1 99:59:59,999 --> 99:59:59,999 10 years ago, 2 99:59:59,999 --> 99:59:59,999 I got a phone call that changed my life. 3 99:59:59,999 --> 99:59:59,999 At the time, I was cardiologist at UCLA, 4 99:59:59,999 --> 99:59:59,999 specializing in cardiac imaging techniques. 5 99:59:59,999 --> 99:59:59,999 The call came from a veterinarian at the Los Angeles Zoo. 6 99:59:59,999 --> 99:59:59,999 An elderly female chimpanzee 7 99:59:59,999 --> 99:59:59,999 had woken up with a facial droop 8 99:59:59,999 --> 99:59:59,999 and the veterinarians were worried that she had had a stroke. 9 99:59:59,999 --> 99:59:59,999 They asked if I could come to the zoo 10 99:59:59,999 --> 99:59:59,999 and image the animal's heart 11 99:59:59,999 --> 99:59:59,999 to look for a possible cardiac cause. 12 99:59:59,999 --> 99:59:59,999 Now, to be clear, North American 13 99:59:59,999 --> 99:59:59,999 North American zoos are staffed 14 99:59:59,999 --> 99:59:59,999 by highly qualified, board-certified veterinarians 15 99:59:59,999 --> 99:59:59,999 who take outstanding care of animal patients. 16 99:59:59,999 --> 99:59:59,999 But occasionally, they do reach into the human medical community, 17 99:59:59,999 --> 99:59:59,999 particularly for some speciality consultation, 18 99:59:59,999 --> 99:59:59,999 and I was one of the lucky physicians who was invited to help. 19 99:59:59,999 --> 99:59:59,999 I had a chance to rule out a stroke in this chimpanzee 20 99:59:59,999 --> 99:59:59,999 and make sure that this gorilla didn't have a torn aorta, 21 99:59:59,999 --> 99:59:59,999 evaluate this macaw for a heart murmur, 22 99:59:59,999 --> 99:59:59,999 make sure that this californian sea lion's paracardium wasn't inflammed, 23 99:59:59,999 --> 99:59:59,999 and in this picture, I'm listening to the heart of a lion 24 99:59:59,999 --> 99:59:59,999 after a lifesaving collaborative procedure with veteranarians and physicians. 25 99:59:59,999 --> 99:59:59,999 We drained 700 CCs of fluid from the sack 26 99:59:59,999 --> 99:59:59,999 in which this lion's heart was contained. 27 99:59:59,999 --> 99:59:59,999 And this procedure, which I have done on many human patients, 28 99:59:59,999 --> 99:59:59,999 was identical with the exception of that paw and that tail. 29 99:59:59,999 --> 99:59:59,999 Now most of the time, I was working at the UCLA Medical Center 30 99:59:59,999 --> 99:59:59,999 with physicians, discussing symptoms and diagnoses and treatments 31 99:59:59,999 --> 99:59:59,999 for my human patients. 32 99:59:59,999 --> 99:59:59,999 But some of the time, I was working at the Los Angeles Zoo 33 99:59:59,999 --> 99:59:59,999 i was working at the Los Angeles Zoo with veteranarians 34 99:59:59,999 --> 99:59:59,999 discussing symptoms, diagnoses and treatments 35 99:59:59,999 --> 99:59:59,999 for their animal patients. 36 99:59:59,999 --> 99:59:59,999 And occasionally, on the very same day, 37 99:59:59,999 --> 99:59:59,999 I went on rounds at the UCLA Medical Center 38 99:59:59,999 --> 99:59:59,999 and at the Los Angeles Zoo, 39 99:59:59,999 --> 99:59:59,999 and here's what started coming into very clear focus for me. 40 99:59:59,999 --> 99:59:59,999 Physicians and veterinarians were essentially taking care 41 99:59:59,999 --> 99:59:59,999 of the same disorders in :their animal and human patients 42 99:59:59,999 --> 99:59:59,999 congestive heart failure, brain tumors, 43 99:59:59,999 --> 99:59:59,999 lukemia, diabetes, arthritis, ALS, breast cancer, 44 99:59:59,999 --> 99:59:59,999 even psychiatric symptoms like depression, 45 99:59:59,999 --> 99:59:59,999 anxiety, compulsions, eating disorders and self injury. 46 99:59:59,999 --> 99:59:59,999 Now, I've got a confession to make. 47 99:59:59,999 --> 99:59:59,999 Even though I studied comparative physiology and evolutionary biology, 48 99:59:59,999 --> 99:59:59,999 as an undergrad, 49 99:59:59,999 --> 99:59:59,999 I had even written my senior thesis on darwinian theory, 50 99:59:59,999 --> 99:59:59,999 learning about the significant overlap 51 99:59:59,999 --> 99:59:59,999 between the disorders of animals and humans. 52 99:59:59,999 --> 99:59:59,999 It came as a much needed wake up call for me. 53 99:59:59,999 --> 99:59:59,999 So I started wondering, with all of these overlaps, 54 99:59:59,999 --> 99:59:59,999 how was it that I had never thought to ask a veterinarian, 55 99:59:59,999 --> 99:59:59,999 or consult the veterinary literature, 56 99:59:59,999 --> 99:59:59,999 for insights into one of my human patients? 57 99:59:59,999 --> 99:59:59,999 Why had I never, nor had any of my physician friends and colleagues who I asked, 58 99:59:59,999 --> 99:59:59,999 ever attended a veterinary conference? 59 99:59:59,999 --> 99:59:59,999 For that matter, why was any of this a surprise? 60 99:59:59,999 --> 99:59:59,999 I mean look, every single physician accepts some biological connection 61 99:59:59,999 --> 99:59:59,999 between animals and humans. 62 99:59:59,999 --> 99:59:59,999 Every medication that we prescribe or that we've taken ourselves 63 99:59:59,999 --> 99:59:59,999 or we've given to our families 64 99:59:59,999 --> 99:59:59,999 has first been tested on an animal. 65 99:59:59,999 --> 99:59:59,999 But there's something very different 66 99:59:59,999 --> 99:59:59,999 about giving an animal a medication or a human disease 67 99:59:59,999 --> 99:59:59,999 and the animal developing congestive heart failure 68 99:59:59,999 --> 99:59:59,999 or diabetes or breats cancer on their own. 69 99:59:59,999 --> 99:59:59,999 Now maybe some of the surprise 70 99:59:59,999 --> 99:59:59,999 comes from the increasing separation in our world 71 99:59:59,999 --> 99:59:59,999 between the urban and the non-urban. 72 99:59:59,999 --> 99:59:59,999 You know, we hear about these city kids who 73 99:59:59,999 --> 99:59:59,999 think that wool grows on trees 74 99:59:59,999 --> 99:59:59,999 or that cheese comes from a plant. 75 99:59:59,999 --> 99:59:59,999 Well today's human hospitals 76 99:59:59,999 --> 99:59:59,999 are turning into increasingly 77 99:59:59,999 --> 99:59:59,999 these gleaming cathedrals of technology. 78 99:59:59,999 --> 99:59:59,999 And this creates a psychological distance between the human patients 79 99:59:59,999 --> 99:59:59,999 who are being treated there 80 99:59:59,999 --> 99:59:59,999 and animal patients who are living in oceans 81 99:59:59,999 --> 99:59:59,999 and farms and jungles. 82 99:59:59,999 --> 99:59:59,999 But I think there's an even deeper reason. 83 99:59:59,999 --> 99:59:59,999 Physicians and scientists, we accept, intellectually that our species 84 99:59:59,999 --> 99:59:59,999 homo sapien, is merely one species 85 99:59:59,999 --> 99:59:59,999 no more unique or special than any other. 86 99:59:59,999 --> 99:59:59,999 But in our hearts, we don't completely believe that. 87 99:59:59,999 --> 99:59:59,999 I feel it myself when I'm listening to Motzart 88 99:59:59,999 --> 99:59:59,999 or looking at pictures of the Mars Rover on my MacBook. 89 99:59:59,999 --> 99:59:59,999 I feel that tug of human exceptionalism, 90 99:59:59,999 --> 99:59:59,999 even as I recognize the scientifically isolating cost 91 99:59:59,999 --> 99:59:59,999 of seeing ourselves as a superior species apart. 92 99:59:59,999 --> 99:59:59,999 Well, I'm trying these days. 93 99:59:59,999 --> 99:59:59,999 When I see a human patient now, I always ask, 94 99:59:59,999 --> 99:59:59,999 "what do the animal doctors know about this problem that I don't know?" 95 99:59:59,999 --> 99:59:59,999 and "Might I be taking better care of my human patient 96 99:59:59,999 --> 99:59:59,999 if I saw them as a human animal patient?" 97 99:59:59,999 --> 99:59:59,999 Here are a few examples of the kind of exciting connections 98 99:59:59,999 --> 99:59:59,999 that this kind of t thinking has led me to: 99 99:59:59,999 --> 99:59:59,999 fear-induced heart failure. 100 99:59:59,999 --> 99:59:59,999 Around the year 2000, 101 99:59:59,999 --> 99:59:59,999 human cardiologists "discovered" emotionally induced heart failure. 102 99:59:59,999 --> 99:59:59,999 It was described in a gambling father who had lost his life's savings 103 99:59:59,999 --> 99:59:59,999 with the roll of a dice, 104 99:59:59,999 --> 99:59:59,999 in a bride who had been left at the alter. 105 99:59:59,999 --> 99:59:59,999 But it turns out that this "new human diagnosis" 106 99:59:59,999 --> 99:59:59,999 was neither new, nor was it uniquely human. 107 99:59:59,999 --> 99:59:59,999 Veterinarians had been diagnosing, treating, and even preventing 108 99:59:59,999 --> 99:59:59,999 emotionally-induced symptoms in animals, 109 99:59:59,999 --> 99:59:59,999 ranging from monkeys to flamingos, to deer to rabbits, 110 99:59:59,999 --> 99:59:59,999 since the 1970s. 111 99:59:59,999 --> 99:59:59,999 How many human lives might have been saved 112 99:59:59,999 --> 99:59:59,999 if this veterinary knowledge had been put into the hands 113 99:59:59,999 --> 99:59:59,999 of ER docs and cardiologists? 114 99:59:59,999 --> 99:59:59,999 Self injury. 115 99:59:59,999 --> 99:59:59,999 Some human patients harm themselves. 116 99:59:59,999 --> 99:59:59,999 Some pluck out patches of hair. 117 99:59:59,999 --> 99:59:59,999 Others actually cut themselves. 118 99:59:59,999 --> 99:59:59,999 Some animal patients also harm themselves. 119 99:59:59,999 --> 99:59:59,999 There are birds that pluck out feathers. 120 99:59:59,999 --> 99:59:59,999 There are stallions that repetitively bite their flanks until they bleed. 121 99:59:59,999 --> 99:59:59,999 But veterinarians have very specific and very effective ways 122 99:59:59,999 --> 99:59:59,999 of treating and even preventing self-injury. 123 99:59:59,999 --> 99:59:59,999 In their self-injuring animals, 124 99:59:59,999 --> 99:59:59,999 shouldn't this veterinary knowledge be put into the hands 125 99:59:59,999 --> 99:59:59,999 of psychotherapists and parents and patients 126 99:59:59,999 --> 99:59:59,999 struggling with self-injury, 127 99:59:59,999 --> 99:59:59,999 post pardem depression and post pardem psychosis? 128 99:59:59,999 --> 99:59:59,999 Sometimes, soon after giving birth 129 99:59:59,999 --> 99:59:59,999 Some women become depressed, 130 99:59:59,999 --> 99:59:59,999 they become seriously depressed and sometimes psychotic. 131 99:59:59,999 --> 99:59:59,999 They may neglect their newborn, 132 99:59:59,999 --> 99:59:59,999 and in some extreme cases, 133 99:59:59,999 --> 99:59:59,999 even harm the child. 134 99:59:59,999 --> 99:59:59,999 Equine veteranarians also know that a mare, 135 99:59:59,999 --> 99:59:59,999 soon after giving birth, 136 99:59:59,999 --> 99:59:59,999 will neglect the foul, refusing to nurture it, 137 99:59:59,999 --> 99:59:59,999 and in some instances, kick the foul even to death. 138 99:59:59,999 --> 99:59:59,999 But veterinarians have divised 139 99:59:59,999 --> 99:59:59,999 an intervention to deal with this foul rejection syndrome 140 99:59:59,999 --> 99:59:59,999 that involves increasing oxytocin in the mare, 141 99:59:59,999 --> 99:59:59,999 oxytocin is the bonding hormone. 142 99:59:59,999 --> 99:59:59,999 And this leads to renewed interest 143 99:59:59,999 --> 99:59:59,999 on the part of the mare in her foul. 144 99:59:59,999 --> 99:59:59,999 Shouldn't this information 145 99:59:59,999 --> 99:59:59,999 be put into the hands of OBGYNs 146 99:59:59,999 --> 99:59:59,999 and family doctors and patients 147 99:59:59,999 --> 99:59:59,999 who are struggling with postpartum depression and psychosis? 148 99:59:59,999 --> 99:59:59,999 Well despite all of this promise, 149 99:59:59,999 --> 99:59:59,999 unfortunately, the gulf between our fields remains large. 150 99:59:59,999 --> 99:59:59,999 To explain it, I'm afraid I'm going to have to air 151 99:59:59,999 --> 99:59:59,999 some dirty laundry. 152 99:59:59,999 --> 99:59:59,999 Some physicians can be real snobs 153 99:59:59,999 --> 99:59:59,999 about doctors who are not MDs. 154 99:59:59,999 --> 99:59:59,999 I'm talking about dentists and optomitrists and psychologists 155 99:59:59,999 --> 99:59:59,999 and optomitrists and psychologists 156 99:59:59,999 --> 99:59:59,999 but maybe especially, animal doctors 157 99:59:59,999 --> 99:59:59,999 of course, most physicians 158 99:59:59,999 --> 99:59:59,999 don't realize that it's harder 159 99:59:59,999 --> 99:59:59,999 to get into vet school these days 160 99:59:59,999 --> 99:59:59,999 than medical school 161 99:59:59,999 --> 99:59:59,999 and that when we go to medical school, 162 99:59:59,999 --> 99:59:59,999 we learn everything there is to konw 163 99:59:59,999 --> 99:59:59,999 about one species, homo sapiens 164 99:59:59,999 --> 99:59:59,999 but veterinarians need to learn 165 99:59:59,999 --> 99:59:59,999 about health and disease 166 99:59:59,999 --> 99:59:59,999 in mammals, amphibians, 167 99:59:59,999 --> 99:59:59,999 reptiles, fish and birds 168 99:59:59,999 --> 99:59:59,999 so, i don't blame the vets 169 99:59:59,999 --> 99:59:59,999 for feeling annoyed by 170 99:59:59,999 --> 99:59:59,999 my profession's condescension 171 99:59:59,999 --> 99:59:59,999 and ignorance 172 99:59:59,999 --> 99:59:59,999 but here's one from the vets 173 99:59:59,999 --> 99:59:59,999 what do you call a veteranarian 174 99:59:59,999 --> 99:59:59,999 who can only take care of one species? 175 99:59:59,999 --> 99:59:59,999 a physician. 176 99:59:59,999 --> 99:59:59,999 closing the gap has become a passions for me 177 99:59:59,999 --> 99:59:59,999 and I'm doing this through programs 178 99:59:59,999 --> 99:59:59,999 like darwin on rounds at UCLA 179 99:59:59,999 --> 99:59:59,999 where we're bringing animal experts and evolutionary biologists 180 99:59:59,999 --> 99:59:59,999 and embedding them on our medical teams 181 99:59:59,999 --> 99:59:59,999 with our interns and our residents 182 99:59:59,999 --> 99:59:59,999 and through zoobiquity conferences 183 99:59:59,999 --> 99:59:59,999 where we bring medical schools together 184 99:59:59,999 --> 99:59:59,999 with veterinary schools 185 99:59:59,999 --> 99:59:59,999 for collabortive discussions 186 99:59:59,999 --> 99:59:59,999 of the shared diseases and disorders 187 99:59:59,999 --> 99:59:59,999 of animal and human patients 188 99:59:59,999 --> 99:59:59,999 at zoobiquity conferences, 189 99:59:59,999 --> 99:59:59,999 participants learn how treating 190 99:59:59,999 --> 99:59:59,999 breast cancer in a tiger can 191 99:59:59,999 --> 99:59:59,999 help us better treat breast cancer in a kindergarten teacher 192 99:59:59,999 --> 99:59:59,999 how understanding polycistic overies in a hole steen cow 193 99:59:59,999 --> 99:59:59,999 can help us better take care 194 99:59:59,999 --> 99:59:59,999 of a dance instructor with painful periods 195 99:59:59,999 --> 99:59:59,999 and how better understanding the 196 99:59:59,999 --> 99:59:59,999 treatment of separation anxiety 197 99:59:59,999 --> 99:59:59,999 in a high strung shelty 198 99:59:59,999 --> 99:59:59,999 can help a high strung child on his first days of school 199 99:59:59,999 --> 99:59:59,999 in the united states and now internationally 200 99:59:59,999 --> 99:59:59,999 at zoobiquity conferences 201 99:59:59,999 --> 99:59:59,999 physicians and veteranarians check 202 99:59:59,999 --> 99:59:59,999 their attitudes and their preconceptions at the door 203 99:59:59,999 --> 99:59:59,999 and come together as colleagues 204 99:59:59,999 --> 99:59:59,999 as peers, 205 99:59:59,999 --> 99:59:59,999 as doctors 206 99:59:59,999 --> 99:59:59,999 after all, we humans 207 99:59:59,999 --> 99:59:59,999 are animals, too 208 99:59:59,999 --> 99:59:59,999 and it's time for us physicians to embrace 209 99:59:59,999 --> 99:59:59,999 our patients and our own animal natures 210 99:59:59,999 --> 99:59:59,999 and join veterinarians 211 99:59:59,999 --> 99:59:59,999 in a species-spannign approach to health 212 99:59:59,999 --> 99:59:59,999 because it turns out 213 99:59:59,999 --> 99:59:59,999 some of the best and most humanistic medicine 214 99:59:59,999 --> 99:59:59,999 is being practiced by doctors whose 215 99:59:59,999 --> 99:59:59,999 patients aren't human 216 99:59:59,999 --> 99:59:59,999 and one of the best ways we can take care 217 99:59:59,999 --> 99:59:59,999 of the human patient is by paying close 218 99:59:59,999 --> 99:59:59,999 attention to how the other patients on the planet 219 99:59:59,999 --> 99:59:59,999 live, grow, get sick and heal 220 99:59:59,999 --> 99:59:59,999 Thank you. 221 99:59:59,999 --> 99:59:59,999 (Applause).