How to stay calm when you know you'll be stressed | Daniel Levitin | TED

Translator: Lucía Campillo Rey Reviewer: Serv. de Norm. Lingüística U. de Santiago de Compostela

A few years ago, I broke into my own house.

Hai uns anos, quedei fóra da casa sen chaves.

I had just driven home,

Acababa de chegar á casa

it was around midnight in the dead of Montreal winter,

era sobre media noite, en pleno inverno en Montreal.

I had been visiting my friend, Jeff, across town,

Fora visitar un amigo ó outro lado da cidade

and the thermometer on the front porch read minus 40 degrees --

e o termómetro do soportal sinalaba 40 graos baixo cero.

and don't bother asking if that's Celsius or Fahrenheit,

E non preguntedes se eran graos Celsius ou Fahrenheit

minus 40 is where the two scales meet --

porque a esa temperatura coinciden as dúas escalas.

it was very cold.

Ía moito frío.

And as I stood on the front porch fumbling in my pockets,

E eu estaba no soportal, buscando nos petos

I found I didn't have my keys.

e deime conta de que non tiña as chaves.

In fact, I could see them through the window,

De feito, podía velas pola fiestra

lying on the dining room table where I had left them.

enriba da mesa do comedor, onde as deixara.

So I quickly ran around and tried all the other doors and windows,

Corrín arredor da casa, comprobando tódalas portas e fiestras

and they were locked tight.

pero estaban todas pechadas.

I thought about calling a locksmith -- at least I had my cellphone,

Pensei en chamar un cerralleiro, xa que tiña o móbil comigo

but at midnight, it could take a while for a locksmith to show up,

pero coa hora que era, podía tardar moito en chegar

and it was cold.

e ía moito frío.

I couldn't go back to my friend Jeff's house for the night

Non podía pasa-la noite na casa do meu amigo

because I had an early flight to Europe the next morning,

porque pola mañá cedo tiña un voo a Europa

and I needed to get my passport and my suitcase.

e necesitaba coller o pasaporte e a maleta.

So, desperate and freezing cold,

Así que, desesperado e morrendo de frío

I found a large rock and I broke through the basement window,

collín unha pedra e rompín a fiestra do soto

cleared out the shards of glass,

limpei ben os cristais e entrei por ela.

I crawled through,

I found a piece of cardboard and taped it up over the opening,

Collín un cacho de cartón e pegueino na fiestra para cubrila.

figuring that in the morning, on the way to the airport,

Díxenme que pola mañá, de camiño ó aeroporto

I could call my contractor and ask him to fix it.

podía chama-lo contratista e pedirlle que o arranxase.

This was going to be expensive,

Íame custar moitos cartos

but probably no more expensive than a middle-of-the-night locksmith,

pero tampouco máis que un cerralleiro no medio da noite.

so I figured, under the circumstances, I was coming out even.

Dadas as circunstancias, pareceume que tanto tiña.

Now, I'm a neuroscientist by training

Ben, dedícome á neurociencia

and I know a little bit about how the brain performs under stress.

e sei bastante sobre como o cerebro se comporta baixo estrés.

It releases cortisol that raises your heart rate,

Emite cortisol, que eleva o ritmo cardíaco

it modulates adrenaline levels

modula os niveis de adrenalina

and it clouds your thinking.

e nubra a mente.

So the next morning,

Así que, á mañá seguinte

when I woke up on too little sleep,

cando me levantei despois de durmir pouco,

worrying about the hole in the window,

preocupado pola fiestra rota

and a mental note that I had to call my contractor,

e por lembrarme de chama-lo contratista e polo frío que ía

and the freezing temperatures,

and the meetings I had upcoming in Europe,

e polas reunións que ía ter en Europa

and, you know, with all the cortisol in my brain,

e, vaia, con todo o cortisol que tiña no cerebro

my thinking was cloudy,

tiña a mente nubrada

but I didn't know it was cloudy because my thinking was cloudy.

pero non sabía que tiña a mente nubrada porque tiña a mente nubrada.

(Laughter)

(Risas)

And it wasn't until I got to the airport check-in counter,

E ata chegar ó mostrador do aeroporto

that I realized I didn't have my passport.

non me dei conta de que esquecera o pasaporte.

(Laughter)

(Risas)

So I raced home in the snow and ice, 40 minutes,

Así que volvín rapidamente á casa, con neve e xeo, en 40 minutos

got my passport, raced back to the airport,

collín o pasaporte, volvín ó aeroporto

I made it just in time,

e cheguei xusto a tempo,

but they had given away my seat to someone else,

pero déranlle o meu asento a outra persoa

so I got stuck in the back of the plane, next to the bathrooms,

así que tiven que sentarme ó fondo, ó lado dos aseos

in a seat that wouldn't recline, on an eight-hour flight.

nun asento que non se podía reclinar nun voo de 8 horas.

Well, I had a lot of time to think during those eight hours and no sleep.

E tiven bastante tempo para pensar sen durmir durante esas 8 horas.

(Risas)

(Laughter)

E empecei a pensar se sería posible facer algo

And I started wondering, are there things that I can do,

establecer sistemas para evitar que pasasen cousas malas.

systems that I can put into place,

that will prevent bad things from happening?

Or at least if bad things happen,

Ou, no caso de que pasasen cousas malas,

will minimize the likelihood of it being a total catastrophe.

para minimizar a probabilidade de que fosen unha catástrofe.

So I started thinking about that,

Pero non cheguei a ningures ata un mes despois.

but my thoughts didn't crystallize until about a month later.

I was having dinner with my colleague, Danny Kahneman, the Nobel Prize winner,

Estaba ceando cun colega, o premio Nobel Danny Kahneman,

e conteille, avergoñado, o que me pasara coa fiestra

and I somewhat embarrassedly told him about having broken my window,

and, you know, forgotten my passport,

e co pasaporte

and Danny shared with me

e Danny contoume

that he'd been practicing something called prospective hindsight.

que estivera practicando o que chamaba pensamento a posteriori anticipado.

(Laughter)

(Risas)

It's something that he had gotten from the psychologist Gary Klein,

Foi algo que sacara do psicólogo Gary Klein

who had written about it a few years before,

que escribira sobre isto había uns anos e que tamén se chama pre mortem.

also called the pre-mortem.

Now, you all know what the postmortem is.

Todos sabedes qué é o post mortem. Cando ocorre un desastre

Whenever there's a disaster,

a team of experts come in and they try to figure out what went wrong, right?

chega un equipo de expertos que intenta determinar qué pasou, non?

Well, in the pre-mortem, Danny explained,

Pois no pre mortem, como explicou Danny,

you look ahead and you try to figure out all the things that could go wrong,

miras cara ó futuro e intentas determinar qué pode saír mal

and then you try to figure out what you can do

e logo intentas determinar qué podes facer

to prevent those things from happening, or to minimize the damage.

para evitar que pasen esas cousas, ou para minimizar os seus efectos.

So what I want to talk to you about today

Do que vos quero falar hoxe é do que podemos facer

are some of the things we can do in the form of a pre-mortem.

no referido ó pre mortem.

Some of them are obvious, some of them are not so obvious.

Algunhas cousas son evidentes, outras non o son tanto.

I'll start with the obvious ones.

Vou empezar polas evidentes.

Around the home, designate a place for things that are easily lost.

Designar lugares por toda a casa para as cousas que se perden facilmente.

Now, this sounds like common sense, and it is,

Ben, isto parece de sentido común, e é así

but there's a lot of science to back this up,

pero a ciencia apoia isto

based on the way our spatial memory works.

baseándose en como funciona a memoria espacial.

There's a structure in the brain called the hippocampus,

Hai unha estrutura do cerebro, chamada hipocampo

that evolved over tens of thousands of years,

que evolucionou durante centos de miles de anos

to keep track of the locations of important things --

para lembrar a localización de cousas importantes.

where the well is, where fish can be found,

Onde está o pozo, onde se pode pescar,

that stand of fruit trees,

onde están as árbores froiteiras

where the friendly and enemy tribes live.

onde viven as tribos aliadas e inimigas.

The hippocampus is the part of the brain

O hipocampo é a parte do cerebro

that in London taxicab drivers becomes enlarged.

que se atopa aumentada nos condutores de taxis de Londres.

It's the part of the brain that allows squirrels to find their nuts.

É a parte do cerebro

que lles permite ós esquíos atopar as súas noces.

And if you're wondering, somebody actually did the experiment

De feito, houbo alguén que fixo o experimento

where they cut off the olfactory sense of the squirrels,

de corta-lo sentido do olfacto dos esquíos

and they could still find their nuts.

e seguían atopando as noces.

They weren't using smell, they were using the hippocampus,

Non usaban o olfacto, senón o hipocampo,

this exquisitely evolved mechanism in the brain for finding things.

un mecanismo do cerebro

exquisitamente evolucionado para atopar cousas.

But it's really good for things that don't move around much,

Pero funciona ben con cousas que non se moven demasiado

not so good for things that move around.

e non con cousas que se moven.

So this is why we lose car keys and reading glasses and passports.

Por iso perdémo-las chaves do coche, as gafas de ler ou o pasaporte.

So in the home, designate a spot for your keys --

Por iso hai que designar algún sitio para as chaves.

a hook by the door, maybe a decorative bowl.

Un gancho ó lado da porta ou un prato decorativo.

For your passport, a particular drawer.

Para o pasaporte, un caixón específico. As gafas de ler, nunha mesa específica.

For your reading glasses, a particular table.

If you designate a spot and you're scrupulous about it,

Se se designa un lugar e se é escrupuloso

your things will always be there when you look for them.

as cousas van estar no seu sitio cando as busquemos.

What about travel?

E cando viaxemos? Saca unha foto co móbil

Take a cell phone picture of your credit cards,

das tarxetas de crédito, do carné de conducir e do pasaporte.

your driver's license, your passport,

mail it to yourself so it's in the cloud.

Mándate un correo coa foto para subila á nube.

If these things are lost or stolen, you can facilitate replacement.

Se perdes ou che rouban estas cousas, pódelas substituír máis facilmente.

Now these are some rather obvious things.

Estas parecen cousas evidentes.

Remember, when you're under stress, the brain releases cortisol.

Recordade que cando estamos baixo estrés, o cerebro emite cortisol.

Cortisol is toxic, and it causes cloudy thinking.

O cortisol é tóxico e nubra a mente.

So part of the practice of the pre-mortem

Parte da práctica do pre mortem

is to recognize that under stress you're not going to be at your best,

consiste en recoñecer que baixo estrés non vas poder dar o mellor de ti mesmo

and you should put systems in place.

e que deberías establecer algún sistema.

And there's perhaps no more stressful a situation

E quizais non haxa una situación de máis estrés

than when you're confronted with a medical decision to make.

que cando te enfrontas a unha decisión médica.

And at some point, all of us are going to be in that position,

Todos estaremos nalgún momento nunha situación

where we have to make a very important decision

na que teñamos que tomar unha decisión importante

about the future of our medical care or that of a loved one,

sobre a nosa saúde ou a dun ser querido ou axudalos a tomar unha decisión.

to help them with a decision.

And so I want to talk about that.

E sobre iso quero falar.

And I'm going to talk about a very particular medical condition.

E vou falar dun problema médico moi particular,

But this stands as a proxy for all kinds of medical decision-making,

pero isto pode aplicarse a calquera tipo de decisión médica

and indeed for financial decision-making, and social decision-making --

e incluso a decisións financeiras ou sociais

any kind of decision you have to make

ou calquera decisión que teñamos que facer

that would benefit from a rational assessment of the facts.

na que sexa beneficioso realizar unha análise racional de datos.

So suppose you go to your doctor and the doctor says,

Supoñamos que ides ó médico e este di

"I just got your lab work back, your cholesterol's a little high."

"Teño os resultados das probas e ten o colesterol un pouco alto".

Now, you all know that high cholesterol

Sabedes que o colesterol alto

is associated with an increased risk of cardiovascular disease,

está asociado a unha elevación do risco de enfermidades cardiovasculares,

heart attack, stroke.

ataque ó corazón ou apoplexía.

And so you're thinking

E dades en pensar que ter o colesterol alto non é moi bo.

having high cholesterol isn't the best thing,

and so the doctor says, "You know, I'd like to give you a drug

E o doutor di: "Quero receitarlle un medicamento

that will help you lower your cholesterol, a statin."

que lle vai axudar a baixa-lo colesterol: unha estatina".

And you've probably heard of statins,

É probable que coñezáde-las estatinas e saibades que son un dos medicamentos

you know that they're among the most widely prescribed drugs

in the world today,

máis receitados hoxe en día. Quizas ata coñecedes

you probably even know people who take them.

a alguén que as toma. E dicides "Si, déame a estatina!"

And so you're thinking, "Yeah! Give me the statin."

But there's a question you should ask at this point,

Pero deberiades preguntar algo neste momento.

a statistic you should ask for

Deberiades pedir unha estatística

that most doctors don't like talking about,

da que moitos doutores non queren falar e as compañías farmacéuticas

and pharmaceutical companies like talking about even less.

aínda menos.

It's for the number needed to treat.

É o número necesario a tratar (NNT). E que é o NNT?

Now, what is this, the NNT?

It's the number of people that need to take a drug

É o número de persoas que teñen que toma-lo medicamento

or undergo a surgery or any medical procedure

ou recibir calquera outro tratamento ou procedemento

before one person is helped.

antes de que axude unha persoa.

And you're thinking, what kind of crazy statistic is that?

E pensaredes "que demo de estatística é esa?

The number should be one.

O número debería ser un. O meu médico non me receitaría algo que non axuda".

My doctor wouldn't prescribe something to me

if it's not going to help.

But actually, medical practice doesn't work that way.

Pero a medicina non funciona así.

And it's not the doctor's fault,

E non é culpa do doutor. Se alguén é culpable sómo-los científicos coma min.

if it's anybody's fault, it's the fault of scientists like me.

We haven't figured out the underlying mechanisms well enough.

Aínda non coñecemos ben os mecanismos subxacentes.

But GlaxoSmithKline estimates

GlaxoSmithKline estima

that 90 percent of the drugs work in only 30 to 50 percent of the people.

que o 90 % dos medicamentos funcionan entre un 30 % e un 50 % dos casos.

So the number needed to treat for the most widely prescribed statin,

Polo que o NNT no caso da estatina máis receitada

what do you suppose it is?

cal pensades que é?

How many people have to take it before one person is helped?

Cantas persoas teñen que tomala antes de que axude a alguén?

300.

300.

This is according to research

Isto segundo os resultados

by research practitioners Jerome Groopman and Pamela Hartzband,

dos investigadores Jerome Groopman e Pamela Hartzband

confirmados de forma independente por Bloomberg.com.

independently confirmed by Bloomberg.com.

I ran through the numbers myself.

Eu mesmo comprobei os datos.

300 people have to take the drug for a year

300 persoas deben toma-la estatina durante un ano

before one heart attack, stroke or other adverse event is prevented.

antes de que evite un ataque ó corazón, unha apoplexía ou outro caso adverso.

Now you're probably thinking,

E pensaredes

"Well, OK, one in 300 chance of lowering my cholesterol.

"Teño unha posibilidade entre 300 de baixa-lo colesterol.

Why not, doc? Give me the prescription anyway."

Por que non? Déame o medicamento, doutor".

But you should ask at this point for another statistic,

Pero neste momento deberiades pedir outra estatística

and that is, "Tell me about the side effects." Right?

que é: "Fáleme dos efectos secundarios", non?

So for this particular drug,

No caso deste medicamento

the side effects occur in five percent of the patients.

os efectos secundarios danse no 5 % dos pacientes.

And they include terrible things --

E inclúen cousas terribles.

debilitating muscle and joint pain, gastrointestinal distress --

Dor aguda en músculos e articulacións, malestar gastrointestinal...

but now you're thinking, "Five percent,

Pero pensaredes, "Un 5 %. Non creo que me pase a min.

not very likely it's going to happen to me,

Sigo querendo tomalo". Pero esperade un momento.

I'll still take the drug."

But wait a minute.

Recordade: baixo estrés non pensades claramente.

Remember under stress you're not thinking clearly.

Pensade en como ides procesar isto antes de tempo

So think about how you're going to work through this ahead of time,

para non ter que crea-lo razoamento no momento.

so you don't have to manufacture the chain of reasoning on the spot.

Ben, 300 persoas toman o medicamento. Unha cura,

300 people take the drug, right? One person's helped,

five percent of those 300 have side effects,

e o 5 % desas 300 sofre efectos secundarios

that's 15 people.

é dicir, 15 persoas.

You're 15 times more likely to be harmed by the drug

Tes 15 veces máis posibilidades de que o medicamento te dane

than you are to be helped by the drug.

que de que te axude.

Now, I'm not saying whether you should take the statin or not.

Non estou dicindo se debedes toma-la estatina ou non

I'm just saying you should have this conversation with your doctor.

só que deberiades ter esta conversación co voso médico.

Medical ethics requires it,

Por ética médica, é parte do principio de consentimento informado.

it's part of the principle of informed consent.

You have the right to have access to this kind of information

Tedes dereito a ter acceso a esta información para poder falar

to begin the conversation about whether you want to take the risks or not.

sobre se aceptade-los riscos. Quizais pensedes

Now you might be thinking

I've pulled this number out of the air for shock value,

que falo deste número para sorprender

but in fact it's rather typical, this number needed to treat.

pero en realidade o NNT

é bastante habitual.

For the most widely performed surgery on men over the age of 50,

No caso da cirurxía máis estendida entre os homes de máis de 50 anos,

removal of the prostate for cancer,

a extracción da próstata por cancro, o NNT é 49.

the number needed to treat is 49.

That's right, 49 surgeries are done for every one person who's helped.

Si: hai que realizar 49 cirurxías por cada persoa que se axuda.

And the side effects in that case occur in 50 percent of the patients.

E os efectos secundarios neste caso danse no 50 % dos pacientes.

They include impotence, erectile dysfunction,

Inclúen impotencia, disfunción eréctil,

urinary incontinence, rectal tearing,

incontinencia urinaria, fisuras anais,

fecal incontinence.

incontinencia fecal.

And if you're lucky, and you're one of the 50 percent who has these,

Se tes sorte, se pertences a este 50 % que sofre isto

they'll only last for a year or two.

só durará un ou dous anos.

So the idea of the pre-mortem is to think ahead of time

Entón, a idea do pre mortem

é pensar antes do momento nas preguntas que podes facer

to the questions that you might be able to ask

that will push the conversation forward.

para que a conversación avance.

You don't want to have to manufacture all of this on the spot.

O ideal é non ter que crear todo isto no momento.

And you also want to think about things like quality of life.

Tamén hai que pensar en temas como a calidade de vida.

Because you have a choice oftentimes,

Porque a miúdo temos opcións.

do you I want a shorter life that's pain-free,

Quero vivir unha vida máis corta pero sen dor

or a longer life that might have a great deal of pain towards the end?

ou unha vida máis longa quizais con moita dor cara ó final?

These are things to talk about and think about now,

Son cousas nas que debemos pensar agora e falalas coa familia e seres queridos.

with your family and your loved ones.

You might change your mind in the heat of the moment,

Pode que cambiemos de idea coa presión do momento

pero é bo practicar este tipo de razoamento.

but at least you're practiced with this kind of thinking.

Remember, our brain under stress releases cortisol,

Recordade: baixo estrés o cerebro emite cortisol

and one of the things that happens at that moment

e unha das cousas que pasa nese momento é que se apagan un montón de sistemas.

is a whole bunch on systems shut down.

There's an evolutionary reason for this.

A evolución dáno-la explicación.

Face-to-face with a predator, you don't need your digestive system,

Cando nos enfrontamos a un predador, non precisamos do sistema dixestivo

or your libido, or your immune system,

ou da libido ou do sistema inmunolóxico

because if you're body is expending metabolism on those things

porque se o corpo inviste metabolismo nestas cousas

and you don't react quickly,

e non reaccionamos rapidamente

you might become the lion's lunch, and then none of those things matter.

podemos se-la comida do león, e todas esas cousas deixan de importar.

Unfortunately,

Desafortunadamente, unha das cousas que se apaga

one of the things that goes out the window during those times of stress

neses momentos de estrés é o pensamento lóxico e racional,

is rational, logical thinking,

as Danny Kahneman and his colleagues have shown.

como demostraron Danny Kahneman e os seus colegas.

So we need to train ourselves to think ahead

Por iso necesitamos adestrarnos para pensar anticipadamente

to these kinds of situations.

neste tipo de situacións.

I think the important point here is recognizing that all of us are flawed.

Creo que o máis importante é recoñecer que todos temos defectos.

We all are going to fail now and then.

Nalgún momento imos equivocarnos.

The idea is to think ahead to what those failures might be,

A idea é pensar anticipadamente no que poden ser estas equivocacións,

to put systems in place that will help minimize the damage,

establecer sistemas que poidan minimizar os danos

or to prevent the bad things from happening in the first place.

ou simplemente evitar que estas cousas malas pasen.

Getting back to that snowy night in Montreal,

Volvendo a aquela noite con neve en Montreal.

when I got back from my trip,

Cando volvín da viaxe

I had my contractor install a combination lock next to the door,

o meu contratista instaloume unha pechadura con código ó lado da porta

with a key to the front door in it, an easy to remember combination.

coa chave da porta da casa dentro e un código fácil de recordar.

And I have to admit,

E recoñezo que teño montóns de correo que aínda teño que ordenar

I still have piles of mail that haven't been sorted,

and piles of emails that I haven't gone through.

e montóns de correos electrónicos que teño que ler.

So I'm not completely organized,

Non son totalmente organizado

but I see organization as a gradual process,

pero creo que a organización é un proceso gradual

and I'm getting there.

e estou traballando niso.

Thank you very much.

Moitas grazas.

(Applause)