Many years ago, I was a doctor in intensive care.
I got a lot of complicated cases.
Very often, the patients had high blood pressure.
I tried as fast as I could to help them, and would ask them:
"OK, quickly,what meds do you take?
What helps you?"
Most of my patients would say:
"I take some pills, two,
a white round one in the morning, and a little blue one in the evening."
I'd say: "Fine. Their names? Dosage? What are they? Quickly!"
The patients would say: "Mm, names - don't know, dosage - don't know.
A health clinic doctor wrote the prescription.
I'm not a doctor, you're the doctor. Please sort it out, it's your job."
I felt frustrated and powerless,
because helping a patient who doesn't know
is a hundred times more complicated than a patient who does.
I wondered for a long time
why they don't know the names and dosages of their meds.
They don't even remember what the packaging looks like.
It seems to me that it is because my patients -
not all, but many of them -
were sure that responsibility for their health
lay with the healthcare system, and not with them.
But I am going to tell you a little secret:
responsibility for health is the domain of everyone.
It is the responsibility of the healthcare system
that there are hospitals,
that they are lit,
that they are equipped with medical equipment,
that new doctors qualify from medical faculties each year,
and that pharmacies are properly stocked.
The healthcare system cannot provide everyone with a personal physician
who will wake them up in the morning and ask them:
"So, how's your blood pressure?
Perhaps a pill?
Maybe we should do an ECG?
I've got the machine with me."
That is why everyone has to consider
whether they can take responsibility for their own health.
And how do you take responsibility for your own health?
It's responsibility for your own body.
And responsibility begins with knowledge.
If you buy some kind of electrical appliance,
I certainly hope that you read the instruction manual.
So it is with the body.
It is important to learn two things, anatomy and physiology,
to understand how our body works.
Anatomy is knowledge about which organs comprise the human body.
Tell me please, how many of you know where to find the iron at your house.
Maybe there's a few men who never use this thing who don't know.
Now tell me who knows where the spleen is in your body.
Hold on!
Don't be so sure!
Who thinks that the spleen is located in the middle?
Who thinks that the spleen is on the right?
Who thinks that it is on the left?
OK, almost 100% of people know where to find the iron,
even though we don't use it every day.
But the spleen is located on the left.
As far as I saw, only half of you know where it is located.
And the spleen serves us every single minute of our lives.
So the very first thing in taking responsibility for your health
is to simply learn which organs reside within my body.
As soon as this area of knowledge is yours,
you should move on to physiology.
This area of knowledge tells you how these organs work,
and how to understand that something is wrong.
I asked some of my friends who drive
if they know what the signs are
that there's something wrong with an internal combustion engine.
Everyone said without fail:
"So, the engine probably starts to act up,
it starts to burn too much oil,
it starts to run at too high a temperature,
or there are some strange knocking noises."
I asked them: "What can you do to prevent this from happening?"
All drivers said: "First, you should check the oil,
keep an eye on the water,
and you have to have it pass the national inspection test."
But the same friends of mine
were not so able to answer another question so well:
"So, what are the symptoms of a heart attack,
the most terrifying malfunction of our own engine, the heart?
Do you know?"
No one could tell me
that the symptoms of a heart attack
are the pain, burning in the chest,
pain on the left,
pain radiating down the left arm,
to the left shoulder or left jaw,
shortness of breath, pallor.
Almost no one could list all the symptoms.
My friends could also not tell me that keeping a check on one's heart
means finding out what your blood pressure is regularly,
checking your cholesterol level regularly,
a regular appointment with a cardiologist,
an ECG, which should be got by everyone at least once in their life,
and an ultrasound of the heart needs to be done.
These are the basic things that you should know
about the physiology of your heart.
But you should also know about how other organs work,
and how to keep a check on their health.
I hope today you will be able to read
something about at least one organ
besides the heart.
If you have mastered anatomy and physiology and you are healthy,
then you may stop there and relax.
If you have any disease,
it is very important to know what it is called
and what kind of disease it is,
why it started, and how to treat it.
Although angiospasm and angina have similar names,
there is a huge difference between them:
in what brings them about, how to treat them, and what you can do.
Recently I have been visiting my gran in Mozyr.
She has atrial fibrillation.
It is a disease in which the heart beat is irregular.
To treat this disease,
it's important to take medicines
that suppress abnormal rhythms of the heart,
to prevent a serious irregular heart beat from developing
that can lead to death.
But, I arrive at Gran's,
I ask her, "Gran, how's the treatment going?
How are you feeling?"
She says, "I take everything, all the meds you said.
You explained it's a very serious disease,
atrial fibrillation.
I understood perfectly."
I ask her, "Where are the pills?"
Gran says, "They're on top of the fridge."
I see that there's still a lot of pills remaining in the packet.
It doesn't add up.
They should have all gone by now.
So I ask her, "Gran, have you taken your pills today?"
It's a very important question for a doctor
because between "I take my pills" and "I took them today",
there is a huge difference.
So, Gran says, "Well, what day is it today?
It's Saturday, it's the weekend,
everyone's having a rest,
and I have to take a rest from the treatment."
If my gran had spent a little more time
and at least read the instructions for the pills she's taking,
she would have known
that to suddenly stop taking the pills that help her heart rhythm
is just as bad as receiving no treatment at all.
It can lead to heart failure.
I'm not saying that you all have to become doctors
and spend the next six years
studying anatomy and physiology and other great subjects
at the Belarusian State Medical University
around the corner.
I think that you don't need those six years today.
Sufficient knowledge abounds.
You can learn about your body, your health,
from popular science books, from YouTube.
There are nice programs about health on every major TV channel.
You can just sit and watch them and learn a lot.
You can watch TED talks.
It is very easy to keep a check on your health today.
My grandfather used to go to the health clinic
to get his blood pressure checked.
Today, anyone can buy a blood pressure monitor at the pharmacist's
and check their blood pressure a hundred times a day.
Tell me, who has a smart watch or a fitness tracker?
A lot of you.
Did you know that a smart watch and a fitness tracker
can check if your heart rate is normal,
if you sleep enough, if you walk enough,
to be healthy?
Technology today really helps us to be responsible for our own health.
For instance, there are many apps for mobile phones
that will do all the work for you, that will help you to become healthy.
I work on an app called Flo.
We work on women's health
and we do exactly what I've told you about.
We tell women about their body.
We did a survey.
Around 40% of women around the world who use our app
have no idea what ovulation is.
Ovulation is the day
when there's the greatest chance of getting pregnant.
How can you take charge of your life,
build a career, and plan vacations,
if you don't know the most important thing about your body?
You're only taking half control of your life.
Mobile apps like Flo can also warn you of existing health problems.
For example, our team has learned how to detect the symptoms
of polycystic ovary syndrome,
and warn a woman that she has a problem, so that she can go to the doctor in time.
Technology helps us a lot.
But technology is not everything.
I have a dream:
that no patient comes to the doctor
with only time to say,
"I've five minutes, my knees hurt.
Please give me something for it,
and I'm gone."
I dream of a patient who can think, who is aware,
who can engage in dialogue with the doctor,
who's able to say to the doctor,
"You know, my knees hurt.
At first, I thought it might be an old football injury.
but then I noticed that they hurt more in the morning.
And I've had a bit of a temperature the past six months.
I've lost weight.
Weakness is wearing at me.
I remember my grandmother also had a problem with her knees,
and it was diagnosed as rheumatoid arthritis.
I think it's something that needs to be sorted out.
These are two completely different cases.
You can't imagine what a pleasure it is
to treat an aware, responsible patient.
When such a patient comes to an appointment,
and we start a conversation,
the doctor freely stops writing, and lifts his eyes.
And you should see what eyes the doctor has!
They are indeed eyes full of happiness.
He is happy that he has someone he can connect with.
Because it is a pleasure to treat an aware and responsible patient.
It's like playing tennis against a wall or against a professional player.
When playing with a partner who plays really well,
even if you slam the ball really hard,
they will return it, keeping pace with you.
Similarly with treatment.
If the doctor prescribes treatment to an aware patient,
but, God forbid, something goes wrong, and there are side effects,
this patient will notice the problem in time
and inform the doctor without angrily blaming him
because he understands his share of responsibility
in the treatment process.
I dream of patients becoming more responsible for their health.
Not because I'd like to free doctors of work,
and not because we doctors are workshy;
but because I sincerely believe
that working on a health action plan together -
a caring, competent doctor and an aware, responsible patient -
is way more effective.
Thank you.
(Applause)