Leana Wen: What your doctor won’t disclose

Prevodilac: Ljiljana Ikodinovic Lektor: Mile Živković

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

Rekli su mi da sam izdajica sopstvene profesije,

that I should be fired,

da treba da budem otpuštena,

have my medical license taken away,

da mi se oduzme dozvola za rad,

that I should go back to my own country.

da treba da se vratim u svoju zemlju.

Hakovali su mi imejl.

My email got hacked.

In a discussion forum for other doctors,

U forumu za diskusije za lekare,

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

neko se pohvalio da je "tviter-bombardovao" moj nalog.

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

Tada nisam znala da li je to dobra ili loša stvar,

but then came the response:

ali je onda stigao odgovor:

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

"Šteta što to nije bila prava bomba".

I never thought that I would do something

Nikada nisam pomislila da ću uraditi nešto

that would provoke this level of anger among other doctors.

što će isprovocirati taj nivo besa među drugim lekarima.

Becoming a doctor was my dream.

Moj san je bio da postanem lekar.

I grew up in China,

Odrasla sam u Kini, i moja najranija sećanja su

and my earliest memories are of being rushed to the hospital

kako sam bila hitno odvedena u bolnicu

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

jer sam imala toliko tešku astmu da sam tamo bila gotovo svake nedelje.

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

Imala sam jednog lekara, dr Sem, koja se uvek brinula o meni.

She was about the same age as my mother.

Ona je bila sličnih godina kao moja majka,

She had this wild, curly hair,

imala je divlju, kovrdžavu kosu,

and she always wore these bright yellow flowery dresses.

i uvek je nosila te jarko žute cvetne haljine.

She was one of those doctors who,

Ona je bila jedan od onih lekara koji,

if you fell and you broke your arm,

ukoliko ste pali i slomili ruku,

she would ask you why you weren't laughing

ona bi vas pitala zašto se ne smejete

because it's your humerus. Get it?

jer je u pitanju humor (humerus tj. nadlaktična kost). Shvatate?

Vidite, vi biste jecali,

See, you'd groan,

ali bi ona uvek učinila da se osećate bolje nakon što ste je videli.

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

Well, we all have that childhood hero

Pa, svi imamo tog heroja iz detinjstva

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

poput kojih bismo želeli da budemo kad porastemo, zar ne?

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

Pa, ja sam želela da budem baš kao dr Sem.

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

Kada sam imala osam godina, preselila sam se sa roditeljima u SAD,

and ours became the typical immigrant narrative.

i naša priča je postala tipično imigrantska.

My parents cleaned hotel rooms and washed dishes and pumped gas

Moji roditelji su čistili hotelske sobe i prali sudove i točili gorivo

so that I could pursue my dream.

kako bih ja mogla da sledim svoj san.

Pa, naposletku sam dovoljno dobro naučila engleski

Well, eventually I learned enough English,

and my parents were so happy

i moji roditelji su bili toliko srećni

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

onoga dana kada sam krenula na medicinski fakultet

i podnela zakletvu lečenja i službe.

But then one day, everything changed.

Ali tada, jednog dana se sve promenilo.

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

Majka me je pozvala da mi kaže da se ne oseća dobro,

da ima taj kašalj koji nikako da prođe, da joj nedostaje dah i da je umorna.

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

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

Pa, znala sam da je moja majka neko ko se nikada ni na šta ne žali.

For her to tell me that something was the matter,

Kad mi je ona rekla kako nešto nije u redu,

znala sam da je nešto moralo biti zaista loše.

I knew something had to be really wrong.

And it was:

I bilo je:

We found out that she had stage IV breast cancer,

otkrili smo da je imala IV fazu raka dojke,

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

raka koji se do tada proširio na njena pluća, kosti i mozak.

Međutim, moja majka je bila hrabra i imala je nade.

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

She went through surgery and radiation,

Prošla je kroz operaciju i zračenje,

and was on her third round of chemotherapy

i bila je na trećoj turi hemoterapije

when she lost her address book.

kada je izgubila adresar.

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

Pokušala je da pronađe broj telefona svog onkologa

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

na internetu, i pronašla ga je, ali je pronašla još nešto.

On several websites,

Na nekoliko sajtova su ga navodili

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

kao visoko plaćenog govornika farmaceutske firme,

and in fact often spoke on behalf

i zapravo je često govorio u interesu

of the same chemo regimen that he had prescribed her.

one iste hemoterapije koju joj je prepisao.

She called me in a panic,

Pozvala me je u panici,

and I didn't know what to believe.

a ja nisam znala u šta da verujem.

Maybe this was the right chemo regimen for her,

Možda je to za nju bila dobra hemoterapija,

but maybe it wasn't.

ali, možda i nije.

It made her scared and it made her doubt.

Ovo ju je uplašilo i navelo da sumnja.

When it comes to medicine,

Kada se radi o medicini,

having that trust is a must,

imati poverenje je neophodno,

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

a kada to poverenje nestane, sve što ostaje je strah.

There's another side to this fear.

Postoji i druga strana ovog straha.

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

Kao student medicine, brinula sam se o tom 19-godišnjaku

who was biking back to his dorm

koji se biciklom vraćao u studentsku sobu

when he got struck and hit,

kada ga je zbacio, udario

run over by an SUV.

i pregazio džip.

He had seven broken ribs,

Imao je sedam polomljenih rebara,

shattered hip bones,

razmrskane karlične kosti,

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

i krvario je unutar stomaka i mozga.

Dakle, zamislite da ste njegovi roditelji

Now, imagine being his parents

koji su doleteli iz Sijetla, udaljenog preko 3000km

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

to find their son in a coma.

kako bi zatekli svog sina u komi.

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

Mislim, želeli biste da saznate šta se sa njim događa, zar ne?

They asked to attend our bedside rounds

Oni su tražili da prisustvuju našim vizitama

where we discussed his condition and his plan,

tokom kojih smo razgovarali o njegovom stanju i planu,

which I thought was a reasonable request,

što sam smatrala prilično razumnim zahtevom,

and also would give us a chance to show them

i što bi nam takođe pružilo mogućnost da im pokažemo

how much we were trying and how much we cared.

koliko smo se trudili i koliko nam je bilo stalo.

The head doctor, though, said no.

Međutim, glavni lekar je rekao ne.

He gave all kinds of reasons.

Pružio je najraznovrsnije razloge.

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

Možda će smetati medicinskoj sestri.

Maybe they'll stop students from asking questions.

Možda će onemogućiti studente da postavljaju pitanja,

He even said,

Čak je rekao:

"What if they see mistakes and sue us?"

"Šta ako vide greške i tuže nas?"

What I saw behind every excuse was deep fear,

Ono što sam videla iza svakog izgovora je bio dubok strah,

and what I learned was that to become a doctor,

i saznala sam kako, da bismo postali lekari,

we have to put on our white coats,

moramo da obučemo bele mantile,

put up a wall, and hide behind it.

podignemo zid, i sakrijemo se iza njega.

U medicini postoji skrivena epidemija.

There's a hidden epidemic in medicine.

Naravno, pacijenti se boje kada dođu da vide lekara.

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

Zar ne? Zamislite da se probudite sa tim strašnim bolom u stomaku,

Imagine you wake up with this terrible bellyache,

you go to the hospital,

odete u bolnicu,

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

ležite u tom stranom mestu, vi ste na bolničkom krevetu,

you're wearing this flimsy gown,

nosite tu tanku spavaćicu,

strangers are coming to poke and prod at you.

stranci dolaze da vas pipkaju i bodu.

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

Ne znate šta će se dogoditi.

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

Čak ne znate ni da li ćete dobiti to ćebe koje ste tražili pre 30 minuta.

But it's not just patients who are scared;

Ali nisu samo pacijenti uplašeni,

doctors are scared too.

i doktori su uplašeni.

We're scared of patients finding out who we are

Mi se bojimo da će pacijenti otkriti ko smo

and what medicine is all about.

i šta je to medicina.

And so what do we do?

I šta onda radimo?

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

Obučemo naše bele mantile i iza njih se sakrijemo.

Of course, the more we hide,

Naravno, što se više krijemo,

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

to više ljudi želi da zna šta mi to krijemo.

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

Još više straha tada vrtoglavo raste u nepoverenje i lošu medicinsku negu.

We don't just have a fear of sickness,

Mi se ne bojimo samo bolesti,

we have a sickness of fear.

mi bolujemo od straha.

Can we bridge this disconnect

Da li možemo da prevaziđemo ovu razdvojenost

between what patients need and what doctors do?

između onoga što je pacijentima potrebno i šta doktori rade?

Can we overcome the sickness of fear?

Da li možemo da prevaziđemo ovu bolest straha?

Let me ask you differently:

Pa, hajde da vas pitam drugačije:

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

ukoliko sakrivanje nije odgovor, šta ukoliko učinimo suprotno?

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

Šta kada bi lekari postali potpuno otvoreni sa svojim pacijentima?

Last fall, I conducted a research study to find out

Prošle jeseni sam sprovela straživačku studiju kako bismo saznali

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

šta to ljudi žele da znaju o njihovoj medicinskoj nezi.

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

Nisam želela da samo ispitujemo pacijente u bolnici

but everyday people.

već svakodnevne ljude.

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

Tako su moje dve studentkinje medicine, Suhavi Taker i Lora Džons,

literally took their research to the streets.

doslovno iznele svoje istraživanje na ulice.

They went to banks, coffee shops, senior centers,

Otišle su u banke, kafiće, klubove penzionera,

Chinese restaurants and train stations.

kineske restorane i železničke stanice.

Šta su ustanovile?

What did they find?

Well, when we asked people,

Pa, kada su pitale ljude:

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

"Šta želite da znate o svojoj zdravstvenoj zaštiti?"

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

ljudi su govorili o tome šta žele da znaju o svojim lekarima,

because people understand health care

jer ljudi shvataju zdravstvenu zaštitu

to be the individual interaction between them and their doctors.

kao ličnu interakciju između njih i njihovih lekara.

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

Kada smo ljude pitali: "Šta želite da znate o svojim lekarima?"

people gave three different answers.

davali su tri različita odgovora.

Some want to know that their doctor is competent

Neki su želeli da znaju da li je njihov lekar stručan

and certified to practice medicine.

i ovlašćen da se bavi medicinom.

Some want to be sure that their doctor is unbiased

Neki žele da budu sigurni da je njiihov lekar nepristrasan

and is making decisions based on evidence and science,

i da odluke donosi na osnovu indikacija i nauke,

not on who pays them.

ne na osnovu toga ko ih plaća.

Surprisingly to us,

Za nas iznenađujuće,

many people want to know something else about their doctors.

mnogi ljudi žele da znaju nešto drugo o svojim lekarima.

Jonathan, a 28-year-old law student,

Džonatan, 28-godišnji student prava,

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

kaže da želi da pronađe nekoga

ko nema predrasuda u radu sa LGBTQ pacijentima

and specializes in LGBT health.

i ko specijalizira zdravlje ove populacije.

Serena, a 32-year-old accountant,

Serena, 32-godišnji računovođa,

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

kaže da je za nju važno da njen lekar deli njene vrednosti

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

kada se radi o reproduktivnom izboru i pravima žena.

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

Frank, 59-godišnji vlasnik gvožđare

doesn't even like going to the doctor

čak ni ne voli da ide kod lekara

and wants to find someone who believes in prevention first,

i želi da pronađe nekoga ko pre svega veruje u prevenciju,

but who is comfortable with alternative treatments.

ali ko prihvata alternativne terapije.

One after another, our respondents told us

Jedan za drugim, naši ispitanici su nam govorili

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

da je odnos lekar-pacijent vrlo intiman,

that to show their doctors their bodies

da bi pokazali lekarima svoja tela

and tell them their deepest secrets,

i rekli im svoje najdublje tajne,

they want to first understand their doctor's values.

oni prvo žele da razumeju vrednosni sistem svojih lekara.

Just because doctors have to see every patient

Samo zato što lekari moraju da prime svakog pacijenta

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

ne znači da pacijenti moraju da idu kod svakog lekara.

People want to know about their doctors first

Ljudi žele da prvo saznaju o svojim lekarima

so that they can make an informed choice.

kako bi mogli da donesu informisani izbor.

As a result of this, I formed a campaign,

Posledica ovoga je bila to da sam započela kampanju

Who's My Doctor?

"Ko je moj lekar?"

that calls for total transparency in medicine.

koja poziva na potpunu javnost u medicini.

Participating doctors voluntarily disclose

Lekari koji učestvuju dobrovoljno izlažu

on a public website

na javnom vebsajtu

not just information about where we went to medical school

ne samo informacije o našem medicinskom školovanju

and what specialty we're in,

i specijalizaciji,

već i o našim sukobima interesa.

but also our conflicts of interest.

We go beyond the Government in the Sunshine Act

Mi idemo dalje od Akta o javnom radu Vlade

about drug company affiliations,

o vezama sa farmaceutskim kompanijama,

and we talk about how we're paid.

i govorimo o tome kako smo plaćeni.

Incentives matter.

Stimulacija je važna.

If you go to your doctor because of back pain,

Ukoliko posetite lekara zbog bola u leđima,

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

možda ćete želeti da znate da je plaćen 5.000 dolara kada operiše kičmu,

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

naspram 25 dolara kada vas uputi na fizikalnu terapiju,

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

ili da li je plaćen isti iznos bez obzira šta preporuči.

Then, we go one step further.

Tada, idemo još jedan korak dalje.

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

Mi dodajemo naše vrednosti kada se radi o zdravlju žena,

LGBT health, alternative medicine,

gej populacije, alternavnoj medicini,

preventive health, and end-of-life decisions.

zdravstvenoj prevenciji i odlukama vezanim za kraj života.

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

Mi se zaklinjemo našim pacijentima da smo ovde da bi vama služili,

so you have a right to know who we are.

tako da vi imate pravo da znate ko smo.

We believe that transparency can be the cure for fear.

Mi verujemo da otvorenost može biti lek protiv straha.

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

Pa, mislila sam da će neki lekari da učestvuju a da neki neće,

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

ali nisam imala predstavu o ogromnoj negativnoj reakciji koja je usledila.

Within one week of starting Who's My Doctor?

U toku jedne nedelje od začetka "Ko je moj lekar?"

Medscape's public forum

Medskejpov javni forum

and several online doctors' communities

i nekoliko lekarskih onlajn zajednica

had thousands of posts about this topic.

je imalo hiljade postavki na ovu temu.

Evo ih nekoliko.

Here are a few.

From a gastroenterologist in Portland:

Od gastroenterologa u Portlandu:

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

"Posvetio sam 12 godina svog života robovanju.

I have loans and mortgages.

Imam kredite i hipoteke,

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

da bih služio pacijente neophodni su mi ručkovi farmaceutskih kompanija "

Well, times may be hard for everyone,

Pa, vremena su možda svima teška,

but try telling your patient

ali pokušajte da kažete svom pacijentu

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

koji godišnje zarađuje 35.000 dolara za četvoročlanu porodicu

that you need the free lunch.

da je vama potreban besplatan ručak.

From an orthopedic surgeon in Charlotte:

Od hirurga ortopeda u Šarlotu:

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

"Za mene je otkrivanje izvora mojih prihoda narušavanje privatnosti.

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

Moji pacijenti ne iznose svoje prihode meni."

Ali izvor prihoda vaših pacijenata ne utiče na vaše zdravlje.

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

From a psychiatrist in New York City:

Od psihijatra u Njujorku:

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

"Uskoro ćemo morati da iznesemo da li više volimo mačke ili pse,

what model of car we drive,

koji model automobila vozimo

and what toilet paper we use."

i koji toalet papir koristimo."

Well, how you feel about Toyotas or Cottonelle

Pa, vaše mišljenje o Tojoti ili Kotonelu

won't affect your patients' health,

neće uticati na zdravlje vaših pacijenata,

but your views on a woman's right to choose

ali vaši pogledi na prava žena na izbor,

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

na preventivnu medicinu i odluke na kraju života mogu.

And my favorite, from a Kansas City cardiologist:

I moj omiljeni, od kardiologa iz Kanzas Sitija:

"More government-mandated stuff?

"Više sr... na koja nas država obavezuje?

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

dr Ven treba da se vrati u svoju zemlju."

Well, two pieces of good news.

Pa, evo dve dobre vesti.

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

Kao prvo, ovo je predviđeno da bude dobrovoljno a ne obavezno,

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

i kao drugo, ja sam Amerikanka i već sam ovde.

(Laughter) (Applause)

(Smeh) (Aplauz)

U roku od mesec dana, moji poslodavci su primali pozive

Within a month, my employers were getting calls

asking for me to be fired.

u kojima je traženo da me otpuste.

I received mail at my undisclosed home address

Na moju kućnu adresu koja nije bila javno dostupna primila sam poštu

with threats to contact the medical board to sanction me.

sa pretanjama da će kontaktirati medicinski odbor kako bi me kaznio.

My friends and family urged me to quit this campaign.

Moji prijatelji i porodica su me ubeđivali da odustanem od ove kampanje.

Posle pretnje bombom, bila sam gotova.

After the bomb threat, I was done.

But then I heard from patients.

Ali tada su mi se javili pacijenti.

Over social media, a TweetChat,

Preko društvenih mreža, tvit-četa,

which I'd learned what that was by then,

do tada sam naučila šta je to,

generated 4.3 million impressions,

generisano je 4,3 miliona utisaka,

and thousands of people wrote to encourage me to continue.

i hiljade ljudi je pisalo kako bi me ohrabrili da nastavim.

They wrote with things like,

Pisali su nešto kao:

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

"Ukoliko lekari rade nešto čega se toliko stide,

they shouldn't be doing it."

ne treba to da rade."

"Zvaničnici treba da iznesu priloge koje su dobili za svoje kampanje.

"Elected officials have to disclose campaign contributions.

Lawyers have to disclose conflicts of interests.

Advokati treba da iznesu konflikte interesa.

Why shouldn't doctors?"

Zašto to ne bi trebali i lekari?"

And finally, many people wrote and said,

I konačno, mnogo ljudi je pisalo i reklo:

"Let us patients decide

"Pustite nas pacijente da odlučimo

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

šta je važno kada biramo lekara."

In our initial trial,

U našem inicijalnom pokušaju,

over 300 doctors have taken the total transparency pledge.

preko 300 lekara je podnelo zakletvu potpune otvorenosti.

What a crazy new idea, right?

Kakva luda nova ideja, zar ne?

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

Ali zapravo, ovo uopšte nije tako nov koncept.

Remember Dr. Sam, my doctor in China,

Setite se dr Sem, moje lekarke u Kini,

with the goofy jokes and the wild hair?

sa šašavim šalama i divljom kosom?

Well, she was my doctor,

Pa, ona je bila moj lekar,

but she was also our neighbor

ali i naša komšinica

who lived in the building across the street.

koja je živela u zgradi preko puta ulice.

I went to the same school as her daughter.

Išla sam u istu školu kao i njena ćerka.

My parents and I trusted her

Moji roditelji su joj verovali jer smo znali ko je ona i za šta se zalagala,

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

and she had no need to hide from us.

i ona nije imala potrebu da se od nas krije.

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

Pre samo jedne generacije, ovo je bilo pravilo i u SAD.

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

Znali ste da je vaš porodični lekar otac dva tinejdžera,

that he quit smoking a few years ago,

da je prestao da puši pre nekoliko godina,

that he says he's a regular churchgoer,

da kaže da redovno odlazi u crkvu,

but you see him twice a year: once at Easter

ali ga vidite dva puta godišnje: jednom za Uskrs

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

i jednom kada mu je tašta u gradu.

You knew what he was about,

Znali ste kakav je,

and he had no need to hide from you.

i on nije imao potrebu da se od vas krije.

But the sickness of fear has taken over,

Ali zavladala je bolest straha

and patients suffer the consequences.

i pacijenti snose posledice.

I know this firsthand.

Ovo znam iz prve ruke.

My mother fought her cancer for eight years.

Moja majka se borila sa rakom osam godina.

She was a planner,

Bila je osoba koja planira

and she thought a lot about how she wanted to live

i puno je razmišljala o tome kako je želela da živi

and how she wanted to die.

i kako je želela da umre.

Not only did she sign advance directives,

Ne samo da je potpisala dokumenta o nezi na kraju života,

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

napisala je i dokument na 12 strana o tome kako je dovoljno patila,

how it was time for her to go.

kako je došlo vreme da ode.

One day, when I was a resident physician,

Jednog dana, kada sam bila lekar specijalizant,

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

primila sam poziv kojim mi je saopšteno

da se ona nalazi na odeljenju intenzivne nege.

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

Dok sam tamo stigla, pripremali su da je intubiraju

and put on a breathing machine.

i priključe na mašinu za veštačko disanje.

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

"Ali to nije ono što ona hoće," rekla sam "i mi imamo sva dokumenta."

The ICU doctor looked at me in the eye,

Lekar sa intenzivne nege me je pogledao u oči,

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

pokazao u pravcu moje tada 16-godišnje sestre, i rekao:

"Da li se sećate kada ste vi bili tih godina?

"Do you remember when you were that age?

Kako biste vi voleli da odrastate bez majke?"

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

Her oncologist was there too, and said,

Njen onkolog je takođe bio tamo i rekao je:

"Ovo je vaša majka.

"This is your mother.

Can you really face yourself for the rest of your life

Da li ćete zaista do kraja života moći da sebe pogledate u oči

if you don't do everything for her?"

ukoliko za nju ne učinite sve?"

I knew my mother so well.

Ja sam moju majku znala tako dobro.

I understood what her directives meant so well,

Tako sam dobro razumela značenje njenih uputstava,

but I was a physician.

ali ja sam bila lekar.

That was the single hardest decision I ever made,

To je bila daleko najteža odluka koju sam ikada načinila,

to let her die in peace,

da je pustim da umre u miru,

and I carry those words of those doctors with me

i nosim u sebi reči tih lekara

every single day.

svakog dana.

We can bridge the disconnect

Mi možemo da prevaziđemo prazninu između

between what doctors do and what patients need.

onoga što lekari rade i šta je potrebno pacijentima.

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

To možemo da postignemo jer smo to već ranije imali

and we know that transparency gets us to that trust.

i znamo da nam otvorenost daje to poverenje.

Research has shown us that openness also helps doctors,

Istraživanja su nam pokazala da otvorenost pomaže i lekarima,

that having open medical records,

da to što imate otvoren medicinski izveštaj,

being willing to talk about medical errors,

spremnost da se govori o medicinskim greškama,

will increase patient trust,

povećava poverenje pacijenata,

improve health outcomes,

poboljšava zdravstvene rezultate

and reduce malpractice.

i smanjuje zloupotrebe.

That openness, that trust,

Ta otvorenost, to poverenje,

is only going to be more important

će samo postajati značajniji

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

kako se krećemo od infektivnog ka biheviorističkom modelu bolesti.

Bacteria may not care so much about trust and intimacy,

Bakterijama možda nije mnogo stalo do poverenja i bliskosti.

but for people to tackle the hard lifestyle choices,

Ali da bi se ljudi latili teških izbora vezanih za stil života,

to address issues like smoking cessation,

da bi uzeli u razmatranje sporna pitanja poput smanjenja pušenja,

blood-pressure management and diabetes control,

održavanja krvnog pritiska i kontrolisanja dijabetesa,

well, that requires us to establish trust.

pa, to zahteva da uspostavimo poverenje.

Evo šta su drugi otvoreni lekari imali da kažu.

Here's what other transparent doctors have said.

Brandon Combs, an internist in Denver:

Brandon Kombs, internista u Denveru:

"This has brought me closer to my patients.

"Ovo me je približilo mojim pacijentima.

The type of relationship I've developed —

Vrsta odnosa koji sam razvio -

that's why I entered medicine."

to je ono zbog čega se bavim medicinom."

Aaron Stupple, an internist in Denver:

Eron Stapl, internista u Denveru:

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

"Ja govorim mojim pacijentima da sam sa njima potpuno otvoren.

I don't hide anything from them.

Ništa od njih ne krijem.

This is me. Now tell me about you.

To sam ja. Sada mi recite o sebi.

We're in this together."

Mi smo u ovome zajedno."

May Nguyen, a family physician in Houston:

Mej Njuen, porodični lekar u Hjustonu:

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

"Moje kolege su zapanjene onim što radim.

They ask me how I could be so brave.

Pitaju me kako mogu biti toliko hrabra.

I said, I'm not being brave,

Ja im kažem da nisam hrabra,

it's my job."

to je moj posao."

Ostavljam vas danas sa završnom mišlju.

I leave you today with a final thought.

Being totally transparent is scary.

Biti potpuno otvoren je strašno.

You feel naked, exposed and vulnerable,

Osećate se obnaženo, eksponirano i ranjivo,

but that vulnerability, that humility,

ali ta ranjivost, ta poniznost

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

može biti izuzetno korisna za praktikovanje medicine.

Kada su lekari spremni da siđu sa našeg pijedastala,

When doctors are willing to step off our pedestals,

take off our white coats,

da skinu bele mantile,

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

i pokažu pacijentima ko smo, i šta je to medicina,

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

tada počinjemo da prevazilazimo bolest straha.

That's when we establish trust.

Tada ustanovljavamo poverenje.

That's when we change the paradigm of medicine

Tada menjamo paradigmu medicine

from one of secrecy and hiding

od tajnovitosti i skrivanja

to one that is fully open and engaged

ka jednoj koja je potpuno otvorena i angažovana

for our patients.

za naše pacijente.

Hvala.

Thank you.

(Applause)

(Aplauz)