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Daniel Levitin: How to stay calm when you know you'll be stressed
Daniel Levitin: Kako ostati mirni kada znate da ćete se iživcirati
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Niste u svom najboljem izdanju kada ste pod stresom. Zapravo, mozak je tijekom tisućljeća evoluirao da u stresnim situacijama luči kortizol, sprječavajući racionalno, logično razmišljanje, ali potencijalno vam pomažući da preživite, npr. napad lava.
Neuroznanstvenik, Daniel Levitin, smatra da postoji način da se u stresnim situacijama izbjegnu kritičke greške, kada razmišljanje nije jasno - tzv. pre-mortem.
"Svi tu i tamo pogriješimo", kaže. "Bit je da unaprijed razmišljamo o tim greškama"
Daniel Levitin - Neuroscientist
Daniel Levitin incorporates findings from neuroscience into everyday life. Full bio
Daniel Levitin incorporates findings from neuroscience into everyday life. Full bio
Double-click the English transcript below to play the video.
00:13
A few years ago,
I broke into my own house.
I broke into my own house.
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Prije nekoliko godina
provalio sam u vlastitu kuću.
provalio sam u vlastitu kuću.
00:16
I had just driven home,
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Upravo sam stigao kući,
00:18
it was around midnight
in the dead of Montreal winter,
in the dead of Montreal winter,
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bilo je oko ponoć,
a u Montrealu je bila ciča zima.
a u Montrealu je bila ciča zima.
00:20
I had been visiting my friend,
Jeff, across town,
Jeff, across town,
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Bio sam kod svog prijatelja Jeffa,
u drugom dijelu grada,
u drugom dijelu grada,
00:23
and the thermometer on the front porch
read minus 40 degrees --
read minus 40 degrees --
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a termometar pred kućom
pokazivao je -40 stupnjeva.
pokazivao je -40 stupnjeva.
00:27
and don't bother asking
if that's Celsius or Fahrenheit,
if that's Celsius or Fahrenheit,
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Ne pitajte radi li se o Celzijevim
ili Fahrenheitovim stupnjevima,
ili Fahrenheitovim stupnjevima,
00:30
minus 40 is where the two scales meet --
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na minus 40 te se ljestvice poklapaju.
00:33
it was very cold.
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Bilo je jako hladno.
00:34
And as I stood on the front porch
fumbling in my pockets,
fumbling in my pockets,
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Dok sam stajao na trijemu
i kopao po džepovima,
i kopao po džepovima,
00:37
I found I didn't have my keys.
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shvatio sam da nemam ključeve.
00:40
In fact, I could see them
through the window,
through the window,
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Zapravo, mogao sam ih vidjeti
kroz prozor
kroz prozor
00:42
lying on the dining room table
where I had left them.
where I had left them.
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na stolu u blagovaonici,
gdje sam ih ranije ostavio.
gdje sam ih ranije ostavio.
00:45
So I quickly ran around
and tried all the other doors and windows,
and tried all the other doors and windows,
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Zato sam brzo obišao kuću
i pokušao otvoriti druga vrata i prozore,
i pokušao otvoriti druga vrata i prozore,
00:48
and they were locked tight.
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ali bili su zaključani.
00:50
I thought about calling a locksmith --
at least I had my cellphone,
at least I had my cellphone,
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Palo mi je na pamet da nazovem
bravara, barem sam imao mobitel,
bravara, barem sam imao mobitel,
00:53
but at midnight, it could take a while
for a locksmith to show up,
for a locksmith to show up,
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ali bila je ponoć, pa bi mu vjerojatno
trebalo neko vrijeme da dođe,
trebalo neko vrijeme da dođe,
00:56
and it was cold.
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a i bilo je hladno.
01:00
I couldn't go back to my friend
Jeff's house for the night
Jeff's house for the night
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Nisam se mogao vratiti k Jeffu
i ondje prespavati
i ondje prespavati
01:03
because I had an early flight
to Europe the next morning,
to Europe the next morning,
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jer sam rano ujutro imao let za Europu,
01:05
and I needed to get
my passport and my suitcase.
my passport and my suitcase.
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a morao sam uzeti putovnicu i putnu torbu.
01:08
So, desperate and freezing cold,
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I tako sam, sav očajan i promrznut,
01:10
I found a large rock and I broke
through the basement window,
through the basement window,
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pronašao velik kamen i provalio
kroz podrumski prozor,
kroz podrumski prozor,
01:14
cleared out the shards of glass,
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raščistio krhotine stakla,
01:16
I crawled through,
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ušao unutra,
01:17
I found a piece of cardboard
and taped it up over the opening,
and taped it up over the opening,
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pronašao komad kartona
i zalijepio ga preko otvora za prozor.
i zalijepio ga preko otvora za prozor.
01:21
figuring that in the morning,
on the way to the airport,
on the way to the airport,
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misleći kako ću ujutro
na putu za zračnu luku
na putu za zračnu luku
01:24
I could call my contractor
and ask him to fix it.
and ask him to fix it.
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nazvati svog majstora
i reći mu da to popravi.
i reći mu da to popravi.
01:26
This was going to be expensive,
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Znao sam da će biti skupo,
01:28
but probably no more expensive
than a middle-of-the-night locksmith,
than a middle-of-the-night locksmith,
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ali vjerojatno ne skuplje od bravara
kojeg bi zvao usred noći,
kojeg bi zvao usred noći,
01:31
so I figured, under the circumstances,
I was coming out even.
I was coming out even.
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pa sam zaključio da mi
ionako dođe na isto.
ionako dođe na isto.
01:36
Now, I'm a neuroscientist by training
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Po zanimanju sam neuroznanstvenik
01:39
and I know a little bit
about how the brain performs under stress.
about how the brain performs under stress.
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i znam ponešto o tome
kako mozak reagira pod stresom.
kako mozak reagira pod stresom.
01:43
It releases cortisol
that raises your heart rate,
that raises your heart rate,
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Luči kortizol koji ubrzava rad srca,
01:46
it modulates adrenaline levels
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regulira razinu adrenalina
01:49
and it clouds your thinking.
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i pomućuje vam razmišljanje.
01:51
So the next morning,
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I tako sam se sljedećeg jutra
01:53
when I woke up on too little sleep,
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probudio neispavan,
01:55
worrying about the hole in the window,
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zabrinut zbog rupe u prozoru,
01:58
and a mental note
that I had to call my contractor,
that I had to call my contractor,
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misleći na to da moram nazvati majstora,
02:01
and the freezing temperatures,
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da je vani ispod ništice
02:02
and the meetings I had upcoming in Europe,
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i da me u Europi čekaju sastanci,
02:05
and, you know, with all
the cortisol in my brain,
the cortisol in my brain,
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a zbog kortizola u mom mozgu
02:08
my thinking was cloudy,
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nisam mogao jasno razmišljati,
02:10
but I didn't know it was cloudy
because my thinking was cloudy.
because my thinking was cloudy.
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ali ja to nisam znao
jer nisam mogao jasno razmišljati.
jer nisam mogao jasno razmišljati.
02:13
(Laughter)
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(Smijeh)
02:15
And it wasn't until I got
to the airport check-in counter,
to the airport check-in counter,
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Zato sam tek na šalteru za prijavu putnika
02:18
that I realized I didn't have my passport.
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shvatio da nemam putovnicu.
02:20
(Laughter)
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(Smijeh)
02:22
So I raced home in the snow
and ice, 40 minutes,
and ice, 40 minutes,
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Odjurio sam kući po snijegu i ledu,
trebalo mi je 40 minuta,
trebalo mi je 40 minuta,
02:26
got my passport,
raced back to the airport,
raced back to the airport,
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uzeo putovnicu i požurio
natrag na aerodrom.
natrag na aerodrom.
02:28
I made it just in time,
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Stigao sam u zadnji čas,
02:30
but they had given away
my seat to someone else,
my seat to someone else,
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ali moje su mjesto već dali nekom drugom,
02:32
so I got stuck in the back of the plane,
next to the bathrooms,
next to the bathrooms,
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pa sam završio na kraju aviona,
pokraj zahoda,
pokraj zahoda,
02:35
in a seat that wouldn't recline,
on an eight-hour flight.
on an eight-hour flight.
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na zakočenom sjedalu,
a čekalo me 8 sati putovanja.
a čekalo me 8 sati putovanja.
02:39
Well, I had a lot of time to think
during those eight hours and no sleep.
during those eight hours and no sleep.
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Imao sam puno vremena za razmišljanje
u tih osam sati bez sna.
u tih osam sati bez sna.
02:43
(Laughter)
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(Smijeh)
02:44
And I started wondering,
are there things that I can do,
are there things that I can do,
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I počeo sam se pitati
mogu li nešto učiniti,
mogu li nešto učiniti,
02:47
systems that I can put into place,
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sustavi koje bih mogao upregnuti,
02:49
that will prevent bad things
from happening?
from happening?
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koji bi spriječili
da se dogode loše stvari?
da se dogode loše stvari?
02:51
Or at least if bad things happen,
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Ili barem, ako se loše stvari i dogode,
02:53
will minimize the likelihood
of it being a total catastrophe.
of it being a total catastrophe.
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oni bi umanjili vjerojatnost
da to bude potpuna katastrofa.
da to bude potpuna katastrofa.
02:59
So I started thinking about that,
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Pa sam počeo razmišljati o tome,
03:00
but my thoughts didn't crystallize
until about a month later.
until about a month later.
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no misli mi se nisu iskristalizirale
sve do mjesec dana kasnije.
sve do mjesec dana kasnije.
03:03
I was having dinner with my colleague,
Danny Kahneman, the Nobel Prize winner,
Danny Kahneman, the Nobel Prize winner,
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Večerao sam sa svojim kolegom nobelovcem,
Dannyjem Kahnemanom,
Dannyjem Kahnemanom,
03:07
and I somewhat embarrassedly told him
about having broken my window,
about having broken my window,
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i pomalo posramljeno ispričao mu o tome
kako sam razbio prozor,
kako sam razbio prozor,
03:10
and, you know, forgotten my passport,
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i zaboravio svoju putovnicu,
03:13
and Danny shared with me
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a Danny mi se povjerio
03:14
that he'd been practicing
something called prospective hindsight.
something called prospective hindsight.
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kako vježba nešto što se zove
vjerojatna neopreznost.
vjerojatna neopreznost.
03:19
(Laughter)
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(Smijeh)
03:20
It's something that he had gotten
from the psychologist Gary Klein,
from the psychologist Gary Klein,
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To je nešto što je čuo od
psihologa Garyja Kleina,
psihologa Garyja Kleina,
03:24
who had written about it
a few years before,
a few years before,
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koji je pisao o tome
prije par godina,
prije par godina,
03:26
also called the pre-mortem.
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također poznato kao pre-mortem.
03:28
Now, you all know what the postmortem is.
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Svi znate što je postmortem (obdukcija).
03:30
Whenever there's a disaster,
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Kada se dogodi katastrofa,
03:31
a team of experts come in and they try
to figure out what went wrong, right?
to figure out what went wrong, right?
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tim stručnjaka dođe i pokuša
odgonetnuti što je pošlo po zlu, zar ne?
odgonetnuti što je pošlo po zlu, zar ne?
03:36
Well, in the pre-mortem, Danny explained,
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E pa, u pre-mortemu, kaže Danny,
03:38
you look ahead and you try to figure out
all the things that could go wrong,
all the things that could go wrong,
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gledate unaprijed i pokušavate odgonetnuti
sve što bi moglo poći po krivu,
sve što bi moglo poći po krivu,
03:42
and then you try to figure out
what you can do
what you can do
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a onda pokušate shvatiti
što možete učiniti
što možete učiniti
03:45
to prevent those things from happening,
or to minimize the damage.
or to minimize the damage.
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kako biste sprječili da se to dogodi
ili da umanjite štetu.
ili da umanjite štetu.
03:48
So what I want to talk to you about today
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Ono o čemu vam ja danas želim pričati
03:51
are some of the things we can do
in the form of a pre-mortem.
in the form of a pre-mortem.
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je nekoliko primjera koje možemo slijediti
u obliku obdukcije.
u obliku obdukcije.
03:55
Some of them are obvious,
some of them are not so obvious.
some of them are not so obvious.
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Neki od njih su očiti,
neki baš i nisu.
neki baš i nisu.
03:58
I'll start with the obvious ones.
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Počet ću s očitima.
03:59
Around the home, designate a place
for things that are easily lost.
for things that are easily lost.
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U cijelom domu, odredite mjesto
za stvari koje se lako gube.
za stvari koje se lako gube.
04:05
Now, this sounds
like common sense, and it is,
like common sense, and it is,
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Znam da ovo zvuči zdravorazumski,
i jest,
i jest,
04:09
but there's a lot of science
to back this up,
to back this up,
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ali i znanost to podupire,
04:12
based on the way our spatial memory works.
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temeljeno na načinu na koji funkcionira
naša spacijalna memorija.
naša spacijalna memorija.
04:15
There's a structure in the brain
called the hippocampus,
called the hippocampus,
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Postoji struktura u mozgu
koja se zove hipokampus,
koja se zove hipokampus,
04:18
that evolved over tens
of thousands of years,
of thousands of years,
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koja evoluirala tijekom
desetaka tisuća godina,
desetaka tisuća godina,
04:21
to keep track of the locations
of important things --
of important things --
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kako bi se pamtila lokacije
važnih stvari --
važnih stvari --
04:25
where the well is,
where fish can be found,
where fish can be found,
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gdje je izvor,
gdje se može naći riba,
gdje se može naći riba,
04:27
that stand of fruit trees,
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gdje su stabla voćki,
04:30
where the friendly and enemy tribes live.
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gdje žive prijateljska
i neprijateljska plemena.
i neprijateljska plemena.
04:32
The hippocampus is the part of the brain
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Hipokampus je dio mozga
04:34
that in London taxicab drivers
becomes enlarged.
becomes enlarged.
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koji se londonskim vozačima taksija
s vremenom povećava.
s vremenom povećava.
04:38
It's the part of the brain
that allows squirrels to find their nuts.
that allows squirrels to find their nuts.
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To je dio mozga zahvaljujući kojem
vjeverice nađu lješnjake.
vjeverice nađu lješnjake.
04:41
And if you're wondering,
somebody actually did the experiment
somebody actually did the experiment
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I ako se pitate,
netko je zapravo proveo eksperiment
netko je zapravo proveo eksperiment
04:44
where they cut off
the olfactory sense of the squirrels,
the olfactory sense of the squirrels,
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u kojem su vjevericama
odstranili osjetilo mirisa,
odstranili osjetilo mirisa,
04:47
and they could still find their nuts.
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a one su i dalje
mogle naći lješnjake.
mogle naći lješnjake.
04:49
They weren't using smell,
they were using the hippocampus,
they were using the hippocampus,
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Nisu koristile njuh,
već hipokampus,
već hipokampus,
04:52
this exquisitely evolved mechanism
in the brain for finding things.
in the brain for finding things.
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taj izvrsno razvijen mehanizam
u mozgu za pronalaženje stvari.
u mozgu za pronalaženje stvari.
04:57
But it's really good for things
that don't move around much,
that don't move around much,
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No, odličan je za stvari
koje se puno ne miču,
koje se puno ne miču,
05:01
not so good for things that move around.
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ne tako dobar za one
koje se miču.
koje se miču.
05:03
So this is why we lose car keys
and reading glasses and passports.
and reading glasses and passports.
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To je razlog zašto gubimo ključeve auta,
naočale za čitanje i putovnice.
naočale za čitanje i putovnice.
05:07
So in the home,
designate a spot for your keys --
designate a spot for your keys --
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Stoga u svome domu odredite mjesto
za svoje ključeve --
za svoje ključeve --
05:10
a hook by the door,
maybe a decorative bowl.
maybe a decorative bowl.
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kukica kraj vrata,
možda dekorativna zdjela.
možda dekorativna zdjela.
05:13
For your passport, a particular drawer.
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Za putovnicu
odredite posebnu ladicu.
odredite posebnu ladicu.
05:15
For your reading glasses,
a particular table.
a particular table.
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Za naočale poseban stol.
05:18
If you designate a spot
and you're scrupulous about it,
and you're scrupulous about it,
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Ako odredite mjesto
i budete savjesni po tom pitanju,
i budete savjesni po tom pitanju,
05:21
your things will always be there
when you look for them.
when you look for them.
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vaše stvari će uvijek biti ondje
kad ih tražite.
kad ih tražite.
05:24
What about travel?
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Što je s putovanjima?
05:25
Take a cell phone picture
of your credit cards,
of your credit cards,
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Mobitelom slikajte kreditne kartice,
05:28
your driver's license, your passport,
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vozačku dozvolu, putovnicu,
05:30
mail it to yourself so it's in the cloud.
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pošaljite to sebi, da bude
na online disku.
na online disku.
05:32
If these things are lost or stolen,
you can facilitate replacement.
you can facilitate replacement.
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Ako se te stvari izgube ili ukradu,
možete si olakšati njihovu zamjenu.
možete si olakšati njihovu zamjenu.
05:37
Now these are some rather obvious things.
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Dakle, ovo su neki od očitih primjera.
05:39
Remember, when you're under stress,
the brain releases cortisol.
the brain releases cortisol.
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Sjetite se, kada ste pod stresom,
mozak luči kortizol.
mozak luči kortizol.
05:43
Cortisol is toxic,
and it causes cloudy thinking.
and it causes cloudy thinking.
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Kortizol je toksičan
i uzrokuje pomućeno razmišljanje.
i uzrokuje pomućeno razmišljanje.
05:46
So part of the practice of the pre-mortem
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Stoga je dio prakse u pre-mortemu
05:49
is to recognize that under stress
you're not going to be at your best,
you're not going to be at your best,
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prepoznati da pod stresom
nećete biti u najboljem izdanju,
nećete biti u najboljem izdanju,
05:53
and you should put systems in place.
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i da morate upregnuti neke sustave.
05:55
And there's perhaps
no more stressful a situation
no more stressful a situation
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Vjerojatno ne postoji
stresnija situacija
stresnija situacija
05:58
than when you're confronted
with a medical decision to make.
with a medical decision to make.
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od one kada ste suočeni s
donošenjem medicinske odluke.
donošenjem medicinske odluke.
06:02
And at some point, all of us
are going to be in that position,
are going to be in that position,
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U nekom trenutku, svi mi ćemo se naći
u toj poziciji,
u toj poziciji,
06:05
where we have to make
a very important decision
a very important decision
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gdje moramo donijeti vrlo važnu odluku
06:07
about the future of our medical care
or that of a loved one,
or that of a loved one,
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o budućoj medicinskoj brizi
o nama ili našim voljenima,
o nama ili našim voljenima,
06:11
to help them with a decision.
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kako bismo im pomogli s odlukom.
06:12
And so I want to talk about that.
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To je ono o čemu želim pričati.
06:14
And I'm going to talk about
a very particular medical condition.
a very particular medical condition.
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Pričat ću o vrlo specifičnom
medicinskom stanju.
medicinskom stanju.
06:17
But this stands as a proxy for all kinds
of medical decision-making,
of medical decision-making,
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Ali to je primjer za sve vrste
donošenja medicinskih odluka
donošenja medicinskih odluka
06:21
and indeed for financial decision-making,
and social decision-making --
and social decision-making --
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i uistinu, za donošenje financijskih
i socijalnih odluka --
i socijalnih odluka --
06:25
any kind of decision you have to make
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bilo kakvih odluka
koje morate donijeti
koje morate donijeti
06:27
that would benefit from a rational
assessment of the facts.
assessment of the facts.
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kojima bi koristilo
racionalno prosuđivanje činjenica.
racionalno prosuđivanje činjenica.
06:31
So suppose you go to your doctor
and the doctor says,
and the doctor says,
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Pretpostavimo da idete kod liječnika
i on kaže,
i on kaže,
06:34
"I just got your lab work back,
your cholesterol's a little high."
your cholesterol's a little high."
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"Upravo su stigli laboratorijski nalazi,
kolesterol Vam je malo povišen."
kolesterol Vam je malo povišen."
06:39
Now, you all know that high cholesterol
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Svi znate da je povišeni kolesterol
06:42
is associated with an increased risk
of cardiovascular disease,
of cardiovascular disease,
136
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povezan s povećanim rizikom
od kardiovaskularnih bolesti,
od kardiovaskularnih bolesti,
06:46
heart attack, stroke.
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srčanim udarom, kapi.
06:47
And so you're thinking
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Pa mislite,
06:49
having high cholesterol
isn't the best thing,
isn't the best thing,
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imati povišen kolesterol
nije baš najbolje,
nije baš najbolje,
06:51
and so the doctor says,
"You know, I'd like to give you a drug
"You know, I'd like to give you a drug
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399240
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a liječnik kaže,
"Znate, dao bih Vam lijek
"Znate, dao bih Vam lijek
06:54
that will help you
lower your cholesterol, a statin."
lower your cholesterol, a statin."
141
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koji će Vam pomoći sniziti
kolesterol, statin."
kolesterol, statin."
06:57
And you've probably heard of statins,
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Vjerojatno ste čuli za statine,
06:59
you know that they're among
the most widely prescribed drugs
the most widely prescribed drugs
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znate da su danas među
najčešće propisanim lijekovima
najčešće propisanim lijekovima
07:01
in the world today,
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1174
na svijetu,
07:03
you probably even know
people who take them.
people who take them.
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vjerojatno poznate i ljude
koji ih uzimaju.
koji ih uzimaju.
07:05
And so you're thinking,
"Yeah! Give me the statin."
"Yeah! Give me the statin."
146
413135
2381
Pa mislite,
"Da! Dajte mi statin."
"Da! Dajte mi statin."
07:07
But there's a question
you should ask at this point,
you should ask at this point,
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Međutim, tada se treba
nešto zapitati,
nešto zapitati,
07:10
a statistic you should ask for
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statistika koju želite saznati
07:11
that most doctors
don't like talking about,
don't like talking about,
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o kojoj većina liječnika
ne voli pričati,
ne voli pričati,
07:14
and pharmaceutical companies
like talking about even less.
like talking about even less.
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a farmaceutske firme još manje.
07:18
It's for the number needed to treat.
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To je broj koji se treba liječiti.
07:21
Now, what is this, the NNT?
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Što je to NNT?
07:23
It's the number of people
that need to take a drug
that need to take a drug
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To je broj ljudi koji
treba uzeti lijek
treba uzeti lijek
07:26
or undergo a surgery
or any medical procedure
or any medical procedure
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ili biti podvrgnut operaciji
ili nekom medicinskom postupku
ili nekom medicinskom postupku
07:29
before one person is helped.
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prije nego što
se pomogne jednoj osobi.
se pomogne jednoj osobi.
07:31
And you're thinking,
what kind of crazy statistic is that?
what kind of crazy statistic is that?
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I mislite se,
kakva je to luda statistika?
kakva je to luda statistika?
07:34
The number should be one.
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Broj bi trebao biti
jedan.
jedan.
07:35
My doctor wouldn't prescribe
something to me
something to me
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Moj liječnik mi
ne bi prepisao nešto
ne bi prepisao nešto
07:37
if it's not going to help.
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ako mi neće pomoći.
07:39
But actually, medical practice
doesn't work that way.
doesn't work that way.
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Ali zapravo, u medicinskoj praksi
nije uvijek tako.
nije uvijek tako.
07:41
And it's not the doctor's fault,
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I nije liječnikova krivica,
07:43
if it's anybody's fault,
it's the fault of scientists like me.
it's the fault of scientists like me.
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ako je ičija krivica, onda je to krivica
znanstvenika poput mene.
znanstvenika poput mene.
07:46
We haven't figured out
the underlying mechanisms well enough.
the underlying mechanisms well enough.
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Nismo baš potpuno dokučili
osnovne mehanizme.
osnovne mehanizme.
07:48
But GlaxoSmithKline estimates
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2410
No, GlaxoSmithKline procjenjuje
07:51
that 90 percent of the drugs work
in only 30 to 50 percent of the people.
in only 30 to 50 percent of the people.
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4976
da 90% lijekova funkcionira u samo
30% do 50% ljudi.
30% do 50% ljudi.
07:56
So the number needed to treat
for the most widely prescribed statin,
for the most widely prescribed statin,
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Pa, što mislite koji bi bio
broj ljudi koji treba liječiti
broj ljudi koji treba liječiti
08:00
what do you suppose it is?
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za najčešće propisani statin?
08:02
How many people have to take it
before one person is helped?
before one person is helped?
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470400
2816
Koliko ljudi ga mora uzimati
prije nego što se pomogne jednoj osobi?
prije nego što se pomogne jednoj osobi?
08:05
300.
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1200
300.
08:07
This is according to research
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1381
Ovo se temelji
na istraživanju
na istraživanju
08:08
by research practitioners
Jerome Groopman and Pamela Hartzband,
Jerome Groopman and Pamela Hartzband,
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liječnika istraživača
Jeromea Groopmana i Pamele Hartzband,
Jeromea Groopmana i Pamele Hartzband,
08:12
independently confirmed by Bloomberg.com.
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2776
nezavisno potvrđenog
od strane Bloomberg.com.
od strane Bloomberg.com.
08:14
I ran through the numbers myself.
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2400
Osobno sam prošao
kroz brojke.
kroz brojke.
08:17
300 people have to
take the drug for a year
take the drug for a year
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2376
300 ljudi mora
godinu dana uzimati lijek
godinu dana uzimati lijek
08:20
before one heart attack, stroke
or other adverse event is prevented.
or other adverse event is prevented.
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prije nego što se spriječi
1 srčani udar, kap ili drugi štetni događaj.
1 srčani udar, kap ili drugi štetni događaj.
08:24
Now you're probably thinking,
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Sad vjerojatno mislite,
08:25
"Well, OK, one in 300 chance
of lowering my cholesterol.
of lowering my cholesterol.
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493725
2811
"Pa, u redu, jedna od 300 šansi
da snizim kolesterol.
da snizim kolesterol.
08:28
Why not, doc? Give me
the prescription anyway."
the prescription anyway."
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496560
2216
Zašto ne, doktore? Svejedno
mi dajte recept."
mi dajte recept."
08:30
But you should ask at this point
for another statistic,
for another statistic,
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498800
2856
Sada biste trebali zatražiti
drugu statistiku,
drugu statistiku,
08:33
and that is, "Tell me
about the side effects." Right?
about the side effects." Right?
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a to je "Recite mi
koje su nuspojave." Zar ne?
koje su nuspojave." Zar ne?
08:36
So for this particular drug,
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1656
Za ovaj lijek, konkretno,
08:37
the side effects occur
in five percent of the patients.
in five percent of the patients.
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505960
3656
do nuspojava dolazi kod
5% pacijenata.
5% pacijenata.
08:41
And they include terrible things --
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1667
A one uključuju strahote --
08:43
debilitating muscle and joint pain,
gastrointestinal distress --
gastrointestinal distress --
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4444
bol u oslabljenim mišićima i zglobovima,
gastrointestinalni bolovi
gastrointestinalni bolovi
08:47
but now you're thinking, "Five percent,
185
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1859
ali sad mislite, "Pet posto,
08:49
not very likely
it's going to happen to me,
it's going to happen to me,
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517682
2014
nije baš vjerojatno
da će se dogoditi meni,
da će se dogoditi meni,
08:51
I'll still take the drug."
187
519720
1238
ipak ću uzeti lijek."
08:52
But wait a minute.
188
520982
1194
Ali samo malo.
08:54
Remember under stress
you're not thinking clearly.
you're not thinking clearly.
189
522200
2336
Sjetite se da pod stresom
ne razmišljate jasno.
ne razmišljate jasno.
08:56
So think about how you're going
to work through this ahead of time,
to work through this ahead of time,
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524560
3165
Pa razmislite kako to premostiti
prije vremena,
prije vremena,
08:59
so you don't have to manufacture
the chain of reasoning on the spot.
the chain of reasoning on the spot.
191
527750
3198
kako ne biste trebali proizvesti
lanac rasuđivanja na licu mjesta.
lanac rasuđivanja na licu mjesta.
09:02
300 people take the drug, right?
One person's helped,
One person's helped,
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530973
2492
300 ljudi uzima lijek, zar ne?
Jednoj osobi se pomogne,
Jednoj osobi se pomogne,
09:05
five percent of those 300
have side effects,
have side effects,
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2407
pet posto od onih 300
imaju nuspojave,
imaju nuspojave,
09:07
that's 15 people.
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535920
1480
to je 15 ljudi.
09:09
You're 15 times more likely
to be harmed by the drug
to be harmed by the drug
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537800
3896
15 puta više vjerojatnosti ima da
vam se lijekom naudi
vam se lijekom naudi
09:13
than you are to be helped by the drug.
196
541720
2816
nego da vam se njime pomogne.
09:16
Now, I'm not saying whether you
should take the statin or not.
should take the statin or not.
197
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2905
Ne poručujem vam da biste trebali
uzimati lijek ili ne.
uzimati lijek ili ne.
09:19
I'm just saying you should have
this conversation with your doctor.
this conversation with your doctor.
198
547489
3143
Samo kažem da biste trebali povesti
ovakav razgovor sa svojim liječnikom.
ovakav razgovor sa svojim liječnikom.
09:22
Medical ethics requires it,
199
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1320
Liječnička etika to zahtijeva,
09:24
it's part of the principle
of informed consent.
of informed consent.
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552000
2296
to je dio principa
o informiranoj suglasnosti.
o informiranoj suglasnosti.
09:26
You have the right to have access
to this kind of information
to this kind of information
201
554320
3216
Imate pravo na pristup
ovakvoj vrsti informacija,
ovakvoj vrsti informacija,
09:29
to begin the conversation about whether
you want to take the risks or not.
you want to take the risks or not.
202
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3896
da započnete razgovor o tome
želite li riskirati ili ne.
želite li riskirati ili ne.
09:33
Now you might be thinking
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Sad možda mislite
09:34
I've pulled this number
out of the air for shock value,
out of the air for shock value,
204
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2696
da sam izvukao bezveze neki broj
radi izazivanja šoka,
radi izazivanja šoka,
09:37
but in fact it's rather typical,
this number needed to treat.
this number needed to treat.
205
565440
3256
ali zapravo je jako tipično,
broj koji se treba liječiti.
broj koji se treba liječiti.
09:40
For the most widely performed surgery
on men over the age of 50,
on men over the age of 50,
206
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4616
Za većinu obavljenih operacija
na muškarcima starijim od 50 godina,
na muškarcima starijim od 50 godina,
09:45
removal of the prostate for cancer,
207
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2216
odstranjivanje prostate zbog raka,
09:47
the number needed to treat is 49.
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2576
broj koji je potrebno liječiti je 49.
09:50
That's right, 49 surgeries are done
for every one person who's helped.
for every one person who's helped.
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4176
Točno tako, 49 operacija mora se izvršiti
za svaku osobu kojoj se pomaže.
za svaku osobu kojoj se pomaže.
09:54
And the side effects in that case
occur in 50 percent of the patients.
occur in 50 percent of the patients.
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582400
4656
Nuspojave u tom slučaju pojavljuju se
kod 50% pacijenata.
kod 50% pacijenata.
09:59
They include impotence,
erectile dysfunction,
erectile dysfunction,
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2856
One uključuju impotenciju,
erektilnu disfunkciju,
erektilnu disfunkciju,
10:01
urinary incontinence, rectal tearing,
212
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2776
urinarnu inkontinenciju,
pucanje rektuma,
pucanje rektuma,
10:04
fecal incontinence.
213
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1456
fekalnu inkontinenciju.
10:06
And if you're lucky, and you're one
of the 50 percent who has these,
of the 50 percent who has these,
214
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3496
A ako imate sreće i jedan ste
od 50% koji ovo imaju,
od 50% koji ovo imaju,
10:09
they'll only last for a year or two.
215
597760
2040
nuspojave će trajati samo
godinu dana ili dvije.
godinu dana ili dvije.
10:12
So the idea of the pre-mortem
is to think ahead of time
is to think ahead of time
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600880
3616
Ideja pre-mortema
je razmišljati unaprijed
je razmišljati unaprijed
10:16
to the questions
that you might be able to ask
that you might be able to ask
217
604520
2536
o pitanjima
koja biste mogli postaviti
koja biste mogli postaviti
10:19
that will push the conversation forward.
218
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2376
koja će pogurnuti razgovor.
10:21
You don't want to have to manufacture
all of this on the spot.
all of this on the spot.
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3096
Ne želite da se dogodi da to sve morate
proizvesti na licu mjesta.
proizvesti na licu mjesta.
10:24
And you also want to think
about things like quality of life.
about things like quality of life.
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A morate i razmišljati
o nečemu kao što je kvaliteta života.
o nečemu kao što je kvaliteta života.
10:27
Because you have a choice oftentimes,
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1776
Zato što često imate izbor,
10:29
do you I want a shorter life
that's pain-free,
that's pain-free,
222
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želite li kraći život, bez boli
10:31
or a longer life that might have
a great deal of pain towards the end?
a great deal of pain towards the end?
223
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3776
ili duži život u kojem ćete pred kraj
možda iskusiti jaku bol?
možda iskusiti jaku bol?
10:35
These are things to talk about
and think about now,
and think about now,
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2416
To je nešto o čemu treba sada
razmisliti i pričati
razmisliti i pričati
10:37
with your family and your loved ones.
225
625880
1816
sa svojom obitelji i bližnjima.
10:39
You might change your mind
in the heat of the moment,
in the heat of the moment,
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2496
Možda se u trenutku predomislite,
10:42
but at least you're practiced
with this kind of thinking.
with this kind of thinking.
227
630240
3056
ali barem ste vježbali
ovakav način razmišljanja.
ovakav način razmišljanja.
10:45
Remember, our brain under stress
releases cortisol,
releases cortisol,
228
633320
4616
Zapamtite, naš mozak pod stresom
luči kortizol,
luči kortizol,
10:49
and one of the things
that happens at that moment
that happens at that moment
229
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2336
a nešto što se tada dogodi
10:52
is a whole bunch on systems shut down.
230
640320
1936
jest da cijeli niz sustava zakaže.
10:54
There's an evolutionary reason for this.
231
642280
1905
Za to postoji evolucijski razlog.
10:56
Face-to-face with a predator,
you don't need your digestive system,
you don't need your digestive system,
232
644209
3407
Licem u lice s predatorom,
ne treba vam probavni sustav,
ne treba vam probavni sustav,
10:59
or your libido, or your immune system,
233
647640
2456
ni libido niti imunološki sustav,
11:02
because if you're body is expending
metabolism on those things
metabolism on those things
234
650120
3656
jer ako vaše tijelo troši
metabolizam na takve stvari,
metabolizam na takve stvari,
11:05
and you don't react quickly,
235
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1656
a vi ne reagirate brzo,
11:07
you might become the lion's lunch,
and then none of those things matter.
and then none of those things matter.
236
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3976
možete lavu postati obrok,
a tada ništa od ovoga nije bitno.
a tada ništa od ovoga nije bitno.
11:11
Unfortunately,
237
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1416
Nažalost,
11:12
one of the things that goes out the window
during those times of stress
during those times of stress
238
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3616
ono što u takvim stresnim trenucima
više ne postoji
više ne postoji
11:16
is rational, logical thinking,
239
664560
1976
je racionalno, logično razmišljanje,
11:18
as Danny Kahneman
and his colleagues have shown.
and his colleagues have shown.
240
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3416
kao što su pokazali Danny Kahneman
i njegovi kolege.
i njegovi kolege.
11:22
So we need to train ourselves
to think ahead
to think ahead
241
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3176
Zato se moramo istrenirati da
razmišljamo unaprijed
razmišljamo unaprijed
11:25
to these kinds of situations.
242
673200
2256
o ovakvim situacijama.
11:27
I think the important point here
is recognizing that all of us are flawed.
is recognizing that all of us are flawed.
243
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6176
Mislim da je bitna stavka ovdje
prepoznati da svi imamo mane.
prepoznati da svi imamo mane.
11:33
We all are going to fail now and then.
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2856
Svi ćemo tu i tamo pogriješiti.
11:36
The idea is to think ahead
to what those failures might be,
to what those failures might be,
245
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3616
Bit je unaprijed
razmišljati o tim greškama,
razmišljati o tim greškama,
11:40
to put systems in place
that will help minimize the damage,
that will help minimize the damage,
246
688200
3896
uspostaviti sustave koji će umanjiti štetu
11:44
or to prevent the bad things
from happening in the first place.
from happening in the first place.
247
692120
3520
ili spriječiti da se loše stvari
uopće i dogode.
uopće i dogode.
11:48
Getting back to that
snowy night in Montreal,
snowy night in Montreal,
248
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2656
Da se vratimo na
onu snježnu noć u Montrealu
onu snježnu noć u Montrealu
11:50
when I got back from my trip,
249
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1736
kad sam se vratio s puta,
11:52
I had my contractor install
a combination lock next to the door,
a combination lock next to the door,
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majstor mi je instalirao
kombinacijsku bravu kraj vrata
kombinacijsku bravu kraj vrata
11:56
with a key to the front door in it,
an easy to remember combination.
an easy to remember combination.
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u kojoj je ključ za prednja vrata,
kombinacija je lako pamtljiva.
kombinacija je lako pamtljiva.
12:00
And I have to admit,
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I moram priznati,
12:01
I still have piles of mail
that haven't been sorted,
that haven't been sorted,
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još uvijek imam hrpe pošte
koja nije svrstana
koja nije svrstana
12:04
and piles of emails
that I haven't gone through.
that I haven't gone through.
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i hrpe e-mailova
koje još nisam niti pogledao.
koje još nisam niti pogledao.
12:07
So I'm not completely organized,
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Tako da nisam potpuno organiziran,
12:09
but I see organization
as a gradual process,
as a gradual process,
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ali na organizaciju gledam kao
postupni proces
postupni proces
12:12
and I'm getting there.
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i napredujem prema tome.
12:13
Thank you very much.
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Hvala puno.
12:14
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Daniel Levitin - NeuroscientistDaniel Levitin incorporates findings from neuroscience into everyday life.
Why you should listen
Dr. Daniel Levitin is a neuroscientist at McGill University in Montreal, dean at Minerva Schools in San Francisco and a musician. His research focuses on pattern processing in the brain.
His three books This Is Your Brain on Music, The World in Six Songs, and the recent The Organized Mind are all bestsellers. A polymath at heart, he has performed with top musicians and holds a few gold and platinum records.
Levitin earned his B.A. in Cognitive Psychology and Cognitive Science at Stanford University, and went on to earn his Ph.D. in Psychology from the University of Oregon, researching complex auditory patterns and pattern processing in expert and non-expert populations. He completed post-doctoral training at Stanford University Medical School (in Neuroimaging) and at UC Berkeley (in Cognitive Psychology). He has consulted on audio sound source separation for the U.S. Navy, and on audio quality for several rock bands and record labels (including the Grateful Dead and Steely Dan), and served as one of the “Golden Ears” expert listeners in the original Dolby AC3 compression tests. He worked for two years at the Silicon Valley think tank Interval Research Corporation.
He taught at Stanford University in the Department of Computer Science, the Program in Human-Computer Interaction, and the Departments of Psychology, Anthropology, Computer Music, and History of Science.
Daniel Levitin | Speaker | TED.com