What really matters at the end of life | BJ Miller | TED

12,750,923 views ・ 2015-09-30

TED


Dvaput kliknite na engleske titlove ispod za reprodukciju videozapisa.

Prevoditelj: Anja Kolobarić Recezent: Ivan Stamenković
00:13
Well, we all need a reason to wake up.
0
13999
3009
Svima nama potreban je razlog da se ujutro ustanemo iz kreveta.
00:18
For me, it just took 11,000 volts.
1
18898
2373
Meni je za to trebalo samo 11 000 volti.
00:23
I know you're too polite to ask,
2
23068
1674
Znam da ste prepristojni da pitate,
00:24
so I will tell you.
3
24766
1635
pa ću vam reći.
00:27
One night, sophomore year of college,
4
27354
2223
Jedne večeri na 2. godini faksa,
00:29
just back from Thanksgiving holiday,
5
29601
3698
baš nakon praznika za Dan zahvalnosti,
00:33
a few of my friends and I were horsing around,
6
33323
2652
nekolicina mojih prijatelja i ja smo se budalesali
00:35
and we decided to climb atop a parked commuter train.
7
35999
3565
i odlučili se popeti na parkirani putnički vlak.
00:40
It was just sitting there, with the wires that run overhead.
8
40167
3114
Samo je stajao tamo, žice su bile na krovu.
00:43
Somehow, that seemed like a great idea at the time.
9
43305
3102
Tada se to nekako činilo kao izvrsna ideja.
00:46
We'd certainly done stupider things.
10
46804
2482
Radili smo i glupljih stvari.
00:50
I scurried up the ladder on the back,
11
50270
3021
Popeo sam se na stražnje ljestve
00:53
and when I stood up,
12
53315
1722
i kad sam ustao,
00:55
the electrical current entered my arm,
13
55061
3582
struja mi je ušla kroz ruku,
00:58
blew down and out my feet, and that was that.
14
58667
2540
pošla prema dolje i prema stopalima i to je bilo to.
01:03
Would you believe that watch still works?
15
63699
2589
Možete li vjerovati da taj sat još uvijek radi?
01:08
Takes a licking!
16
68216
1207
Svašta je prošao.
01:09
(Laughter)
17
69447
1031
(Smijeh)
01:10
My father wears it now in solidarity.
18
70502
2309
Sad ga moj otac nosi iz solidarnosti.
01:15
That night began my formal relationship with death -- my death --
19
75295
6023
Ta je večer započela moju formalnu vezu sa smrti - s mojom smrti -
01:21
and it also began my long run as a patient.
20
81342
3808
a započela je i moju dugoročnu karijeru pacijenta.
01:25
It's a good word.
21
85174
1154
Dobra je to riječ.
01:26
It means one who suffers.
22
86352
1727
Znači "onaj koji pati".
01:28
So I guess we're all patients.
23
88825
1441
Svi smo mi pacijenti.
01:31
Now, the American health care system
24
91607
2366
Američki zdravstveni sustav
01:33
has more than its fair share of dysfunction --
25
93997
3121
nefunkcionalan je
01:37
to match its brilliance, to be sure.
26
97142
2060
koliko i briljantan.
01:39
I'm a physician now, a hospice and palliative medicine doc,
27
99750
4452
Sad sam liječnik za palijativnu njegu u staračkom domu,
01:44
so I've seen care from both sides.
28
104226
2246
pa sam vidio kako je njegovati i biti njegovan.
01:47
And believe me: almost everyone who goes into healthcare
29
107076
3899
Vjerujte mi - gotovo svatko tko se odluči na karijeru u zdravstvu
01:50
really means well -- I mean, truly.
30
110999
3137
ima najbolje namjere. Zaista ima,
01:54
But we who work in it are also unwitting agents
31
114874
3933
ali svi mi koji u njemu radimo smo i nesvjesni agenti
01:58
for a system that too often does not serve.
32
118831
4244
sustava koji nerijetko ne služi svrsi.
02:03
Why?
33
123999
1157
Zašto?
02:05
Well, there's actually a pretty easy answer to that question,
34
125624
3381
Odgovor na to pitanje prilično je jednostavan
02:09
and it explains a lot:
35
129029
2248
i puno toga objašnjava:
02:11
because healthcare was designed with diseases, not people, at its center.
36
131301
5958
zdravstvo je dizajnirano imajući u vidu bolesti, a ne ljude,
02:18
Which is to say, of course, it was badly designed.
37
138419
2906
što, naravno, znači da je loše dizajnirano.
02:22
And nowhere are the effects of bad design more heartbreaking
38
142158
6052
Posljedice lošeg dizajna nigdje nisu toliko žalosne,
02:28
or the opportunity for good design more compelling
39
148234
3335
ili prilike za dobru zamišljenost toliko stvarne,
02:31
than at the end of life,
40
151593
2141
kao na koncu života
02:33
where things are so distilled and concentrated.
41
153758
3356
kad je sve toliko sažeto i koncentrirano.
02:38
There are no do-overs.
42
158234
1786
Tu nema popravaka.
02:42
My purpose today is to reach out across disciplines
43
162073
4491
Moj današnji cilj je doprijeti do različitih disciplina
02:46
and invite design thinking into this big conversation.
44
166588
4367
i pozvati na razmišljanje o planiranju,
02:51
That is, to bring intention and creativity
45
171495
5357
odnosno uvesti namjeru i kreativnost
02:56
to the experience of dying.
46
176876
2769
u doživljaj umiranja.
03:01
We have a monumental opportunity in front of us,
47
181235
4033
Pred nama je monumentalna prilika,
03:05
before one of the few universal issues
48
185292
4341
pred jednim od rijetkih univerzalnih pitanja
03:09
as individuals as well as a civil society:
49
189657
3310
koja se tiču i pojedinaca, a i civilnog društva:
03:12
to rethink and redesign how it is we die.
50
192991
3916
ponovno razmisliti i redizajnirati način na koji umiremo.
03:19
So let's begin at the end.
51
199489
2590
Krenimo od kraja.
03:23
For most people, the scariest thing about death isn't being dead,
52
203611
3935
Kad govorimo o smrti, većini ljudi najveći strah nije to što će biti mrtvi,
03:27
it's dying, suffering.
53
207570
1819
već samo umiranje, patnja.
03:29
It's a key distinction.
54
209809
1375
To je glavna razlika.
03:32
To get underneath this, it can be very helpful
55
212461
2168
Kako bismo to razumjeli, nekad zna pomoći
03:34
to tease out suffering which is necessary as it is,
56
214653
4354
odvojiti patnju koja je ionako nužna
03:39
from suffering we can change.
57
219031
2665
od patnje na koju možemo utjecati.
03:42
The former is a natural, essential part of life, part of the deal,
58
222317
5236
Nužna patnja je prirodna, prirodan dio života, dolazi u paketu,
03:47
and to this we are called to make space, adjust, grow.
59
227577
5114
na to se moramo priviknuti.
03:55
It can be really good to realize forces larger than ourselves.
60
235013
5346
Dobro je uvidjeti sile veće od nas samih
04:01
They bring proportionality,
61
241098
3124
koje nam donose proporcionalnost,
04:04
like a cosmic right-sizing.
62
244246
2319
poput kozmičkog smanjivanja ljudske snage.
04:08
After my limbs were gone,
63
248779
2434
Kad su mi uklonili udove,
04:11
that loss, for example, became fact, fixed --
64
251237
4586
taj je gubitak postao činjeničan, fiksiran -
04:15
necessarily part of my life,
65
255847
3313
nužan dio mog života
04:19
and I learned that I could no more reject this fact than reject myself.
66
259184
6116
i shvatio sam da ne mogu odbacivati tu činjenicu, kao ni sebe.
04:27
It took me a while, but I learned it eventually.
67
267173
2621
Trebalo mi je vremena, ali pomirio sam se s tim.
04:30
Now, another great thing about necessary suffering
68
270572
2444
Još jedna sjajna stvar po pitanju nužne patnje
04:33
is that it is the very thing
69
273040
3508
jest upravo ono
04:36
that unites caregiver and care receiver --
70
276572
5403
što ujedinjuje pružatelja i primatelja njege -
04:41
human beings.
71
281999
1253
ljudska bića.
04:45
This, we are finally realizing, is where healing happens.
72
285089
3814
Konačno uviđamo da se tu odvija ozdravljenje.
04:49
Yes, compassion -- literally, as we learned yesterday --
73
289673
3520
Da, suosjećanje - kao što smo doslovno jučer naučili -
04:53
suffering together.
74
293217
1428
zajednička patnja.
04:56
Now, on the systems side, on the other hand,
75
296672
3338
S druge strane, što se sustava tiče,
05:00
so much of the suffering is unnecessary, invented.
76
300034
3858
puno je patnje bespotrebno, izmišljeno.
05:04
It serves no good purpose.
77
304376
2274
Nema neku svrhu.
05:06
But the good news is, since this brand of suffering is made up,
78
306674
4301
Dobra vijest glasi: budući da je ova vrsta patnje izmišljena,
05:10
well, we can change it.
79
310999
1484
možemo je promijeniti.
05:13
How we die is indeed something we can affect.
80
313681
2654
Na to kako umiremo zaista možemo utjecati.
05:18
Making the system sensitive to this fundamental distinction
81
318446
4053
Osvješćivanje sustava o ovoj ključnoj razlici
05:22
between necessary and unnecessary suffering
82
322523
3452
između nužne i bespotrebne patnje
05:25
gives us our first of three design cues for the day.
83
325999
3690
dobivamo prvi od triju dizajnerskih tragova za danas.
05:30
After all, our role as caregivers, as people who care,
84
330299
4529
Ipak je naša uloga kao pružatelja skrbi, kao ljudi koji brinu,
05:34
is to relieve suffering -- not add to the pile.
85
334852
4662
ublažiti patnju, a ne je dodatno pogoršati.
05:42
True to the tenets of palliative care,
86
342292
1871
Prema stanarima staračkog doma,
05:44
I function as something of a reflective advocate,
87
344187
3673
ja sam nešto kao zagovornik refleksije,
05:47
as much as prescribing physician.
88
347884
2119
kao i liječnik koji propisuje terapiju.
05:51
Quick aside: palliative care -- a very important field but poorly understood --
89
351177
6021
Kratka digresija - palijativna njega - važno polje koje je slabo shvaćeno -
05:57
while it includes, it is not limited to end of life care.
90
357222
2954
uključuje njegu na kraju života, ali nije ograničeno na njega.
06:00
It is not limited to hospice.
91
360200
1841
Nije ograničeno na hospicij,
06:02
It's simply about comfort and living well at any stage.
92
362811
3457
već se tiče ugode i kvalitetnog življenja u bilo kojoj fazi života.
06:06
So please know that you don't have to be dying anytime soon
93
366999
3039
Imajte na umu da se ne morate opasno bližiti smrti
06:10
to benefit from palliative care.
94
370062
1687
da biste imali koristi od palijativne njege.
06:13
Now, let me introduce you to Frank.
95
373450
2280
Upoznajte Franka.
06:17
Sort of makes this point.
96
377768
1215
On to nekako i dokazuje.
06:19
I've been seeing Frank now for years.
97
379007
2030
Viđam se s njim godinama.
06:21
He's living with advancing prostate cancer on top of long-standing HIV.
98
381061
4194
Živi s uznapredovanim rakom prostate, kao i s dugogodišnjim virusom HIV.
06:26
We work on his bone pain and his fatigue,
99
386197
1986
Radimo na njegovoj kostobolji i umoru,
06:28
but most of the time we spend thinking out loud together about his life --
100
388207
4714
ali najviše vremena provodimo razmišljajući naglas o njegovu životu -
06:32
really, about our lives.
101
392945
1365
zapravo, o našim životima.
06:35
In this way, Frank grieves.
102
395071
1660
Frank tako tuguje.
06:37
In this way, he keeps up with his losses as they roll in,
103
397207
3779
Tako prati svoje gubitke kako nadolaze,
06:41
so that he's ready to take in the next moment.
104
401010
3149
pa je spreman proživjeti sljedeći trenutak.
06:45
Loss is one thing, but regret, quite another.
105
405524
4171
Gubitak je jedna stvar, ali žaljenje je nešto sasvim drugo.
06:51
Frank has always been an adventurer --
106
411243
1957
Frank je uvijek bio avanturist -
06:53
he looks like something out of a Norman Rockwell painting --
107
413224
2841
izgleda kao da je iskočio sa slike Normana Rockwella -
06:56
and no fan of regret.
108
416089
1564
i nije ljubitelj žaljenja.
06:58
So it wasn't surprising when he came into clinic one day,
109
418566
2681
Nije me iznenadilo kad mi je jednog dana došao u kliniku
07:01
saying he wanted to raft down the Colorado River.
110
421271
2736
i rekao da želi ići na rafting rijekom Colorado.
07:05
Was this a good idea?
111
425142
1675
Je li to bila dobra ideja?
07:07
With all the risks to his safety and his health, some would say no.
112
427268
4204
Imajući na umu sve rizike po njegovu sigurnost i zdravlje, neki bi rekli - ne.
07:11
Many did, but he went for it, while he still could.
113
431496
3566
Mnogi i jesu, ali odvažio se na to dok je još mogao.
07:15
It was a glorious, marvelous trip:
114
435999
3611
Bio je to veličanstven, sjajan put:
07:20
freezing water, blistering dry heat, scorpions, snakes,
115
440928
5322
ledena voda, strašna vrućina, škorpioni, zmije,
07:26
wildlife howling off the flaming walls of the Grand Canyon --
116
446274
5431
zavijanje divljih životinja širilo se uzavrelim zidinama Grand Canyona -
07:31
all the glorious side of the world beyond our control.
117
451729
3544
sva veličanstvena strana svijeta koja je izvan naše kontrole.
07:36
Frank's decision, while maybe dramatic,
118
456492
1890
Iako je Frankova odluka bila dramatična,
07:38
is exactly the kind so many of us would make,
119
458406
2287
to je i odluka na kakvu bi se mnogi od nas odvažili
07:40
if we only had the support to figure out what is best for ourselves over time.
120
460717
6197
kad bi imali podršku osmisliti što je za nas najbolje, dugoročno gledano.
07:49
So much of what we're talking about today is a shift in perspective.
121
469291
3369
Puno toga o čemu danas govorimo tiče se promjene u perspektivi.
07:54
After my accident, when I went back to college,
122
474723
2252
Nakon nesreće, vratio sam se na faks
07:56
I changed my major to art history.
123
476999
2366
i promijenio glavni studij u povijest umjetnosti.
08:00
Studying visual art, I figured I'd learn something about how to see --
124
480095
4300
Mislio sam da ću proučavajući likovnu umjetnost naučiti kako vidjeti -
08:05
a really potent lesson for a kid who couldn't change
125
485705
3374
bila je to moćna lekcija za mladića koji nije mogao promijeniti
08:09
so much of what he was seeing.
126
489103
2041
puno opažanoga.
08:12
Perspective, that kind of alchemy we humans get to play with,
127
492602
3738
Perspektiva, svojevrsna alkemija kojom se mi ljudi igramo -
08:16
turning anguish into a flower.
128
496364
2510
pretvaramo muku u cvijet.
08:21
Flash forward: now I work at an amazing place in San Francisco
129
501999
3792
Sad radim na krasnom mjestu u San Francisku
08:25
called the Zen Hospice Project,
130
505815
2239
koji se zove Hospicijski projekt Zen
08:28
where we have a little ritual that helps with this shift in perspective.
131
508078
3620
gdje imamo mali ritual koji pomaže s ovim promjenama perspektive.
08:32
When one of our residents dies,
132
512405
3061
Kad jedan od naših stanara umre,
08:35
the mortuary men come, and as we're wheeling the body out through the garden,
133
515490
4470
dolaze mrtvozornici i vozimo tijelo kroz vrt,
08:39
heading for the gate, we pause.
134
519984
2030
idemo prema vratima i zastanemo.
08:42
Anyone who wants --
135
522038
2185
Svatko tko želi -
08:44
fellow residents, family, nurses, volunteers,
136
524247
2724
drugi stanari, obitelj, sestre, volonteri,
08:46
the hearse drivers too, now --
137
526995
2444
pa i vozači mrtvačkih kola -
08:49
shares a story or a song or silence,
138
529463
4427
s ostalima podijeli priču, pjesmu ili tišinu
08:53
as we sprinkle the body with flower petals.
139
533914
2788
dok tijelo posipamo laticama cvijeća.
08:57
It takes a few minutes;
140
537282
2304
Traje nekoliko minuta;
08:59
it's a sweet, simple parting image to usher in grief with warmth,
141
539610
5365
to je dražesna, jednostavna slika kojom tugu pratimo toplinom,
09:04
rather than repugnance.
142
544999
1711
a ne gađenjem.
09:08
Contrast that with the typical experience in the hospital setting,
143
548060
5046
Usporedite to s uobičajenim iskustvom u bolnici
09:13
much like this -- floodlit room lined with tubes and beeping machines
144
553130
4864
koje izgleda ovako nekako - osvijetljena soba puna cijevi i aparata
09:18
and blinking lights that don't stop even when the patient's life has.
145
558018
4168
i svjetla koja neprestano trepere, pa čak i nakon smrti pacijenta.
09:23
Cleaning crew swoops in, the body's whisked away,
146
563419
3026
Dolaze čistačice, tijelo jurno odvoze iz prostorije
09:26
and it all feels as though that person had never really existed.
147
566469
5028
i čini se kao da ta osoba nikad nije ni postojala.
09:33
Well-intended, of course, in the name of sterility,
148
573070
2623
Naravno, sve u najboljoj namjeri, u ime sterilnosti,
09:35
but hospitals tend to assault our senses,
149
575717
3496
ali bolnice vrše udar na naša osjetila,
09:39
and the most we might hope for within those walls is numbness --
150
579237
5504
a najviše čemu se možemo nadati unutar tih zidova jest otupjelost -
09:44
anesthetic, literally the opposite of aesthetic.
151
584765
4242
anestetik - doslovno suprotnost estetici.
09:50
I revere hospitals for what they can do; I am alive because of them.
152
590499
4305
Cijenim bolnice zbog svega što rade, zbog njih sam danas živ,
09:56
But we ask too much of our hospitals.
153
596096
2117
ali previše tražimo od naših bolnica.
09:59
They are places for acute trauma and treatable illness.
154
599436
3593
To su mjesta za akutne traume i izlječive bolesti.
10:03
They are no place to live and die; that's not what they were designed for.
155
603053
4025
To nisu mjesta za život i smrt; nisu za to zamišljene.
10:10
Now mind you -- I am not giving up on the notion
156
610078
2300
Pazite, ne odričem se ideje
10:12
that our institutions can become more humane.
157
612402
3210
da naše institucije mogu postati humanije.
10:16
Beauty can be found anywhere.
158
616057
2381
Ljepotu možemo pronaći svugdje.
10:21
I spent a few months in a burn unit
159
621092
2272
Nekoliko mjeseci proveo sam na odjelu za opekotine
10:23
at St. Barnabas Hospital in Livingston, New Jersey,
160
623388
2748
u bolnici sv. Barnabe u Livingstonu, New Jersey
10:26
where I got really great care at every turn,
161
626160
4157
gdje mi je pružana sjajna njega na svakom koraku
10:30
including good palliative care for my pain.
162
630341
2197
uključujući i izvrsnu palijativnu njegu za moje bolove.
10:33
And one night, it began to snow outside.
163
633415
2845
Jedne je večeri počelo sniježiti.
10:37
I remember my nurses complaining about driving through it.
164
637426
3915
Sjećam se da su se sestre žalile što moraju voziti kroz taj snijeg.
10:42
And there was no window in my room,
165
642103
2184
U sobi nije bilo prozora,
10:44
but it was great to just imagine it coming down all sticky.
166
644311
3306
ali bilo je zabavno zamišljati ga kako pada.
10:49
Next day, one of my nurses smuggled in a snowball for me.
167
649299
3934
Sljedećeg dana jedna od mojih sestara prokrijumčarila mi je grudu snijega.
10:53
She brought it in to the unit.
168
653257
1633
Donijela ju je na odjel.
10:56
I cannot tell you the rapture I felt holding that in my hand,
169
656731
5408
Ne mogu vam opisati koliko sam se sjajno osjećao držeći je u ruci
11:02
and the coldness dripping onto my burning skin;
170
662163
3049
dok je hladnoća kapala po mojoj uzavreloj koži;
11:05
the miracle of it all,
171
665236
2310
koliko je to čudesno bilo,
11:07
the fascination as I watched it melt and turn into water.
172
667570
3759
fascinacija s kojom sam promatrao kako se pretvara u vodu.
11:15
In that moment,
173
675293
2131
U tom trenutku
11:17
just being any part of this planet in this universe mattered more to me
174
677448
4488
sama činjenica da sam bilo koji dio ovog planeta u svemiru značilo mi je više
11:21
than whether I lived or died.
175
681960
2099
od činjenice hoću li živjeti ili umrijeti.
11:24
That little snowball packed all the inspiration I needed
176
684083
3123
Da gruda snijega nosila je inspiraciju koja mi je bila potrebna
11:27
to both try to live and be OK if I did not.
177
687230
3205
da pokušam živjeti i da mi ne smeta ako i ne poživim.
11:31
In a hospital, that's a stolen moment.
178
691176
2884
U bolnici je to ukraden trenutak.
11:36
In my work over the years, I've known many people
179
696356
3389
Tijekom godina karijere upoznao sam mnoge ljude
11:39
who were ready to go, ready to die.
180
699769
1827
koji su bili spremni na smrt -
11:43
Not because they had found some final peace or transcendence,
181
703192
4783
ne zato što su pronašli konačan spokoj ili transcedenciju,
11:47
but because they were so repulsed by what their lives had become --
182
707999
4309
nego zato što im se zgadilo to na što su im se životi sveli -
11:54
in a word, cut off, or ugly.
183
714553
4549
Jednom riječju - odvojeni ili ružni.
12:03
There are already record numbers of us living with chronic and terminal illness,
184
723394
6086
Već postoji rekordni broj nas koji živimo s kroničnim i terminalnim bolestima,
12:09
and into ever older age.
185
729504
1452
pa čak i u starijoj dobi.
12:11
And we are nowhere near ready or prepared for this silver tsunami.
186
731947
4800
Nismo ni blizu spremni ili pripravni za ovaj srebrni tsunami.
12:19
We need an infrastructure dynamic enough to handle
187
739335
3261
Treba nam dovoljno dinamična infrastruktura koja će se nositi
12:22
these seismic shifts in our population.
188
742620
4064
s ovim seizmičkim promjenama u našoj populaciji.
12:27
Now is the time to create something new, something vital.
189
747637
3020
Sad je vrijeme da stvorimo nešto novo, nešto ključno.
12:30
I know we can because we have to.
190
750681
2360
Znam da to možemo jer to moramo.
12:33
The alternative is just unacceptable.
191
753065
2022
Alternativa je jednostavno neprihvatljiva,
12:35
And the key ingredients are known:
192
755651
1882
a ključni sastojci su poznati:
12:37
policy, education and training,
193
757557
3674
politika, odgoj i obrazovanje i obuka,
12:41
systems, bricks and mortar.
194
761255
2062
sustavi, cigle i žbuka.
12:44
We have tons of input for designers of all stripes to work with.
195
764642
3806
Imamo hrpu materijala s kojima mogu raditi dizajneri svih orijentacija.
12:49
We know, for example, from research
196
769123
1881
Npr. iz istraživanja znamo
12:51
what's most important to people who are closer to death:
197
771028
3486
što je najvažnije ljudima koji se bliže smrti:
12:54
comfort; feeling unburdened and unburdening to those they love;
198
774538
6965
ugoda; osjećaj neopterećenosti i nestvaranja tereta onima koje vole;
13:01
existential peace; and a sense of wonderment and spirituality.
199
781527
5242
egzistencijalni mir; osjećaj čuđenja i duhovnosti.
13:08
Over Zen Hospice's nearly 30 years,
200
788896
3758
U gotovo trideset godina hospicija Zen
13:12
we've learned much more from our residents in subtle detail.
201
792678
3643
puno smo više detalja naučili od naših stanara.
13:17
Little things aren't so little.
202
797662
2465
Male stvari i nisu toliko male.
13:21
Take Janette.
203
801499
1174
Npr. Janette je
13:22
She finds it harder to breathe one day to the next due to ALS.
204
802697
3487
svakim danom sve teže disati zbog ALS-a.
13:26
Well, guess what?
205
806208
1150
Znate što?
13:28
She wants to start smoking again --
206
808121
3378
Želi ponovno početi pušiti,
13:31
and French cigarettes, if you please.
207
811523
2928
i to francuske cigarete.
13:36
Not out of some self-destructive bent,
208
816786
2223
Ne iz nekog auto-destruktivnog hira,
13:39
but to feel her lungs filled while she has them.
209
819033
3959
već kako bi osjetila kako joj se pluća pune dok ih još uvijek ima.
13:44
Priorities change.
210
824786
1197
Prioriteti se mijenjaju.
13:47
Or Kate -- she just wants to know
211
827556
2471
Ili npr. Kate koja samo želi znati
13:50
her dog Austin is lying at the foot of her bed,
212
830051
4035
da njezin pas Austin leži ispred njezinog kreveta,
13:54
his cold muzzle against her dry skin,
213
834110
3717
njegova hladna njuška na njezinoj suhoj koži
13:57
instead of more chemotherapy coursing through her veins --
214
837851
2723
umjesto dodatne kemoterapije koja joj teče venama -
14:00
she's done that.
215
840598
1181
učinila je to.
14:02
Sensuous, aesthetic gratification, where in a moment, in an instant,
216
842849
5016
Senzualna, estetička zadovoljština u kojoj u trenutku, u sekundi
14:07
we are rewarded for just being.
217
847889
3352
dobijemo nagradu samo zato što postojimo.
14:15
So much of it comes down to loving our time by way of the senses,
218
855373
4282
Toliko se toga svodi na uživanje u preostalom vremenu putem osjetila,
14:19
by way of the body -- the very thing doing the living and the dying.
219
859679
5292
putem tijela - onoga što je zaslužno za život i smrt.
14:26
Probably the most poignant room
220
866258
1559
Vjerojatno najbolnija soba
14:27
in the Zen Hospice guest house is our kitchen,
221
867841
2253
u gostinjskoj kući hospicija Zen naša je kuhinja,
14:30
which is a little strange when you realize
222
870118
2037
što je malo neobično kad shvatite
14:32
that so many of our residents can eat very little, if anything at all.
223
872179
3813
da toliko naših stanara jede vrlo malo ili nimalo.
14:36
But we realize we are providing sustenance on several levels:
224
876016
5870
Svjesni smo da im pružamo podršku na nekoliko različitih razina:
14:41
smell, a symbolic plane.
225
881910
3066
miris, simboličke osnove.
14:46
Seriously, with all the heavy-duty stuff happening under our roof,
226
886356
4917
Ozbiljno, sa svim obvezama koje su se odvijale pod našim krovom,
14:51
one of the most tried and true interventions we know of,
227
891297
3734
jedna od najboljih intervencija koje smo otkrili
14:55
is to bake cookies.
228
895055
3493
jest pečenje kolača.
15:10
As long as we have our senses --
229
910144
1604
Sve dok imamo osjetila -
15:11
even just one --
230
911772
2012
makar samo jedno -
15:13
we have at least the possibility of accessing
231
913808
3409
imamo barem mogućnost pristupa
15:17
what makes us feel human, connected.
232
917241
3168
onome zbog čega se osjećamo kao ljudi, povezano.
15:22
Imagine the ripples of this notion
233
922999
2786
Zamislite posljedice ovoga
15:25
for the millions of people living and dying with dementia.
234
925809
2785
za milijune ljudi koji žive i umiru s demencijom.
15:29
Primal sensorial delights that say the things we don't have words for,
235
929554
4265
Osnovni senzorni užici koji govore stvari za koje mi nemamo riječi,
15:33
impulses that make us stay present --
236
933843
2874
impulsi koji nam pomažu da ostanemo u sadašnjosti -
15:36
no need for a past or a future.
237
936741
2805
bez potrebe za prošlosti ili budućnosti.
15:42
So, if teasing unnecessary suffering out of the system was our first design cue,
238
942280
6194
Ako nam je prvi dizajnerski trag bio uklanjanje nepotrebne patnje iz sustava,
15:50
then tending to dignity by way of the senses,
239
950559
2704
onda je težnja dostojanstvu putem osjetila,
15:53
by way of the body -- the aesthetic realm --
240
953287
3792
putem tijela - estetski realm -
15:57
is design cue number two.
241
957103
1857
drugi dizajnerski trag.
15:59
Now this gets us quickly to the third and final bit for today;
242
959944
3806
To nas je brzo dovelo do trećeg i posljednjeg dijela;
16:03
namely, we need to lift our sights, to set our sights on well-being,
243
963774
6864
moramo podići pogled i pažnju usmjeriti na našu dobrobit
16:10
so that life and health and healthcare
244
970662
3313
kako bi se život i zdravlje i zdravstvo
16:13
can become about making life more wonderful,
245
973999
2385
više usredotočio na uljepšavanje života,
16:16
rather than just less horrible.
246
976408
2444
umjesto na uklanjanje užasnosti.
16:20
Beneficence.
247
980196
1156
Dobrotvornost.
16:22
Here, this gets right at the distinction
248
982999
2135
Ovo pokazuje razliku
16:25
between a disease-centered and a patient- or human-centered model of care,
249
985158
5134
između modela brige usmjerenog na bolest i onog usmjerenog na pacijenta, čovjeka.
16:30
and here is where caring becomes a creative, generative,
250
990316
3461
Tu briga postaje kreativni, proizvodni,
16:33
even playful act.
251
993801
1842
pa čak i zaigran čin.
16:36
"Play" may sound like a funny word here.
252
996657
2000
Riječ "igra" ovdje se može učiniti čudnom,
16:39
But it is also one of our highest forms of adaptation.
253
999687
2904
ali to je ujedno jedan od najviših oblika prilagođavanja.
16:42
Consider every major compulsory effort it takes to be human.
254
1002615
4659
Razmislite o svakom većem obveznom naporu koji moramo napraviti da bismo bili ljudi.
16:47
The need for food has birthed cuisine.
255
1007298
2503
Potreba za hranom izrodila je kuharstvo.
16:49
The need for shelter has given rise to architecture.
256
1009825
2588
Potreba za skloništem izrodila je arhitekturu.
16:52
The need for cover, fashion.
257
1012437
2206
Potreba za pokrivanjem - modu.
16:54
And for being subjected to the clock,
258
1014667
2731
A kako bismo se podredili satu,
16:57
well, we invented music.
259
1017422
3527
izumili smo glazbu.
17:03
So, since dying is a necessary part of life,
260
1023766
3209
Budući da je umiranje nužan dio življenja,
17:06
what might we create with this fact?
261
1026999
2631
što možemo učiniti s tom činjenicom?
17:12
By "play" I am in no way suggesting we take a light approach to dying
262
1032054
3376
"Igrom" nikako ne predlažem da olako pristupimo smrti
17:15
or that we mandate any particular way of dying.
263
1035454
2639
ili da naredimo kako umirati.
17:18
There are mountains of sorrow that cannot move,
264
1038117
2858
Brda tuge ne možemo pomaknuti
17:20
and one way or another, we will all kneel there.
265
1040999
3067
i bilo kako bilo, svi ćemo pred njima pokleknuti.
17:24
Rather, I am asking that we make space --
266
1044999
3501
Zapravo tražim da napravimo mjesta -
17:28
physical, psychic room, to allow life to play itself all the way out --
267
1048524
5743
fizičkog, psihičkog mjesta da pustimo život da se sam odigra do kraja
17:34
so that rather than just getting out of the way,
268
1054291
3357
i da umjesto da mu se samo izmičemo,
17:37
aging and dying can become a process of crescendo through to the end.
269
1057672
4817
starenje i umiranje može postati proces koji se razvija sve do kraja.
17:44
We can't solve for death.
270
1064931
3841
Ne možemo izliječiti smrt.
17:50
I know some of you are working on this.
271
1070283
2307
Znam da neki od vas rade na tome.
17:52
(Laughter)
272
1072614
3675
(Smijeh)
17:57
Meanwhile, we can --
273
1077003
1812
U međuvremenu možemo -
17:58
(Laughter)
274
1078839
2016
(Smijeh)
18:00
We can design towards it.
275
1080879
2306
- možemo dizajnirati prema njoj.
18:04
Parts of me died early on,
276
1084042
1375
Dijelovi mene rano su umrli,
18:05
and that's something we can all say one way or another.
277
1085441
2764
a to svi mi možemo reći za sebe ovako ili onako.
18:08
I got to redesign my life around this fact,
278
1088583
2641
Dobio sam priliku redizajnirati svoj život oko te činjenice
18:11
and I tell you it has been a liberation
279
1091248
3340
i mogu vam reći da je bilo oslobađajuće
18:14
to realize you can always find a shock of beauty or meaning
280
1094612
3155
shvatiti da uvijek možete pronaći iznenađujuću ljepotu ili smisao
18:17
in what life you have left,
281
1097791
2267
u životu koji vam je preostao,
18:20
like that snowball lasting for a perfect moment,
282
1100082
2764
poput one grude snijega koja je stvorila savršen trenutak
18:22
all the while melting away.
283
1102870
2298
topeći se.
18:26
If we love such moments ferociously,
284
1106700
6019
Ako divljački volimo te trenutke,
18:32
then maybe we can learn to live well --
285
1112743
2272
onda možda možemo naučiti dobro živjeti -
18:35
not in spite of death,
286
1115039
2087
ne u inat smrti,
18:37
but because of it.
287
1117150
1586
već zbog nje.
18:42
Let death be what takes us,
288
1122520
2176
Neka smrt bude ono što će nas izbrisati,
18:44
not lack of imagination.
289
1124720
2862
a ne manjak mašte.
18:48
Thank you.
290
1128868
1152
Hvala vam.
18:50
(Applause)
291
1130044
7920
(Pljesak)
O ovoj web stranici

Ova stranica će vas upoznati s YouTube videozapisima koji su korisni za učenje engleskog jezika. Vidjet ćete lekcije engleskog koje vode vrhunski profesori iz cijelog svijeta. Dvaput kliknite na engleske titlove prikazane na svakoj video stranici da biste reproducirali video s tog mjesta. Titlovi se pomiču sinkronizirano s reprodukcijom videozapisa. Ako imate bilo kakvih komentara ili zahtjeva, obratite nam se putem ovog obrasca za kontakt.

https://forms.gle/WvT1wiN1qDtmnspy7