Why curiosity is the key to science and medicine | Kevin B. Jones

Translator: Joseph Geni Reviewer: Joanna Pietrulewicz

Prevodilac: Vesna Radovic Lektor: Ivana Krivokuća

Science.

Nauka.

The very word for many of you conjures unhappy memories of boredom

Baš ona reči koja mnoge od vas asocira na nesrećne trenutke dosade

in high school biology or physics class.

na časovima biologije ili fizike u srednjoj školi.

Međutim, dopustite da vas uverim da ono što ste tamo radili

But let me assure that what you did there

had very little to do with science.

nema baš mnogo veze sa naukom.

That was really the "what" of science.

To je bilo ono „šta“ u nauci.

It was the history of what other people had discovered.

To je bila istorija onoga što su drugi otkrili.

What I'm most interested in as a scientist

Ono što mene kao naučnika najviše zanima

u nauci je „kako“.

is the "how" of science.

Because science is knowledge in process.

Jer nauka je proces saznavanja.

Prvo ide opažanje, pa naslućivanje objašnjenja za to opažanje,

We make an observation, guess an explanation for that observation,

and then make a prediction that we can test

a onda predviđanje koje možemo proveriti

with an experiment or other observation.

eksperimentom ili drugim opažanjem.

Evo nekoliko primera.

A couple of examples.

First of all, people noticed that the Earth was below, the sky above,

Pre svega, ljudi su primetili da im je zemlja ispod, nebo iznad,

a i Sunce i Mesec su izgledali kao da se okreću oko njih.

and both the Sun and the Moon seemed to go around them.

Their guessed explanation

Njihovo naslućeno objašnjenje

was that the Earth must be the center of the universe.

bilo je da Zemlja mora da je centar univerzuma.

The prediction: everything should circle around the Earth.

Predviđanje: sve bi trebalo da kruži oko Zemlje.

Ovo je prvi put istinski testirano

This was first really tested

when Galileo got his hands on one of the first telescopes,

kada je Galilej došao u posed jednog od prvih teleskopa,

and as he gazed into the night sky,

i dok je posmatrao noćno nebo,

ono što je tamo otkrio bila je planeta Jupiter,

what he found there was a planet, Jupiter,

with four moons circling around it.

sa četiri satelita oko sebe.

He then used those moons to follow the path of Jupiter

Potom je on koristio te satelite da prati Jupiterovu putanju

i otkrio je da Jupiter takođe ne kruži oko Zemlje,

and found that Jupiter also was not going around the Earth

but around the Sun.

već oko Sunca.

Tako da je test sa predviđanjem bio neuspešan.

So the prediction test failed.

And this led to the discarding of the theory

To je dovelo do odbacivanja teorije

that the Earth was the center of the universe.

da je Zemlja centar univerzuma.

Another example: Sir Isaac Newton noticed that things fall to the Earth.

Drugi primer: Ser Isak Njutn je primetio da stvari padaju na zemlju.

The guessed explanation was gravity,

Naslućeno objašnjenje je bilo gravitacija,

the prediction that everything should fall to the Earth.

predviđanje da bi sve trebalo da pada na zemlju.

But of course, not everything does fall to the Earth.

No, naravno, ne pada sve na zemlju.

So did we discard gravity?

Da li smo odbacili gravitaciju?

No. We revised the theory and said, gravity pulls things to the Earth

Ne. Izvršili smo reviziju teorije i rekli da gravitacija privlači stvari ka Zemlji

unless there is an equal and opposite force in the other direction.

osim ako ne postoji jednaka, a suprotna sila u suprotnom smeru.

Ovako smo naučili nešto novo.

This led us to learn something new.

We began to pay more attention to the bird and the bird's wings,

Počeli smo da obraćamo više pažnje na ptice i njihova krila,

and just think of all the discoveries

i pomislite samo na sva otkrića

that have flown from that line of thinking.

koja su ponikla tom linijom razmišljanja.

So the test failures, the exceptions, the outliers

Neuspela testiranja, izuzeci i odstupanja

teach us what we don't know and lead us to something new.

nas uče onome što ne znamo i vode nas nečemu novom.

Ovako nauka napreduje. Ovako nauka uči.

This is how science moves forward. This is how science learns.

Sometimes in the media, and even more rarely,

Ponekad će se u medijima pojaviti, čak sve ređe,

ali će i naučnici ponekad reći

but sometimes even scientists will say

that something or other has been scientifically proven.

da je ovo ili ono naučno dokazano.

But I hope that you understand that science never proves anything

No, nadam se da shvatate da nauka nikad ne dokazuje ništa

definitively forever.

definitivno i zauvek.

Hopefully science remains curious enough

Nadajmo se da će nauka ostati dovoljno radoznala

to look for

da traga

and humble enough to recognize

i dovoljno skromna da prizna

when we have found

kada se pronađe

the next outlier,

sledeće odstupanje,

sledeći izuzetak,

the next exception,

which, like Jupiter's moons,

koji nas, poput Jupiterovih satelita,

teaches us what we don't actually know.

uče onome što zapravo ne znamo.

Napraviću digresiju ovde za trenutak.

We're going to change gears here for a second.

The caduceus, or the symbol of medicine,

Kaducej, simbol medicine,

means a lot of different things to different people,

ne predstavlja isto svim ljudima,

ali većina našeg javnog diskursa na temu medicine

but most of our public discourse on medicine

really turns it into an engineering problem.

to u stvari pretvara u inženjerski problem.

We have the hallways of Congress,

Imamo holove Kongresa

i direktorske kancelarije osiguravajućih kompanija koje smišljaju kako to da plate.

and the boardrooms of insurance companies that try to figure out how to pay for it.

The ethicists and epidemiologists

Etičari i epidemiolozi

try to figure out how best to distribute medicine,

razmišljaju kako najbolje da distribuiraju medicinu;

a bolnice i lekari su apsolutno opsednuti

and the hospitals and physicians are absolutely obsessed

with their protocols and checklists,

svojim protokolima i kontrolnim listama,

trying to figure out how best to safely apply medicine.

pokušavajući da shvate kako najbolje da primene medicinu.

These are all good things.

Sve su ovo dobre stvari.

However, they also all assume

Međutim, oni takođe pretpostavljaju,

at some level

na nekom nivou,

that the textbook of medicine is closed.

da je udžbenik medicine zatvoren.

Počinjemo da merimo kvalitet zdravstvene nege

We start to measure the quality of our health care

by how quickly we can access it.

po tome koiiko brzo joj pristupamo.

It doesn't surprise me that in this climate,

Ne iznenađuje me što u takvoj atmosferi

many of our institutions for the provision of health care

mnoge institucije za pružanje zdravstvene nege

start to look a heck of a lot like Jiffy Lube.

počinju baš da podsećaju na automehaničarsku radnju.

(Laughter)

(Smeh)

The only problem is that when I graduated from medical school,

Jedini problem je što, kada sam diplomirao na medicini,

I didn't get one of those little doohickeys

nisam dobio jednu od onih napravica

that your mechanic has to plug into your car

koje mehaničar mora da uključi u vaš auto

and find out exactly what's wrong with it,

i da sazna šta tačno nije u redu sa njim,

jer udžbenik medicine

because the textbook of medicine

is not closed.

nije gotov.

Medicine is science.

Medicina je nauka.

Medicine is knowledge in process.

Medicina je proces saznavanja.

We make an observation,

Prvo radimo opažanje,

we guess an explanation of that observation,

naslućujemo objašnjenje tog opažanja,

and then we make a prediction that we can test.

a onda pravimo predviđanje koje možemo testirati.

Now, the testing ground of most predictions in medicine

Predmet testiranja većine predviđanja u medicini

su ljudi.

is populations.

And you may remember from those boring days in biology class

Možda ćete se setiti sa onih dosadnih časova biologije

that populations tend to distribute

da populacija ima tendenciju da se raspodeljuje

around a mean

oko srednje vrednosti

as a Gaussian or a normal curve.

kao Gausova ili normalna kriva.

Therefore, in medicine,

Stoga, u medicini,

after we make a prediction from a guessed explanation,

nakon što izvedemo predviđanje iz naslućenog objašnjenja,

we test it in a population.

to testiramo na populaciji.

That means that what we know in medicine,

To znači da ono što znamo u medicini,

our knowledge and our know-how,

naše znanje i veštine,

comes from populations

dolazi iz populacije,

but extends only as far

ali dopire samo do te granice

as the next outlier,

dok ne naiđe na sledeće odstupanje,

the next exception,

sledeći izuzetak,

which, like Jupiter's moons,

koji će nas, poput Jupiterovih satelita,

will teach us what we don't actually know.

naučiti onome što zapravo ne znamo.

E, sad, ja sam hirurg

Now, I am a surgeon

who looks after patients with sarcoma.

koji brine o pacijentima sa sarkomom.

Sarcoma is a very rare form of cancer.

Sarkom je veoma redak oblik raka.

It's the cancer of flesh and bones.

To je rak mesa i kostiju.

And I would tell you that every one of my patients is an outlier,

I reći ću vam da je svaki moj pacijent odstupanje,

is an exception.

izuzetak.

Ne postoji nijedna operacija koju sam izveo na obolelom od sarkoma

There is no surgery I have ever performed for a sarcoma patient

that has ever been guided by a randomized controlled clinical trial,

koja se vodila nekim kliničkim ispitivanjem na nasumičnom uzorku,

what we consider the best kind of population-based evidence in medicine.

što smatramo najboljom vrstom dokaza na populaciji u medicini.

People talk about thinking outside the box,

Pričaju vam da razmišljate izvan kutije,

but we don't even have a box in sarcoma.

ali kod sarkoma mi čak nemamo ni tu kutiju.

What we do have as we take a bath in the uncertainty

Ono što imamo, dok koračamo u neizvesno,

and unknowns and exceptions and outliers that surround us in sarcoma

nepoznato, izuzetke i odstupanja koja nas okružuju kod sarkoma

je lak pristup onome što mislim da su dve najvažnije vrednosti

is easy access to what I think are those two most important values

for any science:

za nauku:

poniznost i radoznalost.

humility and curiosity.

Jer ako sam ponizan i radoznao,

Because if I am humble and curious,

when a patient asks me a question,

kada mi pacijent postavi pitanje,

and I don't know the answer,

i ja ne znam odgovor,

I'll ask a colleague

pitaću nekog kolegu,

koji je imao sličnog, a opet jedinstvenog pacijenta sa sarkomom.

who may have a similar albeit distinct patient with sarcoma.

We'll even establish international collaborations.

Čak ćemo uspostaviti međunarodnu saradnju.

Those patients will start to talk to each other through chat rooms

Ovi pacijenti će početi da komuniciraju putem pričaonica na internetu

i grupa za podršku.

and support groups.

It's through this kind of humbly curious communication

Kroz ovakvu vrstu ponizne i radoznale komunikacije

that we begin to try and learn new things.

krećemo sa pokušajima da saznamo nove stvari.

As an example, this is a patient of mine

Primera radi, ovo je jedan moj pacijent

who had a cancer near his knee.

koji je imao kancer blizu kolena.

Because of humbly curious communication

Zbog ponizno radoznale komunikacije

in international collaborations,

putem međunarodne saradnje,

saznali smo da možemo članak staviti u funkciju kolena

we have learned that we can repurpose the ankle to serve as the knee

when we have to remove the knee with the cancer.

kada moramo da odstranimo koleno zbog kancera.

He can then wear a prosthetic and run and jump and play.

On onda može nositi protezu, trčati, skakati i igrati se.

This opportunity was available to him

Ova mogućnost mu se pružila

because of international collaborations.

zbog međunarodne saradnje.

It was desirable to him

Bila je dobra za njega

because he had contacted other patients who had experienced it.

jer je kontaktirao sa drugim obolelima koji su prošli kroz to.

And so exceptions and outliers in medicine

Tako nas izuzeci i odstupanja u medicini

uče onome što ne znamo, ali i nas i uče novom načinu razmišljanja.

teach us what we don't know, but also lead us to new thinking.

Što je veoma važno,

Now, very importantly,

all the new thinking that outliers and exceptions lead us to in medicine

sva to novo razmišljanja kome nas vode odstupanja i izuzeci u medicini

does not only apply to the outliers and exceptions.

ne važe samo za odstupanja i izuzetke.

It is not that we only learn from sarcoma patients

Ne učimo mi samo od pacijenata sa sarkomom

kako da tretiramo obolele od sarkoma.

ways to manage sarcoma patients.

Sometimes, the outliers

Katkad, odstupanja

i izuzeci

and the exceptions

teach us things that matter quite a lot to the general population.

nas uče stvarima koje dosta znače opštoj populaciji.

Like a tree standing outside a forest,

Poput stabala izvan šume,

the outliers and the exceptions draw our attention

odstupanja i izuzeci nam privlače pažnju

and lead us into a much greater sense of perhaps what a tree is.

i vode nas ka možda mnogo boljoj spoznaji o tome šta je to stablo.

We often talk about losing the forests for the trees,

Često govorimo o žrtvovanju šume zbog stabala,

ali neko takođe izgubi stablo

but one also loses a tree

u svoj toj šumi.

within a forest.

Ali ono drvo koje stoji izdvojeno

But the tree that stands out by itself

makes those relationships that define a tree,

čini da ove veze koje određuju drvo,

the relationships between trunk and roots and branches,

veze između stabla, korenja i grana,

much more apparent.

budu mnogo vidljivije.

Even if that tree is crooked

Čak i ako je to stablo iskrivljeno

ili čak i ako to stablo ima veoma neobičnu vezu

or even if that tree has very unusual relationships

između stabla, korena i grana,

between trunk and roots and branches,

it nonetheless draws our attention

ono svakako privlači našu pažnju

i dozvoljava nam da izvršimo posmatranja

and allows us to make observations

i to posle primenimo na opštu populaciju.

that we can then test in the general population.

Rekao sam vam da je sarkom redak.

I told you that sarcomas are rare.

Čini oko jedan posto svih kancera.

They make up about one percent of all cancers.

You also probably know that cancer is considered a genetic disease.

Verovatno znate da se kancer smatra genetskom bolešću.

By genetic disease we mean that cancer is caused by oncogenes

Pod genetskom bolešću mislimo da kancer izazivaju onkogeni

koji se aktiviraju kod kancera

that are turned on in cancer

and tumor suppressor genes that are turned off to cause cancer.

i tumor supresorski geni koji se isključuju kako bi nastao kancer.

Možda mislite da smo naučili o onkogenima

You might think that we learned about oncogenes

and tumor suppressor genes from common cancers

i tumor supresorskim genima iz uobičajenih kancera

like breast cancer and prostate cancer

poput raka dojke ili prostate

and lung cancer,

i raka pluća,

but you'd be wrong.

ali pogrešili biste.

O onkogenima i tumor supresorskim genima naučili smo

We learned about oncogenes and tumor suppressor genes

for the first time

po prvi put

iz tog sitnog jednog procenta kancera koji se zove sarkom.

in that itty-bitty little one percent of cancers called sarcoma.

In 1966, Peyton Rous got the Nobel Prize

Pejton Rus je 1966. dobio Nobelovu nagradu

for realizing that chickens

za saznanje da pilići

had a transmissible form of sarcoma.

imaju prenosivi oblik sarkoma.

Thirty years later, Harold Varmus and Mike Bishop discovered

Trideset godina kasnije, Harold Vermus i Majk Bišop otkrivaju

koji je to prenosivi element bio.

what that transmissible element was.

It was a virus

Bio je to virus

carrying a gene,

koji prenosi jedan gen,

the src oncogene.

src onkogen.

Now, I will not tell you that src is the most important oncogene.

Neću vam reći da je src najvažniji onkogen.

I will not tell you

Neću vam reći da se src onkogen

that src is the most frequently turned on oncogene in all of cancer.

koji se najčešće aktivira kod svih kancera.

But it was the first oncogene.

Međutim, to je bio prvi onkogen.

The exception, the outlier

Taj izuzetak i to odstupanje

drew our attention and led us to something

nam je privuklo pažnju i odvelo nas ka nečemu

that taught us very important things about the rest of biology.

što nas je naučilo veoma važnim stvarima o ostatku biologije.

Now, TP53 is the most important tumor suppressor gene.

TP53 je najvažniji tumor supresorski gen.

To je tumor supresorski gen koji se najčešće deaktivira

It is the most frequently turned off tumor suppressor gene

in almost every kind of cancer.

u skoro svakoj vrsti kancera.

But we didn't learn about it from common cancers.

No, o tome nismo naučili iz uobičajenih kancera.

We learned about it when doctors Li and Fraumeni

O tome smo naučili kada su lekari Li i Fraumeni

posmatrali porodice

were looking at families,

and they realized that these families

i shvatili da u ovim porodicama

had way too many sarcomas.

ima previše slučajeva sarkoma.

I told you that sarcoma is rare.

Rekao sam vam da je sarkom redak.

Remember that a one in a million diagnosis,

Upamtite da je jedna od milion dijagnoza,

if it happens twice in one family,

ako se desi dva puta u jednoj porodici,

previše česta u toj porodici.

is way too common in that family.

The very fact that these are rare

Sama činjenica da se ovo retko dešava

draws our attention

privlači našu pažnju

and leads us to new kinds of thinking.

i usmerava nas na novi način razmišljanja.

Now, many of you may say,

Mnogi od vas mogu reći,

and may rightly say,

i to sa punim pravom,

that yeah, Kevin, that's great,

da, Kevine, sve je to super,

but you're not talking about a bird's wing.

ali ne pričaš o krilima ptica.

You're not talking about moons floating around some planet Jupiter.

Ne pričaš o satelitima koji kruže oko tamo neke planete Jupiter.

This is a person.

Ovo je osoba.

Ovo odstupanje, ovaj izuzetak, može dovesti do napretka u nauci,

This outlier, this exception, may lead to the advancement of science,

but this is a person.

ali ovo je osoba.

And all I can say

I sve što mogu reći

is that I know that all too well.

je da sve to previše dobro znam.

I have conversations with these patients with rare and deadly diseases.

Razgovarao sam sa pacijentima obolelim od retkih i smrtonosnih bolesti.

I write about these conversations.

Pišem o ovim razgovorima.

These conversations are terribly fraught.

Ovi razgovori unose strašan nemir.

Unose nemir sa užasnim frazama

They're fraught with horrible phrases

like "I have bad news" or "There's nothing more we can do."

poput „Imam loše vesti za vas“ ili „Ne možemo ništa više da uradimo.“

Sometimes these conversations turn on a single word:

Ponekad se ovi razgovori svedu na jednu jedinu reč:

"terminal."

„neizlečivo“.

Silence can also be rather uncomfortable.

Tišina takođe može biti prilično nelagodna.

Where the blanks are in medicine

Prazna polja u medicini

can be just as important

mogu biti isto toliko važna,

as the words that we use in these conversations.

koliko i reči pri ovakvim razgovorima.

Šta su nepoznate?

What are the unknowns?

What are the experiments that are being done?

Kakvi su eksperimenti koji se izvode?

Do this little exercise with me.

Uradimo zajedno ovu malu vežbu.

Up there on the screen, you see this phrase, "no where."

Gore na ekranu, vidite frazu „ni gde“.

Notice where the blank is.

Pogledajte prazno polje.

If we move that blank one space over

Ako prazno polje pomerimo za jedno mesto,

"no where"

„ne gde“

becomes "now here,"

postaje „sada ovde“,

the exact opposite meaning,

dobija potpuno suprotno značenje,

just by shifting the blank one space over.

samo pomeranjem praznog polja za jedno mesto.

I'll never forget the night

Nikad neću zaboraviti noć

that I walked into one of my patients' rooms.

kada sam ušao u sobu jednog pacijenta.

I had been operating long that day

Dugo sam bio u operacionoj sali,

but I still wanted to come and see him.

ali sam ipak želeo da ga obiđem.

Bio je to dečak kome sam dijagnostikovao rak kostiju nešto ranije.

He was a boy I had diagnosed with a bone cancer a few days before.

He and his mother had been meeting with the chemotherapy doctors

On i njegova majka su se sastali sa doktorima za hemoterapiju

earlier that day,

prethodno tog dana,

i primili su ga u bolnicu kako bi počeo sa hemoterapijama.

and he had been admitted to the hospital to begin chemotherapy.

Bila je skoro ponoć kada sam ušao u sobu.

It was almost midnight when I got to his room.

He was asleep, but I found his mother

Spavao je, ali zatekao sam mu majku

reading by flashlight

kako čita uz baterijsku lampu

pored njegovog kreveta.

next to his bed.

She came out in the hall to chat with me for a few minutes.

Izašla je u hodnik da popriča sa mnom na nekoliko minuta.

It turned out that what she had been reading

Ispostavilo se da je ono što je čitala

bio protokol koji su im lekari za hemoterapiju dali tog dana.

was the protocol that the chemotherapy doctors

had given her that day.

She had memorized it.

Naučila ga je napamet.

She said, "Dr. Jones, you told me

Rekla je: „Dr Džounse, rekli ste mi

that we don't always win

da ne pobeđujemo uvek

with this type of cancer,

ovu vrstu kancera,

but I've been studying this protocol, and I think I can do it.

ali proučavala sam ovaj protokol, i smatram da mogu.

I think I can comply with these very difficult treatments.

Mislim da mogu da se izborim sa ovim vrlo teškim tretmanima.

I'm going to quit my job. I'm going to move in with my parents.

Ostaviću posao. Preseliću se kod roditelja.

I'm going to keep my baby safe."

Sve ću uraditi da spasem mog mališu.“

I didn't tell her.

Nisam joj rekao.

I didn't stop to correct her thinking.

Nisam probao da je razuverim.

She was trusting in a protocol

Ona je imala vere u protokol

that even if complied with,

koji, čak i ako ga se pridržava,

wouldn't necessarily save her son.

ne znači da bi spasio njenog sina.

I didn't tell her.

Nisam joj rekao.

I didn't fill in that blank.

Nisam popunio prazno polje.

No, godinu i po dana kasnije

But a year and a half later

njen dečak je ipak preminuo od raka.

her boy nonetheless died of his cancer.

Should I have told her?

Je li trebalo da joj kažem?

Now, many of you may say, "So what?

Mnogi od vas će možda reći: „Pa šta?

I don't have sarcoma.

Nemam sarkom.

No one in my family has sarcoma.

Niko u mojoj porodici nema sarkom.

And this is all fine and well,

I sve ovo je lepo i korisno,

but it probably doesn't matter in my life."

ali mi verovatno neće trebati u životu.“

I verovatno ste u pravu.

And you're probably right.

Sarcoma may not matter a whole lot in your life.

Sarkom može uopšte da vas se ne tiče.

Ali ono gde su prazna polja u medicini

But where the blanks are in medicine

does matter in your life.

može veoma da vas se tiče.

I didn't tell you one dirty little secret.

Nisam vam otkrio jednu malu bezobraznu tajnu.

I told you that in medicine, we test predictions in populations,

Rekao sam vam da u medicini testiramo predviđanja na populaciji,

but I didn't tell you,

ali vam nisam rekao,

and so often medicine never tells you

i vrlo često vam medicina ne kaže,

that every time an individual

da svaki put kada se pojedinac

encounters medicine,

susretne sa medicinom,

even if that individual is firmly embedded in the general population,

čak i ako je taj pojedinac deo opšte populacije,

neither the individual nor the physician knows

ni ta osoba ni lekar ne znaju

where in that population the individual will land.

gde će u toj populaciji taj pojedinac zauzeti mesto.

Stoga, svaki susret sa medicinom

Therefore, every encounter with medicine

is an experiment.

je jedan eksperiment.

You will be a subject

Bićete predmet eksperimenta.

in an experiment.

And the outcome will be either a better or a worse result for you.

A ishod će biti rezultat koji će vam ići na ruku ili ne.

As long as medicine works well,

Sve dok medicina funkcioniše dobro,

we're fine with fast service,

u redu su nam brze usluge,

bravado, brimmingly confident conversations.

razmetanje hrabrošću, razgovori prepuni samopouzdanja.

But when things don't work well,

No, kada stvari ne teku dobro,

sometimes we want something different.

ponekad nam je potrebno nešto drugo.

A colleague of mine removed a tumor from a patient's limb.

Jedan moj kolega uklonio je tumor sa uda pacijentkinje.

He was concerned about this tumor.

Brinuo ga je ovaj tumor.

In our physician conferences, he talked about his concern

Na našim kolegijumima, pričao nam je kako ga brine

that this was a type of tumor

da je ovo vrsta tumora

that had a high risk for coming back in the same limb.

za koju postoji veliki rizik da se vrati na istom udu.

But his conversations with the patient

Međutim, njegovi razgovori sa pacijentkinjom

were exactly what a patient might want:

bili su baš onakvi kakve je pacijentkinja želela:

brimming with confidence.

puni samopouzdanja.

Govorio je: „Sve sam odstranio, dobro vam je i možete da idete.“

He said, "I got it all and you're good to go."

Ona i suprug su bili oduševljeni.

She and her husband were thrilled.

They went out, celebrated, fancy dinner, opened a bottle of champagne.

Izašli su i proslavili uz raskošnu večeru, otvorili bocu šampanjca.

Jedini problem je bio što je nakon par nedelja

The only problem was a few weeks later,

she started to notice another nodule in the same area.

počela da primećuje drugi čvorić na istom mestu.

It turned out he hadn't gotten it all, and she wasn't good to go.

Ispostavilo se da nije sve odstranio i nije bila dobro.

But what happened at this juncture absolutely fascinates me.

No, ono što se dogodilo tad me je apsolutno fasciniralo.

My colleague came to me and said,

Kolega je došao do mene i rekao:

"Kevin, would you mind looking after this patient for me?"

„Kevine, možeš li da pogledaš moju pacijentkinju umesto mene?“

I said, "Why, you know the right thing to do as well as I do.

Rekao sam: „Pa, znaš da uradiš pravu stvar isto kao i ja.

You haven't done anything wrong."

Nisi nigde pogrešio.“

Odgovorio je: „Molim te, samo pogledaj ovu pacijentkinju umesto mene.“

He said, "Please, just look after this patient for me."

He was embarrassed --

Bilo ga je sramota -

not by what he had done,

ne zbog onog što je uradio,

već zbog razgovora koji je vodio,

but by the conversation that he had had,

by the overconfidence.

zbog previše samopouzdanja.

So I performed a much more invasive surgery

Tako sam ja izveo mnogo invazivniju operaciju

and had a very different conversation with the patient afterwards.

i potpuno drugačije razgovarao sa pacijentkinjom nakon toga.

I said, "Most likely I've gotten it all

Rekao sam: „Najverovatnije sam sve odstranio

and you're most likely good to go,

i najverovatnije će vam biti dobro,

but this is the experiment that we're doing.

ali ovo što radimo je eksperiment.

Na to ćete morati da pazite.

This is what you're going to watch for.

Na to ću ja morati da pazim.

This is what I'm going to watch for.

I zajedno ćemo raditi na tome da otkrijemo da li ćemo ovom operacijom

And we're going to work together to find out if this surgery will work

to get rid of your cancer."

moći da pobedimo kancer."

I can guarantee you, she and her husband

Garantujem vam da ona i suprug

did not crack another bottle of champagne after talking to me.

nisu otvorili flašu šampanjca posle razgovora sa mnom.

But she was now a scientist,

No, ona je sada bila naučnik,

not only a subject in her experiment.

ne samo predmet eksperimenta.

And so I encourage you

Zato vas ohrabrujem

to seek humility and curiosity

da tražite poniznost i radoznalost

kod svog lekara.

in your physicians.

Almost 20 billion times each year,

Skoro 20 milijardi puta svake godine,

a person walks into a doctor's office,

osoba uđe kod lekara u ordinaciju,

and that person becomes a patient.

i ta osoba postane pacijent.

You or someone you love will be that patient sometime very soon.

Vi ili neko koga volite će biti taj pacijent uskoro.

How will you talk to your doctors?

Kako ćete pričati sa lekarima?

What will you tell them?

Šta ćete im reći?

What will they tell you?

Šta će oni reći vama?

They cannot tell you

Ne mogu vam reći

what they do not know,

ono što ne znaju,

but they can tell you when they don't know

ali mogu vam reći kada nešto ne znaju

if only you'll ask.

ako ih samo pitate.

I zato vas molim, uključite se u razgovor.

So please, join the conversation.

Thank you.

Hvala vam.

(Applause)

(Aplauz)