguran sam, dovoljno razvedenih ljudi
u ovoj prostoriji
u ovoj prostoriji
08:06
to know about the hostility, the anger, who knows what.
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koji su upoznati sa ovim neprijateljstvima,
besom, ko zna sa čim još.
besom, ko zna sa čim još.
08:12
Being someone who had had a very difficult childhood,
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Pošto sam neko ko je imao teško detinjstvo,
08:17
a very difficult adolescence --
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tešku adolescenciju -
08:18
it had to do with not quite poverty but close.
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što je imalo veze sa ne baš siromaštvom,
ali blizu toga.
ali blizu toga.
08:22
It had to do with being brought up in a family where no one spoke English,
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Imalo je veze sa odrastanjem u porodici
u kojoj niko nije govorio engleski,
u kojoj niko nije govorio engleski,
08:25
no one could read or write English.
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niko nije ni čitao ni pisao na engleskom.
08:27
It had to do with death and disease and lots of other things.
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Imalo je veze sa smrću i bolešću
i mnogim drugim stvarima.
i mnogim drugim stvarima.
08:31
I was a little prone to depression.
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Bio sam malo sklon depresiji.
08:33
So, as things got worse, as we really began to hate each other,
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Kako su se stvari pogoršale i kako smo
stvarno počeli da mrzimo jedno drugo,
stvarno počeli da mrzimo jedno drugo,
08:37
I became progressively depressed over a period of a couple of years,
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postao sam progresivno depresivan
u roku od par godina,
u roku od par godina,
08:41
trying to save this marriage,
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pokušavajući da spasem brak,
08:43
which was inevitably not to be saved.
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koji se neizbežno nije mogao spasiti.
08:47
Finally, I would schedule -- all my major surgical cases,
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Konačno, zakazivao bih -
sve svoje veće hirurške slučajeve,
sve svoje veće hirurške slučajeve,
08:53
I was scheduling them for 12, one o'clock in the afternoon,
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zakazivao bih ih za 12, 1 sat popodne
08:57
because I couldn't get out of bed before about 11 o'clock.
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jer nisam mogao da ustanem pre 11 sati.
09:01
And anybody who's been depressed here knows what that's like.
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Svako ko je bio depresivan
zna kako to izgleda.
zna kako to izgleda.
09:04
I couldn't even pull the covers off myself.
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Nisam mogao čak ni prekrivač
da skinem sa sebe.
da skinem sa sebe.
09:08
Well, you're in a university medical center,
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Pa, vi ste u univerzitetskom
medicinskom centru,
medicinskom centru,
09:10
where everybody knows everybody, and it's perfectly clear to my colleagues,
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gde svako poznaje svakoga i sve je
savršeno jasno mojim kolegama,
savršeno jasno mojim kolegama,
09:13
so my referrals began to decrease.
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pa su moje preporuke počele da opadaju.
09:15
As my referrals began to decrease,
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Kako su se moje preporuke smanjivale,
09:18
I clearly became increasingly depressed
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postao sam još depresivniji
09:22
until I thought, my God, I can't work anymore.
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dok nisam pomislio, moj bože,
ja više ne mogu da radim.
ja više ne mogu da radim.
09:24
And, in fact, it didn't make any difference
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I zapravo, nije bilo nikakve razlike
09:26
because I didn't have any patients anymore.
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jer i onako nisam više imao pacijenata.
09:28
So, with the advice of my physician,
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Kako me je savetovao moj lekar,
09:32
I had myself admitted to the acute care psychiatric unit of our university hospital.
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prijavio sam se za akutnu negu u psihijatrijskoj
jedinici naše univerzitetske bolnice.
jedinici naše univerzitetske bolnice.
09:37
And my colleagues, who had known me since medical school
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Moje kolege, koje su me znale
još od medicinske škole
još od medicinske škole
09:40
in that place, said, "Don't worry, chap. Six weeks,
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u tom mestu, su mi rekle:
"Ne brini druže. Za 6 nedelja
"Ne brini druže. Za 6 nedelja
09:42
you're back in the operating room. Everything's going to be great."
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bićeš ponovo u operacionoj sali.
Sve će biti dobro."
Sve će biti dobro."
09:46
Well, you know what bovine stercus is?
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Da li znate sta je goveđi izmet?
09:50
That proved to be a lot of bovine stercus.
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E pa 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 neke ljude koji su osvojili mandat
na tom mestu sa lažima poput ovih.
na tom mestu sa lažima poput ovih.
10:01
(Laughter)
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(Smeh)
10:07
So I was one of their failures.
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Tako da 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. Jer kada
10:12
I got out of that unit, I was not functional at all.
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sam izašao iz te jedinice nisam uopšte
mogao da funkcionišem.
mogao da funkcionišem.
10:17
I could hardly see five feet in front of myself.
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Jedva sam video na metar i po ispred sebe.
10:19
I shuffled when I walked. I was bowed over.
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Teturao sam se dok hodam.
Bio sam nakrivljen.
Bio sam nakrivljen.
10:22
I rarely bathed. I sometimes didn't shave. It was dreadful.
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Retko sam se kupao. Nekad se nisam ni brijao.
Bilo je užasno.
Bilo je užasno.
10:27
And it was clear -- not to me,
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I postalo je jasno - ne meni,
10:30
because nothing was clear to me at that time anymore --
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jer meni više ništa nije bilo jasno u to vreme -
10:33
that I would need long-term hospitalization
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da će mi trebati dugotrajna hospitalizacija
10:37
in that awful place called a mental hospital.
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u tom groznom mestu zvanom mentalna bolnica.
10:41
So I was admitted, in 1973, in the spring of 1973,
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Bio sam primljen 1973., u proleće 1973.
10:47
to the Institute of Living, which used to be called the Hartford Retreat.
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u Living institut, koji se ranije zvao Hartford Retreat.
10:50
It was founded in the eighteenth century,
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Osnovan je u 18. veku,
10:52
the largest psychiatric hospital in the state of
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najveća psihijatrijska bolnica u državi
10:56
Connecticut, other than the huge public hospitals
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Konektikat, za razliku od ogromnih javnih bolnica
10:58
that existed at that time.
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koje su postojale u to vreme.
11:01
And they tried everything they had.
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Pokušali su sa svim što su imali.
11:02
They tried the usual psychotherapy.
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Pokušali su sa psihoterapijom.
11:04
They tried every medication available in those days.
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Pokušali su sa svim lekovima
dostupnim u to vreme.
dostupnim u to vreme.
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 - melaril,
ko zna šta sve.
ko zna šta sve.
11:11
Nothing happened except that I got jaundiced from one of these things.
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Ništa se nije desilo osim što sam dobio žuticu
od jedne od ovih stvari.
od jedne od ovih stvari.
11:15
And finally, because I was well known in Connecticut,
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I konačno, pošto sam bio
opšte poznat u Konektikatu,
opšte poznat u Konektikatu,
11:21
they decided they better have a meeting of the senior staff.
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odlučili su da sazovu sastanak uprave.
11:25
All the senior staff got together, and I later found out what happened.
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Uprava se sastala i
kasnije sam saznao šta se dogodilo.
kasnije sam saznao šta se dogodilo.
11:31
They put all their heads together and they decided
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Svi su razmislili i rešili
11:35
that there was nothing that could be done
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da ne postoji ništa što može da se uradi
11:37
for this surgeon who had essentially separated himself from the world,
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za ovog hirurga koji se
suštinski odvojio od sveta,
suštinski odvojio od sveta,
11:41
who by that time had become so overwhelmed,
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koji je do tada postao toliko preplavljen,
11:45
not just with depression and feelings
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ne samo depresijom i osećanjima
11:48
of worthlessness and inadequacy,
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beskorisnosti i neadekvatnosti,
11:50
but with obsessional thinking,
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već i opsesivnim razmišljanjima,
11:53
obsessional thinking about coincidences.
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opsesivnim mislima o slučajnostima.
11:55
And there were particular numbers that every time I saw them,
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Postojali su određeni brojevi
koji su me svaki put kada bih ih video,
koji su me svaki put kada bih ih video,
11:58
just got me dreadfully upset -- all kinds of ritualistic observances,
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užasno uznemiravali -
sve vrste ritualnih posmatranja,
sve vrste ritualnih posmatranja,
12:04
just awful, awful stuff.
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samo užasne, užasne stvari.
12:06
Remember when you were a kid, and you had to step on every line?
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Sećate se kada ste bili deca i morali ste
da nagazite na svaku liniju?
da nagazite na svaku liniju?
12:09
Well, I was a grown man who had all of these rituals,
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Pa, ja sam bio odrastao čovek
koji je imao sve ove rituale
koji je imao sve ove rituale
12:13
and it got so there was a throbbing, there was a ferocious fear in my head.
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i postalo je tako probadajuće da se
stvorio surovi strah u mojoj glavi.
stvorio surovi strah u mojoj glavi.
12:17
You've seen this painting by Edvard Munch,
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Videli ste ovu sliku Edvarda Munka,
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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Bio je nemoguće. Zato su odlučili
da nema terapije,
da nema terapije,
12:27
there was no treatment. But there was one treatment,
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da nema lečenja. 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 je zapravo bio započet u
Hartford bolnici u ranim 1940-im
Hartford bolnici u ranim 1940-im
12:35
and you can imagine what it was. It was pre-frontal lobotomy.
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i možete zamisliti šta je to bilo.
Bila je to prefrontalna lobotomija.
Bila je to prefrontalna lobotomija.
12:43
So they decided -- I didn't know this, again,
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Zato su rešili - nisam znao za ovo, opet,
12:45
I found this out later --
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saznao sam tek kasnije -
12:46
that the only thing that could be done was
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da jedina stvar koja se može uraditi je
12:48
for this 43-year-old man to have a pre-frontal
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da ovaj 43-godišnjak ima prefrontalnu
12:52
lobotomy.
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lobotomiju.
12:55
Well, as in all hospitals, there was a resident
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Kao i u svim bolnicama, jedan stažista
12:58
assigned to my case. He was 27 years old,
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je dodeljen mom slučaju. Imao je 27 godina
13:01
and he would meet with me two or three times a week.
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i posećivao me je 2-3 puta nedeljno.
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 oko
3-4 meseca u to vreme.
3-4 meseca u to vreme.
13:07
And he asked to meet with the senior staff, and they agreed to meet with him
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I on je tražio da se sastane sa upravom,
oni su prihvatili da se sastanu sa njim
oni su prihvatili da se sastanu sa njim
13:10
because he was very well thought of in that place.
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jer su svi imali dobro mišljenje o njemu.
13:12
They thought he had a really extraordinary future.
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Mislili su da ga čeka zaista izuzetna budućnost.
13:16
And he dug in his heels and said,
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On je izvukao iz petnih žila 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. Poznajem ovog čoveka bolje nego bilo ko
od vas. Viđao sam ga iznova i iznova.
od vas. Viđao sam ga iznova i iznova.
13:21
You've just seen him from time to time. You've read reports and so forth.
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Vi ste ga viđali s vremena na vreme.
Pročitali ste izveštaje i tako dalje.
Pročitali ste izveštaje i tako dalje.
13:25
I really honestly believe that the basic problem here is pure depression,
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Zaista verujem da je glavni problem
ovde čista depresija
ovde čista depresija
13:30
and all of the obsessional thinking comes out of it.
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i da sva ta opsesivna razmišljanja dolaze od nje.
13:33
And you know, of course, what'll happen if you do a pre-frontal lobotomy.
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A znate, naravno, šta će se desiti
ako izvedete prefrontalnu lobotomiju.
ako izvedete prefrontalnu lobotomiju.
13:36
Any of the results along the spectrum,
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Svi rezultati širom spektra,
13:40
from pretty bad to terrible, terrible, terrible
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od prilično loših ka očajnim, očajnim, očajnim
13:42
is going to happen. If he does the best he can,
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će se desiti. Ako se svojski potrudi,
13:46
he will have no further obsessions,
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on neće imati više opsesije,
13:48
probably no depression, but his affect will be dulled,
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verovatno ne depresiju, ali njegove reakcije
će biti otupljene,
će biti otupljene,
13:51
he will never go back to surgery,
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nikad se neće vratiti hirurgiji,
13:53
he will never be the loving father that he was to his two children,
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nikad neće biti dobar otac svoja 2 deteta,
13:57
his life will be changed. If he has the usual result,
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njegov život će se promeniti.
Ako ima uobičajene rezultate,
Ako ima uobičajene rezultate,
14:00
he will end up like 'One Flew Over the Cuckoo's Nest.'
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završiće kao "Let iznad kukavičjeg gnezda".
14:03
And you know about that, just essentially in a stupor the rest of his life."
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A znate sve o tome, samo u suštini
obamrlost do kraja svog života."
obamrlost do kraja svog života."
14:08
Well, he said, "Can't we try a course of electroshock therapy?"
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Pa, rekao je: "Možemo li da probamo
sa elektrošok terapijom?"
sa elektrošok terapijom?"
14:14
And you know why they agreed? They agreed to humor him.
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I znate li zašto su se složili?
Složili su se da bi mu udovoljili.
Složili su se da bi mu udovoljili.
14:17
They just thought, "Well, we'll give a course of 10.
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Samo su pomislili: "Pa, daćemo mu 10 tretmana.
14:21
And so we'll lose a little time. Big deal. It doesn't make any difference."
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Time ćemo malo da izgubimo vreme. Jaka stvar.
Ionako ništa neće da se promeni."
Ionako ništa neće da se promeni."
14:25
So they gave the course of 10,
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Te su dali 10 tretmana,
14:26
and the first -- the usual course, incidentally, was six to eight
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i prvi je - uobičajen tretman,
slučajno, bio 6 do 8
slučajno, bio 6 do 8
14:30
and still is six to eight.
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i dalje je 6 do 8.
14:32
Plugged me into the wires, put me to sleep, gave me the muscle relaxant.
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Priključili su me na žice, uspavali me,
dali mi lek za opuštanje mišića.
dali mi lek za opuštanje mišića.
14:36
Six didn't work. Seven didn't work.
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6 nije delovalo. 7 nije delovalo.
14:38
Eight didn't work. At nine, I noticed --
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8 nije delovalo. Kod 9., sam primetio -
14:41
and it's wonderful that I could notice anything
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bilo je sjajno što sam bilo šta primetio
14:44
-- I noticed a change. And at 10, I noticed a real change.
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- primetio sam promenu.
A kod 10. sam osetio pravu promenu.
A kod 10. sam osetio pravu promenu.
14:48
And he went back to them, and they agreed to do another 10.
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On se vratio kod njih i oni su pristali 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 oko 7 ili 8 -
14:55
thought this would do any good. They thought this was a temporary change.
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nije mislio da će ovo pomoći.
Mislili su da je to privremena promena.
Mislili su da je to privremena promena.
14:57
But, lo and behold, by 16, by 17,
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Ali vidite, do 16., do 17.,
15:01
there were demonstrable differences in the way I felt.
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bilo je očiglednih razlika u tome
kako sam se osećao.
kako sam se osećao.
15:05
By 18 and 19, I was sleeping through the night.
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Do 18. i 19., spavao sam cele noći.
15:08
And by 20, I had the sense, I really had the sense
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Do 20. imao sam osećaj,
zaista sam imao osećaj
zaista sam imao osećaj
15:12
that I could overcome this,
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da mogu ovo da prevaziđem,
15:15
that I was now strong enough that by an act of will,
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da sam sada dovoljno jak da snagom volje,
15:18
I could blow the obsessional thinking away.
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mogu da odagnam opsesivna razmišljanja.
15:20
I could blow the depression away.
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Da mogu da odagnam depresiju.
15:23
And I've never forgotten -- I never will forget
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I nikada nisam zaboravio -
nikad neću zaboraviti
nikad neću zaboraviti
15:26
-- standing in the kitchen of the unit,
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- stajao sam u kuhinji na odeljenju,
15:29
it was a Sunday morning in January of 1974,
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bila je nedelja ujutru januara 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 na odeljenju sam i razmišljao:
"Sada imam snage da ovo prevaziđem."
"Sada imam snage da ovo prevaziđem."
15:39
It was as though those tightly coiled wires in my head had been disconnected
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To je bilo kao da su se one čelične žice
u mojoj glavi isključile
u mojoj glavi isključile
15:44
and I could think clearly.
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i mogu da razmišljam jasno.
15:46
But I need a formula. I need some thing to say to myself
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Ali treba mi formula.
Treba mi nešto da kažem sebi
Treba mi nešto da kažem sebi
15:51
when I begin thinking obsessionally, obsessively.
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kada počnem opsesivno da razmišljam.
15:55
Well, the Gilbert and Sullivan fans in this room
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Pa, fanovi Gilberta i Salivena u ovoj prostoriji
16:00
will remember "Ruddigore," and they will remember Mad Margaret,
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se sećaju Rudigora i setiće se Mad Margaret
16:03
and they will remember that she was married
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i setiće se da je ona bila udata
16:05
to a fellow named Sir Despard Murgatroyd.
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za momka po imenu ser Despard Murgatrojd.
16:09
And she used to go nuts, every five minutes or so in the play,
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Ona je imala običaj da poludi
na svakih 5 minuta u predstavi,
na 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 da imamo reč
koja će te vratiti u realnost
koja će te vratiti u realnost
16:16
and the word, my dear, will be 'Basingstoke.'"
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i ta reč, draga moja, biće Basingstok."
16:20
So every time she got a little nuts,
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Tako da svaki put kad bi malo poludela,
16:22
he would say, "Basingstoke!" And she would say,
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on bi rekao: "Basingstok!" i ona bi rekla:
16:24
"Basingstoke, it is." And she would be fine for a little while.
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"Basingstok, će biti." I bila bi dobro neko vreme.
16:28
Well, you know, I'm from the Bronx. I can't say "Basingstoke."
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Znate ja sam iz Bronksa. Ja ne mogu reći:
"Basingstok".
"Basingstok".
16:32
But I had something better. And it was very simple.
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Imao sam nešto bolje. I bilo je vrlo jednostavno.
16:36
It was, "Ah, fuck it!"
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Bilo je: "E, jebi ga!"
16:39
(Laughter) Much better than "Basingstoke,"
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(Smeh)
Mnogo bolje od: "Basingstok",
Mnogo bolje od: "Basingstok",
16:44
at least for me. And it worked -- my God, it worked.
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bar za mene. I upalilo je -
moj bože, upalilo je.
moj bože, upalilo je.
16:48
Every time I would begin thinking obsessionally --
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Svaki put kad bih počeo
opsesivno da razmišljam -
opsesivno da razmišljam -
16:50
again, once more, after 20 shock treatments
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opet, još jednom, nakon 20 šok tretmana
16:54
-- I would say, "Ah, fuck it."
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- rekao bih: "E, jebi ga."
16:58
And things got better and better,
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I bilo je sve bolje i bolje
17:00
and within three or four months,
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i u roku od 3 ili 4 meseca,
17:03
I was discharged from that hospital, and I joined a group of surgeons
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otpušten sam iz bolnice i
priključio sam se grupi hirurga,
priključio sam se grupi hirurga,
17:06
where I could work with other people in the community,
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gde sam mogao da radim sa
drugim ljudima u zajednici,
drugim ljudima u zajednici,
17:10
not in New Haven, but fairly close by.
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ne u Nju Hejvenu, ali blizu toga.
17:13
I stayed there for three years.
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Ostao sam tamo 3 godine.
17:15
At the end of three years, I went back to New Haven,
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Po završetku te 3 godine,
vratio sam se u Nju Hejven,
vratio sam se u Nju Hejven,
17:19
had remarried by that time.
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a u međuvremenu sam se ponovo oženio.
17:23
I brought my wife with me, actually, to make sure I could get through this.
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Poveo sam suprugu sa sobom, zapravo,
da bih bio siguran da mogu da prebrodim to.
da bih bio siguran da mogu da prebrodim to.
17:29
My children came back to live with us.
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Moja deca su se vratila da žive sa nama.
17:35
We had two more children after that.
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Imali smo još dvoje dece nakon toga.
17:38
Resuscitated the career, even better than it had been before.
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Oživeo sam karijeru, još više
nego što je bila ranije.
nego što je bila ranije.
17:43
Went right back into the university
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Vratio sam se pravo na univerzitet
17:47
and began to write books.
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i počeo da pišem knjige.
17:50
Well, you know, it's been a wonderful life.
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Znate, to je bio divan život.
17:53
It's been, as I said, close to 30 years.
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Prošlo je, kao što sam rekao,
skoro 30 godina.
skoro 30 godina.
17:57
I stopped doing surgery about six years ago
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Prestao sam da se bavim hirurgijom
pre oko 6 godina
pre oko 6 godina
18:00
and became a full-time writer, as many people know.
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i postao pisac sa punim radnim vremenom,
kao što mnogi znaju.
kao što mnogi znaju.
18:04
But it's been very exciting. It's been very happy.
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Bilo je veoma uzbudljivo.
Bilo je veoma srećno.
Bilo je veoma srećno.
18:07
Every once in a while, I have to say, "Ah, fuck it."
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S vremena na vreme, moram da kažem:
"E, jebi ga."
"E, jebi ga."
18:09
Every once in a while, I get somewhat depressed and a little obsessional.
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S vremena na vreme, postanem
pomalo depresivan i malo opsesivan.
pomalo 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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Tako da se nisam oslobodio svega toga.
Ali je upalilo. Uvek upali.
Ali je upalilo. Uvek upali.
18:22
Why have I chosen, after never, ever talking about this, to talk about it now?
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Zašto sam izabrao, nakon što nikada nisam
govorio o ovome, da govorim sada?
govorio o ovome, da govorim sada?
18:30
Well, those of you who know some of these books
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Oni koji znaju neke od ovih 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 telu 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 koji su mistične
misli uvek u našem umu
misli uvek u našem umu
18:43
and they have always to do with my own personal experiences.
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i one uvek imaju veze sa
mojim ličnim iskustvom.
mojim ličnim iskustvom.
18:48
One might think reading these books
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Neko bi pomislio čitajući ove knjige
18:51
-- and I've gotten thousands of letters about them
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- a dobio sam hiljade pisama o njima
18:54
by people who do think this --
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od ljudi koji zaista ovo misle -
18:56
that based on my life's history as I've portrayed in the books,
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da zasnovano na istoriji mog života
kao što sam opisao u knjigama,
kao što sam opisao u knjigama,
18:59
my early life's history, I am someone who has overcome adversity.
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istorija mog ranog života, ja sam neko
ko je prevazišao nesreću.
ko je prevazišao nesreću.
19:04
That I am someone who has drunk, drank, drunk
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A to je da sam ja, neko ko je pijan, pio, pije
19:09
of the bitter dregs of near-disaster in childhood
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gorak talog zamalo katastrofalnog detinjstva,
19:16
and emerged not just unscathed but strengthened.
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isplivao ne samo nepovređen već i ojačan.
19:21
I really have it figured out, so that I can advise people about
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Zaista sam shvatio, tako da mogu
da savetujem ljude o
da savetujem 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, tako da mogu da pričam o
misticizmu i ljudskom duhu.
misticizmu i ljudskom duhu.
19:29
And I've always felt guilty about that.
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Oduvek sam se osećao krivim zbog toga.
19:31
I've always felt that somehow I was an impostor
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Oduvek sam osećao da sam nekako uljez
19:34
because my readers don't know what I have just told you.
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jer moji čitaoci ne znaju šta sam
vama upravo rekao.
vama upravo rekao.
19:39
It's known by some people in New Haven, obviously,
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Poznato je nekim ljudima u Nju Hejvenu,
očito,
očito,
19:42
but it is not generally known.
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ali nije opšte poznato.
19:44
So one of the reasons that I have come here to talk about this today
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Stoga, jedan od razloga zbog kog sam došao
ovde da govorim o ovome danas
ovde da govorim o ovome danas
19:49
is to -- frankly, selfishly --
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je da - iskreno, sebično -
19:54
unburden myself and let it be known
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rasteretim sebe i stavim do znanja
19:57
that this is not an untroubled mind that has written all of these books.
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da ovo nije neopterećen mozak
koji je napisao sve ove knjige.
koji je napisao sve ove knjige.
20:03
But more importantly, I think,
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Ali što je još važnije, mislim,
20:06
is the fact that a very significant proportion
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je činjenica da veoma značajan deo
20:08
of people in this audience are under 30,
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ljudi u publici ima ispod 30 godina
20:12
and there are many, of course, who are well over 30.
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i ima mnogih, naravno,
koji su uveliko prešli 30.
koji su uveliko prešli 30.
20:18
For people under 30, and it looks to me like almost all of you
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Za ljude ispod 30, a meni se čini
da skoro svi vi
da skoro svi vi
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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su ili na vrhuncu veličanstvene i
uzbudljive karijere
uzbudljive karijere
20:27
or right into a magnificent and exciting career:
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ili usred veličanstvene i uzbudljive karijere:
20:31
anything can happen to you. Things change.
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svašta vam se može desiti.
Stvari se menjaju.
Stvari se menjaju.
20:35
Accidents happen. Something from childhood comes back to haunt you.
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Nesreće se dešavaju. Nešto iz detinjstva
se vrati da vas proganja.
se vrati da vas proganja.
20:39
You can be thrown off the track.
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Možete ispasti iz koloseka.
20:41
I hope it happens to none of you,
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Nadam se da se to nikome od vas neće desiti,
20:42
but it will probably happen to a small percentage of you.
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ali verovatno će se desiti malom delu vas.
20:47
To those to whom it doesn't happen, there will be adversities.
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Za one kojima se ne desi, postojaće nesreće.
20:52
If I, with the bleakness of spirit,
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Ako ja, sa opustelim duhom,
20:56
with no spirit, that I had in the 1970s
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bez duha, ono što sam doživljavao 1970-ih,
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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kao što je ta grupa veoma
iskusnih psihijatara mislila,
iskusnih psihijatara mislila,
21:07
if I can find my way back from this,
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ako sam ja mogao da nađem izlaz iz toga,
21:09
believe me, anybody can find their way back
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verujte mi, svako može da nađe izlaz
21:13
from any adversity that exists in their lives.
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iz bilo koje nesreće koja postoji u našim životima.
21:18
And for those who are older, who have lived through
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A za one koji su stariji, koji su preživeli
21:19
perhaps not something as bad as this,
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nešto možda ne toliko loše kao ovo,
21:22
but who have lived through difficult times,
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ali koji su proživeli teška vremena,
21:25
perhaps where they lost everything, as I did,
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gde su možda 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 sve ispočetka, nešto od ovoga
će im delovati vrlo poznato.
će im delovati vrlo poznato.
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. I postoji vaskrsnuće.
21:47
There are resurrection themes in every society that has ever been studied,
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Postoje teme o vaskrsnuću u svakom društvu
koje je ikada bilo proučavano
koje je ikada bilo proučavano
21:51
and it is because not just only do we fantasize
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i to ne samo što maštamo
21:54
about the possibility of resurrection and recovery,
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o mogućnosti vaskrsnuća i oporavka,
21:57
but it actually happens. And it happens a lot.
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već zato što se to zaista dešava.
I dešava se često.
I dešava se često.
22:01
Perhaps the most popular resurrection theme,
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Možda najpopularnija tema o vaskrsnuću,
22:05
outside of specifically religious ones,
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van onih religioznih,
22:08
is the one about the phoenix, the ancient story of the phoenix,
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je ona 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, vaskrsne iz svog pepela
22:19
to go on to live a life that is
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da bi živeo život koji je
22:22
even more beautiful than it was before. Richard,
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još lepši od prethodnog. Ričarde,
22:25
thanks very much.
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mnogo ti hvala.
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