Leana Wen: What your doctor won’t disclose

Translator: Petra Aquamarine Reviewer: Linda Magáthová

They told me that I'm a traitor to my own profession,

Povedali, že som zradila svoje povolanie,

that I should be fired,

že by ma mali vyhodiť,

have my medical license taken away,

zobrať mi licenciu,

that I should go back to my own country.

že by som sa mala vrátiť, odkiaľ som prišla.

My email got hacked.

Hackli môj e-mail.

In a discussion forum for other doctors,

V jednom fóre pre lekárov

someone took credit for "Twitter-bombing" my account.

sa niekto pochválil, že „bombarduje“ môj twitter.

Now, I didn't know if this was a good or bad thing,

Nebolo mi celkom jasné, či je to dobre alebo zle,

but then came the response:

ale potom prišla odpoveď:

"Too bad it wasn't a real bomb."

„Škoda, že to neboli reálne bomby.“

I never thought that I would do something

Nikdy by som si nepomyslela,

that would provoke this level of anger among other doctors.

že niečím spôsobím toľko hnevu medzi lekármi.

Becoming a doctor was my dream.

Stať sa lekárkou bol môj sen.

I grew up in China,

Vyrastala som v Číne

and my earliest memories are of being rushed to the hospital

a moje prvé spomienky sú na prevoz do nemocnice,

because I had such bad asthma that I was there nearly every week.

kde som bola skoro každý týždeň kvôli ťažkej astme.

I had this one doctor, Dr. Sam, who always took care of me.

Starala sa tam o mňa pani doktorka Sam.

She was about the same age as my mother.

Bola vo veku mojej mamy.

She had this wild, curly hair,

Mala veľké kučeravé vlasy

and she always wore these bright yellow flowery dresses.

a nosievala žlté kvietkované šaty.

She was one of those doctors who,

Bola z tých lekárov,

if you fell and you broke your arm,

ktorí, keď si zlomíte ruku,

she would ask you why you weren't laughing

spýtajú sa, prečo sa nesmejete,

because it's your humerus. Get it?

veď ide o váš humerus. Chápete.

See, you'd groan,

Takže stonáte,

but she'd always make you feel better after having seen her.

ale po jej návšteve je vám vždy lepšie.

Well, we all have that childhood hero

Každý máme svojho hrdinu z detstva,

that we want to grow up to be just like, right?

a chceme byť ako on, keď vyrastieme, nie?

Well, I wanted to be just like Dr. Sam.

Ja som chcela byť ako doktorka Sam.

When I was eight, my parents and I moved to the U.S.,

Keď som mala osem rokov, presťahovali sme sa s rodičmi do USA

and ours became the typical immigrant narrative.

a stali sme sa typickými prisťahovalcami.

My parents cleaned hotel rooms and washed dishes and pumped gas

Moji rodičia upratovali v hoteloch, umývali riad a robili na pumpe,

so that I could pursue my dream.

aby som ja mohla ísť za svojím snom.

Well, eventually I learned enough English,

Naučila som sa po anglicky

and my parents were so happy

a naši boli strašne šťastní,

the day that I got into medical school and took my oath of healing and service.

keď ma vzali na medicínu a zložila som lekársku prísahu.

But then one day, everything changed.

Jedného dňa sa všetko zmenilo.

My mother called me to tell me that she wasn't feeling well,

Volala mi mama, že sa necíti dobre,

she had a cough that wouldn't go away, she was short of breath and tired.

neutíšiteľný kašeľ, únava a nemohla sa nadýchnuť.

Well, I knew that my mother was someone who never complained about anything.

Vedela som, že mama je z tých, čo sa nikdy nesťažujú.

For her to tell me that something was the matter,

Keď už s niečím prišla,

bolo jasné, že je to vážne.

I knew something had to be really wrong.

And it was:

A bolo.

We found out that she had stage IV breast cancer,

Zistili sme že má rakovinu prsníka v pokročilom štádiu,

cancer that by then had spread to her lungs, her bones, and her brain.

metastázy na pľúcach, kostiach a mozgu.

My mother was brave, though, and she had hope.

Bola statočná a nezúfala si.

She went through surgery and radiation,

Podstúpila operáciu a ožarovanie

and was on her third round of chemotherapy

a práve prechádzala tretím kolom chemoterapie,

when she lost her address book.

keď stratila svoj notes.

She tried to look up her oncologist's phone number on the Internet

Skúsila nájsť číslo na svojho onkológa na internete,

and she found it, but she found something else too.

čo sa jej podarilo, ale našla aj niečo iné.

On several websites,

Na rôznych stránkach

he was listed as a highly paid speaker to a drug company,

sa písalo, že je platený farmaceutickou firmou,

and in fact often spoke on behalf

aby propagoval

of the same chemo regimen that he had prescribed her.

práve takú chemoliečbu, ktorú predpísal aj mame.

She called me in a panic,

Volala mi v panike

and I didn't know what to believe.

a ja som nevedela, čomu veriť.

Maybe this was the right chemo regimen for her,

Možno to bola pre ňu vhodná liečba,

but maybe it wasn't.

ale možno nie.

It made her scared and it made her doubt.

Bola vystrašená a na pochybách.

When it comes to medicine,

Čo sa týka liečenia,

having that trust is a must,

dôvera je nevyhnutná

and when that trust is gone, then all that's left is fear.

a keď sa stratí, zostane len strach.

There's another side to this fear.

Tento strach má aj ďalšiu stránku.

As a medical student, I was taking care of this 19-year-old

Ešte ako študentka som zažila prípad 19-ročného chalana,

who was biking back to his dorm

ktorý sa vracal

when he got struck and hit,

na bicykli na intrák,

run over by an SUV.

keď ho zrazilo SUV.

He had seven broken ribs,

Mal zlomených sedem rebier,

shattered hip bones,

roztrieštenú panvu

and he was bleeding inside his belly and inside his brain.

a vnútorné krvácanie do brucha a do mozgu.

Now, imagine being his parents

Predstavte si jeho rodičov,

who flew in from Seattle, 2,000 miles away,

ktorí prileteli 3 000 km zo Seattlu

to find their son in a coma.

a našli svojho syna v kóme.

I mean, you'd want to find out what's going on with him, right?

Asi by ste chceli vedieť, čo s ním je, nie?

They asked to attend our bedside rounds

Chceli byť prítomní pri vizite,

where we discussed his condition and his plan,

kde sme preberali jeho stav a možnosti,

which I thought was a reasonable request,

čo mi prišlo pochopiteľné

and also would give us a chance to show them

a tiež sme im mohli ukázať,

how much we were trying and how much we cared.

ako sa snažíme pomôcť mu.

The head doctor, though, said no.

Hlavný lekár ale povedal nie.

He gave all kinds of reasons.

Pre všetky možné dôvody.

Maybe they'll get in the nurse's way.

Aby nezavadzali sestrám.

Maybe they'll stop students from asking questions.

Aby sa študenti nebáli pýtať.

He even said,

Dokonca povedal:

"What if they see mistakes and sue us?"

„Čo keď nás budú žalovať pre nejaké chyby?“

What I saw behind every excuse was deep fear,

Za každou výhovorkou som videla jeho strach

and what I learned was that to become a doctor,

a naučila som sa, že byť lekárom znamená

we have to put on our white coats,

obliecť si plášť,

put up a wall, and hide behind it.

vytvoriť múr a skryť za zaň.

There's a hidden epidemic in medicine.

V medicíne je jedna skrytá epidémia.

Of course, patients are scared when they come to the doctor.

Jasné, že pacient sa bojí, keď ide k lekárovi.

Imagine you wake up with this terrible bellyache,

Predstavte si, že sa zobudíte s hroznou bolesťou brucha,

you go to the hospital,

idete do nemocnice,

you're lying in this strange place, you're on this hospital gurney,

ležíte v tej divnej budove, na kolieskovom lôžku,

you're wearing this flimsy gown,

v tenučkej nemocničnej blúze,

strangers are coming to poke and prod at you.

cudzí ľudia chodia do vás šťuchať.

You don't know what's going to happen.

Neviete, čo bude.

You don't even know if you're going to get the blanket you asked for 30 minutes ago.

Neviete ani, či dostanete tú deku, o ktorú ste žiadali pred pol hodinou.

But it's not just patients who are scared;

Ale nielen pacienti majú strach,

doctors are scared too.

lekári sa boja tiež.

We're scared of patients finding out who we are

Bojíme sa, že pacienti zistia, kto sme

and what medicine is all about.

a o čom je celá medicína.

And so what do we do?

Takže robíme čo?

We put on our white coats and we hide behind them.

Dáme si tie plášte a skryjeme sa za nimi.

Of course, the more we hide,

Jasné, že čím viac sa skrývame,

the more people want to know what it is that we're hiding.

tým viac chcú ľudia vedieť, čo skrývame.

The more fear then spirals into mistrust and poor medical care.

Výsledkom tejto špirály nedôvery je potom slabá lekárska starostlivosť.

We don't just have a fear of sickness,

Nemáme len strach z choroby,

we have a sickness of fear.

sme chorí strachom.

Can we bridge this disconnect

Môžeme premostiť túto medzeru

between what patients need and what doctors do?

medzi potrebami pacientov a konaním lekárov?

Can we overcome the sickness of fear?

Prekonať našu chorobu zo strachu?

Let me ask you differently:

Spýtam sa inak:

If hiding isn't the answer, what if we did the opposite?

Skrývanie nepomáha, čo keby sme to skúsili opačne?

What if doctors were to become totally transparent with their patients?

Čo keby sa lekári voči pacientom totálne otvorili?

Last fall, I conducted a research study to find out

Vlani na jeseň som viedla výskum, ktorý zisťoval,

what it is that people want to know about their healthcare.

čo chcú ľudia vedieť o svojej zdravotnej starostlivosti.

I didn't just want to study patients in a hospital,

Pýtali sme sa nielen pacientov v nemocnici,

but everyday people.

ale aj obyčajných ľudí.

So my two medical students, Suhavi Tucker and Laura Johns,

Dvaja z mojich študentov - medikov, Suhavi Tucker a Laura Johns,

literally took their research to the streets.

vyšli s naším výskumom do ulíc.

They went to banks, coffee shops, senior centers,

Do bánk, kaviarní, domovov dôchodcov,

Chinese restaurants and train stations.

čínskych reštaurácií, na vlakové stanice.

What did they find?

Čo zistili?

Well, when we asked people,

Na otázku

"What do you want to know about your healthcare?"

„Čo chcete vedieť o vašej zdravotnej starostlivosti?“

people responded with what they want to know about their doctors,

ľudia odpovedali tým, čo chcú vedieť o svojich lekároch,

because people understand health care

lebo chápu zdravotnú starostlivosť

to be the individual interaction between them and their doctors.

ako individuálnu interakciu medzi nimi a lekárom.

When we asked, "What do you want to know about your doctors?"

Tak sme sa pýtali: „Čo chcete vedieť o vašich lekároch?“

people gave three different answers.

Dostali sme tri odpovede:

Some want to know that their doctor is competent

Niektorých zajímalo, či je ich lekár kompetentný

and certified to practice medicine.

a má príslušné atestácie.

Some want to be sure that their doctor is unbiased

Ďalší sa chceli uistiť, že lekár je nezaujatý

and is making decisions based on evidence and science,

a jeho rozhodnutia sú založené na vede

not on who pays them.

a nie na tom, kto ho platí.

Surprisingly to us,

Prekvapilo nás,

many people want to know something else about their doctors.

že mnoho ľudí chce o svojich lekároch vedieť aj čosi iné.

Jonathan, a 28-year-old law student,

Jonathan, 28-ročný študent práv,

says he wants to find someone who is comfortable with LGBTQ patients

by rád našiel lekára, ktorý nie je zaujatý voči LGBTQ

and specializes in LGBT health.

a špecializuje sa na takýchto pacientov.

Serena, a 32-year-old accountant,

Pre Serenu, 32-ročnú účtovníčku,

says that it's important to her for her doctor to share her values

je dôležité, aby lekár zdieľal jej hodnoty

when it comes to reproductive choice and women's rights.

ohľadne práva ženy na reprodukčné rozhodnutia.

Frank, a 59-year-old hardware store owner,

Frank, 59-ročný majiteľ železiarstva,

doesn't even like going to the doctor

by najradšej k lekárom vôbec nechodil

and wants to find someone who believes in prevention first,

a chce nájsť niekoho, kto verí najmä v prevenciu,

but who is comfortable with alternative treatments.

ale je otvorený aj alternatívnej liečbe.

One after another, our respondents told us

Jeden za druhým nám respondenti odhaľovali,

that that doctor-patient relationship is a deeply intimate one —

že vzťah lekár-pacient je veľmi intímny,

that to show their doctors their bodies

že skôr než ukážu lekárom svoje telo

and tell them their deepest secrets,

a povedia im svoje tajomstvá,

they want to first understand their doctor's values.

chcú poznať lekárove hodnoty.

Just because doctors have to see every patient

To, že lekár musí prijať každého pacienta,

doesn't mean that patients have to see every doctor.

neznamená, že pacient by mal byť spokojný s každým lekárom.

People want to know about their doctors first

Pacienti by najprv chceli niečo o lekároch vedieť,

so that they can make an informed choice.

aby si mohli medzi nimi vybrať.

As a result of this, I formed a campaign,

Na základe toho som spustila kampaň

Who's My Doctor?

„Kto je môj doktor?“

that calls for total transparency in medicine.

za úplnú transparentnosť v medicíne.

Participating doctors voluntarily disclose

Zúčastnení lekári dobrovoľne odhaľujú

on a public website

na internetovej stránke

not just information about where we went to medical school

nielen informácie o svojom štúdiu

and what specialty we're in,

a špecializácii,

but also our conflicts of interest.

ale tiež o strete záujmov.

We go beyond the Government in the Sunshine Act

Ideme za Zákon o strete záujmov

about drug company affiliations,

o príklone k farma-firmám,

and we talk about how we're paid.

a hovoríme o tom, ako sme platení.

Incentives matter.

Na odmenách záleží.

If you go to your doctor because of back pain,

Ak idete k lekárovi s bolesťou chrbta,

you might want to know he's getting paid 5,000 dollars to perform spine surgery

radi by ste vedeli, či berie 5 000 dolárov za operáciu

versus 25 dollars to refer you to see a physical therapist,

oproti 25 dolárom za to, že vás pošle k fyzioterapeutovi

or if he's getting paid the same thing no matter what he recommends.

alebo či zarába nezávisle na tom, čo vám odporučí.

Then, we go one step further.

Ideme ešte o krok ďalej.

We add our values when it comes to women's health,

Zverejňujeme svoje postoje k ženskému zdraviu,

LGBT health, alternative medicine,

LGBT zdraviu, alternatívym metódam,

preventive health, and end-of-life decisions.

prevencii a eutanázii.

We pledge to our patients that we are here to serve you,

Ako lekári sme sľúbili pacientom, že vám budeme slúžiť,

so you have a right to know who we are.

takže máte právo vedieť, kto sme.

We believe that transparency can be the cure for fear.

Veríme, že transparentnosť môže vyliečiť ten strach.

I thought some doctors would sign on and others wouldn't,

Čakala som, že niektorí lekári do toho pôjdu a iní nie,

but I had no idea of the huge backlash that would ensue.

ale netušila som, akú reakciu to vyvolá.

Within one week of starting Who's My Doctor?

Za týždeň od spustenia „Kto je môj doktor?“

Medscape's public forum

pribudli na fóre Medscape

and several online doctors' communities

a ďalších lekárskych weboch

had thousands of posts about this topic.

tisíce postov na túto tému.

Here are a few.

Tu je pár z nich.

From a gastroenterologist in Portland:

Gastroenterológ z Portlandu:

"I devoted 12 years of my life to being a slave.

„12 rokov som otrokom.

I have loans and mortgages.

Mám pôžičky a hypotéky.

I depend on lunches from drug companies to serve patients."

Som závislý na obedoch od farma-firiem, aby som mohol slúžiť pacientom.“

Well, times may be hard for everyone,

OK, časy sú ťažké pre všetkých,

but try telling your patient

ale skúste povedať pacientovi,

making 35,000 dollars a year to serve a family of four

ktorý s príjmom 35 000 dolárov ročne živí štvorčlennú rodinu,

that you need the free lunch.

že vy potrebujete obedy zadarmo.

From an orthopedic surgeon in Charlotte:

Ortopéd z Charlotte:

"I find it an invasion of my privacy to disclose where my income comes from.

„Zverejnenie zdrojov mojich príjmov považujem za zásah do súkromia.

My patients don't disclose their incomes to me."

Pacienti mi neodhaľujú svoje príjmy.“

But your patients' sources of income don't affect your health.

Ale pacientove zdroje príjmu nemajú vplyv na vaše zdravie.

From a psychiatrist in New York City:

Psychiater z New Yorku:

"Pretty soon we will have to disclose whether we prefer cats to dogs,

„Čoskoro budeme nútení rozhlasovať, či máme radšej psy či mačky,

what model of car we drive,

aké máme auto

and what toilet paper we use."

a aký používame toaleťák.“

Well, how you feel about Toyotas or Cottonelle

Či máte radšej Toyoty alebo Cottonellky

won't affect your patients' health,

neovplyvní zdravie vašich pacientov,

but your views on a woman's right to choose

ale váš postoj k právu ženy na rozhodnutie,

and preventive medicine and end-of-life decisions just might.

k preventívnej medicíne či k eutanázii ho ovplyvniť môže.

And my favorite, from a Kansas City cardiologist:

A môj obľúbený, kardiológ z Kansas City:

"More government-mandated stuff?

„Ďalšie vládou nariadené sra… ndy?

Dr. Wen needs to move back to her own country."

To sa Dr. Wen môže vrátiť do rodnej krajiny.“

Well, two pieces of good news.

K tomu mám dve dobré správy.

First of all, this is meant to be voluntary and not mandatory,

Celé to má byť dobrovoľné a nie nariadené.

and second of all, I'm American and I'm already here.

Po druhé, ja som Američanka a už som tu.

(Laughter) (Applause)

(smiech) (potlesk)

Within a month, my employers were getting calls

V priebehu mesiaca dostávali moji šéfovia

telefonické žiadosti, aby ma vykopli.

asking for me to be fired.

I received mail at my undisclosed home address

Na moju nezverejnenú domácu adresu chodila pošta

with threats to contact the medical board to sanction me.

s vyhrážkami, že ma udajú lekárskej komisii.

My friends and family urged me to quit this campaign.

Priatelia a rodina naliehali, nech s kampaňou skončím.

After the bomb threat, I was done.

Po tej hrozbe s bombami som bola hotová.

But then I heard from patients.

Ale potom sa ozvali pacienti.

Over social media, a TweetChat,

Cez sociálne médiá; TweetChat,

which I'd learned what that was by then,

o ktorom som už vedela, čo to je,

generated 4.3 million impressions,

priniesol 4,3 miliónu „dojmov“

and thousands of people wrote to encourage me to continue.

a tisíce ľudí ma povzbudzovali, aby som pokračovala.

They wrote with things like,

Písali veci ako:

"If doctors are doing something they're that ashamed of,

„Ak lekári robia niečo, za čo sa tak hanbia,

they shouldn't be doing it."

tak by to robiť nemali.“

"Elected officials have to disclose campaign contributions.

„Volení činitelia musia priznať príspevky na kampaň,

Lawyers have to disclose conflicts of interests.

právnici musia priznať strety záujmov.

Why shouldn't doctors?"

Prečo nie lekári?“

And finally, many people wrote and said,

A veľa ľudí písalo:

"Let us patients decide

„Nech my pacienti rozhodujeme

what's important when we're choosing a doctor."

o tom, čo je dôležité pri voľbe lekára.“

In our initial trial,

V našej skúšobnej verzii

over 300 doctors have taken the total transparency pledge.

sa vyše 300 lekárov zaviazalo k totálnej transparentnosti.

What a crazy new idea, right?

K tej šialenej novinke.

But actually, this is not that new of a concept at all.

Ale v skutočnosti to nie je taký novátorský koncept.

Remember Dr. Sam, my doctor in China,

Pamätáte na moju čínsku doktorku Sam,

with the goofy jokes and the wild hair?

s jej vtípkami a divokým három?

Well, she was my doctor,

Bola moja lekárka,

but she was also our neighbor

ale aj naša suseda,

who lived in the building across the street.

bývala oproti cez ulicu.

I went to the same school as her daughter.

S jej dcérou sme boli spolužiačky.

My parents and I trusted her

Moji rodičia a ja sme jej verili,

because we knew who she was and what she stood for,

lebo sme vedeli, kto je a o čo jej ide,

and she had no need to hide from us.

nemala potrebu to pred nami skrývať.

Just one generation ago, this was the norm in the U.S. as well.

Jednu generáciu dozadu bol toto štandard aj v USA.

You knew that your family doctor was the father of two teenage boys,

O vašom rodinnom lekárovi ste vedeli, že má dvoch pubertálnych synov,

that he quit smoking a few years ago,

že pred pár rokmi prestal fajčiť,

that he says he's a regular churchgoer,

že hovorí, že chodí do kostola,

but you see him twice a year: once at Easter

ale vy viete, že len dvakrát ročne: na Veľkú noc

and once when his mother-in-law comes to town.

a keď príde do mesta jeho svokra.

You knew what he was about,

Vedeli ste, aký je,

and he had no need to hide from you.

a on to nepotreboval pred vami skryť.

But the sickness of fear has taken over,

Ale choroba strachu nás premohla

and patients suffer the consequences.

a doplácajú na to pacienti.

I know this firsthand.

Poznám to z prvej ruky.

My mother fought her cancer for eight years.

Mama bojovala s rakovinou osem rokov.

She was a planner,

Rada plánovala,

and she thought a lot about how she wanted to live

veľa premýšľala o tom, ako chce žiť

and how she wanted to die.

aj ako chce umrieť.

Not only did she sign advance directives,

Napísala poslednú vôľu s presnými inštrukciami

she wrote a 12-page document about how she had suffered enough,

aj 12-stranový list o tom, ako už trpela dosť

how it was time for her to go.

a že už je čas ísť.

One day, when I was a resident physician,

Jedného dňa, to som pracovala v nemocnici,

I got a call to say that she was in the intensive care unit.

mi volali, že mamu previezli na ARO.

By the time I got there, she was about to be intubated

Keď som prišla, práve sa chystali

and put on a breathing machine.

pripojiť ju na dýchací prístroj.

"But this is not what she wants," I said, "and we have documents."

„Ale ona toto nechcela,“ vravím, „máme na to papiere.“

The ICU doctor looked at me in the eye,

Lekár z ARO sa mi pozrel do očí,

pointed at my then 16-year-old sister, and said,

ukázal na moju 16-ročnú sestru a povedal:

"Do you remember when you were that age?

„Pamätáš, keď si bola v jej veku?

How would you have liked to grow up without your mother?"

Ako by sa ti páčilo vyrastať bez mamy?“

Her oncologist was there too, and said,

Bol tam aj jej onkológ, ten povedal:

"This is your mother.

„Je to tvoja matka.

Can you really face yourself for the rest of your life

Vedela by si sa po zvyšok života pozrieť sebe do očí,

if you don't do everything for her?"

keby si pre ňu nespravila všetko?“

I knew my mother so well.

Poznala som mamu dokonale.

I understood what her directives meant so well,

Dokonale som vedela, čo si priala,

but I was a physician.

ale bola som lekárka.

That was the single hardest decision I ever made,

Bolo to najťažšie rozhodnutie môjho života,

to let her die in peace,

nechať ju v kľude umrieť

and I carry those words of those doctors with me

a doteraz si nesiem slová tých doktorov so sebou,

every single day.

každý jeden deň.

We can bridge the disconnect

Môžeme premostiť tú medzeru

between what doctors do and what patients need.

medzi tým, čo robia lekári a čo potrebujú pacienti.

We can get there, because we've been there before,

Dostaneme sa tam, lebo sme tam už kedysi boli

and we know that transparency gets us to that trust.

a vieme, že transparentnosť nás dovedie k dôvere.

Research has shown us that openness also helps doctors,

Výskum ukázal, že otvorenosť pomáha aj lekárom,

that having open medical records,

že otvorenie záznamov

being willing to talk about medical errors,

a ochota rozprávať o lekárskych omyloch

will increase patient trust,

zvýšia dôveru pacientov,

improve health outcomes,

zlepšia výsledky liečby

and reduce malpractice.

a zredukujú nedbalosť.

That openness, that trust,

Tá otvorenosť a dôvera

is only going to be more important

je dôležitejšia

as we move from the infectious to the behavioral model of disease.

pri behaviorálnom modeli choroby než pri infekčnom modeli.

Bacteria may not care so much about trust and intimacy,

Baktériám môže byť dôvera a intimita ukradnutá,

but for people to tackle the hard lifestyle choices,

ale keď ide o zmeny životného štýlu,

to address issues like smoking cessation,

aby sme dokázali prestať fajčiť,

blood-pressure management and diabetes control,

mať pod kontrolou krvný tlak alebo cukrovku,

well, that requires us to establish trust.

to vyžaduje dôveru k lekárovi.

Here's what other transparent doctors have said.

Toto povedal jeden z transparentných lekárov,

Brandon Combs, an internist in Denver:

Brandon Combs, internista z Denveru:

"This has brought me closer to my patients.

„Priviedlo ma to bližšie k pacientom.

The type of relationship I've developed —

Ten vzťah, čo sme si vybudovali...

that's why I entered medicine."

preto som vlastne šiel na medicínu.“

Aaron Stupple, an internist in Denver:

Aaron Stupple, internista z Denveru:

"I tell my patients that I am totally open with them.

„Hovorím pacientom, že som k nim totálne úprimný.

I don't hide anything from them.

Nič pred nimi neskrývam.

This is me. Now tell me about you.

Toto som ja. A teraz mi povedzte o sebe.

We're in this together."

Sme v tom spolu.“

May Nguyen, a family physician in Houston:

May Nguyen, rodinná lekárka z Houstonu:

"My colleagues are astounded by what I'm doing.

„Mojich kolegov šokuje, čo robím.

They ask me how I could be so brave.

Pýtajú sa, ako to, že som taká odvážna.

I said, I'm not being brave,

Hovorím, nie som odvážna,

it's my job."

je to moja práca.“

I leave you today with a final thought.

Myšlienka na koniec.

Being totally transparent is scary.

Byť úplne otvorený je desivé.

You feel naked, exposed and vulnerable,

Cítite sa nahý, nechránený a zraniteľný,

but that vulnerability, that humility,

ale tá zraniteľnosť a pokora

it can be an extraordinary benefit to the practice of medicine.

môže byť jedinečným darom pre lekársku prax.

When doctors are willing to step off our pedestals,

Keď budú lekári ochotní zostúpiť z piedestálu,

take off our white coats,

vyzliecť biele plášte

and show our patients who we are and what medicine is all about,

a ukázať pacientom, kto sme a o čom je medicína,

that's when we begin to overcome the sickness of fear.

vtedy začneme prekonávať tú chorobu strachu.

That's when we establish trust.

Vtedy sa nastolí dôvera.

That's when we change the paradigm of medicine

Vtedy zmeníme lekársku paradigmu

from one of secrecy and hiding

z tajností a ukrývania

to one that is fully open and engaged

na otvorenosť a angažovanosť

for our patients.

pre našich pacientov.

Thank you.

Ďakujem.

(Applause)

(potlesk)