David Casarett: A doctor's case for medical marijuana
大卫·卡萨瑞特: 从医生角度看药用大麻
David Casarett asks: What if mainstream health care operated more like a medical marijuana dispensary? Full bio
Double-click the English transcript below to play the video.
about the most embarrassing thing
在我作为饱受疗法医生的许多年里,
of working as a palliative care physician.
to see a woman in her 70s --
who had pancreatic cancer.
并患胰腺癌。
因为她感到疼痛、恶心、呕吐...
she had pain, nausea, vomiting ...
we talked about those symptoms
我们讨论了这些症状,
that medical marijuana might help her.
about medical marijuana,
因为我完全没学到什么东西。
because I had learned absolutely nothing.
had no benefits whatsoever.
把手伸到了床边的手提包里,
into the handbag next to the bed,
随机对照实验的记录,
randomized controlled trials
marijuana has benefits
这样的症状有一定好处。
and pain and anxiety.
也许你应该读下这些文章...
before offering an opinion ...
同时也找到了更多的文章。
and found a bunch more.
看起来是有些证据表明
there is some evidence
如果真的感兴趣的话,
really was interested,
retired English professor?
退休的英语教授?
about six months ago.
六个月前就试过了,
才发现它,这实在太棒了。
to discover this stuff. It's amazing."
about medical marijuana
in medical school
I started talking to researchers,
开始与研究人员交流,
我开始倾听病人的意见。
I started listening to patients.
based on those conversations,
around three surprises --
to medical marijuana.
没有那些医用大麻的热切拥护者
as huge or as stunning
of medical marijuana
那些反对者想要我们相信的那样
as huge and as scary
marijuana would have us believe,
that was most ...
of the patients I talked with
marijuana for help,
because of its benefits
这是奇药而求助于它,
it was a wonder drug,
control over their illness.
let me tell you about another patient.
我再提一下另一个病人。
like she was in her late 60s.
她饱受类风湿性关节炎的折磨,
for the last 20 years,
on a wheelchair to get around.
cognitively, psychologically,
people I've ever met.
in Northern California
to medical marijuana,
from many patients before.
she slept better.
that I'd never heard before,
control over her life
that worked for her.
then she could make changes.
anybody else's permission --
not a doctor's prescription,
for somebody with chronic illness,
or lupus or cancer or diabetes,
will face a chronic serious illness
甚至有些人的认知能力也会下降,
some of us will see our cognition decline,
to care for ourselves,
我们将失去对自己身体的掌控。
my palliative care patients,
that will end their lives,
constipation, fatigue,
more than anything else
control of their health,
dependent on others,
that patients like Robin,
some semblance of control.
marijuana dispensaries --
以所需的控制感的?
back the sort of control that they need?
medical hospitals and clinics,
in Venice Beach in California
to be a medical marijuana patient.
that would let me buy medical marijuana.
a resident of California --
of recommendation to make a purchase,
make a purchase though,
because it let me be a patient.
因为这让我成为了一位病人。
what patients like Robin experience
marijuana dispensary.
of people like Robin --
many of these clinics and dispensaries,
at the outset about who I am,
for a medical marijuana prescription,
what my preferences are,
this might help me,
get asked all the time.
that make me confident
really has my best interests at heart
in those clinics
behind the counter,
from folks in the waiting room.
as I was sitting next to them --
why they use medical marijuana,
建议和支持的热闹场所。
a hive of interaction, advice and support.
those people were
talking me through the nuances
making any purchase whatsoever.
you went to any hospital or clinic
对你解释这类事物。
explaining those sorts of things to you.
are going to these clinics,
of personalized attention
to the healthcare system.
from mainstream medicine,
are giving them what they need.
to the medical establishment,
of my colleagues are either not hearing
physicians in particular,
特别是内科医生
做更多的调查获得更多的证据。”
we need more evidence about risks."
我们确实需要更多证据。
about the benefits of medical marijuana.
把大麻重新定义为二类药,
to reschedule marijuana to Schedule II,
让这种研究成为可能。
to make that research possible.
into medical marijuana's risks.
做更多研究。
the risks of recreational use,
about the risks of medical marijuana.
to make any changes now
aren't seeking out medical marijuana
it's entirely risk-free.
in which it's delivered and administered
对于生活的掌控,
they need over their lives.
we really need to pay attention to.
there are lessons we can learn today
we really should learn.
mom-and-pop operations
and dispensaries are providing services
健康保障体系所没有提供的——
healthcare systems aren't --
three lessons at least
from those small dispensaries.
to give patients more control
更多控制感的方式,
with healthcare providers,
in ways that work for them.
creative and flexible
in using drugs safely
或苯二氮平类药物,
are drugs like opioids or benzodiazepines
if they're not used in a way
what patients want and need.
如果安全地使用药物,
if it's delivered safely,
for patients and their families.
of those medical marijuana dispensaries
a lot of physician time necessarily,
about what medications we're using
to learn from each other.
展现的场景?
dispensary waiting rooms?
人们是如何与他人分享的。
how people share with each other.
those medical marijuana dispensaries do,
把患者放在第一位,
他们想要什么,
legitimately like what they want,
作为医疗保障提供者,
their fears, their goals and preferences.
恐惧、目标以及偏好。
什么是他们希望的及害怕的。
hoping for and what they're afraid of.
直到他们患严重慢性病
until they're chronically seriously ill,
直到他们遇到像我一样的医师的时候
until they're seeing a physician like me
医疗保健被传递的一种方式。
that healthcare is delivered.
and clinics all across the country
health systems are years behind.
lots of letters after our name,
of a large healthcare system,
about how to meet patients' needs.
a few medical marijuana dispensaries.
如此多的像罗宾一样的患者
why so many patients like Robin
marijuana dispensaries instead.
what their tricks are,
and I absolutely think we have to,
都会有更好的就诊经历。
will have a much better experience.
ABOUT THE SPEAKER
David Casarett - PhysicianDavid Casarett asks: What if mainstream health care operated more like a medical marijuana dispensary?
Why you should listen
In his third book, Stoned: A Doctor's Case for Medical Marijuana, palliative care physician David Casarett takes a first-person investigative journalist's approach to making sense of marijuana's therapeutic potential and adverse effects. He shares what he's learned about this chronically misunderstood drug -- including the control it gives patients over their health and the educational atmosphere of dispensaries -- and outlines what we still need to do to explore its potential health benefits.
Casarett is a professor of medicine at the Duke University School of Medicine and chief of palliative care for the Duke Health System. He is the author of more than 100 journal articles, numerous magazine articles, and Shocked, another nonfiction book about the science of resuscitation. Casarett's first novel in the Ethical Chiang Mai Detective Agency series, Murder at the House of Rooster Happiness, was published in September 2016. The next installment, The Missing Guests of the Magic Grove Hotel, will be published in the fall of 2017.
David Casarett | Speaker | TED.com