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

Prevoditelj: Jasna Matek Recezent: Ivan Stamenković

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

Prije nekoliko godina provalio sam u vlastitu kuću.

I had just driven home,

Upravo sam stigao kući,

it was around midnight in the dead of Montreal winter,

bilo je oko ponoć, a u Montrealu je bila ciča zima.

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

Bio sam kod svog prijatelja Jeffa, u drugom dijelu grada,

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

a termometar pred kućom pokazivao je -40 stupnjeva.

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

Ne pitajte radi li se o Celzijevim ili Fahrenheitovim stupnjevima,

minus 40 is where the two scales meet --

na minus 40 te se ljestvice poklapaju.

it was very cold.

Bilo je jako hladno.

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

Dok sam stajao na trijemu i kopao po džepovima,

I found I didn't have my keys.

shvatio sam da nemam ključeve.

In fact, I could see them through the window,

Zapravo, mogao sam ih vidjeti kroz prozor

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

na stolu u blagovaonici, gdje sam ih ranije ostavio.

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

Zato sam brzo obišao kuću i pokušao otvoriti druga vrata i prozore,

and they were locked tight.

ali bili su zaključani.

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

Palo mi je na pamet da nazovem bravara, barem sam imao mobitel,

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

ali bila je ponoć, pa bi mu vjerojatno trebalo neko vrijeme da dođe,

and it was cold.

a i bilo je hladno.

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

Nisam se mogao vratiti k Jeffu i ondje prespavati

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

jer sam rano ujutro imao let za Europu,

and I needed to get my passport and my suitcase.

a morao sam uzeti putovnicu i putnu torbu.

So, desperate and freezing cold,

I tako sam, sav očajan i promrznut,

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

pronašao velik kamen i provalio kroz podrumski prozor,

cleared out the shards of glass,

raščistio krhotine stakla,

I crawled through,

ušao unutra,

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

pronašao komad kartona i zalijepio ga preko otvora za prozor.

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

misleći kako ću ujutro na putu za zračnu luku

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

nazvati svog majstora i reći mu da to popravi.

This was going to be expensive,

Znao sam da će biti skupo,

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

ali vjerojatno ne skuplje od bravara kojeg bi zvao usred noći,

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

pa sam zaključio da mi ionako dođe na isto.

Now, I'm a neuroscientist by training

Po zanimanju sam neuroznanstvenik

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

i znam ponešto o tome kako mozak reagira pod stresom.

It releases cortisol that raises your heart rate,

Luči kortizol koji ubrzava rad srca,

it modulates adrenaline levels

regulira razinu adrenalina

and it clouds your thinking.

i pomućuje vam razmišljanje.

So the next morning,

I tako sam se sljedećeg jutra

when I woke up on too little sleep,

probudio neispavan,

worrying about the hole in the window,

zabrinut zbog rupe u prozoru,

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

misleći na to da moram nazvati majstora,

and the freezing temperatures,

da je vani ispod ništice

and the meetings I had upcoming in Europe,

i da me u Europi čekaju sastanci,

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

a zbog kortizola u mom mozgu

my thinking was cloudy,

nisam mogao jasno razmišljati,

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

ali ja to nisam znao jer nisam mogao jasno razmišljati.

(Laughter)

(Smijeh)

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

Zato sam tek na šalteru za prijavu putnika

that I realized I didn't have my passport.

shvatio da nemam putovnicu.

(Laughter)

(Smijeh)

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

Odjurio sam kući po snijegu i ledu, trebalo mi je 40 minuta,

got my passport, raced back to the airport,

uzeo putovnicu i požurio natrag na aerodrom.

I made it just in time,

Stigao sam u zadnji čas,

but they had given away my seat to someone else,

ali moje su mjesto već dali nekom drugom,

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

pa sam završio na kraju aviona, pokraj zahoda,

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

na zakočenom sjedalu, a čekalo me 8 sati putovanja.

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

Imao sam puno vremena za razmišljanje u tih osam sati bez sna.

(Laughter)

(Smijeh)

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

I počeo sam se pitati mogu li nešto učiniti,

systems that I can put into place,

sustavi koje bih mogao upregnuti,

that will prevent bad things from happening?

koji bi spriječili da se dogode loše stvari?

Or at least if bad things happen,

Ili barem, ako se loše stvari i dogode,

will minimize the likelihood of it being a total catastrophe.

oni bi umanjili vjerojatnost da to bude potpuna katastrofa.

So I started thinking about that,

Pa sam počeo razmišljati o tome,

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

no misli mi se nisu iskristalizirale sve do mjesec dana kasnije.

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

Večerao sam sa svojim kolegom nobelovcem, Dannyjem Kahnemanom,

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

i pomalo posramljeno ispričao mu o tome kako sam razbio prozor,

and, you know, forgotten my passport,

i zaboravio svoju putovnicu,

and Danny shared with me

a Danny mi se povjerio

that he'd been practicing something called prospective hindsight.

kako vježba nešto što se zove vjerojatna neopreznost.

(Laughter)

(Smijeh)

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

To je nešto što je čuo od psihologa Garyja Kleina,

who had written about it a few years before,

koji je pisao o tome prije par godina,

also called the pre-mortem.

također poznato kao pre-mortem.

Now, you all know what the postmortem is.

Svi znate što je postmortem (obdukcija).

Whenever there's a disaster,

Kada se dogodi katastrofa,

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

tim stručnjaka dođe i pokuša odgonetnuti što je pošlo po zlu, zar ne?

Well, in the pre-mortem, Danny explained,

E pa, u pre-mortemu, kaže Danny,

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

gledate unaprijed i pokušavate odgonetnuti sve što bi moglo poći po krivu,

and then you try to figure out what you can do

a onda pokušate shvatiti što možete učiniti

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

kako biste sprječili da se to dogodi ili da umanjite štetu.

So what I want to talk to you about today

Ono o čemu vam ja danas želim pričati

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

je nekoliko primjera koje možemo slijediti u obliku obdukcije.

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

Neki od njih su očiti, neki baš i nisu.

I'll start with the obvious ones.

Počet ću s očitima.

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

U cijelom domu, odredite mjesto za stvari koje se lako gube.

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

Znam da ovo zvuči zdravorazumski, i jest,

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

ali i znanost to podupire,

based on the way our spatial memory works.

temeljeno na načinu na koji funkcionira naša spacijalna memorija.

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

Postoji struktura u mozgu koja se zove hipokampus,

that evolved over tens of thousands of years,

koja evoluirala tijekom desetaka tisuća godina,

to keep track of the locations of important things --

kako bi se pamtila lokacije važnih stvari --

where the well is, where fish can be found,

gdje je izvor, gdje se može naći riba,

that stand of fruit trees,

gdje su stabla voćki,

where the friendly and enemy tribes live.

gdje žive prijateljska i neprijateljska plemena.

The hippocampus is the part of the brain

Hipokampus je dio mozga

that in London taxicab drivers becomes enlarged.

koji se londonskim vozačima taksija s vremenom povećava.

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

To je dio mozga zahvaljujući kojem vjeverice nađu lješnjake.

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

I ako se pitate, netko je zapravo proveo eksperiment

where they cut off the olfactory sense of the squirrels,

u kojem su vjevericama odstranili osjetilo mirisa,

and they could still find their nuts.

a one su i dalje mogle naći lješnjake.

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

Nisu koristile njuh, već hipokampus,

this exquisitely evolved mechanism in the brain for finding things.

taj izvrsno razvijen mehanizam u mozgu za pronalaženje stvari.

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

No, odličan je za stvari koje se puno ne miču,

not so good for things that move around.

ne tako dobar za one koje se miču.

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

To je razlog zašto gubimo ključeve auta, naočale za čitanje i putovnice.

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

Stoga u svome domu odredite mjesto za svoje ključeve --

a hook by the door, maybe a decorative bowl.

kukica kraj vrata, možda dekorativna zdjela.

For your passport, a particular drawer.

Za putovnicu odredite posebnu ladicu.

For your reading glasses, a particular table.

Za naočale poseban stol.

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

Ako odredite mjesto i budete savjesni po tom pitanju,

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

vaše stvari će uvijek biti ondje kad ih tražite.

What about travel?

Što je s putovanjima?

Take a cell phone picture of your credit cards,

Mobitelom slikajte kreditne kartice,

your driver's license, your passport,

vozačku dozvolu, putovnicu,

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

pošaljite to sebi, da bude na online disku.

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

Ako se te stvari izgube ili ukradu, možete si olakšati njihovu zamjenu.

Now these are some rather obvious things.

Dakle, ovo su neki od očitih primjera.

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

Sjetite se, kada ste pod stresom, mozak luči kortizol.

Cortisol is toxic, and it causes cloudy thinking.

Kortizol je toksičan i uzrokuje pomućeno razmišljanje.

So part of the practice of the pre-mortem

Stoga je dio prakse u pre-mortemu

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

prepoznati da pod stresom nećete biti u najboljem izdanju,

and you should put systems in place.

i da morate upregnuti neke sustave.

And there's perhaps no more stressful a situation

Vjerojatno ne postoji stresnija situacija

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

od one kada ste suočeni s donošenjem medicinske odluke.

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

U nekom trenutku, svi mi ćemo se naći u toj poziciji,

where we have to make a very important decision

gdje moramo donijeti vrlo važnu odluku

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

o budućoj medicinskoj brizi o nama ili našim voljenima,

to help them with a decision.

kako bismo im pomogli s odlukom.

And so I want to talk about that.

To je ono o čemu želim pričati.

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

Pričat ću o vrlo specifičnom medicinskom stanju.

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

Ali to je primjer za sve vrste donošenja medicinskih odluka

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

i uistinu, za donošenje financijskih i socijalnih odluka --

any kind of decision you have to make

bilo kakvih odluka koje morate donijeti

that would benefit from a rational assessment of the facts.

kojima bi koristilo racionalno prosuđivanje činjenica.

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

Pretpostavimo da idete kod liječnika i on kaže,

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

"Upravo su stigli laboratorijski nalazi, kolesterol Vam je malo povišen."

Now, you all know that high cholesterol

Svi znate da je povišeni kolesterol

is associated with an increased risk of cardiovascular disease,

povezan s povećanim rizikom od kardiovaskularnih bolesti,

heart attack, stroke.

srčanim udarom, kapi.

And so you're thinking

Pa mislite,

having high cholesterol isn't the best thing,

imati povišen kolesterol nije baš najbolje,

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

a liječnik kaže, "Znate, dao bih Vam lijek

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

koji će Vam pomoći sniziti kolesterol, statin."

And you've probably heard of statins,

Vjerojatno ste čuli za statine,

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

znate da su danas među najčešće propisanim lijekovima

in the world today,

na svijetu,

you probably even know people who take them.

vjerojatno poznate i ljude koji ih uzimaju.

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

Pa mislite, "Da! Dajte mi statin."

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

Međutim, tada se treba nešto zapitati,

a statistic you should ask for

statistika koju želite saznati

that most doctors don't like talking about,

o kojoj većina liječnika ne voli pričati,

and pharmaceutical companies like talking about even less.

a farmaceutske firme još manje.

It's for the number needed to treat.

To je broj koji se treba liječiti.

Now, what is this, the NNT?

Što je to NNT?

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

To je broj ljudi koji treba uzeti lijek

or undergo a surgery or any medical procedure

ili biti podvrgnut operaciji ili nekom medicinskom postupku

before one person is helped.

prije nego što se pomogne jednoj osobi.

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

I mislite se, kakva je to luda statistika?

The number should be one.

Broj bi trebao biti jedan.

My doctor wouldn't prescribe something to me

Moj liječnik mi ne bi prepisao nešto

if it's not going to help.

ako mi neće pomoći.

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

Ali zapravo, u medicinskoj praksi nije uvijek tako.

And it's not the doctor's fault,

I nije liječnikova krivica,

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

ako je ičija krivica, onda je to krivica znanstvenika poput mene.

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

Nismo baš potpuno dokučili osnovne mehanizme.

But GlaxoSmithKline estimates

No, GlaxoSmithKline procjenjuje

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

da 90% lijekova funkcionira u samo 30% do 50% ljudi.

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

Pa, što mislite koji bi bio broj ljudi koji treba liječiti

what do you suppose it is?

za najčešće propisani statin?

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

Koliko ljudi ga mora uzimati prije nego što se pomogne jednoj osobi?

300.

300.

This is according to research

Ovo se temelji na istraživanju

by research practitioners Jerome Groopman and Pamela Hartzband,

liječnika istraživača Jeromea Groopmana i Pamele Hartzband,

independently confirmed by Bloomberg.com.

nezavisno potvrđenog od strane Bloomberg.com.

I ran through the numbers myself.

Osobno sam prošao kroz brojke.

300 people have to take the drug for a year

300 ljudi mora godinu dana uzimati lijek

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

prije nego što se spriječi 1 srčani udar, kap ili drugi štetni događaj.

Now you're probably thinking,

Sad vjerojatno mislite,

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

"Pa, u redu, jedna od 300 šansi da snizim kolesterol.

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

Zašto ne, doktore? Svejedno mi dajte recept."

But you should ask at this point for another statistic,

Sada biste trebali zatražiti drugu statistiku,

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

a to je "Recite mi koje su nuspojave." Zar ne?

So for this particular drug,

Za ovaj lijek, konkretno,

the side effects occur in five percent of the patients.

do nuspojava dolazi kod 5% pacijenata.

And they include terrible things --

A one uključuju strahote --

debilitating muscle and joint pain, gastrointestinal distress --

bol u oslabljenim mišićima i zglobovima, gastrointestinalni bolovi

but now you're thinking, "Five percent,

ali sad mislite, "Pet posto,

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

nije baš vjerojatno da će se dogoditi meni,

I'll still take the drug."

ipak ću uzeti lijek."

But wait a minute.

Ali samo malo.

Remember under stress you're not thinking clearly.

Sjetite se da pod stresom ne razmišljate jasno.

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

Pa razmislite kako to premostiti prije vremena,

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

kako ne biste trebali proizvesti lanac rasuđivanja na licu mjesta.

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

300 ljudi uzima lijek, zar ne? Jednoj osobi se pomogne,

five percent of those 300 have side effects,

pet posto od onih 300 imaju nuspojave,

that's 15 people.

to je 15 ljudi.

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

15 puta više vjerojatnosti ima da vam se lijekom naudi

than you are to be helped by the drug.

nego da vam se njime pomogne.

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

Ne poručujem vam da biste trebali uzimati lijek ili ne.

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

Samo kažem da biste trebali povesti ovakav razgovor sa svojim liječnikom.

Medical ethics requires it,

Liječnička etika to zahtijeva,

it's part of the principle of informed consent.

to je dio principa o informiranoj suglasnosti.

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

Imate pravo na pristup ovakvoj vrsti informacija,

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

da započnete razgovor o tome želite li riskirati ili ne.

Now you might be thinking

Sad možda mislite

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

da sam izvukao bezveze neki broj radi izazivanja šoka,

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

ali zapravo je jako tipično, broj koji se treba liječiti.

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

Za većinu obavljenih operacija na muškarcima starijim od 50 godina,

removal of the prostate for cancer,

odstranjivanje prostate zbog raka,

the number needed to treat is 49.

broj koji je potrebno liječiti je 49.

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

Točno tako, 49 operacija mora se izvršiti za svaku osobu kojoj se pomaže.

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

Nuspojave u tom slučaju pojavljuju se kod 50% pacijenata.

They include impotence, erectile dysfunction,

One uključuju impotenciju, erektilnu disfunkciju,

urinary incontinence, rectal tearing,

urinarnu inkontinenciju, pucanje rektuma,

fecal incontinence.

fekalnu inkontinenciju.

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

A ako imate sreće i jedan ste od 50% koji ovo imaju,

they'll only last for a year or two.

nuspojave će trajati samo godinu dana ili dvije.

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

Ideja pre-mortema je razmišljati unaprijed

to the questions that you might be able to ask

o pitanjima koja biste mogli postaviti

that will push the conversation forward.

koja će pogurnuti razgovor.

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

Ne želite da se dogodi da to sve morate proizvesti na licu mjesta.

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

A morate i razmišljati o nečemu kao što je kvaliteta života.

Because you have a choice oftentimes,

Zato što često imate izbor,

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

želite li kraći život, bez boli

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

ili duži život u kojem ćete pred kraj možda iskusiti jaku bol?

These are things to talk about and think about now,

To je nešto o čemu treba sada razmisliti i pričati

with your family and your loved ones.

sa svojom obitelji i bližnjima.

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

Možda se u trenutku predomislite,

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

ali barem ste vježbali ovakav način razmišljanja.

Remember, our brain under stress releases cortisol,

Zapamtite, naš mozak pod stresom luči kortizol,

and one of the things that happens at that moment

a nešto što se tada dogodi

is a whole bunch on systems shut down.

jest da cijeli niz sustava zakaže.

There's an evolutionary reason for this.

Za to postoji evolucijski razlog.

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

Licem u lice s predatorom, ne treba vam probavni sustav,

or your libido, or your immune system,

ni libido niti imunološki sustav,

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

jer ako vaše tijelo troši metabolizam na takve stvari,

and you don't react quickly,

a vi ne reagirate brzo,

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

možete lavu postati obrok, a tada ništa od ovoga nije bitno.

Unfortunately,

Nažalost,

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

ono što u takvim stresnim trenucima više ne postoji

is rational, logical thinking,

je racionalno, logično razmišljanje,

as Danny Kahneman and his colleagues have shown.

kao što su pokazali Danny Kahneman i njegovi kolege.

So we need to train ourselves to think ahead

Zato se moramo istrenirati da razmišljamo unaprijed

to these kinds of situations.

o ovakvim situacijama.

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

Mislim da je bitna stavka ovdje prepoznati da svi imamo mane.

We all are going to fail now and then.

Svi ćemo tu i tamo pogriješiti.

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

Bit je unaprijed razmišljati o tim greškama,

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

uspostaviti sustave koji će umanjiti štetu

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

ili spriječiti da se loše stvari uopće i dogode.

Getting back to that snowy night in Montreal,

Da se vratimo na onu snježnu noć u Montrealu

when I got back from my trip,

kad sam se vratio s puta,

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

majstor mi je instalirao kombinacijsku bravu kraj vrata

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

u kojoj je ključ za prednja vrata, kombinacija je lako pamtljiva.

And I have to admit,

I moram priznati,

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

još uvijek imam hrpe pošte koja nije svrstana

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

i hrpe e-mailova koje još nisam niti pogledao.

So I'm not completely organized,

Tako da nisam potpuno organiziran,

but I see organization as a gradual process,

ali na organizaciju gledam kao postupni proces

and I'm getting there.

i napredujem prema tome.

Thank you very much.

Hvala puno.

(Applause)

(Pljesak)