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

Prevodilac: Aleksandra Vukelić Lektor: Mile Živković

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

Pre nekoliko godina, provalio sam u sopstvenu kuću.

I had just driven home,

Upravo sam stigao kući,

it was around midnight in the dead of Montreal winter,

bilo je oko ponoći usred montrealske zime,

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

bio sam u poseti prijatelju, Džefu, na drugom kraju grada

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

i termometar na tremu je pokazivao minus 40 stepeni -

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

i ne pitajte da li se radi o stepenima Celzijusa ili Farenhajta

minus 40 is where the two scales meet --

na minus 40 se skale susreću -

it was very cold.

bilo je jako hladno.

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

I dok sam stajao na tremu i preturao 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, video sam ih kroz prozor

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

kako stoje na trpezarijskom stolu gde sam ih i ostavio.

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

Brzo sam sve obišao i pokušao da otvorim druga vrata i prozore,

and they were locked tight.

i sva su bila zaključana.

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

Palo mi je na pamet da zovem bravara - makar sam imao mobilni,

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

ali u ponoć, moglo je potrajati dok bravar stigne,

and it was cold.

a bilo je hladno.

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

Nisam mogao da se vratim da prespavam kod Džefa

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

jer je rano ujutru trebalo da letim za Evropu,

and I needed to get my passport and my suitcase.

i morao sam da uzmem pasoš i kofer.

So, desperate and freezing cold,

Tako sam, očajan i smrzavajući se

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

pronašao veliki kamen i provalio kroz prozor na podrumu,

cleared out the shards of glass,

uklonio komade stakla,

I crawled through,

provukao se kroz prozor,

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

našao parče kartona i zalepio ga preko otvora,

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

računajući da ću ujutru, na putu do aerodroma,

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

pozvati majstora i zamoliti ga da to popravi.

This was going to be expensive,

Znao sam da će to biti skupo,

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

ali verovatno ne skuplje nego da bravar dolazi usred noći,

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

tako da sam računao, s obzirom na okolnosti, da sam na istom.

Now, I'm a neuroscientist by training

Po obrazovanju sam neurolog

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

i znam ponešto o tome kako mozak funkcioniše pod stresom.

It releases cortisol that raises your heart rate,

Oslobađa kortizol koji ubrzava otkucaje srca,

it modulates adrenaline levels

utiče na nivo adrenalina

and it clouds your thinking.

i pomućuje razmišljanje.

So the next morning,

Sledećeg jutra,

when I woke up on too little sleep,

kada sam se probudio nakon premalo sna,

worrying about the hole in the window,

zabrinut zbog rupe u prozoru

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

i imajući u glavi da moram da zovem majstora,

and the freezing temperatures,

a uz ledene temperature

and the meetings I had upcoming in Europe,

i sastanke koji su me čekali u Evropi

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

i, znate, sa svim tim kortizolom u mozgu,

my thinking was cloudy,

nisam jasno razmišljao.

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

Ali nisam znao da ne razmišljam jasno jer nisam jasno razmišljao.

(Laughter)

(Smeh)

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

I tek kada sam došao do šaltera za čekiranje na aerodromu,

that I realized I didn't have my passport.

shvatio sam da nisam poneo pasoš.

(Laughter)

(Smeh)

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

Tako da sam za 40 minuta odjurio kući po snegu i ledu,

got my passport, raced back to the airport,

uzeo pasoš, odjurio nazad na aerodrom,

I made it just in time,

stigao sam tačno na vreme,

but they had given away my seat to someone else,

ali su već dali moje sedište nekom drugom,

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

pa sam zaglavio u zadnjem delu aviona, pored kupatila,

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

u sedištu koje nije moglo da se spusti, na letu od osam sati.

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

Pa, tokom tih osam besanih sati imao sam dosta vremena za razmišljanje.

(Laughter)

(Smeh)

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

I zapitao sam se postoji li nešto što mogu da uradim,

systems that I can put into place,

sistemi koje mogu da postavim,

that will prevent bad things from happening?

koji će sprečiti da se loše stvari dešavaju?

Or at least if bad things happen,

Ili će bar, ako se loše stvari dogode,

will minimize the likelihood of it being a total catastrophe.

smanjiti verovatnoću da dođe do potpune katastrofe.

So I started thinking about that,

Počeo sam da razmišljam o tome,

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

ali su mi se misli iskristalisale tek oko mesec dana kasnije.

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

Večerao sam sa kolegom, Nobelovcem Denijem Kanemanom

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

i pomalo postiđeno mu ispričao kako sam razbio prozor

and, you know, forgotten my passport,

i, znate već, zaboravio pasoš,

and Danny shared with me

i Deni mi je otkrio

that he'd been practicing something called prospective hindsight.

da primenjuje nešto što se zove buduće osvrtanje.

(Laughter)

(Smeh)

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

To je nešto za šta je čuo od psihologa Gerija Klajna,

who had written about it a few years before,

koji je pisao o tome nekoliko godina ranije,

also called the pre-mortem.

a zove se još i pred-uviđaj.

Now, you all know what the postmortem is.

Sad, svi znate šta je uviđaj.

Whenever there's a disaster,

Kad god dođe do katastrofe,

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

tim stručnjaka dolazi i pokušava da otkrije šta je pošlo naopako.

Well, in the pre-mortem, Danny explained,

Pa, u pred-uviđaju, objasnio je Deni,

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

gledate unapred i pokušavate da vidite šta bi sve moglo poći naopako

and then you try to figure out what you can do

i onda da smislite šta možete da uradite

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

da biste sprečili da se to desi, ili smanjili štetu.

So what I want to talk to you about today

Danas hoću da pričam sa vama

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

o nekim vrstama pred-uviđaja koje možemo da primenimo.

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

Neke od njih su očigledne, neke nisu toliko očigledne.

I'll start with the obvious ones.

Krenuću od onih očiglednih.

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

Odredite mesto u kući za stvari koje se lako zagube.

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

Ovo zvuči zdravorazumski, i jeste,

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

ali je utemeljeno na dosta naučnih činjenica,

based on the way our spatial memory works.

zasnovanih na načinu na koji funkcioniše prostorna memorija.

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

U mozgu postoji struktura koja se zove hipokampus,

that evolved over tens of thousands of years,

koja je evoluirala tokom desetina hiljada godina,

to keep track of the locations of important things --

kako bi vodila računa o lokacijama bitnih stvari -

where the well is, where fish can be found,

gde je izvor, gde se može naći riba,

that stand of fruit trees,

ono drveće sa voćem,

where the friendly and enemy tribes live.

gde žive prijateljska i neprijateljska plemena.

The hippocampus is the part of the brain

Hipokampus je deo mozga

that in London taxicab drivers becomes enlarged.

koji se uvećava kod londonskih taksista.

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

To je deo mozga zahvaljujući kome veverice pronalaze svoje lešnike.

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

I ako ste se pitali, neko je zaista izveo eksperiment

where they cut off the olfactory sense of the squirrels,

u kome su vevericama blokirali čulo mirisa

and they could still find their nuts.

i one su ipak uspevale da nađu lešnike.

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

Nisu koristile miris, koristile su hipokampus,

this exquisitely evolved mechanism in the brain for finding things.

taj izvanredno razvijeni mehanizam za nalaženje stvari.

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

Ali on dobro funkcioniše sa stvarima koje uglavnom miruju,

not so good for things that move around.

a slabije sa onima koje se kreću.

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

Zbog toga gubimo ključeve od auta i naočare za čitanje i pasoše.

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

Zato odredite mesto za ključeve u kući -

a hook by the door, maybe a decorative bowl.

kukicu pored vrata, možda ukrasnu činiju.

For your passport, a particular drawer.

Odredite posebnu fioku za pasoš.

For your reading glasses, a particular table.

Za naočare za čitanje, određeni sto.

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

Ako odredite jedno mesto i pridržavate se toga,

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

stvari će vam biti tamo kad god ih budete tražili.

What about travel?

A šta je sa putovanjima?

Take a cell phone picture of your credit cards,

Uslikajte telefonom kreditne kartice,

your driver's license, your passport,

vozačku dozvolu, pasoš,

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

pošaljite to sebi mejlom da vam bude dostupno.

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

U slučaju gubitka ili krađe tih stvari, biće lakše da izvadite nove.

Now these are some rather obvious things.

To su neke prilično očigledne stvari.

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

Setite se, kada ste pod stresom, mozak oslobađa kortizol.

Cortisol is toxic, and it causes cloudy thinking.

Kortizol je toksičan, i pomućuje misli.

So part of the practice of the pre-mortem

Zato je deo pred-uviđaja

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

da shvatite da niste u najboljem izdanju kad ste pod stresom

and you should put systems in place.

i da bi trebalo da postavite sisteme.

And there's perhaps no more stressful a situation

A možda nema stresnije situacije

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

nego kada se suočite sa donošenjem medicinske odluke.

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

I svi ćemo mi u nekom trenutku biti u tom položaju,

where we have to make a very important decision

u kome moramo da donesemo veoma važnu odluku

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

o svom budućem medicinskom lečenju, ili lečenju voljene osobe,

to help them with a decision.

da im pomognemo oko odluke.

And so I want to talk about that.

I o tome želim da pričam.

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

I pričaću o konkretnom medicinskom problemu.

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

Ali on služi da predstavi sve vrste medicinskog odlučivanja,

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

ali i finansijske odluke, kao i društvene odluke -

any kind of decision you have to make

sve odluke koje morate da donesete

that would benefit from a rational assessment of the facts.

u kojima bi vam pomogla racionalna procena činjenica.

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

Zamislite da odete kod lekara i on kaže:

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

"Dobio sam vaše rezultate iz laboratorije i holesterol vam je malo povišen."

Now, you all know that high cholesterol

Svi znate da je povišen holesterol

is associated with an increased risk of cardiovascular disease,

povezan sa povećanim rizikom od kardiovaskularnih bolesti,

heart attack, stroke.

od srčanog udara, infarkta.

And so you're thinking

I zato pomišljate

having high cholesterol isn't the best thing,

kako nije baš dobro imati povišen holesterol,

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

a doktor kaže: "Znate, hteo bih da vam prepišem lek

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

koji će pomoći da vam se snizi holesterol, statin."

And you've probably heard of statins,

I verovatno ste čuli za statine,

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

znate da su među najčešće prepisivanim lekovima

in the world today,

u svetu danas,

you probably even know people who take them.

verovatno čak poznajete ljude koji ih piju.

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

I zato mislite: "Da! Dajte mi taj statin."

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

Ali postoji pitanje koje sada treba da postavite,

a statistic you should ask for

statistika za koju treba da pitate,

that most doctors don't like talking about,

a o kojoj većina lekara ne voli da govori,

and pharmaceutical companies like talking about even less.

a farmaceutske kompanije još manje.

It's for the number needed to treat.

To je broj potreban za izlečenje.

Now, what is this, the NNT?

Dakle, šta je to to, taj BPI?

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

To je broj ljudi koji treba da uzmu lek

or undergo a surgery or any medical procedure

ili se podvrgu operaciji ili nekoj medicinskoj proceduri

before one person is helped.

da bi se jedna osoba izlečila.

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

I vi mislite, kakva je to suluda statistika?

The number should be one.

Taj broj treba da bude 1.

My doctor wouldn't prescribe something to me

Moj lekar mi ne bi prepisao nešto

if it's not going to help.

ako mi to neće pomoći.

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

Ali zapravo, medicinska praksa ne funkcioniše tako.

And it's not the doctor's fault,

I za to nisu krivi lekari,

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

ako je iko kriv onda su to naučnici poput mene.

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

Nismo otkrili dovoljno o mehanizmima koji leže u osnovi.

But GlaxoSmithKline estimates

Ali kompanija GlaxoSmithCline procenjuje

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

da 90 procenata lekova deluje na samo 30 do 50 procenata ljudi.

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

Zato je broj potreban za izlečenje za statin koji se najčešće prepisuje,

what do you suppose it is?

šta mislite koji?

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

Koliko ga pacijenata mora uzeti pre nego što pomogne jednom?

300.

300.

This is according to research

To su podaci istraživanja

by research practitioners Jerome Groopman and Pamela Hartzband,

koje su sproveli Džerom Grupmen i Pamela Harcbend,

independently confirmed by Bloomberg.com.

a nezavisno potvrdio Bloomberg.com.

I ran through the numbers myself.

I sam sam prošao kroz brojeve.

300 people have to take the drug for a year

Potrebno je da 300 ljudi pije lek godinu dana

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

da bi se sprečio jedan srčani udar ili drugi zdravstveni problem.

Now you're probably thinking,

Sada verovatno mislite:

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

"Dobro, verovatnoća da snizim holesterol je 1 prema 300.

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

Što da ne, doktore? Ipak mi dajte recept."

But you should ask at this point for another statistic,

Ali sada treba da pitate za još jedan statistički podatak,

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

a to su neželjena dejstva. Zar ne?

So for this particular drug,

Kod ovog konkretnog leka,

the side effects occur in five percent of the patients.

neželjena dejstva se javljaju kod pet posto pacijenata.

And they include terrible things --

I ona mogu biti užasna -

debilitating muscle and joint pain, gastrointestinal distress --

iznurujući bol u mišićima i zglobovima, gastrointestinalne tegobe -

but now you're thinking, "Five percent,

ali sada vi mislite: "Pet posto,

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

mala je verovatnoća da se to meni desi,

I'll still take the drug."

ipak ću uzeti lek."

But wait a minute.

Ali čekajte malo.

Remember under stress you're not thinking clearly.

Setite se da pod stresom ne razmišljate jasno.

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

Zato razmislite unapred kako ćete ovo rešiti,

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

kako ne biste na licu mesta morali da osmislite lanac zaključaka.

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

Lek uzima 300 osoba, je li tako? Jednoj pomogne,

five percent of those 300 have side effects,

5 posto od tih 300 oseća neželjena dejstva,

that's 15 people.

to je njih 15.

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

Verovatnoća da će vam lek naškoditi je 15 puta veća

than you are to be helped by the drug.

nego da će vam pomoći.

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

Ne kažem da li bi trebalo da uzmete statin ili ne.

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

Samo kažem da treba da razgovarate o ovome sa svojim lekarom.

Medical ethics requires it,

To zahteva lekarska etika,

it's part of the principle of informed consent.

to je deo principa o informisanoj saglasnosti.

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

Imate pravo da pristupite ovakvim informacijama

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

da biste započeli razgovor o tome želite li da prihvatite rizike ili ne.

Now you might be thinking

Sada možda mislite

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

da sam ovaj broj izvukao niotkuda da bih vas zapanjio,

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

ali je taj broj potreban za izlečenje zapravo prilično uobičajen.

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

Za najčešću operaciju među muškarcima starijim od 50 godina,

removal of the prostate for cancer,

uklanjanje prostate zbog raka,

the number needed to treat is 49.

broj potreban za izlečenje je 49.

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

Tako je, izvrši se 49 operacija, da bi se izlečila jedna osoba.

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

U tom slučaju se neželjene posledice javljaju kod 50 posto pacijenata.

They include impotence, erectile dysfunction,

Među njima su impotencija, erektilna disfunkcija,

urinary incontinence, rectal tearing,

urinarna inkontinencija, analne fisure,

fecal incontinence.

fekalna inkontinencija.

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

I ako imate sreće, a jedan ste od onih 50 posto kojima se ovo dogodi,

they'll only last for a year or two.

potrajaće samo godinu ili dve.

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

Zato je ideja pred-uviđaja da mislite unapred

to the questions that you might be able to ask

o pitanjima koja ćete moći da postavite

that will push the conversation forward.

i tako podstaknete razgovor.

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

Ne morate sve ovo da smislite na licu mesta.

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

I još treba da razmislite o pitanjima poput kvaliteta života.

Because you have a choice oftentimes,

Jer često imate izbor,

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

želite li kraći život bez bola,

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

ili duži život koji će pred kraj možda biti izuzetno bolan?

These are things to talk about and think about now,

O tome treba pričati i razmišljati sada,

with your family and your loved ones.

sa porodicom i voljenim osobama.

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

Možda ćete se predomisliti u žaru trenutka,

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

ali makar ćete uvežbati da razmišljate na ovaj način.

Remember, our brain under stress releases cortisol,

Setite se, mozak oslobađa kortizol kada je pod stresom

and one of the things that happens at that moment

i jedna od stvari koje se tada dese

is a whole bunch on systems shut down.

je isključivanje gomile sistema.

There's an evolutionary reason for this.

Postoji evolutivni razlog za to.

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

Kad se suočite sa predatorom, ne treba vam sistem za varenje,

or your libido, or your immune system,

niti libido, niti imuni sistem,

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

jer ako vaše telo troši metabolizam na sve to

and you don't react quickly,

i ako ne reagujete brzo,

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

možete postati ručak za lava, a onda ništa od svega toga nije bitno.

Unfortunately,

Nažalost,

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

jedna od stvari koje nestaju tokom tih stresnih trenutaka

is rational, logical thinking,

je racionalno, logičko mišljenje,

as Danny Kahneman and his colleagues have shown.

kao što su pokazali Deni Kaneman i njegove kolege.

So we need to train ourselves to think ahead

Zato moramo da se naviknemo da mislimo unapred

to these kinds of situations.

o takvim situacijama.

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

Mislim da je ovde važno da shvatimo da svi mi imamo mane.

We all are going to fail now and then.

S vremena na vreme, svi pogrešimo.

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

Ideja je da unapred mislimo o tome koje bismo greške mogli napraviti,

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

da postavimo sisteme koji će pomoći da se umanji šteta,

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

ili sprečiti da se loše stvari uopšte dogode.

Getting back to that snowy night in Montreal,

Da se vratimo na onu snežnu noć u Montrealu,

when I got back from my trip,

kada sam se vratio sa putovanja,

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

majstor mi je ugradio bravu sa šifrom pored vrata,

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

koja otključava ulazna vrata, sa kombinacijom koja se lako pamti.

And I have to admit,

I moram da priznam,

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

još uvek imam gomilu pošte koju nisam sredio

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

i gomilu mejlova koje nisam pročitao.

So I'm not completely organized,

Dakle, nisam sasvim organizovan,

but I see organization as a gradual process,

ali organizaciju posmatram kao postepeni proces

and I'm getting there.

i bližim se cilju.

Thank you very much.

Hvala vam mnogo.

(Applause)

(Aplauz)