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Daniel Levitin: How to stay calm when you know you'll be stressed
Danijel Levitin (Daniel Levitin): Kako da ostanete smireni kada znate da ćete biti pod stresom
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Kada ste pod stresom, ne funkcionišete najbolje. Zapravo, tokom milenijuma je vaš mozak evoluirao kako bi u stresnim situacijama oslobađao kortizol, koji inhibira racionalno, logičko mišljenje, ali vam može pomoći da preživite ako vas, recimo, napadne lav. Neurolog Danijel Levitin misli da postoji način da se izbegnu presudne greške u stresnim situacijama, kada ne razmišljate jasno - to je pred-uviđaj. "S vremena na vreme, svi pogrešimo," kaže on. "Ideja je da unapred mislimo o tome koje bismo greške mogli napraviti."
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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Pre nekoliko godina,
provalio sam u sopstvenu kuću.
provalio sam u sopstvenu 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 ponoći
usred montrealske zime,
usred montrealske zime,
00:20
I had been visiting my friend,
Jeff, across town,
Jeff, across town,
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bio sam u poseti prijatelju, Džefu,
na drugom kraju grada
na drugom kraju grada
00:23
and the thermometer on the front porch
read minus 40 degrees --
read minus 40 degrees --
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i termometar na tremu
je pokazivao minus 40 stepeni -
je pokazivao minus 40 stepeni -
00:27
and don't bother asking
if that's Celsius or Fahrenheit,
if that's Celsius or Fahrenheit,
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i ne pitajte da li se radi
o stepenima Celzijusa ili Farenhajta
o stepenima Celzijusa ili Farenhajta
00:30
minus 40 is where the two scales meet --
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na minus 40 se skale susreću -
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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I dok sam stajao na tremu
i preturao po džepovima,
i preturao 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, video sam ih kroz prozor
00:42
lying on the dining room table
where I had left them.
where I had left them.
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kako stoje na trpezarijskom stolu
gde sam ih i ostavio.
gde sam ih i 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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Brzo sam sve obišao i pokušao
da otvorim druga vrata i prozore,
da otvorim druga vrata i prozore,
00:48
and they were locked tight.
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i sva su bila zaključana.
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 zovem bravara -
makar sam imao mobilni,
makar sam imao mobilni,
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 u ponoć, moglo je potrajati
dok bravar stigne,
dok bravar stigne,
00:56
and it was cold.
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a 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 mogao da se vratim
da prespavam kod Džefa
da prespavam kod Džefa
01:03
because I had an early flight
to Europe the next morning,
to Europe the next morning,
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jer je rano ujutru
trebalo da letim za Evropu,
trebalo da letim za Evropu,
01:05
and I needed to get
my passport and my suitcase.
my passport and my suitcase.
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i morao sam da uzmem pasoš i kofer.
01:08
So, desperate and freezing cold,
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Tako sam, očajan i smrzavajući se
01:10
I found a large rock and I broke
through the basement window,
through the basement window,
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pronašao veliki kamen
i provalio kroz prozor na podrumu,
i provalio kroz prozor na podrumu,
01:14
cleared out the shards of glass,
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uklonio komade stakla,
01:16
I crawled through,
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provukao se kroz prozor,
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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našao parče kartona
i zalepio ga preko otvora,
i zalepio ga preko otvora,
01:21
figuring that in the morning,
on the way to the airport,
on the way to the airport,
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računajući da ću ujutru,
na putu do aerodroma,
na putu do aerodroma,
01:24
I could call my contractor
and ask him to fix it.
and ask him to fix it.
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pozvati majstora
i zamoliti ga da to popravi.
i zamoliti ga da to popravi.
01:26
This was going to be expensive,
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Znao sam da će to 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 verovatno ne skuplje
nego da bravar dolazi usred noći,
nego da bravar dolazi usred noći,
01:31
so I figured, under the circumstances,
I was coming out even.
I was coming out even.
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tako da sam računao, s obzirom
na okolnosti, da sam na istom.
na okolnosti, da sam na istom.
01:36
Now, I'm a neuroscientist by training
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Po obrazovanju sam neurolog
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 funkcioniše pod stresom.
kako mozak funkcioniše pod stresom.
01:43
It releases cortisol
that raises your heart rate,
that raises your heart rate,
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Oslobađa kortizol
koji ubrzava otkucaje srca,
koji ubrzava otkucaje srca,
01:46
it modulates adrenaline levels
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utiče na nivo adrenalina
01:49
and it clouds your thinking.
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i pomućuje razmišljanje.
01:51
So the next morning,
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Sledećeg jutra,
01:53
when I woke up on too little sleep,
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kada sam se probudio
nakon premalo sna,
nakon premalo sna,
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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i imajući u glavi
da moram da zovem majstora,
da moram da zovem majstora,
02:01
and the freezing temperatures,
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a uz ledene temperature
02:02
and the meetings I had upcoming in Europe,
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i sastanke koji su me čekali u Evropi
02:05
and, you know, with all
the cortisol in my brain,
the cortisol in my brain,
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i, znate, sa svim tim kortizolom u mozgu,
02:08
my thinking was cloudy,
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nisam jasno razmišljao.
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 nisam znao da ne razmišljam jasno
jer nisam jasno razmišljao.
jer nisam jasno razmišljao.
02:13
(Laughter)
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(Smeh)
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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I tek kada sam došao do šaltera
za čekiranje na aerodromu,
za čekiranje na aerodromu,
02:18
that I realized I didn't have my passport.
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shvatio sam da nisam poneo pasoš.
02:20
(Laughter)
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(Smeh)
02:22
So I raced home in the snow
and ice, 40 minutes,
and ice, 40 minutes,
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Tako da sam za 40 minuta
odjurio kući po snegu i ledu,
odjurio kući po snegu i ledu,
02:26
got my passport,
raced back to the airport,
raced back to the airport,
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uzeo pasoš, odjurio nazad na aerodrom,
02:28
I made it just in time,
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stigao sam tačno na vreme,
02:30
but they had given away
my seat to someone else,
my seat to someone else,
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ali su već dali moje sedište 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 zaglavio u zadnjem delu aviona,
pored kupatila,
pored kupatila,
02:35
in a seat that wouldn't recline,
on an eight-hour flight.
on an eight-hour flight.
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u sedištu koje nije moglo da se spusti,
na letu od osam sati.
na letu od osam sati.
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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Pa, tokom tih osam besanih sati
imao sam dosta vremena za razmišljanje.
imao sam dosta vremena za razmišljanje.
02:43
(Laughter)
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(Smeh)
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 zapitao sam se
postoji li nešto što mogu da uradim,
postoji li nešto što mogu da uradim,
02:47
systems that I can put into place,
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sistemi koje mogu da postavim,
02:49
that will prevent bad things
from happening?
from happening?
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koji će sprečiti
da se loše stvari dešavaju?
da se loše stvari dešavaju?
02:51
Or at least if bad things happen,
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Ili će bar, ako se loše stvari dogode,
02:53
will minimize the likelihood
of it being a total catastrophe.
of it being a total catastrophe.
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smanjiti verovatnoću
da dođe do potpune katastrofe.
da dođe do potpune katastrofe.
02:59
So I started thinking about that,
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Počeo sam da razmišljam o tome,
03:00
but my thoughts didn't crystallize
until about a month later.
until about a month later.
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ali su mi se misli iskristalisale
tek oko mesec dana kasnije.
tek oko mesec 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 kolegom,
Nobelovcem Denijem Kanemanom
Nobelovcem Denijem Kanemanom
03:07
and I somewhat embarrassedly told him
about having broken my window,
about having broken my window,
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i pomalo postiđeno mu ispričao
kako sam razbio prozor
kako sam razbio prozor
03:10
and, you know, forgotten my passport,
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i, znate već, zaboravio pasoš,
03:13
and Danny shared with me
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i Deni mi je otkrio
03:14
that he'd been practicing
something called prospective hindsight.
something called prospective hindsight.
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da primenjuje nešto što se zove
buduće osvrtanje.
buduće osvrtanje.
03:19
(Laughter)
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(Smeh)
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 za šta je čuo
od psihologa Gerija Klajna,
od psihologa Gerija Klajna,
03:24
who had written about it
a few years before,
a few years before,
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koji je pisao o tome
nekoliko godina ranije,
nekoliko godina ranije,
03:26
also called the pre-mortem.
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a zove se još i pred-uviđaj.
03:28
Now, you all know what the postmortem is.
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Sad, svi znate šta je uviđaj.
03:30
Whenever there's a disaster,
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Kad god dođe do katastrofe,
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 dolazi i pokušava
da otkrije šta je pošlo naopako.
da otkrije šta je pošlo naopako.
03:36
Well, in the pre-mortem, Danny explained,
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Pa, u pred-uviđaju, objasnio je Deni,
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 unapred i pokušavate
da vidite šta bi sve moglo poći naopako
da vidite šta bi sve moglo poći naopako
03:42
and then you try to figure out
what you can do
what you can do
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i onda da smislite šta možete da uradite
03:45
to prevent those things from happening,
or to minimize the damage.
or to minimize the damage.
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da biste sprečili da se to desi,
ili smanjili štetu.
ili smanjili štetu.
03:48
So what I want to talk to you about today
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Danas hoću da pričam sa vama
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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o nekim vrstama pred-uviđaja
koje možemo da primenimo.
koje možemo da primenimo.
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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Neke od njih su očigledne,
neke nisu toliko očigledne.
neke nisu toliko očigledne.
03:58
I'll start with the obvious ones.
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Krenuću od onih očiglednih.
03:59
Around the home, designate a place
for things that are easily lost.
for things that are easily lost.
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Odredite mesto u kući
za stvari koje se lako zagube.
za stvari koje se lako zagube.
04:05
Now, this sounds
like common sense, and it is,
like common sense, and it is,
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Ovo zvuči zdravorazumski, i jeste,
04:09
but there's a lot of science
to back this up,
to back this up,
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ali je utemeljeno
na dosta naučnih činjenica,
na dosta naučnih činjenica,
04:12
based on the way our spatial memory works.
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zasnovanih na načinu na koji funkcioniše
prostorna memorija.
prostorna memorija.
04:15
There's a structure in the brain
called the hippocampus,
called the hippocampus,
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U mozgu postoji struktura
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 je evoluirala
tokom desetina hiljada godina,
tokom desetina hiljada godina,
04:21
to keep track of the locations
of important things --
of important things --
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kako bi vodila računa o lokacijama
bitnih stvari -
bitnih stvari -
04:25
where the well is,
where fish can be found,
where fish can be found,
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gde je izvor, gde se može naći riba,
04:27
that stand of fruit trees,
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ono drveće sa voćem,
04:30
where the friendly and enemy tribes live.
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gde žive prijateljska
i neprijateljska plemena.
i neprijateljska plemena.
04:32
The hippocampus is the part of the brain
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Hipokampus je deo mozga
04:34
that in London taxicab drivers
becomes enlarged.
becomes enlarged.
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koji se uvećava kod londonskih taksista.
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 deo mozga zahvaljujući kome
veverice pronalaze svoje lešnike.
veverice pronalaze svoje lešnike.
04:41
And if you're wondering,
somebody actually did the experiment
somebody actually did the experiment
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I ako ste se pitali,
neko je zaista izveo eksperiment
neko je zaista izveo eksperiment
04:44
where they cut off
the olfactory sense of the squirrels,
the olfactory sense of the squirrels,
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u kome su vevericama blokirali čulo mirisa
04:47
and they could still find their nuts.
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i one su ipak uspevale da nađu lešnike.
04:49
They weren't using smell,
they were using the hippocampus,
they were using the hippocampus,
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Nisu koristile miris,
koristile su hipokampus,
koristile su hipokampus,
04:52
this exquisitely evolved mechanism
in the brain for finding things.
in the brain for finding things.
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taj izvanredno razvijeni mehanizam
za nalaženje stvari.
za nalaženje 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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Ali on dobro funkcioniše
sa stvarima koje uglavnom miruju,
sa stvarima koje uglavnom miruju,
05:01
not so good for things that move around.
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a slabije sa onima koje se kreću.
05:03
So this is why we lose car keys
and reading glasses and passports.
and reading glasses and passports.
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Zbog toga gubimo ključeve od auta
i naočare za čitanje i pasoše.
i naočare za čitanje i pasoše.
05:07
So in the home,
designate a spot for your keys --
designate a spot for your keys --
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Zato odredite mesto za ključeve u kući -
05:10
a hook by the door,
maybe a decorative bowl.
maybe a decorative bowl.
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kukicu pored vrata, možda ukrasnu činiju.
05:13
For your passport, a particular drawer.
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Odredite posebnu fioku za pasoš.
05:15
For your reading glasses,
a particular table.
a particular table.
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Za naočare za čitanje, određeni sto.
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 jedno mesto
i pridržavate se toga,
i pridržavate se toga,
05:21
your things will always be there
when you look for them.
when you look for them.
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stvari će vam biti tamo
kad god ih budete tražili.
kad god ih budete tražili.
05:24
What about travel?
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A šta je sa putovanjima?
05:25
Take a cell phone picture
of your credit cards,
of your credit cards,
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Uslikajte telefonom kreditne kartice,
05:28
your driver's license, your passport,
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vozačku dozvolu, pasoš,
05:30
mail it to yourself so it's in the cloud.
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pošaljite to sebi mejlom
da vam bude dostupno.
da vam bude dostupno.
05:32
If these things are lost or stolen,
you can facilitate replacement.
you can facilitate replacement.
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U slučaju gubitka ili krađe tih stvari,
biće lakše da izvadite nove.
biće lakše da izvadite nove.
05:37
Now these are some rather obvious things.
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To su neke prilično očigledne stvari.
05:39
Remember, when you're under stress,
the brain releases cortisol.
the brain releases cortisol.
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Setite se, kada ste pod stresom,
mozak oslobađa kortizol.
mozak oslobađa kortizol.
05:43
Cortisol is toxic,
and it causes cloudy thinking.
and it causes cloudy thinking.
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Kortizol je toksičan, i pomućuje misli.
05:46
So part of the practice of the pre-mortem
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Zato je deo pred-uviđaja
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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da shvatite da niste u najboljem izdanju
kad ste pod stresom
kad ste pod stresom
05:53
and you should put systems in place.
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i da bi trebalo da postavite sisteme.
05:55
And there's perhaps
no more stressful a situation
no more stressful a situation
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A možda nema stresnije situacije
05:58
than when you're confronted
with a medical decision to make.
with a medical decision to make.
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nego kada se suočite
sa donošenjem medicinske odluke.
sa 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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I svi ćemo mi u nekom trenutku
biti u tom položaju,
biti u tom položaju,
06:05
where we have to make
a very important decision
a very important decision
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u kome moramo da donesemo
veoma važnu odluku
veoma 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 svom budućem medicinskom lečenju,
ili lečenju voljene osobe,
ili lečenju voljene osobe,
06:11
to help them with a decision.
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da im pomognemo oko odluke.
06:12
And so I want to talk about that.
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I o tome želim da pričam.
06:14
And I'm going to talk about
a very particular medical condition.
a very particular medical condition.
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I pričaću o konkretnom
medicinskom problemu.
medicinskom problemu.
06:17
But this stands as a proxy for all kinds
of medical decision-making,
of medical decision-making,
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Ali on služi da predstavi sve vrste
medicinskog odlučivanja,
medicinskog odlučivanja,
06:21
and indeed for financial decision-making,
and social decision-making --
and social decision-making --
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ali i finansijske odluke,
kao i društvene odluke -
kao i društvene odluke -
06:25
any kind of decision you have to make
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sve odluke koje morate da donesete
06:27
that would benefit from a rational
assessment of the facts.
assessment of the facts.
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u kojima bi vam pomogla
racionalna procena činjenica.
racionalna procena činjenica.
06:31
So suppose you go to your doctor
and the doctor says,
and the doctor says,
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Zamislite da odete kod lekara
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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"Dobio sam vaše rezultate iz laboratorije
i holesterol vam je malo povišen."
i holesterol vam je malo povišen."
06:39
Now, you all know that high cholesterol
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Svi znate da je povišen holesterol
06:42
is associated with an increased risk
of cardiovascular disease,
of cardiovascular disease,
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povezan sa povećanim rizikom
od kardiovaskularnih bolesti,
od kardiovaskularnih bolesti,
06:46
heart attack, stroke.
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od srčanog udara, infarkta.
06:47
And so you're thinking
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I zato pomišljate
06:49
having high cholesterol
isn't the best thing,
isn't the best thing,
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kako nije baš dobro
imati povišen holesterol,
imati povišen holesterol,
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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a doktor kaže:
"Znate, hteo bih da vam prepišem lek
"Znate, hteo bih da vam prepišem lek
06:54
that will help you
lower your cholesterol, a statin."
lower your cholesterol, a statin."
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koji će pomoći da vam se
snizi holesterol, statin."
snizi holesterol, statin."
06:57
And you've probably heard of statins,
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I verovatno 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 među najčešće
prepisivanim lekovima
prepisivanim lekovima
07:01
in the world today,
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u svetu danas,
07:03
you probably even know
people who take them.
people who take them.
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verovatno čak poznajete
ljude koji ih piju.
ljude koji ih piju.
07:05
And so you're thinking,
"Yeah! Give me the statin."
"Yeah! Give me the statin."
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I zato mislite:
"Da! Dajte mi taj statin."
"Da! Dajte mi taj statin."
07:07
But there's a question
you should ask at this point,
you should ask at this point,
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Ali postoji pitanje koje sada
treba da postavite,
treba da postavite,
07:10
a statistic you should ask for
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statistika za koju treba da pitate,
07:11
that most doctors
don't like talking about,
don't like talking about,
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a o kojoj većina lekara ne voli da govori,
07:14
and pharmaceutical companies
like talking about even less.
like talking about even less.
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a farmaceutske kompanije još manje.
07:18
It's for the number needed to treat.
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To je broj potreban za izlečenje.
07:21
Now, what is this, the NNT?
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Dakle, šta je to to, taj BPI?
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 da uzmu lek
07:26
or undergo a surgery
or any medical procedure
or any medical procedure
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ili se podvrgu operaciji
ili nekoj medicinskoj proceduri
ili nekoj medicinskoj proceduri
07:29
before one person is helped.
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da bi se jedna osoba izlečila.
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 vi mislite,
kakva je to suluda statistika?
kakva je to suluda statistika?
07:34
The number should be one.
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Taj broj treba da bude 1.
07:35
My doctor wouldn't prescribe
something to me
something to me
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Moj lekar mi ne bi prepisao nešto
07:37
if it's not going to help.
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ako mi to neće pomoći.
07:39
But actually, medical practice
doesn't work that way.
doesn't work that way.
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Ali zapravo, medicinska praksa
ne funkcioniše tako.
ne funkcioniše tako.
07:41
And it's not the doctor's fault,
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I za to nisu krivi lekari,
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 iko kriv
onda su to naučnici poput mene.
onda su to naučnici poput mene.
07:46
We haven't figured out
the underlying mechanisms well enough.
the underlying mechanisms well enough.
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Nismo otkrili dovoljno
o mehanizmima koji leže u osnovi.
o mehanizmima koji leže u osnovi.
07:48
But GlaxoSmithKline estimates
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Ali kompanija GlaxoSmithCline
procenjuje
procenjuje
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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da 90 procenata lekova deluje
na samo 30 do 50 procenata ljudi.
na samo 30 do 50 procenata 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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Zato je broj potreban za izlečenje
za statin koji se najčešće prepisuje,
za statin koji se najčešće prepisuje,
08:00
what do you suppose it is?
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šta mislite koji?
08:02
How many people have to take it
before one person is helped?
before one person is helped?
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Koliko ga pacijenata mora uzeti
pre nego što pomogne jednom?
pre nego što pomogne jednom?
08:05
300.
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1200
300.
08:07
This is according to research
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To su podaci istraživanja
08:08
by research practitioners
Jerome Groopman and Pamela Hartzband,
Jerome Groopman and Pamela Hartzband,
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koje su sproveli
Džerom Grupmen i Pamela Harcbend,
Džerom Grupmen i Pamela Harcbend,
08:12
independently confirmed by Bloomberg.com.
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a nezavisno potvrdio Bloomberg.com.
08:14
I ran through the numbers myself.
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I sam sam prošao kroz brojeve.
08:17
300 people have to
take the drug for a year
take the drug for a year
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Potrebno je da 300 ljudi pije lek
godinu dana
godinu dana
08:20
before one heart attack, stroke
or other adverse event is prevented.
or other adverse event is prevented.
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da bi se sprečio jedan srčani udar
ili drugi zdravstveni problem.
ili drugi zdravstveni problem.
08:24
Now you're probably thinking,
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Sada verovatno mislite:
08:25
"Well, OK, one in 300 chance
of lowering my cholesterol.
of lowering my cholesterol.
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2811
"Dobro, verovatnoća
da snizim holesterol je 1 prema 300.
da snizim holesterol je 1 prema 300.
08:28
Why not, doc? Give me
the prescription anyway."
the prescription anyway."
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2216
Što da ne, doktore?
Ipak mi dajte recept."
Ipak mi dajte recept."
08:30
But you should ask at this point
for another statistic,
for another statistic,
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2856
Ali sada treba da pitate
za još jedan statistički podatak,
za još jedan statistički podatak,
08:33
and that is, "Tell me
about the side effects." Right?
about the side effects." Right?
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a to su neželjena dejstva.
Zar ne?
Zar ne?
08:36
So for this particular drug,
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Kod ovog konkretnog leka,
08:37
the side effects occur
in five percent of the patients.
in five percent of the patients.
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3656
neželjena dejstva se javljaju
kod pet posto pacijenata.
kod pet posto pacijenata.
08:41
And they include terrible things --
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509640
1667
I ona mogu biti užasna -
08:43
debilitating muscle and joint pain,
gastrointestinal distress --
gastrointestinal distress --
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511331
4444
iznurujući bol u mišićima i zglobovima,
gastrointestinalne tegobe -
gastrointestinalne tegobe -
08:47
but now you're thinking, "Five percent,
185
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1859
ali sada vi mislite: "Pet posto,
08:49
not very likely
it's going to happen to me,
it's going to happen to me,
186
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2014
mala je verovatnoća da se to meni desi,
08:51
I'll still take the drug."
187
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1238
ipak ću uzeti lek."
08:52
But wait a minute.
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1194
Ali čekajte malo.
08:54
Remember under stress
you're not thinking clearly.
you're not thinking clearly.
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Setite 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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Zato razmislite unapred
kako ćete ovo rešiti,
kako ćete ovo rešiti,
08:59
so you don't have to manufacture
the chain of reasoning on the spot.
the chain of reasoning on the spot.
191
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kako ne biste na licu mesta
morali da osmislite lanac zaključaka.
morali da osmislite lanac zaključaka.
09:02
300 people take the drug, right?
One person's helped,
One person's helped,
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2492
Lek uzima 300 osoba, je li tako?
Jednoj pomogne,
Jednoj pomogne,
09:05
five percent of those 300
have side effects,
have side effects,
193
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2407
5 posto od tih 300
oseća neželjena dejstva,
oseća neželjena dejstva,
09:07
that's 15 people.
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1480
to je njih 15.
09:09
You're 15 times more likely
to be harmed by the drug
to be harmed by the drug
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Verovatnoća da će vam lek naškoditi
je 15 puta veća
je 15 puta veća
09:13
than you are to be helped by the drug.
196
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2816
nego da će vam pomoći.
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 kažem da li bi trebalo
da uzmete statin ili ne.
da uzmete statin ili ne.
09:19
I'm just saying you should have
this conversation with your doctor.
this conversation with your doctor.
198
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Samo kažem da treba da razgovarate
o ovome sa svojim lekarom.
o ovome sa svojim lekarom.
09:22
Medical ethics requires it,
199
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1320
To zahteva lekarska etika,
09:24
it's part of the principle
of informed consent.
of informed consent.
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to je deo principa
o informisanoj saglasnosti.
o informisanoj saglasnosti.
09:26
You have the right to have access
to this kind of information
to this kind of information
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Imate pravo da pristupite
ovakvim informacijama
ovakvim informacijama
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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da biste započeli razgovor o tome
želite li da prihvatite rizike ili ne.
želite li da prihvatite rizike ili ne.
09:33
Now you might be thinking
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Sada 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 ovaj broj izvukao niotkuda
da bih vas zapanjio,
da bih vas zapanjio,
09:37
but in fact it's rather typical,
this number needed to treat.
this number needed to treat.
205
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3256
ali je taj broj potreban za izlečenje
zapravo prilično uobičajen.
zapravo prilično uobičajen.
09:40
For the most widely performed surgery
on men over the age of 50,
on men over the age of 50,
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Za najčešću operaciju među muškarcima
starijim od 50 godina,
starijim od 50 godina,
09:45
removal of the prostate for cancer,
207
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uklanjanje prostate zbog raka,
09:47
the number needed to treat is 49.
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broj potreban za izlečenje 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
Tako je, izvrši se 49 operacija,
da bi se izlečila jedna osoba.
da bi se izlečila jedna osoba.
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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4656
U tom slučaju se neželjene posledice
javljaju kod 50 posto pacijenata.
javljaju kod 50 posto pacijenata.
09:59
They include impotence,
erectile dysfunction,
erectile dysfunction,
211
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2856
Među njima su impotencija,
erektilna disfunkcija,
erektilna disfunkcija,
10:01
urinary incontinence, rectal tearing,
212
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2776
urinarna inkontinencija, analne fisure,
10:04
fecal incontinence.
213
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1456
fekalna inkontinencija.
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,
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I ako imate sreće, a jedan ste od onih
50 posto kojima se ovo dogodi,
50 posto kojima se ovo dogodi,
10:09
they'll only last for a year or two.
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2040
potrajaće samo godinu ili dve.
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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Zato je ideja pred-uviđaja
da mislite unapred
da mislite unapred
10:16
to the questions
that you might be able to ask
that you might be able to ask
217
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2536
o pitanjima koja ćete moći da postavite
10:19
that will push the conversation forward.
218
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i tako podstaknete 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 morate sve ovo da smislite
na licu mesta.
na licu mesta.
10:24
And you also want to think
about things like quality of life.
about things like quality of life.
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I još treba da razmislite
o pitanjima poput kvaliteta života.
o pitanjima poput kvaliteta života.
10:27
Because you have a choice oftentimes,
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Jer često imate izbor,
10:29
do you I want a shorter life
that's pain-free,
that's pain-free,
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želite li kraći život bez bola,
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 koji će pred kraj
možda biti izuzetno bolan?
možda biti izuzetno bolan?
10:35
These are things to talk about
and think about now,
and think about now,
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O tome treba pričati i razmišljati sada,
10:37
with your family and your loved ones.
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1816
sa porodicom i voljenim osobama.
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 ćete se predomisliti
u žaru trenutka,
u žaru trenutka,
10:42
but at least you're practiced
with this kind of thinking.
with this kind of thinking.
227
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ali makar ćete uvežbati
da razmišljate na ovaj način.
da razmišljate na ovaj način.
10:45
Remember, our brain under stress
releases cortisol,
releases cortisol,
228
633320
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Setite se, mozak oslobađa kortizol
kada je pod stresom
kada je pod stresom
10:49
and one of the things
that happens at that moment
that happens at that moment
229
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2336
i jedna od stvari koje se tada dese
10:52
is a whole bunch on systems shut down.
230
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1936
je isključivanje gomile sistema.
10:54
There's an evolutionary reason for this.
231
642280
1905
Postoji evolutivni razlog za to.
10:56
Face-to-face with a predator,
you don't need your digestive system,
you don't need your digestive system,
232
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3407
Kad se suočite sa predatorom,
ne treba vam sistem za varenje,
ne treba vam sistem za varenje,
10:59
or your libido, or your immune system,
233
647640
2456
niti libido, niti imuni sistem,
11:02
because if you're body is expending
metabolism on those things
metabolism on those things
234
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3656
jer ako vaše telo troši metabolizam
na sve to
na sve to
11:05
and you don't react quickly,
235
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1656
i ako ne reagujete 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 postati ručak za lava,
a onda ništa od svega toga nije bitno.
a onda ništa od svega toga nije bitno.
11:11
Unfortunately,
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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
jedna od stvari koje nestaju
tokom tih stresnih trenutaka
tokom tih stresnih trenutaka
11:16
is rational, logical thinking,
239
664560
1976
je racionalno, logičko mišljenje,
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 Deni Kaneman
i njegove kolege.
i njegove kolege.
11:22
So we need to train ourselves
to think ahead
to think ahead
241
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Zato moramo da se naviknemo
da mislimo unapred
da mislimo unapred
11:25
to these kinds of situations.
242
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2256
o takvim 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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Mislim da je ovde važno
da shvatimo da svi mi imamo mane.
da shvatimo da svi mi imamo mane.
11:33
We all are going to fail now and then.
244
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2856
S vremena na vreme, svi pogrešimo.
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
Ideja je da unapred mislimo o tome
koje bismo greške mogli napraviti,
koje bismo greške mogli napraviti,
11:40
to put systems in place
that will help minimize the damage,
that will help minimize the damage,
246
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da postavimo sisteme
koji će pomoći da se umanji šteta,
koji će pomoći da se umanji šteta,
11:44
or to prevent the bad things
from happening in the first place.
from happening in the first place.
247
692120
3520
ili sprečiti da se loše stvari
uopšte dogode.
uopšte 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
snežnu noć u Montrealu,
snežnu noć u Montrealu,
11:50
when I got back from my trip,
249
698960
1736
kada sam se vratio sa putovanja,
11:52
I had my contractor install
a combination lock next to the door,
a combination lock next to the door,
250
700720
3856
majstor mi je ugradio
bravu sa šifrom pored vrata,
bravu sa šifrom pored vrata,
11:56
with a key to the front door in it,
an easy to remember combination.
an easy to remember combination.
251
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3536
koja otključava ulazna vrata,
sa kombinacijom koja se lako pamti.
sa kombinacijom koja se lako pamti.
12:00
And I have to admit,
252
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1216
I moram da priznam,
12:01
I still have piles of mail
that haven't been sorted,
that haven't been sorted,
253
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još uvek imam gomilu pošte
koju nisam sredio
koju nisam sredio
12:04
and piles of emails
that I haven't gone through.
that I haven't gone through.
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i gomilu mejlova koje nisam pročitao.
12:07
So I'm not completely organized,
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Dakle, nisam sasvim organizovan,
12:09
but I see organization
as a gradual process,
as a gradual process,
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ali organizaciju posmatram
kao postepeni proces
kao postepeni proces
12:12
and I'm getting there.
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i bližim se cilju.
12:13
Thank you very much.
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Hvala vam mnogo.
12:14
(Applause)
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(Aplauz)
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