Eric Dishman: Health care should be a team sport

Translator: Joseph Geni Reviewer: Morton Bast

Prevodilac: Ivana Korom Lektor: Mile Živković

I want to share some personal friends and stories with you

Želim da podelim sa vama nekoliko ličnih prijatelja i priča

that I've actually never talked about in public before

o kojima nikada nisam pre pričao u javnosti

to help illustrate the idea

da pomogne da ilustrujem ideju

and the need and the hope

i potrebu i nadu

for us to reinvent our health care system around the world.

da ponovo osmislimo sistem zdravstvene zaštite širom sveta.

Twenty-four years ago, I had -- a sophomore in college,

Pre dvadeset četiri godine, bio sam student druge godine fakulteta,

I had a series of fainting spells. No alcohol was involved.

imao sam čitav niz nesvestica. Alkohol nije bio uključen.

And I ended up in student health,

Završio sam u studentskoj ambulanti,

and they ran some labwork and came back right away,

uradili su nekoliko analiza i odmah sam dobio rezultate,

and said, "Kidney problems."

i rekli su: "Problemi sa bubrezima."

And before I knew it, I was involved and thrown into

Pre nego što sam i shvatio, bio sam uključen i bačen

this six months of tests and trials and tribulations

u testiranja i ispitivanja i teškoće u trajanju od šest meseci

with six doctors across two hospitals

sa šest doktora u dve bolnice,

in this clash of medical titans

u tom sudaru medicinskih titana

to figure out which one of them was right

da ustanove koji od njih je u pravu

about what was wrong with me.

o tome šta nije u redu sa mnom.

And I'm sitting in a waiting room some time later for an ultrasound,

Nešto kasnije, sedim u čekaonici za ultrazvuk

and all six of these doctors actually show up in the room at once,

i svih šest doktora se pojave u sobi odjednom,

and I'm like, "Uh oh, this is bad news."

a ja mislim: "O-o, to su loše vesti."

And their diagnosis was this:

A njihova dijagnoza je bila:

They said, "You have two rare kidney diseases

rekli su: "Imaš dve retke bolesti bubrega

that are going to actually destroy your kidneys eventually,

koje je će ti uništiti bubrege s vremenom,

you have cancer-like cells in your immune system

imaš ćelije slične raku u svom imunom sistemu

that we need to start treatment right away,

i potrebno je početi odmah sa lečenjem,

and you'll never be eligible for a kidney transplant,

i nikad nećeš biti podložan za transplantaciju bubrega,

and you're not likely to live more than two or three years."

nije verovatno da ćeš živeti više od dve ili tri godine."

Now, with the gravity of this doomsday diagnosis,

Sa težinom ove dijagnoze sudnjeg dana,

it just sucked me in immediately,

u momentu me usisalo,

as if I began preparing myself as a patient

kao da sam počeo da se pripremam, kao pacijent

to die according to the schedule that they had just given to me,

da umrem u skladu sa rasporedom koji su mi upravo dali,

until I met a patient named Verna in a waiting room,

dok nisam u čekaonici upoznao pacijentkinju zvanu Verna,

who became a dear friend, and she grabbed me one day

koja mi je postala draga prijateljica, i zgrabila me jednog dana

and took me off to the medical library

i odvela me u medicinsku biblioteku

and did a bunch of research on these diagnoses and these diseases,

i uradila gomilu istraživanja ovih dijagnoza i bolesti,

and said, "Eric, these people who get this

i rekla: "Erik, ljudi koji dobiju te bolesti

are normally in their '70s and '80s.

su obično u svojim 70-im i 80-im.

They don't know anything about you. Wake up.

Oni ne znaju ništa o tebi. Probudi se.

Take control of your health and get on with your life."

Uzmi kontrolu nad svojim zdravljem u svoje ruke i nastavi sa svojim životom."

And I did.

I jesam.

Now, these people making these proclamations to me

Ljudi koji su mi davali ta saopštenja

were not bad people.

nisu bili loši ljudi.

In fact, these professionals were miracle workers,

Zapravo, ovi stručnjaci su čudotvorci,

but they're working in a flawed, expensive system that's set up the wrong way.

ali rade u skupom sistemu sa greškama koji je osnovan na pogrešan način.

It's dependent on hospitals and clinics for our every care need.

Zavise od bolnica i klinika za svaku našu potrebu brige.

It's dependent on specialists who just look at parts of us.

Zavise od specijalista koji samo gledaju pojedine naše delove.

It's dependent on guesswork of diagnoses and drug cocktails,

Zavise od nagađanja dijagnoza i koktela lekova,

and so something either works or you die.

tako da nešto ili deluje ili umrete.

And it's dependent on passive patients

Takođe zavise od pasivnih pacijenata

who just take it and don't ask any questions.

koji samo uzimaju i ne pitaju ništa.

Now the problem with this model

Problem sa ovim modelom

is that it's unsustainable globally.

je to što je neodrživ na globalnom nivou.

It's unaffordable globally.

Nepriuštiv je na globalnom nivou.

We need to invent what I call a personal health system.

Treba da izmislimo nešto što ja zovem ličnim zdravstvenim sistemom.

So what does this personal health system look like,

Na šta liči taj lični zdravstveni sistem,

and what new technologies and roles is it going to entail?

i koje nove tehnologije i uloge će zahtevati?

Now, I'm going to start by actually sharing with you

Počeću tako što ću vas upoznati

a new friend of mine, Libby,

sa mojom novom prijateljicom, Libi,

somebody I've become quite attached to over the last six months.

s kojom sam se poprilično zbližio tokom poslednjih šest meseci.

This is Libby, or actually, this is an ultrasound image of Libby.

Ovo je Libi, odnosno ovo je ultrazvučna slika Libi.

This is the kidney transplant I was never supposed to have.

Ovo je transplantacija bubrega koju nikad nije trebalo da imam.

Now, this is an image that we shot a couple of weeks ago for today,

Ova slika je snimljena pre nekoliko nedelja za danas,

and you'll notice, on the edge of this image,

i primetićete, na ivici ove slike,

there's some dark spots there, which was really concerning to me.

postoje neke crne tačke koje su me jako zabrinjavale.

So we're going to actually do a live exam

Tako da ćemo uraditi pregled uživo

to sort of see how Libby's doing.

da na neki način vidimo kako je Libi.

This is not a wardrobe malfunction. I have to take my belt off here.

Ovo nije kvar garderobe. Moram da skinem kaiš ovde.

Don't you in the front row worry or anything.

Ne brinite vi iz prvog reda.

(Laughter)

(Smeh)

I'm going to use a device from a company called Mobisante.

Koristiću jednu spravu kompanije zvane Mobisante.

This is a portable ultrasound.

Ovo je prenosivi ultrazuvk.

It can plug into a smartphone. It can plug into a tablet.

Može da se prikljući na pametni telefon. Može da se priključi na tablet.

Mobisante is up in Redmond, Washington,

Mobisante se nalazi u Redmondu, u državi Vašington

and they kindly trained me to actually do this on myself.

i ljubazno su me osposobili da mogu da ga koristim na sebi.

They're not approved to do this. Patients are not approved to do this.

Pacijentima nije odobreno da ovo rade.

This is a concept demo, so I want to make that clear.

Ovo je konceptualna demonstracija, da to odmah raščistim.

All right, I gotta gel up.

Dobro, moram da se namažem gelom.

Now the people in the front row are very nervous. (Laughter)

Ljudi u prvim redovima su jako nervozni sada. (Smeh)

And I want to actually introduce you to Dr. Batiuk,

Želim da vas upoznam sa dr Batukom,

who's another friend of mine.

koji je takođe moj prijatelj.

He's up in Legacy Good Samaritan Hospital in Portland, Oregon.

On je u bolnici Nasleđa dobrog Samarićanina u Portlandu, u Oregonu.

So let me just make sure. Hey, Dr. Batiuk. Can you hear me okay?

Samo da se uverim. Hej, dr Batuk. Da li me čujete dobro?

And actually, can you see Libby?

Zapravo, da li vidite Libi?

Thomas Batuik: Hi there, Eric.

Tomas Batuk: Zdravo Erik.

You look busy. How are you?

Izgledate zauzeto. Kako ste?

Eric Dishman: I'm good. I'm just taking my clothes off

Erik Dišman: Dobro sam. Samo skidam odeću

in front of a few hundred people. It's wonderful.

ispred nekoliko stotina ljudi. Divno je.

So I just wanted to see, is this the image you need to get?

Hteo sam da vidim, je li ovo slika koju treba da dobijete?

And I know you want to look and see if those spots are still there.

I znam da želite da pogledate da li su još te tačke tamo.

TB: Okay. Well let's scan around a little bit here,

TB: U redu, Hajde da malo pretražimo okolo,

give me a lay of the land.

dajte mi pregled površine.

ED: All right.TB: Okay. Turn it a little bit inside,

ED: U redu. TB: Dobro. Okreni ga malo unutra,

a little bit toward the middle for me.

malčice prema sredini.

Okay, that's good. How about up a little bit?

Dobro, to je dobro. Kako bi bilo malo na gore?

Okay, freeze that image. That's a good one for me.

Dobro, zamrzni tu sliku. Ta mi odgovara.

ED: All right. Now last week, when I did this,

ED: U redu. Prošle nedelje, kada sam ovo uradio,

you had me measure that spot to the right.

trebalo je da izmerim to mesto udesno.

Should I do that again?

Treba li da to uradim ponovo?

TB: Yeah, let's do that.

TB: Da, hajde uradite ponovo.

ED: All right. This is kind of hard to do

ED: U redu. Ovo je malo teško uraditi

with one hand on your belly and one hand on measuring,

sa jednom rukom na stomaku i jednom na merenju,

but I've got it, I think,

ali mi uspeva, mislim,

and I'll save that image and send it to you.

sačuvaću tu sliku i poslati je vama.

So tell me a little bit about what this dark spot means.

Recite mi nešto o tome šta te tamne tačke znače.

It's not something I was very happy about.

Nije nešto čemu sam se radovao.

TB: Many people after a kidney transplant

TB: Mnogo ljudi nakon transplantacije bubrega

will develop a little fluid collection around the kidney.

će razviti malo skupljanje tečnosti oko bubrega.

Most of the time it doesn't create any kind of mischief,

U većini slučajeva to neće naneti nikakvu štetu,

but it does warrant looking at,

ali ne škodi proveriti,

so I'm happy we've got an opportunity to look at it today,

tako da sam srećan što imamo priliku da danas pogledamo.

make sure that it's not growing, it's not creating any problems.

da se uverimo da ne raste, i da ne stvara probleme.

Based on the other images we have,

Na osnovu drugih slika koje imamo,

I'm really happy how it looks today.

jako sam zadovoljan time kako izgleda danas.

ED: All right. Well, I guess we'll double check it when I come in.

ED: U redu. Pa, mislim da ćemo proveriti još jednom kada dođem.

I've got my six month biopsy in a couple of weeks,

Imam šestomesečnu biopsiju za koju nedelju,

and I'm going to let you do that in the clinic,

pustiću vas da to vi uradite u klinici,

because I don't think I can do that one on myself.

jer mislim da to ne mogu da uradim sam na sebi.

TB: Good choice.ED: All right, thanks, Dr. Batiuk.

TB: Dobar izbor. ED: U redu, hvala, dr Batuk.

All right. So what you're sort of seeing here

U redu. Dakle ono što vidite su otprilike

is an example of disruptive technologies,

primeri tehnologije koja remeti,

of mobile, social and analytic technologies.

mobilne, socijalne i analitičke tenhologije.

These are the foundations of what's going to make personal health possible.

Ovo su osnove koje će učiniti lično zdravstvo mogućim.

Now there's really three pillars

Postoje tri stuba

of this personal health I want to talk to you about now,

ličnog zdravstva o kojim želim da vam pričam,

and it's care anywhere, care networking and care customization.

a to je nega svugde, umrežavanje nege i prilagođavanje nege.

And you just saw a little bit of the first two

Videli ste samo malo od prva dva

with my interaction with Dr. Batiuk.

kroz moju interakciju s dr Batukom.

So let's start with care anywhere.

Dakle, da počnemo sa negom svugde.

Humans invented the idea of hospitals and clinics

Ljudi su izumeli ideju bolnica i klinika

in the 1780s. It is time to update our thinking.

1780-ih. Vreme je da unapredimo naše razmišljanje.

We have got to untether clinicians and patients

Moramo da razvežemo lekare i pacijente

from the notion of traveling to a special

od pojma putovanja do specijalnog mesta

bricks-and-mortar place for all of our care,

od cigle i maltera za našu negu,

because these places are often the wrong tool,

jer ova mesta su obično pogrešan alat,

and the most expensive tool, for the job.

i najskuplji alat za posao.

And these are sometimes unsafe places to send our sickest patients,

To su ponekad nesigurna mesta za slanje najbolesnijih pacijenata,

especially in an era of superbugs

posebno u doba superbakterija

and hospital-acquired infections.

i infekcija zarađenih u bolnici.

And many countries are going to go brickless from the start

Mnoge države će ostati bez cigala od samog početka

because they're never going to be able to afford

jer nikada neće biti u mogućnosti da priušte

the mega-medicalplexes that a lot of the rest of the world has built.

mega medicinske komplekse koje je izgradio ostatak sveta.

Now I personally learned that hospitals

Lično sam naučio da bolnice

can be a very dangerous place at a young age.

mogu da budu jako opasna mesta u ranim godinama.

This was me in third grade.

Ovo sam ja u trećem razredu.

I broke my elbow very seriously, had to have surgery,

Veoma ozbiljno sam polomio lakat, morao sam na operaciju,

worried that they were going to actually lose the arm.

brinuo sam se da ću stvarno izgubiti ruku.

Recovering from the surgery in the hospital, I get bedsores.

Oporavljajući se od operacije u bolnici, dobio sam rane od ležanja.

Those bedsores become infected,

Rane su se inficirale,

and they give me an antibiotic which I end up being allergic to,

dali su mi antibiotik na koji sam na kraju bio alergičan,

and now my whole body breaks out,

po celom telu mi izbije koprivnjača,

and now all of those become infected.

i sve se inficiralo.

The longer I stayed in the hospital, the sicker I became,

Što sam duže bio u bolnici, to sam bio bolesniji,

and the more expensive it became,

i sve je bilo skuplje,

and this happens to millions of people around the world every year.

ovo se dešava milionima ljudi širom sveta svake godine.

The future of personal health that I'm talking about

Budućnost ličnog zdravstva o kojem ja pričam

says care must occur at home as the default model,

je nega koja mora da se odvija kod kuće kao podrazumevani model,

not in a hospital or clinic.

a ne u bolnici ili klinici.

You have to earn your way into those places

Morate da zaradite boravak u tim mestima,

by being sick enough to use that tool for the job.

da budete dovoljno bolesni da koristite taj alat za posao.

Now the smartphones that we're already carrying

Telefoni koje nosimo sa sobom

can clearly have diagnostic devices like ultrasounds plugged into them,

mogu da imaju priključene dijagnostičke uređaje poput ultrazvuka,

and a whole array of others, today,

i čitav niz drugih, danas,

and as sensing is built into these,

i kako imaju ugrađene senzore,

we'll be able to do vital signs monitor

bićemo u stanju da pratimo vitalne znakove

and behavioral monitoring like we've never had before.

i da pratimo ponašanje kao nikada ranije.

Many of us will have implantables that will actually look

Mnogi od nas će imati implante koji će pratiti

real-time at what's going on with our blood chemistry

u stvarnom vremenu šta se dešava sa krvnom hemijom

and in our proteins right now.

i sa našim proteinima u momentu.

Now the software is also getting smarter, right?

Čak i softver postaje pametniji, zar ne?

Think about a coach, an agent online,

Zamislite trenera, internet agenta,

that's going to help me do safe self-care.

koji će vam pomoći oko sigurne sopstvene nege.

That same interaction that we just did with the ultrasound

Ista interakcija, kao što smo upravo uradili sa ultrazvukom,

will likely have real-time image processing,

imaće verovatno obradu slika u realnom vremenu,

and the device will say, "Up, down, left, right,

a uređaj će reći: "Gore, dole, levo, desno,

ah, Eric, that's the perfect spot to send that image

ah, Erik, to je savršeno mesto da se pošalje slika

off to your doctor."

tvom lekaru."

Now, if we've got all these networked devices

Ako već imamo sve ove umrežene uređaje

that are helping us to do care anywhere,

koji nam pomažu oko nege bilo gde,

it stands to reason that we also need a team

razumno je da nam takođe treba i tim

to be able to interact with all of that stuff,

da bismo mogli komunicirati sa svim tim stvarima,

and that leads to the second pillar I want to talk about,

i to nas dovodi do drugog stuba o kojem želim da pričam,

care networking.

umrežavanje nege.

We have got to go beyond this paradigm

Moramo da idemo izvan paradigme

of isolated specialists doing parts care

izolovanih specijalista koji brinu o delovima

to multidisciplinary teams doing person care.

do multidiscipliniranih timova koji rade na ličnoj nezi.

Uncoordinated care today is expensive at best,

Danas je nekoordinisana nega preskupa u najboljem slučaju

and it is deadly at worst.

i smrtonosna u najgorem.

Eighty percent of medical errors are actually caused

80% medicinskih grešaka je izvazvano

by communication and coordination problems

problemima komunikacije i koordinacije

amongst medical team members.

među članovima medicinskog tima.

I had my own heart scare years ago in graduate school,

Pre nekoliko godina na postdiplomskim studijama i ja sam se uplašio,

when we're under treatment for the kidney,

kada sam bio na tretmanu za bubrege,

and suddenly, they're like, "Oh, we think you have a heart problem."

i odjednom čujem: "O, mislimo da imate srčane probleme."

And I have these palpitations that are showing up.

Imam ta mala lupanja srca.

They put me through five weeks of tests --

Idem pet nedelja na testiranja -

very expensive, very scary -- before the nurse finally notices

veoma skupa, veoma strašna - pre nego što medicinska sestra primeti

the piece of the paper, my meds list

komad papira, moju listu lekova

that I've been carrying to every single appointment,

koju sam nosio na svaki pregled,

and says, "Oh my gosh."

i kaže: "O moj bože!"

Three different specialists had prescribed

Tri različita specijalista su mi prepisali

three different versions of the same drug to me.

tri različite verzije istog leka.

I did not have a heart problem. I had an overdose problem.

Nisam imao srčanih problema. Imao sam problem predoziranja.

I had a care coordination problem.

Imao sam problem koordinacije nege.

And this happens to millions of people every year.

To se dešava milionima ljudi svake godine.

I want to use technology that we're all working on and making happen

Želim da koristim tehnologiju na kojoj svi radimo da ostvarimo

to make health care a coordinated team sport.

da zdravstvena nega bude koordinirani timski sport.

Now this is the most frightening thing to me.

Ovo me najviše plaši.

Out of all the care I've had in hospitals and clinics around the world,

Od sve nege koju sam dobio u bolnicama i klinikama svuda u svetu,

the first time I've ever had a true team-based care experience

prvi put kada sam iskusio pravu timsku negu

was at Legacy Good Sam these last six months

je bilo u Nasleđu dobrog Sema ovih poslednjih šest meseci

for me to go get this.

da bih ovo dobio.

And this is a picture of my graduation team from Legacy.

Ovo je slika mog diplomskog tima iz Nasleđa.

There's a couple of the folks here. You'll recognize Dr. Batiuk.

Ima tu nekoliko ljudi. Prepoznaćete dr Batuka.

We just talked to him. Here's Jenny, one of the nurses,

Upravo smo pričali sa njim. Ovo je Dženi, jedna od medicinskih sestara,

Allison, who helped manage the transplant list,

Alison, koja je pomogla u rukovođenju transplantne liste,

and a dozen other people who aren't pictured,

i desetak drugih ljudi koji nisu na slici,

a pharmacist, a psychologist, a nutritionist,

apotekar, psiholog, nutricionista,

even a financial counselor, Lisa,

čak i finansijski savetnik, Lisa,

who helped us deal with all the insurance hassles.

koja nam je pomogla da rešimo osiguravajuće poteškoće.

I wept the day I graduated.

Plakao sam na dan diplomiranja.

I should have been happy, because I was so well

Trebalo je da budem srećan, jer sam sam bio toliko dobro

that I could go back to my normal doctors,

da sam mogao da se vratim svojim normalnim lekarima,

but I wept because I was so actually connected to this team.

ali sam plakao jer sam se toliko povezao sa ovim timom.

And here's the most important part.

A evo i najvažnijeg dela.

The other people in this picture are me and my wife, Ashley.

Ostali ljudi na ovoj slici smo moja žena Ešli i ja.

Legacy trained us on how to do care for me at home

U Nasleđu su nas obučili kako da se staramo o meni kod kuće

so that they could offload the hospitals and clinics.

kako bi mogli da rasterete bolnice i klinike.

That's the only way that the model works.

To je jedini način da model radi.

My team is actually working in China

Moj tim zapravo radi u Kini

on one of these self-care models

na jednom od tih modela sopstvene nege

for a project we called Age-Friendly Cities.

za projekat koji smo nazvali Starosno naklonjeni gradovi.

We're trying to help build a social network

Pomažemo da se izgradi društvena mreža

that can help track and train the care of seniors

koja može da prati i obuči negu starih

caring for themselves

koji se sami brinu za sebe,

as well as the care provided by their family members

kao i negu koju pružaju njihovi članovi porodice

or volunteer community health workers,

ili dobrovoljni zdravstveni radnici u zajednici,

as well as have an exchange network online,

i da takođe postoji mreža razmene na internetu,

where, for example, I can donate three hours of care a day to your mom,

gde, na primer, mogu da doniram tri sata negovanja vaše majke dnevno,

if somebody else can help me with transportation to meals,

ako neko drugi može da pomogne sa prenosom obroka,

and we exchange all of that online.

i to sve razmenimo preko interneta.

The most important point I want to make to you about this

Najvažnija tačka na koju želim da ukažem

is the sacred and somewhat over-romanticized

je sveti i malo previše romantizovan

doctor-patient one-on-one

odnos lekara i pacijenta, jedan na jedan,

is a relic of the past.

to je relikvija prošlosti.

The future of health care is smart teams,

Budućnost zdravstvene nege su pametni timovi,

and you'd better be on that team for yourself.

i bolje je da budete u tom timu za sebe.

Now, the last thing that I want to talk to you about

Poslednje o čemu želim da vam govorim

is care customization,

je prilagođavanje nege,

because if you've got care anywhere and you've got care networking,

jer ako imate negu bilo gde i imate umrežavanje nege,

those are going to go a long way towards improving our health care system,

te stvari će mnogo pomoći u poboljšanju našeg zdravstvenog sistema,

but there's still too much guesswork.

ali još uvek ima previše nagađanja.

Randomized clinical trials were actually invented in 1948

Nasumične kliničke probe su smišljene još 1948.

to help invent the drugs that cured tuberculosis,

da pomognu oko stvaranja leka koji leči tuberkulozu,

and those are important things, don't get me wrong.

to su važne stvari, nemojte me pogrešno shvatiti.

These population studies that we've done have created

Ova istraživanja populacije koje smo sproveli su stvorila

tons of miracle drugs that have saved millions of lives,

tonu čudotvornih lekova koji su spasili milione života,

but the problem is that health care

ali je problem u tome što zdravstveni sistem

is treating us as averages, not unique individuals,

tretira nas kao prosečne, a ne kao jedinstvene pojedince,

because at the end of the day,

jer na kraju krajeva,

the patient is not the same thing as the population

pacijent nije isto što i populacija

who are studied. That's what's leading to the guesswork.

koja se proučava. To nas vodi ka nagađanjima.

The technologies that are coming,

Tehnologije koje dolaze,

high-performance computing, analytics,

računarstvo visokih performansi, analitika,

big data that everyone's talking about,

veliki podaci o kojima svi govore,

will allow us to build predictive models for each of us

omogućiće nam da izgradimo prognostičke modele za sve nas

as individual patients.

pojedinačne pacijente.

And the magic here is, experiment on my avatar

Magija je, eksperimentisanje na mom avataru

in software, not my body in suffering.

u softveru, ne na mom telu koje pati.

Now, I've had two examples I want to quickly share with you

Želim brzo da podelim sa vama dva primera

of this kind of care customization on my own journey.

ovakve vrste prilagođavanja nege na svom putovanju.

The first was quite simple. I finally realized some years ago

Prvi je bio poprilično jednostavan. Napokon sam shvatio pre nekoliko godina

that all my medical teams were optimizing my treatment for longevity.

da su mi svi medicinski timovi optimizovali tretman za dugovečnost.

It's like a badge of honor to see how long they can get the patient to live.

To je kao bedž časti da vide koliko dugo mogu da održe pacijenta u životu.

I was optimizing my life for quality of life,

Ja sam optimizovao svoj život za kvalitetan život,

and quality of life for me means time in snow.

a za mene kvalitetan život znači vreme u snegu.

So on my chart, I forced them to put, "Patient goal:

Tako sam ih naterao da na mom kartonu piše: "Ciljevi pacijenta:

low doses of drugs over longer periods of time,

male doze lekova tokom dugog perioda vremena,

side effects friendly to skiing."

nuspojave - prijateljski nastrojen za skijanje."

And I think that's why I achieved longevity.

Mislim da sam zbog toga postigao dugovečnost.

I think that time-in-snow therapy was as important

Mislim da je snežna terapija bila jednako važna

as the pharmaceuticals that I had.

kao i lekovi koje sam uzimao.

Now the second example of customization -- and by the way,

Drugi primer prilagođavanja - i uzgred

you can't customize care if you don't know your own goals,

ne možete prilagoditi negu ako ne znate sopstvene ciljeve,

so health care can't know those until you know your own health care goals.

tako da zdravstvo ne može da ih zna dok vi ne znate sopstvene zdravstvene ciljeve.

But the second example I want to give you is,

Ali drugi primer koji želim da vam ispričam je,

I happened to be an early guinea pig,

bio sam rano zamorče,

and I got very lucky to have my whole genome sequenced.

imao sam jako puno sreće da mi sekvenciraju ceo genom.

Now it took about two weeks of processing

Trebalo je oko dve nedelje obrade

on Intel's highest-end servers to make this happen,

na Intelovim vrhunskim serverima da bi se to dogodilo,

and another six months of human and computing labor

i još šest meseci ljudskog i računarskog rada

to make sense of all of that data.

da se da smisao svim tim podacima.

And at the end of all of that, they said, "Yes,

Na kraju svega toga, rekli su: "Da,

those diagnoses of that clash of medical titans

te dijagnoze u sudaru medicinskih titana

all of those years ago were wrong,

svih onih godina su pogrešne,

and we have a better path forward."

imamo bolji put za napredak."

The future that Intel's working on now is to figure out

Budućnost na kojoj radi Intel je da se shvati

how to make that computing for personalized medicine

kako da se računanje za personalizovanu medicinu

go from months and weeks to even hours,

smanji sa meseca i nedelja pa i na sate,

and make this kind of tool available,

i da se stavi takav alat na raspolaganje,

not just in the mainframes of tier-one research hospitals around the world,

ne samo u glavnom okviru prvoklasnih istraživačkih bolnica širom sveta,

but in the mainstream -- every patient, every clinic

nego u glavnom toku - svaki pacijent, svaka klinika

with access to whole genome sequencing.

koja ima pristup sekvenciranju celog genoma.

And I tell you, this kind of care customization

Kažem vam, ova vrsta prilagođavanja nege

for everything from your goals to your genetics

za sve od vaših ciljeva do vaše genetike

will be the most game-changing transformation

će biti najveća promena

that we witness in health care during our lifetime.

zdravstvenog sistema naših života kojoj ćemo biti svedoci.

So these three pillars of personal health,

Tako da ti stubovi ličnog zdravstva,

care anywhere, care networking, care customization,

nega bilo gde, umrežavanje nege, prilagođavanje nege,

are happening in pieces now,

dešavaju se u delićima,

but this vision will completely fail if we don't step up

ali će vizija potpuno propasti ako se ne pokažemo

as caregivers and as patients to take on new roles.

kao negovatelji i kao pacijenti i zauzmemo nove uloge.

It's what my friend Verna said:

Kao što je moja prijateljica Verna rekla:

Wake up and take control of your health.

Probudi se i preuzmi kontrolu nad svojim zdravljem.

Because at the end of the day these technologies

Jer na kraju dana ove tehnologije

are simply about people caring for other people

se jednostavno koriste za brigu o ljudima koji se brinu o drugima

and ourselves in some powerful new ways.

i o sebi na neki moćniji, novi način.

And it's in that spirit that I want to introduce you

I u tom duhu želim da vam predstavim

to one last friend, very quickly.

poslednjeg prijatelja, veoma brzo.

Tracey Gamley stepped up to give me the impossible kidney

Trejsi Gemli se odvažila da mi da nemogući bubreg

that I was never supposed to have.

koji nikad nije trebalo da dobijem.

(Applause)

(Aplauz)

So Tracey, just tell us a little bit quickly about what the donor experience was like with you.

Trejsi, samo nam ispričajte brzo nešto o tome kakvo je bilo iskustvo donora za vas.

Tracey Gamley: For me, it was really easy.

Trejsi Gemli: Za mene, bilo je jako lako.

I only had one night in the hospital.

Provela sam samo jednu noć u bolnici.

The surgery was done laparoscopically,

Operacija je odrađena laparoskopski,

so I have just five very small scars on my abdomen,

tako da imam pet veoma malih ožiljaka na svom stomaku,

and I had four weeks away from work

i imala sam četiri nedelje odsustva sa posla

and went back to doing everything I'd done before

i radila sam sve kao i pre,

without any changes.

bez ikakvih promena.

ED: Well, I probably will never get a chance to say this to you

ED: Verovatno neću imati priliku da kažem ovo

in such a large audience ever again.

ponovo pred tako velikom publikom.

So "thank you" feel likes a really trite word,

"Hvala" zvuči kao zaista banalna reč,

but thank you from the bottom of my heart for saving my life.

ali hvala od srca što ste mi spasili život.

(Applause)

(Aplauz)

This TED stage and all of the TED stages

Ova TED bina i sve TED bine

are often about celebrating innovation

su obično za proslavu inovacije

and celebrating new technologies,

i proslavu novih thenologija,

and I've done that here today,

to sam danas ovde uradio,

and I've seen amazing things coming from TED speakers,

video sam zapanjujuće stvari od TED govornika,

I mean, my gosh, artificial kidneys, even printable kidneys, that are coming.

mislim, bože, veštački bubrezi, čak i bubrezi za štampanje, koji su na pomolu.

But until such time that these amazing technologies

Ali dok ove zapanjujuće tehnologije

are available to all of us, and even when they are,

ne budu raspoložive svima nama, i čak i kada budu,

it's up to us to care for, and even save, one another.

na nama je da se brinemo jedni o drugima, i spasimo jedni druge.

I hope you will go out and make personal health happen

Nadam se da ćete ostvariti lično zdravstvo

for yourselves and for everyone. Thanks so much.

zbog sebe i svih ostalih. Hvala vam puno.

(Applause)

(Aplauz)