A doctor's case for medical marijuana | David Casarett

Prevoditelj: Sanda L Recezent: Ivan Stamenković

I would like to tell you about the most embarrassing thing

Ispričao bih vam najneugodniju situaciju

that has ever happened to me in my years of working as a palliative care physician.

koja mi se ikada dogodila u dugogodišnjoj praksi kao liječniku palijativne njege.

This happened a couple of years ago.

Dogodilo se to prije nekoliko godina.

I was asked as a consultant to see a woman in her 70s --

Tražili su me da kao konzultant posjetim ženu od 70-ak godina,

retired English professor who had pancreatic cancer.

umirovljenu profesoricu engleskog koja je imala tumor gušterače.

I was asked to see her because she had pain, nausea, vomiting ...

Tražili su me da je vidim jer je patila od boli, mučnine, povraćanja...

When I went to see her, we talked about those symptoms

Kada sam je posjetio, pričali smo o tim simptomima

and in the course of that consultation,

i tijekom te konzultacije,

she asked me whether I thought that medical marijuana might help her.

pitala me mislim li može li joj pomoći medicinska konoplja.

I thought back to everything

Prisjetio sam se svega

that I had learned in medical school about medical marijuana,

što sam naučio na fakultetu o medicinskoj konoplji,

which didn't take very long because I had learned absolutely nothing.

što nije dugo trajalo, jer nisam naučio apsolutno ništa.

And so I told her that as far as I knew,

I tako sam joj rekao da, koliko znam,

medical marijuana had no benefits whatsoever.

od medicinske konoplje nema baš nikakve koristi.

And she smiled and nodded and reached into the handbag next to the bed,

Nasmijala se, kimnula i posegnula za svojom torbicom pored kreveta

and pulled out a stack of about a dozen randomized controlled trials

i izvukla snop od desetak nasumično kontroliranih pokusa,

showing that medical marijuana has benefits

koji pokazuju da medicinska konoplja ima povoljne učinke

for symptoms like nausea and pain and anxiety.

za simptome poput mučnine, bolova i tjeskobe.

She handed me those articles and said,

Dala mi je te članke i rekla:

"Maybe you should read these before offering an opinion ...

"Možda biste trebali ovo pročitati prije negoli dajete svoje mišljenje,

doctor."

doktore."

(Laughter)

(Smijeh)

So I did.

I pročitao sam.

That night I read all of those articles and found a bunch more.

Te noći pročitao sam sve te članke i našao još hrpu novih.

When I came to see her the next morning,

Kada sam je posjetio sljedeće jutro,

I had to admit that it looks like there is some evidence

morao sam priznati da izgleda kako postoji neki dokaz

that marijuana can offer medical benefits

da konoplja može biti medicinski korisna

and I suggested that if she really was interested,

i predložio sam joj, ako je zaista zainteresirana,

she should try it.

neka je proba.

You know what she said?

Znate li što je rekla?

This 73-year-old, retired English professor?

Ta 73-godišnja umirovljena profesorica engleskog?

Rekla je: "Probala sam je prije otprilike šest mjeseci.

She said, "I did try it about six months ago.

It was amazing.

Bilo je nevjerojatno.

I've been using it every day since.

Od tada je uzimam svaki dan.

It's the best drug I've discovered.

To je najbolji lijek koji sam otkrila.

I don't know why it took me 73 years to discover this stuff. It's amazing."

Ne znam zašto mi je trebalo 73 godine da je otkrijem."

(Smijeh)

'Nevjerojatna je.'

(Laughter)

That was the moment at which I realized

To je bio trenutak u kojem sam shvatio

I needed to learn something about medical marijuana

da trebam nešto naučiti o medicinskoj konoplji

because what I was prepared for in medical school

jer ono za što sam se pripremao na fakultetu,

bore no relationship to reality.

nije imalo veze sa stvarnošću.

So I started reading more articles, I started talking to researchers,

Stoga sam počeo čitati više članaka, razgovarati s istraživačima,

I started talking to doctors,

počeo sam razgovarati s liječnicima,

and most importantly, I started listening to patients.

i najvažnije, počeo sam slušati pacijente.

I ended up writing a book based on those conversations,

I tako sam napisao knjigu koja se temelji na tim razgovorima,

and that book really revolved around three surprises --

i ta knjiga je zaista obradila tri iznenađenja,

surprises to me, anyway.

iznenađenja za mene.

One I already alluded to --

Jedno, koje sam već dao naslutiti,

that there really are some benefits to medical marijuana.

da medicinska konoplja zaista daje neke povoljne učinke.

Those benefits may not be as huge or as stunning

Ti učinci ne moraju biti toliko veliki ili zapanjujući,

as some of the most avid proponents of medical marijuana

kao što bi neki od najgorljivijih predlagatelja medicinske konoplje

would have us believe,

željeli da vjerujemo,

but they are real.

no, ti učinci su stvarni.

Surprise number two:

Drugo iznenađenje,

medical marijuana does have some risks.

medicinska konoplja ima neke rizike.

Those risks may not be as huge and as scary

Ti rizici ne moraju biti toliko veliki ili zastrašujući,

as some of the opponents of medical marijuana would have us believe,

kao što bi neki od protivnika medicinske konoplje željeli da vjerujemo,

but they are real risks, nonetheless.

ali to jesu stvarni rizici, bez obzira na sve.

But it was the third surprise that was most ...

No, treće iznenađenje bilo je

surprising.

najiznenađujuće.

And that is that a lot of the patients I talked with

A to je da mnogi pacijenti s kojima sam razgovarao,

who've turned to medical marijuana for help,

a koji su se okrenuli medicinskoj konoplji radi pomoći,

weren't turning to medical marijuana because of its benefits

nisu joj se okrenuli samo zbog njezinih povoljnih učinaka,

or the balance of risks and benefits,

ili zbog ravnoteže između rizika i koristi,

or because they thought it was a wonder drug,

ili zato što su mislili da je ona čudotvoran lijek,

but because it gave them control over their illness.

nego zato što im je pružila kontrolu nad njihovom bolešću.

It let them manage their health

Pomoću nje upravljali su svojim zdravljem

in a way that was productive and efficient

na produktivan i učinkovit način,

and effective and comfortable for them.

te učinkovit i ležeran za njih same.

Da bolje predočim, pričat ću

To show you what I mean, let me tell you about another patient.

i o drugom pacijentu.

Robin je bila u svojim ranim 40-im godinama kada sam je upoznao.

Robin was in her early 40s when I met her.

She looked though like she was in her late 60s.

No, izgledala je kao da je u svojim kasnim 60-ima.

She had suffered from rheumatoid arthritis for the last 20 years,

Patila je reumatoidnog artritisa preko 20 godina,

her hands were gnarled by arthritis,

ruke su joj zbog artritisa bile kvrgave,

her spine was crooked,

kralježnica iskrivljena,

she had to rely on a wheelchair to get around.

morala je koristiti invalidska kolica kako bi se kretala.

She looked weak and frail,

Izgledala je nemoćno i slabo,

and I guess physically she probably was,

mislim da je fizički vjerojatno i bila takva,

but emotionally, cognitively, psychologically,

no emocionalno, kognitivno, psihološki,

she was among the toughest people I've ever met.

bila je među najčvršćim ljudima koje sam ikada upoznao.

And when I sat down next to her

I kada sam sjeo pored nje

in a medical marijuana dispensary in Northern California

u jednoj ambulanti za medicinsku konoplju,

u Sjevernoj Karolini,

to ask her about why she turned to medical marijuana,

kako bih je pitao zašto se okrenula uzimanju medicinske konoplje,

what it did for her and how it helped her,

kako je utjecala na nju i kako joj je pomogla,

she started out by telling me things

počela mi je govoriti o stvarima

that I had heard from many patients before.

koje sam već čuo od mnogih pacijenata prije.

It helped with her anxiety;

Pomogla joj je kod tjeskobe,

it helped with her pain;

pomogla joj je kod boli,

when her pain was better, she slept better.

kada se bol smanjila počela je bolje spavati.

And I'd heard all that before.

A sve bih to čuo i prije.

But then she said something that I'd never heard before,

No, tada je rekla nešto što još nikada nisam čuo,

and that is that it gave her control over her life

a to je da joj je dala kontrolu nad životom

and over her health.

i nad njezinim zdravljem.

She could use it when she wanted,

Mogla ju je koristiti kada je htjela,

in the way that she wanted,

kako je htjela,

at the dose and frequency that worked for her.

u onoj dozi i onoliko često koliko joj je odgovaralo.

And if it didn't work for her, then she could make changes.

A ako joj nije odgovaralo, mogla je to mijenjati.

Everything was up to her.

Sve je ovisilo o njoj.

The most important thing she said

Najvažnija stvar koju ju rekla,

was she didn't need anybody else's permission --

bila je ta da nije trebala ničije dopuštenje,

not a clinic appointment, not a doctor's prescription,

ni zakazani termin u bolnici, ni liječnički recept,

not a pharmacist's order.

ni uputu od strane ljekarnika.

It was all up to her.

Sve je ovisilo o njoj.

She was in control.

Imala je kontrolu.

And if that seems like a little thing for somebody with chronic illness,

I ako se to čini kao mala stvar za nekoga tko ima kroničnu bolest,

nije, nije uopće.

it's not -- not at all.

When we face a chronic serious illness,

Kada se suočimo s ozbiljnom kroničnom bolešću,

whether it's rheumatoid arthritis or lupus or cancer or diabetes,

bio to reumatoidni artritis, lupus, tumor ili dijabetes,

or cirrhosis,

ili ciroza,

we lose control.

mi gubimo kontrolu.

And note what I said: "when," not "if."

I uočavate što sam rekao - 'kada', a ne 'ako'.

All of us at some point in our lives will face a chronic serious illness

Svi ćemo se u nekom trenutku u životu suočiti s ozbiljnom kroničnom bolešću,

that causes us to lose control.

zbog koje ćemo izgubiti kontrolu.

We'll see our function decline, some of us will see our cognition decline,

Gledat ćemo kako nam otkazuju vitalne funkcije, kod nekih i kognitivne funkcije,

we'll be no longer able to care for ourselves,

više se nećemo moći sami brinuti za sebe,

to do the things that we want to do.

raditi ono što želimo.

Our bodies will betray us,

Tijelo će nas izdati,

and in that process, we'll lose control.

i u tom procesu, izgubit ćemo kontrolu.

And that's scary.

A to je strašno.

Not just scary -- that's frightening,

Ne samo strašno, to je zastrašujuće,

it's terrifying.

užasavajuće.

When I talk to my patients, my palliative care patients,

Kada pričam sa svojim pacijentima s palijativne njege,

many of whom are facing illnesses that will end their lives,

od koji se mnogi suočavaju s bolešću od koje će umrijeti,

they have a lot of be frightened of --

oni zaista imaju od čega biti uplašeni.

pain, nausea, vomiting, constipation, fatigue,

Bol, mučnine, povraćanje, zatvor, umor,

their impending mortality.

nadolazeći kraj.

But what scares them more than anything else

No, ono što ih plaši više od svega,

is this possibility that at some point,

je mogućnost da će u nekom trenutku,

tomorrow or a month from now,

sutra ili za mjesec dana,

they're going to lose control of their health,

izgubiti kontrolu nad svojim zdravljem,

of their lives,

nad svojim životima,

of their healthcare,

zdravstvenom njegom,

and they're going to become dependent on others,

i da će postati ovisni o drugima,

and that's terrifying.

a to je zastrašujuće.

So it's no wonder really that patients like Robin,

Stoga nije uopće čudo da se pacijenti poput Robin,

who I just told you about,

o kojoj sam vam upravo pričao,

who I met in that clinic,

koju sam sreo u toj klinici,

turn to medical marijuana

okreću medicinskoj konoplji

to try to claw back some semblance of control.

pokušavajući vratiti neki privid kontrole.

How do they do it though?

Kako to čine?

How do these medical marijuana dispensaries --

Kako te ambulante u kojima se izdaje medicinska konoplja

like the one where I met Robin --

poput one u kojoj sam sreo Robin,

how do they give patients like Robin back the sort of control that they need?

kako oni pacijentima poput Robin vraćaju kontrolu koja im je potrebna?

And how do they do it

I kako to uspjevaju

in a way that mainstream medical hospitals and clinics,

kada redovne bolnice i klinike,

at least for Robin, weren't able to?

barem kod Robin, nisu uspjele?

What's their secret?

Koja je njihova tajna?

So I decided to find out.

Stoga sam odlučio saznati.

I went to a seedy clinic in Venice Beach in California

Otišao sam u kliniku na Venice Beach-u u Kaliforniji

and got a recommendation

i dobio preporuku

that would allow me to be a medical marijuana patient.

koja mi dozvoljava kao pacijentu korištenje medicinske konoplje.

I got a letter of recommendation that would let me buy medical marijuana.

Dobio sam pismo preporuke koje mi dozvoljava kupnju medicinske konoplje.

I got that recommendation illegally,

Dobio sam tu preporuku ilegalno,

because I'm not a resident of California --

budući nisam stanovnik Kalifornije,

I should note that.

trebam to istaknuti.

I should also note, for the record,

Trebam istaknuti također, neka se zna,

that I never used that letter of recommendation to make a purchase,

da nikada nisam iskoristio to pismo preporuke kako bih je kupio,

and to all of you DEA agents out there --

i za sve vas agente DEA-e tamo vani...

(Laughter)

(Smijeh)

love the work that you're doing,

cijenim to što radite,

keep it up.

samo nastavite.

(Laughter)

Even though it didn't let me make a purchase though,

(Smijeh)

Iako mi to nije omogućilo kupnju,

that letter was priceless because it let me be a patient.

to pismo je bilo neprocjenjivo, jer mi je omogućilo da postanem pacijent.

It let me experience what patients like Robin experience

Omogućilo mi je steći iskustvo koje prolaze pacijenti poput Robin

when they go to a medical marijuana dispensary.

kada idu u ambulantu gdje se izdaje medicinska konoplja.

And what I experienced --

I kroz što sam sve prošao,

what they experience every day,

kroz što oni prolaze svakodnevno,

hundreds of thousands of people like Robin --

stotine tisuća ljudi poput Robin,

was really amazing.

bilo je zaista nevjerojatno.

I walked into the clinic,

Ušao sam u kliniku,

and from the moment that I entered many of these clinics and dispensaries,

i od trenutka kada sam ušao u mnoge od tih klinika i ambulanti,

I felt like that dispensary, that clinic,

imao sam osjećaj kako je ta ambulanta, ta klinika,

was there for me.

tu zbog mene.

There were questions at the outset about who I am,

Bilo je pitanja na početku o tome tko sam,

what kind of work I do,

što točno radim,

what my goals are in looking for a medical marijuana prescription,

što točno želim tražeći recept za medicinsku marihuanu,

or product,

ili proizvod,

what my goals are, what my preferences are,

koji su moji ciljevi, koji su moji prioriteti,

what my hopes are,

moje nade,

how do I think, how do I hope this might help me,

što mislim, čemu se nadam, kako bi mi to moglo pomoći,

what am I afraid of.

čega se bojim.

These are the sorts of questions

To su vrste pitanja

that patients like Robin get asked all the time.

koja se pacijentima poput Robin neprestano postavljaju.

These are the sorts of questions that make me confident

To su vrste pitanja s kojima sam siguran

that the person I'm talking with really has my best interests at heart

da osoba s kojom razgovaram iskreno radi u mojem najboljem interesu

and wants to get to know me.

i želi me dobro upoznati.

The second thing I learned in those clinics

Druga stvar koju sam naučio u tim klinikama

is the availability of education.

je dostupnost informacija.

Education from the folks behind the counter,

Informiranost od strane osoblja za pultom,

but also education from folks in the waiting room.

ali i od ljudi u čekaonici.

People I met were more than happy, as I was sitting next to them --

Ljudi koje sam sretao bili su više nego srdačni, dok sam sjedio uz njih,

people like Robin --

ljudi poput Robin,

to tell me about who they are, why they use medical marijuana,

kako bi mi ispričali tko su, zašto uzimaju medicinsku konoplju,

what helps them, how it helps them,

što im pomaže, kako im pomaže,

and to give me advice and suggestions.

te kako bi mi dali savjet i preporuke.

Those waiting rooms really are a hive of interaction, advice and support.

Te čekaonice su zaista poput košnica za interakciju, savjete i podršku.

And third, the folks behind the counter.

I treće, osoblje za pultom.

I was amazed at how willing those people were

Bio sam zadivljen koliko su ti ljudi bili željni

to spend sometimes an hour or more talking me through the nuances

provesti ponekad sat vremena i više, pričajući mi o nijansama

of this strain versus that strain,

ove vrste biljke naspram one druge,

smoking versus vaporizing,

pušenja naspram udisanja pare,

edibles versus tinctures --

uzimanja kroz hranu naspram tinktura,

all, remember, without me making any purchase whatsoever.

sve to, zapamtite, bez da sam išta kupio.

Think about the last time you went to any hospital or clinic

Sjetite se kada ste zadnji puta otišli u neku bolnicu illi kliniku

and the last time anybody spent an hour explaining those sorts of things to you.

i kada je zadnji puta itko s vama proveo jedan sat, objašnjavajući vam ovako nešto.

The fact that patients like Robin are going to these clinics,

Činjenica da pacijenti poput Robin idu u te klinike,

are going to these dispensaries

idu u te ambulante,

and getting that sort of personalized attention

i dobivaju ovakvu vrstu osobne, prilagođene pažnje

and education and service,

potrebne informacije i uslugu,

really should be a wake-up call to the healthcare system.

zaista treba postati poziv na buđenje sustavu zdravstvene skrbi.

People like Robin are turning away from mainstream medicine,

Ljudi poput Robin okreću leđa službenoj medicini,

turning to medical marijuana dispensaries

okreću se ambulantama za medicinsku konoplju,

because those dispensaries are giving them what they need.

jer im one daju ono što im treba.

If that's a wake-up call to the medical establishment,

Ako je ovo poziv na buđenje medicinskom sustavu,

it's a wake-up call that many of my colleagues are either not hearing

poziv je također kojeg mnogi moji kolege ili ne čuju,

or not wanting to hear.

ili ne žele čuti.

When I talk to my colleagues, physicians in particular,

Kada razgovaram sa svojim kolegama, naročito s liječnicima,

about medical marijuana,

o medicinskoj konoplji,

they say, "Oh, we need more evidence.

oni kažu: 'Trebamo više dokaza o tome.'

We need more research into benefits, we need more evidence about risks."

Trebamo više istraživanja o povoljnim učincima te više dokaza o rizicima.'

And you know what? They're right.

I znate što? U pravu su.

They're absolutely right.

Apsolutno su u pravu.

We do need much more evidence about the benefits of medical marijuana.

Zaista trebamo mnogo više dokaza o povoljnim učincima medicinske konoplje.

We also need to ask the federal government to reschedule marijuana to Schedule II,

Trebamo također tražiti našu vladu da prebaci konoplju u skupinu II,

or to deschedule it entirely to make that research possible.

ili posve izbaci iz klasifikacija, kako bi se omogućilo istraživanje.

We also need more research into medical marijuana's risks.

Također, trebamo više istraživanja o rizicima medicinske konoplje.

Medical marijuana's risks --

Rizicima medicinske konoplje,

we know a lot about the risks of recreational use,

mnogo znamo o rizicima rekreativne uporabe,

a ne znamo skoro ništa o rizicima medicinske konoplje.

we know next to nothing about the risks of medical marijuana.

So we absolutely do need research,

Dakle, apsolutno trebamo istraživanja,

but to say that we need research

ali reći da trebamo istraživanja,

and not that we need to make any changes now

a ne reći da trebamo sada i nešto promijeniti,

is to miss the point entirely.

znači posve promašiti bit svega.

People like Robin aren't seeking out medical marijuana

Ljudi poput Robin ne traže medicinsku konoplju

because they think it's a wonder drug,

jer misle da je ona čudotvoran lijek,

or because they think it's entirely risk-free.

ili jer misle da nema nikakvih rizika.

They seek it out because the context in which it's delivered and administered

Traže je jer okruženje u kojem se ona isporučuje te njome upravlja

and used,

i koristi,

gives them the sort of control they need over their lives.

daje im jednu vrstu kontrole koja im je potrebna nad njihovim životom.

And that's a wake-up call we really need to pay attention to.

I to je poziv na buđenje kojem zaista trebamo posvetiti pažnju.

The good news though is that there are lessons we can learn today

Ipak, dobra vijest je što postoje lekcije koje danas možemo naučiti

from those medical marijuana dispensaries.

od tih mjesta koja izdaju medicinsku konoplju.

And those are lessons we really should learn.

I to su lekcije koje zaista trebamo usvojiti.

These are often small, mom-and-pop operations

To su često mala okruženja

run by people with no medical training.

koja vode osobe bez medicinskog obrazovanja.

And while it's embarrassing to think

I dok je neugodno i pomisliti

that many of these clinics and dispensaries are providing services

da mnoge od tih klinika i ambulanti pružaju usluge i podršku,

and support and meeting patients' needs

zadovoljavajući potrebe pacijenata,

in ways that billion-dollar healthcare systems aren't --

na načine na koje zdravstveni sustavi vrijedni milijarde dolara to ne čine,

we should be embarrassed by that --

trebalo bi nas biti sram zbog toga,

but we can also learn from that.

no, iz toga možemo i nešto naučiti.

And there are probably three lessons at least

Postoje vjerojatno najmanje tri lekcije

that we can learn from those small dispensaries.

koje možemo naučiti od tih malih ambulanti.

One: we need to find ways to give patients more control

Prva, moramo naći načina da pacijentima damo više kontrole

in small but important ways.

kroz male ali važne načine.

How to interact with healthcare providers,

Kako komunicirati s medicinskim djelatnicima,

when to interact with healthcare providers,

gdje komunicirati s medicinskim djelatnicima,

how to use medications in ways that work for them.

kako uzimati lijekove a da im oni koriste.

In my own practice,

U svojoj vlastitoj praksi,

I've gotten much more creative and flexible

postao sam mnogo kreativniji i fleksibilniji

in supporting my patients in using drugs safely

u podršci pacijentima, da koriste lijekove na siguran način,

to manage their symptoms --

nadzirući simptome,

with the emphasis on safely.

s naglaskom na sigurnost.

Many of the drugs I prescribe are drugs like opioids or benzodiazepines

Mnogi lijekovi koje propisujem su oni poput opioida ili benzodiazepina,

which can be dangerous if overused.

koji mogu biti opasni ako se premaši doza.

But here's the point.

Ali ovo je ključno.

They can be dangerous if they're overused,

Oni mogu biti opasni ako se premaši doza,

but they can also be ineffective if they're not used in a way

ali mogu biti i bez učinka ako se ne koriste na način,

that's consistent with what patients want and need.

koji je dosljedan u onome što pacijenti žele i trebaju.

So that flexibility, if it's delivered safely,

Zato ta fleksibilnost, ako je pružena na siguran način,

can be extraordinarily valuable for patients and their families.

može biti izvanredno vrijedna za pacijente i njihove obitelji.

That's number one.

To je prvo.

Number two: education.

Drugo - edukacija.

Huge opportunities

Ogromne su mogućnosti

to learn from some of the tricks of those medical marijuana dispensaries

za naučiti neke od trikova tih ustanova koje izdaju medicinsku konoplju,

to provide more education

da bi se pružilo više edukacije

that doesn't require a lot of physician time necessarily,

a koja ne traži nužno mnogo vremena od strane liječnika,

or any physician time,

ili ikakvo njegovo vrijeme,

but opportunities to learn about what medications we're using

već mogućnosti da naučimo koje lijekove koristimo

and why,

i zašto,

prognoses, trajectories of illness,

prognoze, tijek bolesti,

and most importantly,

i ono najvažnije,

opportunities for patients to learn from each other.

mogućnosti za pacijente da uče jedni od drugih.

How can we replicate what goes on

Kako možemo preslikati ono što se događa

in those clinic and medical dispensary waiting rooms?

u čekaonicama tih klinika i medicinskih ambulanti?

How patients learn from each other, how people share with each other.

Kako pacijenti uče jedni od drugih, kako ljudi međusobno dijele iskustva.

And last but not least,

I zadnje, ali ne manje važno,

putting patients first the way those medical marijuana dispensaries do,

stavljajući pacijente na prvo mjesto, kao što to rade te male ambulante,

making patients feel legitimately like what they want,

čime bi se pacijenti osjećali da imaju pravo na ono što žele

what they need,

i ono što trebaju,

is why, as healthcare providers,

razlog je što smo mi,

pružatelji medicinskih usluga, ovdje.

we're here.

Asking patients about their hopes, their fears, their goals and preferences.

Pitati pacijente za njihove nade, strahove, ciljeve i prioritete.

As a palliative care provider,

Kao pružatelj palijativne njege,

I ask all my patients what they're hoping for and what they're afraid of.

pitam sve svoje pacijente čemu se nadaju i čega se boje.

But here's the thing.

Ali stvar je u sljedećem.

Patients shouldn't have to wait until they're chronically seriously ill,

Pacijenti ne bi trebali čekati da postanu teško, kronično bolesni,

often near the end of life,

često blizu kraja svog života,

they shouldn't have to wait until they're seeing a physician like me

ne bi smjeli čekati da posjete liječnika poput mene,

before somebody asks them,

prije nego ih netko upita,

"What are you hoping for?"

'Čemu se nadate?'

"What are you afraid of?"

'Čega se bojite?'

That should be baked into the way that healthcare is delivered.

To bi trebalo biti sastavni dio onoga što zdravstvena skrb pruža.

We can do this --

Mi to možemo,

we really can.

zaista možemo.

Medical marijuana dispensaries and clinics all across the country

Ambulante i klinike diljem zemlje, koje izdaju medicinsku konoplju

are figuring this out.

to shvaćaju.

They're figuring this out

One to shvaćaju

in ways that larger, more mainstream health systems are years behind.

na načine za kojima veliki, standardni zdravstveni sustavi zaostaju godinama.

But we can learn from them,

No, mi možemo učiti od njih,

and we have to learn from them.

i moramo učiti od njih.

All we have to do is swallow our pride --

Samo moramo progutati svoj ponos,

put aside the thought for a minute

na minutu staviti misao po strani,

that because we have lots of letters after our name,

da to što imamo mnogo slova i titula iza svog imena,

because we're experts,

jer mi smo ipak stručnjaci,

because we're chief medical officers of a large healthcare system,

jer smo važne medicinske osobe u velikom sustavu zdravstvene skrbi,

we know all there is to know about how to meet patients' needs.

da zato znamo sve što treba o tome kako zadovoljiti potrebe pacijenata.

We need to swallow our pride.

Trebamo progutati svoj ponos.

We need to go visit a few medical marijuana dispensaries.

Trebamo posjetiti nekoliko ustanova koje izdaju medicinsku konoplju.

We need to figure out what they're doing.

Moramo shvatiti što oni rade.

We need to figure out why so many patients like Robin

Moramo shvatiti zašto toliko pacijenata poput Robin

are leaving our mainstream medical clinics

napušta naše standardne medicinske klinike

and going to these medical marijuana dispensaries instead.

i umjesto njih odlaze u te ustanove gdje se izdaje medicinska konoplja.

We need to figure out what their tricks are,

Moramo shvatiti koji su njihovi trikovi,

what their tools are,

koji su njihovi alati

and we need to learn from them.

i moramo učiti od njih.

If we do,

I ako to učinimo,

and I think we can, and I absolutely think we have to,

a mislim da možemo i apsolutno mislim da moramo,

we can guarantee all of our patients will have a much better experience.

možemo jamčiti da će svi naši pacijenti imati mnogo bolje iskustvo.

Thank you.

Hvala vam.

(Applause)

(Pljesak)