How your emotions change the shape of your heart | Sandeep Jauhar

Prevoditelj: Martina Peraic Recezent: Sanda L

No other organ,

Nijedan drugi organ,

perhaps no other object in human life,

a možda i nijedan drugi predmet u životu ljudi,

is as imbued with metaphor and meaning as the human heart.

nije toliko obuhvaćen metaforom i značenjem kao ljudsko srce.

Over the course of history,

Kroz tijek povijesti,

the heart has been a symbol of our emotional lives.

srce je bilo simbol naših emocionalnih života.

It was considered by many to be the seat of the soul,

Mnogi su ga smatrali sjedištem duše,

the repository of the emotions.

skladištem emocija.

The very word "emotion" stems in part from the French verb "émouvoir,"

Sama riječ "emocija" dijelom potječe od francuskog glagola "émouvoir,"

meaning "to stir up."

što znači "pobuditi".

And perhaps it's only logical that emotions would be linked to an organ

I možda je doista logično da se emocije povezuje s organom

characterized by its agitated movement.

za kojeg su tipične pobuđene kretnje.

But what is this link?

Ali što je ta veza?

Is it real or purely metaphorical?

Je li stvarna ili samo metaforična?

As a heart specialist,

Kao stručnjak za srce,

I am here today to tell you that this link is very real.

ovdje sam danas da bih vam rekao kako je ta veza vrlo stvarna.

Emotions, you will learn,

Emocije, naučit ćete,

can and do have a direct physical effect on the human heart.

mogu imati i imaju izravan tjelesni učinak na ljudsko srce.

But before we get into this,

Ali prije nego što se upustimo u to,

let's talk a bit about the metaphorical heart.

popričajmo malo o metaforičnom srcu.

The symbolism of the emotional heart endures even today.

Simbolika emocionalnog srca živi čak i danas.

If we ask people which image they most associate with love,

Ako pitamo ljude koju sliku najviše povezuju s ljubavlju,

there's no question that the Valentine heart would the top the list.

neupitno je da će valentinsko srce biti na vrhu popisa.

The heart shape, called a cardioid,

Oblik srca, zvan kardioid,

is common in nature.

uobičajen je u prirodi.

It's found in the leaves, flowers and seeds of many plants,

Nalazimo ga u lišću, cvijeću i sjemenju mnogih biljaka,

including silphium,

uključujući silfij,

which was used for birth control in the Middle Ages

koji se koristio za kontrolu začeća u srednjem vijeku

and perhaps is the reason why the heart became associated

i mogao bi biti razlog zbog kojeg smo srce počeli povezivati

with sex and romantic love.

sa spolnim odnosom i romantičnom ljubavi.

Whatever the reason,

Koji god razlog bio,

hearts began to appear in paintings of lovers in the 13th century.

srca su se počela pojavljivati na crtežima ljubavnika u 13. stoljeću.

Over time, the pictures came to be colored red,

S vremenom, počelo se bojati slike u crveno,

the color of blood,

boju krvi,

a symbol of passion.

simbol strasti.

In the Roman Catholic Church,

U rimokatoličkoj crkvi,

the heart shape became known as the Sacred Heart of Jesus.

oblik srca postao je poznat kao sveto srce Isusovo.

Adorned with thorns and emitting ethereal light,

Ukrašeno trnjem i isijavajući blagu svjetlost,

it became an insignia of monastic love.

postalo je oznaka skromne ljubavi.

This association between the heart and love has withstood modernity.

Povezivanje srca s ljubavlju preživjelo je do suvremenosti.

When Barney Clark, a retired dentist with end-stage heart failure,

Kada je Barney Clark, umirovljeni zubar u zadnjem stadiju zatajenja srca,

received the first permanent artificial heart in Utah in 1982,

dobio prvo trajno umjetno srce u Uti 1982. godine,

his wife of 39 years reportedly asked the doctors,

njegova supruga u 39-godišnjem braku navodno je pitala liječnike,

"Will he still be able to love me?"

"Hoće li me i dalje moći voljeti?"

Today, we know that the heart is not the source of love

Danas znamo da srce nije izvor ljubavi

or the other emotions, per se;

a ni ostalih emocija, samo po sebi;

the ancients were mistaken.

preci su se zabunili.

And yet, more and more, we have come to understand

A ipak, sve više dolazimo do saznanja

that the connection between the heart and the emotions is a highly intimate one.

kako postoji vrlo bliska veza između srca i emocija.

The heart may not originate our feelings,

Srce možda nije mjesto gdje nastaju naši osjećaji,

but it is highly responsive to them.

ali je visoko reaktivno na njih.

In a sense, a record of our emotional life

U određenom smislu, dosje našeg emocionalnog života

is written on our hearts.

zapisan je na našim srcima.

Fear and grief, for example, can cause profound cardiac injury.

Strah i tuga, primjerice, mogu izazvati jaku srčanu povredu.

The nerves that control unconscious processes such as the heartbeat

Živci koji upravljaju nesvjesnim procesima poput kucanja srca

can sense distress

mogu osjetiti uznemirenost

and trigger a maladaptive fight-or-flight response

te radi brze prilagodbe izazvati reakciju "borba-ili-bijeg"

that triggers blood vessels to constrict,

koja čini da se krvne žile stežu,

the heart to gallop

srce počne galopirati,

and blood pressure to rise,

krvni tlak se diže,

resulting in damage.

a to sve završi štetno.

In other words,

Drugim riječima,

it is increasingly clear

sve više postaje jasno

that our hearts are extraordinarily sensitive to our emotional system,

da su naša srca iznimno osjetljiva na naš emocionalni sustav,

to the metaphorical heart, if you will.

na metaforično srce, možemo reći.

There is a heart disorder first recognized about two decades ago

Postoji srčani poremećaj koji smo prvi put zapazili prije dva desetljeća

called "takotsubo cardiomyopathy," or "the broken heart syndrome,"

zvan "takotsubo kardiomiopatija", ili "sindrom slomljenog srca",

in which the heart acutely weakens in response to intense stress or grief,

u kojem srce osjetno slabi u reakciji na snažan stres ili tugu,

such as after a romantic breakup or the death of a loved one.

kao nakon prekida romantičnog odnosa ili nakon smrti voljene osobe.

As these pictures show, the grieving heart in the middle

Kako slike pokazuju, žalujuće srce u sredini

looks very different than the normal heart on the left.

izgleda znatno drugačije od normalnog srca lijevo.

It appears stunned

Djeluje zapanjeno

and frequently balloons into the distinctive shape of a takotsubo,

i često se napuhuje u oblik takotsuba,

shown on the right,

koji vidimo desno,

a Japanese pot with a wide base and a narrow neck.

a to je japanska posuda širokog dna i uskog grla.

We don't know exactly why this happens,

Ne znamo točno zašto se to događa,

and the syndrome usually resolves within a few weeks.

a sindrom obično prolazi za nekoliko tjedana.

However, in the acute period,

Međutim, u akutnom razdoblju,

it can cause heart failure,

može izazvati zatajenje srca,

life-threatening arrhythmias,

aritmije opasne po život,

even death.

čak i smrt.

For example, the husband of an elderly patient of mine

Primjerice, suprug moje starije pacijentice

had died recently.

nedavno je umro.

She was sad, of course, but accepting.

Naravno, bila je tužna, ali pomirena s tim.

Maybe even a bit relieved.

Možda joj je malčice i laknulo.

It had been a very long illness; he'd had dementia.

Bila je to vrlo duga bolest; bolovao je od demencije.

But a week after the funeral, she looked at his picture

Ali tjedan dana nakon pogreba, pogledala je njegovu sliku

and became tearful.

i spopale su je suze.

And then she developed chest pain, and with it, came shortness of breath,

Tada se razvila bol u prsima, a s tim je došlo i do gubitka daha,

distended neck veins, a sweaty brow,

natečenih vratnih vena, znojenja,

a noticeable panting as she was sitting up in a chair --

vidljivog uzdisanja dok se ispravljala u stolici --

all signs of heart failure.

sve su to znakovi zatajenja srca.

She was admitted to the hospital,

Primljena je u bolnicu,

where an ultrasound confirmed what we already suspected:

gdje je ultrazvuk potvrdio ono na što smo već bili sumnjali,

her heart had weakened to less than half its normal capacity

srce joj je oslabilo na manje od polovine normalnog kapaciteta

and had ballooned into the distinctive shape of a takotsubo.

i napuhalo se u izražajan oblik takotsuba.

But no other tests were amiss,

Ali drugi testovi nisu ništa otkrili,

no sign of clogged arteries anywhere.

nigdje nije bilo ni traga začepljenim arterijama.

Two weeks later, her emotional state had returned to normal

Dva tjedna poslije, njezino emocionalno stanje se normaliziralo,

and so, an ultrasound confirmed,

a ultrazvuk je potvrdio

had her heart.

da se to dogodilo i sa srcem.

Takotsubo cardiomyopathy has been linked to many stressful situations,

Takotsubo kardiomiopatiju možemo povezati s mnogim stresnim situacijama,

including public speaking --

uključujući javno govorenje --

(Laughter)

(Smijeh)

(Applause)

(Pljesak)

domestic disputes, gambling losses,

obiteljske razmirice, gubitke na kockanju,

even a surprise birthday party.

čak i zabavu iznenađenja za rođendan.

(Laughter)

(Smijeh)

It's even been associated with widespread social upheaval,

Čak je se povezuje s društvenim nemirima širih razmjera,

such as after a natural disaster.

kao, primjerice, uslijed prirodne katastrofe.

For example, in 2004,

Na primjer, 2004. godine

a massive earthquake devastated a district on the largest island in Japan.

snažan potres razorio je pokrajinu na najvećem japanskom otoku.

More than 60 people were killed, and thousands were injured.

Poginulo je više od 60 osoba, a tisuće su zadobile ozljede.

On the heels of this catastrophe,

Ubrzo nakon te nesreće,

researchers found that the incidents of takotsubo cardiomyopathy

istraživači su otkrili da su se slučajevi takotsubo kardiomiopatije

increased twenty-four-fold in the district one month after the earthquake,

udvadesetčetverostručili u toj pokrajini mjesec dana nakon potresa,

compared to a similar period the year before.

u usporedbi sa sličnim razdobljem prethodne godine.

The residences of these cases

Lokacije ovih slučaja

closely correlated with the intensity of the tremor.

bile su blisko povezane s jačinom potresa.

In almost every case, patients lived near the epicenter.

U gotovo svim slučajevima, pacijenti su živjeli blizu epicentra.

Interestingly, takotsubo cardiomyopathy has been seen after a happy event, too,

Zanimljivo, takotsubo kardiomiopatija zamijećena je i nakon sretnog događaja,

but the heart appears to react differently,

ali čini se da srce reagira drukčije,

ballooning in the midportion, for example, and not at the apex.

napuhuje se u središnjem dijelu, primjerice, a ne na vrhu.

Why different emotional precipitants would result in different cardiac changes

Zašto različito pobuđene emocije daju različite srčane promjene,

remains a mystery.

ostaje tajna.

But today, perhaps as an ode to our ancient philosophers,

Ali danas, možda kao posvetu drevnim filozofima,

we can say that even if emotions are not contained inside our hearts,

možemo reći da čak iako se emocije ne nalaze unutar naših srca,

the emotional heart overlaps

emocionalno srce se isprepliće

its biological counterpart,

sa svojim biološkim kolegom,

in surprising and mysterious ways.

na iznenađujuće i tajanstvene načine.

Heart syndromes, including sudden death,

Srčani sindromi, uključujući iznenadnu smrt,

have long been reported in individuals experiencing intense emotional disturbance

već dugo su zapaženi u osoba koje prolaze kroz snažne emocionalne poremećaje

or turmoil in their metaphorical hearts.

ili nemire u svom metaforičnom srcu.

In 1942,

1942. godine,

the Harvard physiologist Walter Cannon published a paper called "'Voodoo' Death,"

fiziolog s Harvarda Walter Cannon objavio je članak "Smrt od vudua",

in which he described cases of death from fright

u kojem je opisao slučajeve smrti od straha

in people who believed they had been cursed,

kod ljudi koji su vjerovali da ih je netko prokleo,

such as by a witch doctor or as a consequence of eating taboo fruit.

primjerice vrač, ili kao posljedica jedenja zabranjenog (tabu) voća.

In many cases, the victim, all hope lost, dropped dead on the spot.

U mnogim slučajevima, žrtva je nakon gubitka svake nade pala na mjestu mrtva.

What these cases had in common was the victim's absolute belief

Zajedničko tim slučajevima bilo je žrtvino nepokolebljivo vjerovanje

that there was an external force that could cause their demise,

da postoji vanjska sila koja može uzrokovati njihovu kob,

and against which they were powerless to fight.

i protiv koje su bespomoćni boriti se.

This perceived lack of control, Cannon postulated,

Ovaj umišljeni manjak kontrole, tvrdio je Cannon,

resulted in an unmitigated physiological response,

doveo je do neizbježne fiziološke reakcije

in which blood vessels constricted to such a degree

pri kojoj su se krvne žile stegnule do takve mjere

that blood volume acutely dropped,

da je volumen krvi osjetno opao,

blood pressure plummeted,

krvni tlak odletio u visine,

the heart acutely weakened,

srce snažno oslabilo,

and massive organ damage resulted from a lack of transported oxygen.

a teško oštećenje organa nastalo je zbog manjka prenesenog kisika.

Cannon believed that voodoo deaths

Cannon je vjerovao kako su vudu smrti

were limited to indigenous or "primitive" people.

ograničene na urođeničke ili "primitivne" narode.

But over the years, these types of deaths have been shown to occur

Ali tijekom godina, ovakvi tipovi smrti pojavljuju se

in all manner of modern people, too.

i kod najrazličitijih suvremenih ljudi.

Today, death by grief has been seen in spouses and in siblings.

Danas, smrt od tuge bilježimo kod životnih partnera te braće i sestara.

Broken hearts are literally and figuratively deadly.

Slomljena srca su doslovno i metaforično smrtonosna.

These associations hold true even for animals.

Ovi zaključci pokazuju se točnima čak i kod životinja.

In a fascinating study in 1980 published in the journal "Science,"

U zapanjujućoj studiji objavljenoj u časopisu "Science" 1980. godine,

researchers fed caged rabbits a high-cholesterol diet

istraživači su hranili zečeve u kavezima hranom bogatom kolesterolom

to study its effect on cardiovascular disease.

kako bi proučili njegov utjecaj na bolesti krvožilnog sustava.

Surprisingly, they found that some rabbits developed a lot more disease than others,

Iznenađujuće, otkrili su da su neki zečevi pretrpili jače oboljenje od ostalih,

but they couldn't explain why.

ali nisu mogli objasniti zašto.

The rabbits had very similar diet, environment and genetic makeup.

Zečevi su jeli gotovo identičnu hranu, dijelili isti okoliš i genetski zapis.

They thought it might have something to do with

Mislili su da to ima veze s tim

how frequently the technician interacted with the rabbits.

koliko često su tehničari bili u kontaktu sa zečevima.

So they repeated the study,

Pa su ponovili studiju,

dividing the rabbits into two groups.

razdijelivši zečeve u dvije skupine.

Both groups were fed a high-cholesterol diet.

Objema skupinama davana je hrana bogata kolesterolom.

But in one group, the rabbits were removed from their cages,

Ali u jednoj skupini, zečeve se puštalo iz kaveza,

held, petted, talked to, played with,

držalo ih se, mazilo, pričalo im se, igralo se s njima,

and in the other group, the rabbits remained in their cages

a u drugoj skupini, zečevi su ostajali u kavezima

and were left alone.

i ostavljalo ih se samima.

At one year, on autopsy,

Nakon godine dana, radeći autopsiju,

the researchers found that the rabbits in the first group,

istraživači su otkrili kako su zečevi iz prve skupine,

that received human interaction,

koji su imali kontakt s ljudima,

had 60 percent less aortic disease than rabbits in the other group,

imali 60 posto manje aortnih oboljenja od zečeva iz druge skupine,

despite having similar cholesterol levels, blood pressure and heart rate.

usprkos podjednakim razinama kolesterola, krvnog tlaka i srčanog pulsa.

Today, the care of the heart has become less the province of philosophers,

Danas je briga o srcu postala manje domenom filozofa,

who dwell upon the heart's metaphorical meanings,

koji promišljaju o metaforičnim značenjima srca,

and more the domain of doctors like me,

a više domenom liječnika poput mene,

wielding technologies that even a century ago,

koji barataju tehnologijama koje bi čak i prije jednog stoljeća

because of the heart's exalted status in human culture,

zbog uzvišenog statusa koji srce ima u ljudskoj kulturi,

were considered taboo.

bile smatrane tabuom.

In the process, the heart has been transformed

U tom procesu, srce se promijenilo

from an almost supernatural object imbued with metaphor and meaning

iz gotovo nadnaravnog predmeta uronjenog u metaforu i značenja,

into a machine that can be manipulated and controlled.

u stroj kojim se može rukovati i upravljati.

But this is the key point:

Ali ovo je ključno zapažanje:

these manipulations, we now understand,

takvim rukovanjima, sada znamo,

must be complemented by attention to the emotional life

moramo pridružiti posvećivanje pažnje emocionalnom životu

that the heart, for thousands of years, was believed to contain.

za koji se tisućama godina smatra da je smješten u srcu.

Consider, for example, the Lifestyle Heart Trial,

Promotrimo, primjerice, ispitivanje načina života i srca

published in the British journal "The Lancet" in 1990.

objavljeno u britanskom časopisu "The Lancet" 1990. godine.

Forty-eight patients with moderate or severe coronary disease

Četrdeset i osam pacijenata s umjerenom ili ozbiljnom bolesti krvnih žila

were randomly assigned to usual care

proizvoljno su stavljeni pod uobičajenu njegu

or an intensive lifestyle that included a low-fat vegetarian diet,

ili pod intenzivan način života koji je uključivao vegetarijanstvo s malo masti,

moderate aerobic exercise,

umjerene aerobne vježbe,

group psychosocial support

grupnu psihosocijalnu podršku

and stress management advice.

te savjetovanje o upravljanju stresom.

The researchers found that the lifestyle patients

Istraživači su otkrili da je kod pacijenata s takvim načinom života

had a nearly five percent reduction in coronary plaque.

došlo do čak 5-postotnog smanjenja naslaga na krvnim žilama.

Control patients, on the other hand,

S druge strane, pacijenti kontrolne skupine

had five percent more coronary plaque at one year

imali su 5 posto više žilnih naslaga nakon godinu dana

and 28 percent more at five years.

i 28 posto više naslaga nakon 5 godina.

They also had nearly double the rate of cardiac events,

Također su imali dvostruko više pojava srčanih smetnji,

like heart attacks, coronary bypass surgery

kao što su srčani udari, ugrađivanje žilnih premosnica

and cardiac-related deaths.

i smrti od srčanog uzroka.

Now, here's an interesting fact:

Evo zanimljivog podatka:

some patients in the control group adopted diet and exercise plans

neki od pacijenata iz kontrolne skupine proveli su plan prehrane i vježbanja

that were nearly as intense as those in the intensive lifestyle group.

gotovo jednako obuhvatan kao kod osoba u skupini intenzivnog načina života.

Their heart disease still progressed.

Njihove srčane bolesti nastavile su napredovati.

Diet and exercise alone were not enough to facilitate coronary disease regression.

Samo prehrana i vježbanje nisu dostajali da omoguće povlačenje žilnih bolesti.

At both one- and five-year follow-ups,

Kod jednogodišnje i petogodišnje provjere,

stress management was more strongly correlated

upravljanje stresom pokazalo se puno jače povezanim

with reversal of coronary disease

s povlačenjem žilnih bolesti

than exercise was.

nego što je to bilo vježbanje.

No doubt, this and similar studies are small,

Naravno, ovakve studije su malene,

and, of course, correlation does not prove causation.

a korelacija ne dokazuje nužno i uzročno-posljedičnu vezu.

It's certainly possible that stress leads to unhealthy habits,

Zasigurno je moguće da stres vodi k nezdravim navikama,

and that's the real reason for the increased cardiovascular risk.

a to je pravi razlog za povećani rizik od krvožilnih bolesti.

But as with the association of smoking and lung cancer,

Ali baš kao i kod povezivanja pušenja s rakom pluća,

when so many studies show the same thing,

kada tolike studije upućuju na istu stvar,

and when there are mechanisms to explain a causal relationship,

i kada postoje mehanizmi koji objašnjavaju uzročno-posljedičnu vezu,

it seems capricious to deny that one probably exists.

čini mi se hirovitim zanijekati da ona vjerojatno postoji.

What many doctors have concluded is what I, too, have learned

Brojni liječnici su zaključili nešto što sam i sam naučio

in my nearly two decades as a heart specialist:

u gotovo dva desetljeća bivanja stručnjakom za srce:

the emotional heart intersects with its biological counterpart

emocionalno srce se isprepliće sa svojim biološkim kolegom

in surprising and mysterious ways.

na iznenađujuće i tajanstvene načine.

And yet, medicine today continues to conceptualize the heart as a machine.

A ipak, današnja medicina nastavlja pojmiti srce kao stroj.

This conceptualization has had great benefits.

Takvo poimanje imalo je mnoge prednosti.

Cardiology, my field,

Moje polje, kardiologija,

is undoubtedly one of the greatest scientific success stories

je bez sumnje jedna od najuspješnijih znanstvenih priča

of the past 100 years.

u posljednjih 100 godina.

Stents, pacemakers, defibrillators, coronary bypass surgery,

Stent, elektrostimulatori srca, defibrilatori, operacije premosnice,

heart transplants --

presađivanja srca --

all these things were developed or invented after World War II.

sve te stvari razvile su se ili su izumljene nakon 2. svjetskog rata.

However, it's possible

Međutim, moguće je

that we are approaching the limits of what scientific medicine can do

da se približavamo granicama onoga što znanstvena medicina može učiniti

to combat heart disease.

da zaustavi oboljenja srca.

Indeed, the rate of decline of cardiovascular mortality

Doista, stupanj pada kardiovaskularne smrtnosti

has slowed significantly in the past decade.

osjetno se usporio u zadnjem desetljeću.

We will need to shift to a new paradigm

Morat ćemo se prebaciti na novo poimanje

to continue to make the kind of progress to which we have become accustomed.

kako bismo nastavili napredovati brzinom na kakvu smo se navikli.

In this paradigm, psychosocial factors will need to be front and center

U ovom poimanju, psihosocijalni čimbenici morat će biti u središtu pažnje

in how we think about heart problems.

kada promišljamo o srčanim problemima.

This is going to be an uphill battle,

To će biti sizifovska borba,

and it remains a domain that is largely unexplored.

a i dalje u velikoj mjeri ostaje neistraženo područje.

The American Heart Association still does not list emotional stress

Američko udruženje za srce još uvijek nije uvrstilo emocionalni stres

as a key modifiable risk factor for heart disease,

na popis ključnih promjenjivih čimbenika rizika za oboljenje srca,

perhaps in part because blood cholesterol is so much easier to lower

možda dijelom zbog toga što je puno lakše ublažiti razinu kolesterola u krvi

than emotional and social disruption.

nego emocionalni i društveni nemir.

There is a better way, perhaps,

Možda postoji bolji način

if we recognize that when we say "a broken heart,"

ako prepoznamo da kada govorimo o "slomljenom srcu",

we are indeed sometimes talking about a real broken heart.

doista katkada govorimo o pravom slomljenom srcu.

We must, must pay more attention to the power and importance of the emotions

Moramo, moramo više pažnje posvetiti snazi i važnosti emocija

in taking care of our hearts.

kada brinemo o našim srcima.

Emotional stress, I have learned,

Emocionalni stres, naučio sam,

is often a matter of life and death.

često je pitanje života i smrti.

Thank you.

Hvala.

(Applause)

(Pljesak)