0:00:01.643,0:00:02.789 10 years ago, 9:59:59.000,9:59:59.000 I got a phone call that[br]changed my life. 9:59:59.000,9:59:59.000 At the time, I was [br]cardiologist at UCLA, 9:59:59.000,9:59:59.000 specializing in cardiac [br]imaging techniques. 9:59:59.000,9:59:59.000 The call came from a veterinarian[br]at the Los Angeles Zoo. 9:59:59.000,9:59:59.000 An elderly female chimpanzee 9:59:59.000,9:59:59.000 had woken up with a facial droop 9:59:59.000,9:59:59.000 and the veterinarians were worried[br]that she had had a stroke. 9:59:59.000,9:59:59.000 They asked if I could [br]come to the zoo 9:59:59.000,9:59:59.000 and image the animal's heart 9:59:59.000,9:59:59.000 to look for a possible cardiac cause. 9:59:59.000,9:59:59.000 Now, to be clear, North American[br]zoos are staffed 9:59:59.000,9:59:59.000 by highly qualified, [br]board-certified veterinarians 9:59:59.000,9:59:59.000 who take outstanding [br]care of animal patients. 9:59:59.000,9:59:59.000 But occasionally, they do reach into [br]the human medical community, 9:59:59.000,9:59:59.000 particularly for some [br]speciality consultation, 9:59:59.000,9:59:59.000 and I was one of the lucky physicians[br]who was invited to help. 9:59:59.000,9:59:59.000 I had a chance to rule out[br]a stroke in this chimpanzee 9:59:59.000,9:59:59.000 and make sure that this gorilla [br]didn't have a torn aorta. 9:59:59.000,9:59:59.000 Evaluate this macaw[br]for a heart murmur, 9:59:59.000,9:59:59.000 make sure that this californian sea lion's[br]paracardium wasn't inflamed. 9:59:59.000,9:59:59.000 And in this picture, I'm listening[br]to the heart of a lion 9:59:59.000,9:59:59.000 after a lifesaving collaborative procedure [br]with veteranarians and physicians. 9:59:59.000,9:59:59.000 We drained 700 CCs of [br]fluid from the sack 9:59:59.000,9:59:59.000 in which this lion's [br]heart was contained. 9:59:59.000,9:59:59.000 And this procedure, which I have[br]done on many human patients, 9:59:59.000,9:59:59.000 was identical with the exception[br]of that paw and that tail. 9:59:59.000,9:59:59.000 Now most of the time, I was[br]working at the UCLA Medical Center 9:59:59.000,9:59:59.000 with physicians, discussing symptoms[br]and diagnoses and treatments 9:59:59.000,9:59:59.000 for my human patients. 9:59:59.000,9:59:59.000 But some of the time, I was[br]working at the Los Angeles Zoo 9:59:59.000,9:59:59.000 i was working at the [br]Los Angeles Zoo with veteranarians 9:59:59.000,9:59:59.000 discussing symptoms, [br]diagnoses and treatments 9:59:59.000,9:59:59.000 for their animal patients. 9:59:59.000,9:59:59.000 And occasionally, on [br]the very same day, 9:59:59.000,9:59:59.000 I went on rounds at the [br]UCLA Medical Center 9:59:59.000,9:59:59.000 and at the Los Angeles Zoo, 9:59:59.000,9:59:59.000 and here's what started coming[br]into very clear focus for me. 9:59:59.000,9:59:59.000 Physicians and veterinarians[br]were essentially taking care 9:59:59.000,9:59:59.000 of the same disorders in :their [br]animal and human patients 9:59:59.000,9:59:59.000 congestive heart failure, brain tumors, 9:59:59.000,9:59:59.000 lukemia, diabetes, [br]arthritis, ALS, breast cancer, 9:59:59.000,9:59:59.000 even psychiatric symptoms like depression, 9:59:59.000,9:59:59.000 anxiety, compulsions, eating disorders[br]and self injury. 9:59:59.000,9:59:59.000 Now, I've got a confession to make. 9:59:59.000,9:59:59.000 Even though I studied comparative[br]physiology and evolutionary biology, 9:59:59.000,9:59:59.000 as an undergrad, 9:59:59.000,9:59:59.000 I had even written my senior [br]thesis on darwinian theory, 9:59:59.000,9:59:59.000 learning about the [br]significant overlap 9:59:59.000,9:59:59.000 between the disorders of [br]animals and humans. 9:59:59.000,9:59:59.000 It came as a much needed [br]wake up call for me. 9:59:59.000,9:59:59.000 So I started wondering,[br]with all of these overlaps, 9:59:59.000,9:59:59.000 how was it that I had never[br]thought to ask a veterinarian, 9:59:59.000,9:59:59.000 or consult the veterinary literature, 9:59:59.000,9:59:59.000 for insights into one [br]of my human patients? 9:59:59.000,9:59:59.000 Why had I never, nor had any of my physician[br]friends and colleagues who I asked, 9:59:59.000,9:59:59.000 ever attended a veterinary conference? 9:59:59.000,9:59:59.000 For that matter, why was [br]any of this a surprise? 9:59:59.000,9:59:59.000 I mean look, every single physician[br]accepts some biological connection 9:59:59.000,9:59:59.000 between animals and humans. 9:59:59.000,9:59:59.000 Every medication that we prescribe[br]or that we've taken ourselves 9:59:59.000,9:59:59.000 or we've given to our families[br] 9:59:59.000,9:59:59.000 has first been tested on an animal. 9:59:59.000,9:59:59.000 But there's something very different 9:59:59.000,9:59:59.000 about giving an animal a [br]medication or a human disease 9:59:59.000,9:59:59.000 and the animal developing [br]congestive heart failure 9:59:59.000,9:59:59.000 or diabetes or breats cancer on their own. 9:59:59.000,9:59:59.000 Now maybe some of the surprise 9:59:59.000,9:59:59.000 comes from the increasing[br]separation in our world 9:59:59.000,9:59:59.000 between the urban and the non-urban. 9:59:59.000,9:59:59.000 You know, we hear about [br]these city kids who 9:59:59.000,9:59:59.000 think that wool grows on trees 9:59:59.000,9:59:59.000 or that cheese comes from a plant. 9:59:59.000,9:59:59.000 Well today's human hospitals 9:59:59.000,9:59:59.000 are turning into increasingly[br] 9:59:59.000,9:59:59.000 these gleaming cathedrals[br]of technology. 9:59:59.000,9:59:59.000 And this creates a psychological[br]distance between the human patients 9:59:59.000,9:59:59.000 who are being treated there 9:59:59.000,9:59:59.000 and animal patients who[br]are living in oceans 9:59:59.000,9:59:59.000 and farms and jungles. 9:59:59.000,9:59:59.000 But I think there's an even deeper reason. 9:59:59.000,9:59:59.000 Physicians and scientists, we accept,[br]intellectually that our species 9:59:59.000,9:59:59.000 homo sapien, is merely one species[br] 9:59:59.000,9:59:59.000 no more unique or[br]special than any other. 9:59:59.000,9:59:59.000 But in our hearts, we don't [br]completely believe that. 9:59:59.000,9:59:59.000 I feel it myself when I'm [br]listening to Motzart 9:59:59.000,9:59:59.000 or looking at pictures of the [br]Mars Rover on my MacBook. 9:59:59.000,9:59:59.000 I feel that tug of [br]human exceptionalism, 9:59:59.000,9:59:59.000 even as I recognize the [br]scientifically isolating cost 9:59:59.000,9:59:59.000 of seeing ourselves as a[br]superior species apart. 9:59:59.000,9:59:59.000 Well, I'm trying these days. 9:59:59.000,9:59:59.000 When I see a human patient[br]now, I always ask, 9:59:59.000,9:59:59.000 "what do the animal doctors know[br]about this problem that I don't know?" 9:59:59.000,9:59:59.000 and "Might I be taking better [br]care of my human patient 9:59:59.000,9:59:59.000 if I saw them as a human[br]animal patient?" 9:59:59.000,9:59:59.000 Here are a few examples of the [br]kind of exciting connections[br] 9:59:59.000,9:59:59.000 that this kind of t[br]thinking has led me to: 9:59:59.000,9:59:59.000 fear-induced heart failure. 9:59:59.000,9:59:59.000 Around the year 2000, 9:59:59.000,9:59:59.000 human cardiologists "discovered"[br]emotionally induced heart failure. 9:59:59.000,9:59:59.000 It was described in a gambling father [br]who had lost his life's savings 9:59:59.000,9:59:59.000 with the roll of a dice, 9:59:59.000,9:59:59.000 in a bride who had [br]been left at the alter. 9:59:59.000,9:59:59.000 But it turns out that this [br]"new human diagnosis" 9:59:59.000,9:59:59.000 was neither new, nor[br]was it uniquely human. 9:59:59.000,9:59:59.000 Veterinarians had been diagnosing, [br]treating, and even preventing 9:59:59.000,9:59:59.000 emotionally-induced[br]symptoms in animals, 9:59:59.000,9:59:59.000 ranging from monkeys to flamingos,[br]to deer to rabbits, 9:59:59.000,9:59:59.000 since the 1970s. 9:59:59.000,9:59:59.000 How many human lives [br]might have been saved 9:59:59.000,9:59:59.000 if this veterinary knowledge had [br]been put into the hands 9:59:59.000,9:59:59.000 of ER docs and cardiologists? 9:59:59.000,9:59:59.000 Self injury. 9:59:59.000,9:59:59.000 Some human patients harm themselves. 9:59:59.000,9:59:59.000 Some pluck out patches of hair. 9:59:59.000,9:59:59.000 Others actually cut themselves. 9:59:59.000,9:59:59.000 Some animal patients [br]also harm themselves. 9:59:59.000,9:59:59.000 There are birds that pluck out feathers. 9:59:59.000,9:59:59.000 There are stallions that repetitively[br]bite their flanks until they bleed. 9:59:59.000,9:59:59.000 But veterinarians have very specific[br]and very effective ways 9:59:59.000,9:59:59.000 of treating and even[br]preventing self-injury. 9:59:59.000,9:59:59.000 In their self-injuring animals, 9:59:59.000,9:59:59.000 shouldn't this veterinary knowledge[br]be put into the hands 9:59:59.000,9:59:59.000 of psychotherapists and [br]parents and patients 9:59:59.000,9:59:59.000 struggling with self-injury, 9:59:59.000,9:59:59.000 post pardem depression and [br]post pardem psychosis? 9:59:59.000,9:59:59.000 Sometimes, soon after giving birth 9:59:59.000,9:59:59.000 Some women become depressed, 9:59:59.000,9:59:59.000 they become seriously depressed[br]and sometimes psychotic. 9:59:59.000,9:59:59.000 They may neglect their newborn, 9:59:59.000,9:59:59.000 and in some extreme cases, 9:59:59.000,9:59:59.000 even harm the child. 9:59:59.000,9:59:59.000 Equine veteranarians also[br]know that a mare, 9:59:59.000,9:59:59.000 soon after giving birth, 9:59:59.000,9:59:59.000 will neglect the foul,[br]refusing to nurture it, 9:59:59.000,9:59:59.000 and in some instances,[br]kick the foul even to death. 9:59:59.000,9:59:59.000 But veterinarians have divised 9:59:59.000,9:59:59.000 an intervention to deal with[br]this foul rejection syndrome 9:59:59.000,9:59:59.000 that involves increasing [br]oxytocin in the mare, 9:59:59.000,9:59:59.000 oxytocin is the bonding hormone. 9:59:59.000,9:59:59.000 And this leads to renewed interest 9:59:59.000,9:59:59.000 on the part of the mare in her foul. 9:59:59.000,9:59:59.000 Shouldn't this information 9:59:59.000,9:59:59.000 be put into the hands of OBGYNs 9:59:59.000,9:59:59.000 and family doctors and patients 9:59:59.000,9:59:59.000 who are struggling with postpartum[br]depression and psychosis? 9:59:59.000,9:59:59.000 Well despite all of this promise, 9:59:59.000,9:59:59.000 unfortunately, the gulf between[br]our fields remains large. 9:59:59.000,9:59:59.000 To explain it, I'm afraid I'm [br]going to have to air 9:59:59.000,9:59:59.000 some dirty laundry. 9:59:59.000,9:59:59.000 Some physicians can [br]be real snobs 9:59:59.000,9:59:59.000 about doctors who are not MDs. 9:59:59.000,9:59:59.000 I'm talking about dentists and [br]optomitrists and psychologists 9:59:59.000,9:59:59.000 and optomitrists and psychologists. 9:59:59.000,9:59:59.000 But maybe especially, animal doctors. 9:59:59.000,9:59:59.000 Of course, most physicians 9:59:59.000,9:59:59.000 don't realize that it's harder 9:59:59.000,9:59:59.000 to get into vet school these[br]days than medical school. 9:59:59.000,9:59:59.000 And that when we go [br]to medical school, 9:59:59.000,9:59:59.000 we learn everything there is to konw 9:59:59.000,9:59:59.000 about one species, homo sapiens. 9:59:59.000,9:59:59.000 But veterinarians need to learn[br]about health and disease. 9:59:59.000,9:59:59.000 in mammals, amphibians,[br]reptiles, fish and birds. 9:59:59.000,9:59:59.000 So I don't blame the vets 9:59:59.000,9:59:59.000 for feeling annoyed by 9:59:59.000,9:59:59.000 my profession's condescension[br]and ignorance. 9:59:59.000,9:59:59.000 But here's one from the vets: 9:59:59.000,9:59:59.000 What do you call a veteranarian 9:59:59.000,9:59:59.000 who can only take care of one species? 9:59:59.000,9:59:59.000 A physician. 9:59:59.000,9:59:59.000 Closing the gap has become [br]a passion for me 9:59:59.000,9:59:59.000 and I'm doing this [br]through programs 9:59:59.000,9:59:59.000 like Darwin on Rounds at UCLA 9:59:59.000,9:59:59.000 where we're bringing animal experts [br]and evolutionary biologists 9:59:59.000,9:59:59.000 and embedding them on [br]our medical teams[br] 9:59:59.000,9:59:59.000 with our interns and our residents. 9:59:59.000,9:59:59.000 And through Zoobiquity conferences 9:59:59.000,9:59:59.000 where we bring medical schools [br]together with veterinary schools 9:59:59.000,9:59:59.000 for collabortive discussions 9:59:59.000,9:59:59.000 of the shared diseases and disorders[br] 9:59:59.000,9:59:59.000 of animal and human patients. 9:59:59.000,9:59:59.000 At Zoobiquity conferences, 9:59:59.000,9:59:59.000 participants learn how treating[br]breast cancer in a tiger 9:59:59.000,9:59:59.000 can help us better [br]treat breast cancer 9:59:59.000,9:59:59.000 in a kindergarten teacher. 9:59:59.000,9:59:59.000 How understanding polycistic[br]overies in a holstein cow 9:59:59.000,9:59:59.000 can help us better take care 9:59:59.000,9:59:59.000 of a dance instructor with painful periods. 9:59:59.000,9:59:59.000 And how better understanding the [br]treatment of separation anxiety 9:59:59.000,9:59:59.000 in a high-strung Sheltie 9:59:59.000,9:59:59.000 can help a high strung child [br]on his first days of school. 9:59:59.000,9:59:59.000 In the United States and [br]now internationally 9:59:59.000,9:59:59.000 At Zoobiquity conferences,[br] 9:59:59.000,9:59:59.000 physicians and veterinarians check[br]their attitudes and their preconceptions 9:59:59.000,9:59:59.000 at the door and come [br]together as colleagues 9:59:59.000,9:59:59.000 as peers, as doctors. 9:59:59.000,9:59:59.000 After all, we humans [br]are animals, too. 9:59:59.000,9:59:59.000 And it's time for us [br]physicians to embrace 9:59:59.000,9:59:59.000 our patients and [br]our own animal natures 9:59:59.000,9:59:59.000 and join veterinarians 9:59:59.000,9:59:59.000 in a species-spannign approach to health. 9:59:59.000,9:59:59.000 Because it turns out, 9:59:59.000,9:59:59.000 some of the best and [br]most humanistic medicine 9:59:59.000,9:59:59.000 is being practiced by doctors whose[br]patients aren't human. 9:59:59.000,9:59:59.000 And one of the best ways [br]we can take care 9:59:59.000,9:59:59.000 of the human patient is by [br]paying close attention 9:59:59.000,9:59:59.000 to how the other [br]patients on the planet 9:59:59.000,9:59:59.000 live, grow, get sick and heal. 9:59:59.000,9:59:59.000 Thank you. 9:59:59.000,9:59:59.000 (Applause).