Can you outsmart the fallacy that fooled a generation of doctors? - Elizabeth Cox

Prevodilac: Jovana Babic Lektor: Milenka Okuka

Oh the humanity!

Oh čovečanstvo!

Ah... humanity...

Ah... čovečanstvo...

It’s a trainwreck, but I can’t look away.

Kao katastrofa od koje ne mogu da odvojim pogled.

It’s 1843, and a debate is raging among physicians

Godina je 1843, a među lekarima se vodi žestoka debata

about one of the most common killers of women: childbed fever.

oko jednog od najčešćih uzroka smrti kod žena: porodiljske groznice.

Childbed fever strikes within days of giving birth,

Porodiljska groznica nastaje u danima nakon porođaja

killing more than 70% of those infected— and nobody knows what causes it.

i dovodi do smrti više od 70% inficiranih- a niko ne zna zašto nastaje.

Obstetrician Charles Meigs has a theory.

Akušer Čarls Migs ima teoriju.

Having observed abdominal inflammation

On je primetio da se zapaljenje abdomena

in patients who go on to develop the fever,

javlja kod pacijentkinja koje kasnije dobiju groznicu

he claims this inflammation is the cause of childbed fever.

i zbog toga je tvrdio da je zapaljenje uzrok porodiljske groznice.

Much of the medical establishment supports his theory.

Većina medicinskog establišmenta je potvrdila njegovu teoriju.

Oh, come on!

Ma daj!

They really leave me no choice but to teach them some skepticism.

Ne ostavljaju mi izbora, moram ih naučiti nešto o skepticizmu.

That’s better.

Tako je bolje.

Now, Meigs, your argument is based on a fallacy— the false cause fallacy.

Hej, Migs, tvoj argument je zasnovan na tipu logičke greške - lažni uzrok.

Correlation does not imply causation:

Povezanost ne znači uzročnost:

When two phenomena regularly occur together,

kada se dva događaja često dešavaju zajedno

one does not necessarily cause the other.

ne mora da znači da jedan uzrokuje drugi.

So you say women who have inflammation also come down with childbed fever,

Dakle, ti kažeš da žene sa zapaljenjem dobijaju porodiljsku groznicu

therefore the inflammation caused the fever.

i zbog toga zapaljenje uzrokuje groznicu.

But that’s not necessarily true.

Ali to nije nužno tačno.

Yes, yes, the inflammation comes first, then the fever,

Da, da, zapaljenje se prvo javlja, pa onda groznica,

so it seems like the inflammation causes the fever.

pa zato deluje da zapaljenje izaziva groznicu.

But by that logic, since babies usually grow hair before teeth,

Po ovoj logici, pošto bebama kosa poraste pre zuba,

hair growth must cause tooth growth.

rast kose mora da izaziva rast zuba.

And we all know that’s not true, right?

A svi mi znamo da to nije tačno, zar ne?

Actually, don’t answer that.

Zapravo, ne odgovaraj.

A couple of different things could be going on here.

Ovde se može dešavati nekoliko stvari.

First, it’s possible that fever and inflammation are correlated

Prvo, moguće je da su groznica i zapaljenje povezani

purely by coincidence.

sasvim slučajno.

Or, there could be a causal relationship that’s the opposite of what you think—

Ili je moguće da postoji uzročna veza suprotna onoj koju si pretpostavio -

the fever causes the inflammation,

da groznica izaziva zapaljenje,

rather than the inflammation causing the fever.

a ne zapaljenje groznicu.

Or both could share a common underlying cause you haven’t thought of.

Ili imaju zajednički skriveni uzrok za koji ne znaš.

If I may, just what do you think causes inflammation? Nothing?

Uz dužno poštovanje, šta misliš da izaziva zapaljenje?

Ništa?

It just is? Really?

Samo nastaje? Stvarno?

Humor me for a moment in discussing one of your colleague’s ideas—

Hajde da na kratko razmotrimo ideju jednog od tvojih kolega -

Dr. Oliver Wendell Holmes.

Dr Olivera Vendela Holmsa.

I know, I know, you don’t like his theory—

Znam, znam da ti se ne sviđa njegova teorija -

you already wrote a scathing letter about it.

već si napisao oštro pismo o njoj.

But let’s fill your students in, shall we?

Ali hajde da uputimo tvoje učenike o tome.

Holmes noticed a pattern: when a patient dies of childbed fever,

Holms je primetio obrazac: kada god pacijentkinja umre od porodiljske groznice

a doctor performs an autopsy.

doktor uradi obdukciju.

If the doctor then treats a new patient,

Ako doktor nakon toga pregleda novog pacijenta,

that patient often comes down with the fever.

taj pacijent često razvije groznicu.

Based on this correlation

Na osnovu ove korelacije

between autopsies of fever victims and new fever patients,

između obdukcije umrlih od groznice i novih pacijenata sa groznicom,

he proposes a possible cause.

Holms predlaže moguće objašnjenje.

Since there’s no evidence that the autopsy causes the fever beyond this correlation,

Pošto ne postoje dokazi da obdukcija izaziva groznicu van ove korelacije

he doesn’t jump to the conclusion that autopsy causes fever.

on nije odmah ishitreno zaključio da obdukcija izaziva groznicu.

Instead, he suggests that doctors are infecting their patients

Umesto toga, on smatra da doktori inficiraju svoje pacijente

via an invisible contaminant on their hands and surgical instruments.

nevidljivim zagađivačem preko svojih ruku i hirurških instrumenata.

This idea outrages most doctors, who see themselves as infallible.

Ova ideja nervira većinu doktora jer oni sebe smatraju nepogrešivim.

Like Meigs here, who refuses to consider the possibility

Isto kao Migs, koji odbija i da razmotri mogućnost

that he’s playing a role in his patients’ plight.

da on igra ulogu u patnji svojih pacijenata.

His flawed argument doesn’t leave any path forward for further investigation—

Njegov manjkavi argument ne daje mesta za dalje istraživanje -

but Holmes’ does.

ali Holmsov daje.

It’s 1847, and physician Ignaz Semmelweis

Godina je 1847, a doktor Ignac Zemelvajs

has reduced the number of childbed fever deaths

je smanjio smtrtnost od porodiljske groznice

in a clinic from 12% to 1% by requiring all medical personnel

u klinici sa 12% na 1% jer je zahtevao da sve medicinsko osoblje

to disinfect their hands after autopsies and between patient examinations.

dezinfikuje svoje ruke nakon obdukcije i između pregleda pacijenata.

With this initiative, he has proven the contagious nature of childbed fever.

Ovom praksom, on je dokazao zaraznu prirodu porodiljske groznice.

Ha!

Ha!

It’s 1879, and Louis Pasteur has identified

Godina je 1879. i Luj Paster je identifikovao

the contaminant responsible for many cases of childbed fever:

kontaminant odgovoran za mnoge slučajeve porodiljske groznice:

Hemolytic streptococcus bacteria.

hemolitičku streptokoknu bakteriju.

Hmm, my fries are cold.

Hmm, moj pomfrit je hladan.

Must be because my ice cream melted.

Mora da je tako jer mi se sladoled istopio.