1 00:00:01,643 --> 00:00:02,789 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 zoos are staffed 13 99:59:59,999 --> 99:59:59,999 by highly qualified, board-certified veterinarians 14 99:59:59,999 --> 99:59:59,999 who take outstanding care of animal patients. 15 99:59:59,999 --> 99:59:59,999 But occasionally, they do reach into the human medical community, 16 99:59:59,999 --> 99:59:59,999 particularly for some speciality consultation, 17 99:59:59,999 --> 99:59:59,999 and I was one of the lucky physicians who was invited to help. 18 99:59:59,999 --> 99:59:59,999 I had a chance to rule out a stroke in this chimpanzee 19 99:59:59,999 --> 99:59:59,999 and make sure that this gorilla didn't have a torn aorta. 20 99:59:59,999 --> 99:59:59,999 Evaluate this macaw for a heart murmur, 21 99:59:59,999 --> 99:59:59,999 make sure that this californian sea lion's paracardium wasn't inflamed. 22 99:59:59,999 --> 99:59:59,999 And in this picture, I'm listening to the heart of a lion 23 99:59:59,999 --> 99:59:59,999 after a lifesaving collaborative procedure with veteranarians and physicians. 24 99:59:59,999 --> 99:59:59,999 We drained 700 CCs of fluid from the sack 25 99:59:59,999 --> 99:59:59,999 in which this lion's heart was contained. 26 99:59:59,999 --> 99:59:59,999 And this procedure, which I have done on many human patients, 27 99:59:59,999 --> 99:59:59,999 was identical with the exception of that paw and that tail. 28 99:59:59,999 --> 99:59:59,999 Now most of the time, I was working at the UCLA Medical Center 29 99:59:59,999 --> 99:59:59,999 with physicians, discussing symptoms and diagnoses and treatments 30 99:59:59,999 --> 99:59:59,999 for my human patients. 31 99:59:59,999 --> 99:59:59,999 But some of the time, I was working at the Los Angeles Zoo 32 99:59:59,999 --> 99:59:59,999 i was working at the Los Angeles Zoo with veteranarians 33 99:59:59,999 --> 99:59:59,999 discussing symptoms, diagnoses and treatments 34 99:59:59,999 --> 99:59:59,999 for their animal patients. 35 99:59:59,999 --> 99:59:59,999 And occasionally, on the very same day, 36 99:59:59,999 --> 99:59:59,999 I went on rounds at the UCLA Medical Center 37 99:59:59,999 --> 99:59:59,999 and at the Los Angeles Zoo, 38 99:59:59,999 --> 99:59:59,999 and here's what started coming into very clear focus for me. 39 99:59:59,999 --> 99:59:59,999 Physicians and veterinarians were essentially taking care 40 99:59:59,999 --> 99:59:59,999 of the same disorders in :their animal and human patients 41 99:59:59,999 --> 99:59:59,999 congestive heart failure, brain tumors, 42 99:59:59,999 --> 99:59:59,999 lukemia, diabetes, arthritis, ALS, breast cancer, 43 99:59:59,999 --> 99:59:59,999 even psychiatric symptoms like depression, 44 99:59:59,999 --> 99:59:59,999 anxiety, compulsions, eating disorders and self injury. 45 99:59:59,999 --> 99:59:59,999 Now, I've got a confession to make. 46 99:59:59,999 --> 99:59:59,999 Even though I studied comparative physiology and evolutionary biology, 47 99:59:59,999 --> 99:59:59,999 as an undergrad, 48 99:59:59,999 --> 99:59:59,999 I had even written my senior thesis on darwinian theory, 49 99:59:59,999 --> 99:59:59,999 learning about the significant overlap 50 99:59:59,999 --> 99:59:59,999 between the disorders of animals and humans. 51 99:59:59,999 --> 99:59:59,999 It came as a much needed wake up call for me. 52 99:59:59,999 --> 99:59:59,999 So I started wondering, with all of these overlaps, 53 99:59:59,999 --> 99:59:59,999 how was it that I had never thought to ask a veterinarian, 54 99:59:59,999 --> 99:59:59,999 or consult the veterinary literature, 55 99:59:59,999 --> 99:59:59,999 for insights into one of my human patients? 56 99:59:59,999 --> 99:59:59,999 Why had I never, nor had any of my physician friends and colleagues who I asked, 57 99:59:59,999 --> 99:59:59,999 ever attended a veterinary conference? 58 99:59:59,999 --> 99:59:59,999 For that matter, why was any of this a surprise? 59 99:59:59,999 --> 99:59:59,999 I mean look, every single physician accepts some biological connection 60 99:59:59,999 --> 99:59:59,999 between animals and humans. 61 99:59:59,999 --> 99:59:59,999 Every medication that we prescribe or that we've taken ourselves 62 99:59:59,999 --> 99:59:59,999 or we've given to our families 63 99:59:59,999 --> 99:59:59,999 has first been tested on an animal. 64 99:59:59,999 --> 99:59:59,999 But there's something very different 65 99:59:59,999 --> 99:59:59,999 about giving an animal a medication or a human disease 66 99:59:59,999 --> 99:59:59,999 and the animal developing congestive heart failure 67 99:59:59,999 --> 99:59:59,999 or diabetes or breats cancer on their own. 68 99:59:59,999 --> 99:59:59,999 Now maybe some of the surprise 69 99:59:59,999 --> 99:59:59,999 comes from the increasing separation in our world 70 99:59:59,999 --> 99:59:59,999 between the urban and the non-urban. 71 99:59:59,999 --> 99:59:59,999 You know, we hear about these city kids who 72 99:59:59,999 --> 99:59:59,999 think that wool grows on trees 73 99:59:59,999 --> 99:59:59,999 or that cheese comes from a plant. 74 99:59:59,999 --> 99:59:59,999 Well today's human hospitals 75 99:59:59,999 --> 99:59:59,999 are turning into increasingly 76 99:59:59,999 --> 99:59:59,999 these gleaming cathedrals of technology. 77 99:59:59,999 --> 99:59:59,999 And this creates a psychological distance between the human patients 78 99:59:59,999 --> 99:59:59,999 who are being treated there 79 99:59:59,999 --> 99:59:59,999 and animal patients who are living in oceans 80 99:59:59,999 --> 99:59:59,999 and farms and jungles. 81 99:59:59,999 --> 99:59:59,999 But I think there's an even deeper reason. 82 99:59:59,999 --> 99:59:59,999 Physicians and scientists, we accept, intellectually that our species 83 99:59:59,999 --> 99:59:59,999 homo sapien, is merely one species 84 99:59:59,999 --> 99:59:59,999 no more unique or special than any other. 85 99:59:59,999 --> 99:59:59,999 But in our hearts, we don't completely believe that. 86 99:59:59,999 --> 99:59:59,999 I feel it myself when I'm listening to Motzart 87 99:59:59,999 --> 99:59:59,999 or looking at pictures of the Mars Rover on my MacBook. 88 99:59:59,999 --> 99:59:59,999 I feel that tug of human exceptionalism, 89 99:59:59,999 --> 99:59:59,999 even as I recognize the scientifically isolating cost 90 99:59:59,999 --> 99:59:59,999 of seeing ourselves as a superior species apart. 91 99:59:59,999 --> 99:59:59,999 Well, I'm trying these days. 92 99:59:59,999 --> 99:59:59,999 When I see a human patient now, I always ask, 93 99:59:59,999 --> 99:59:59,999 "what do the animal doctors know about this problem that I don't know?" 94 99:59:59,999 --> 99:59:59,999 and "Might I be taking better care of my human patient 95 99:59:59,999 --> 99:59:59,999 if I saw them as a human animal patient?" 96 99:59:59,999 --> 99:59:59,999 Here are a few examples of the kind of exciting connections 97 99:59:59,999 --> 99:59:59,999 that this kind of t thinking has led me to: 98 99:59:59,999 --> 99:59:59,999 fear-induced heart failure. 99 99:59:59,999 --> 99:59:59,999 Around the year 2000, 100 99:59:59,999 --> 99:59:59,999 human cardiologists "discovered" emotionally induced heart failure. 101 99:59:59,999 --> 99:59:59,999 It was described in a gambling father who had lost his life's savings 102 99:59:59,999 --> 99:59:59,999 with the roll of a dice, 103 99:59:59,999 --> 99:59:59,999 in a bride who had been left at the alter. 104 99:59:59,999 --> 99:59:59,999 But it turns out that this "new human diagnosis" 105 99:59:59,999 --> 99:59:59,999 was neither new, nor was it uniquely human. 106 99:59:59,999 --> 99:59:59,999 Veterinarians had been diagnosing, treating, and even preventing 107 99:59:59,999 --> 99:59:59,999 emotionally-induced symptoms in animals, 108 99:59:59,999 --> 99:59:59,999 ranging from monkeys to flamingos, to deer to rabbits, 109 99:59:59,999 --> 99:59:59,999 since the 1970s. 110 99:59:59,999 --> 99:59:59,999 How many human lives might have been saved 111 99:59:59,999 --> 99:59:59,999 if this veterinary knowledge had been put into the hands 112 99:59:59,999 --> 99:59:59,999 of ER docs and cardiologists? 113 99:59:59,999 --> 99:59:59,999 Self injury. 114 99:59:59,999 --> 99:59:59,999 Some human patients harm themselves. 115 99:59:59,999 --> 99:59:59,999 Some pluck out patches of hair. 116 99:59:59,999 --> 99:59:59,999 Others actually cut themselves. 117 99:59:59,999 --> 99:59:59,999 Some animal patients also harm themselves. 118 99:59:59,999 --> 99:59:59,999 There are birds that pluck out feathers. 119 99:59:59,999 --> 99:59:59,999 There are stallions that repetitively bite their flanks until they bleed. 120 99:59:59,999 --> 99:59:59,999 But veterinarians have very specific and very effective ways 121 99:59:59,999 --> 99:59:59,999 of treating and even preventing self-injury. 122 99:59:59,999 --> 99:59:59,999 In their self-injuring animals, 123 99:59:59,999 --> 99:59:59,999 shouldn't this veterinary knowledge be put into the hands 124 99:59:59,999 --> 99:59:59,999 of psychotherapists and parents and patients 125 99:59:59,999 --> 99:59:59,999 struggling with self-injury, 126 99:59:59,999 --> 99:59:59,999 post pardem depression and post pardem psychosis? 127 99:59:59,999 --> 99:59:59,999 Sometimes, soon after giving birth 128 99:59:59,999 --> 99:59:59,999 Some women become depressed, 129 99:59:59,999 --> 99:59:59,999 they become seriously depressed and sometimes psychotic. 130 99:59:59,999 --> 99:59:59,999 They may neglect their newborn, 131 99:59:59,999 --> 99:59:59,999 and in some extreme cases, 132 99:59:59,999 --> 99:59:59,999 even harm the child. 133 99:59:59,999 --> 99:59:59,999 Equine veteranarians also know that a mare, 134 99:59:59,999 --> 99:59:59,999 soon after giving birth, 135 99:59:59,999 --> 99:59:59,999 will neglect the foul, refusing to nurture it, 136 99:59:59,999 --> 99:59:59,999 and in some instances, kick the foul even to death. 137 99:59:59,999 --> 99:59:59,999 But veterinarians have divised 138 99:59:59,999 --> 99:59:59,999 an intervention to deal with this foul rejection syndrome 139 99:59:59,999 --> 99:59:59,999 that involves increasing oxytocin in the mare, 140 99:59:59,999 --> 99:59:59,999 oxytocin is the bonding hormone. 141 99:59:59,999 --> 99:59:59,999 And this leads to renewed interest 142 99:59:59,999 --> 99:59:59,999 on the part of the mare in her foul. 143 99:59:59,999 --> 99:59:59,999 Shouldn't this information 144 99:59:59,999 --> 99:59:59,999 be put into the hands of OBGYNs 145 99:59:59,999 --> 99:59:59,999 and family doctors and patients 146 99:59:59,999 --> 99:59:59,999 who are struggling with postpartum depression and psychosis? 147 99:59:59,999 --> 99:59:59,999 Well despite all of this promise, 148 99:59:59,999 --> 99:59:59,999 unfortunately, the gulf between our fields remains large. 149 99:59:59,999 --> 99:59:59,999 To explain it, I'm afraid I'm going to have to air 150 99:59:59,999 --> 99:59:59,999 some dirty laundry. 151 99:59:59,999 --> 99:59:59,999 Some physicians can be real snobs 152 99:59:59,999 --> 99:59:59,999 about doctors who are not MDs. 153 99:59:59,999 --> 99:59:59,999 I'm talking about dentists and optomitrists and psychologists 154 99:59:59,999 --> 99:59:59,999 and optomitrists and psychologists. 155 99:59:59,999 --> 99:59:59,999 But maybe especially, animal doctors. 156 99:59:59,999 --> 99:59:59,999 Of course, most physicians 157 99:59:59,999 --> 99:59:59,999 don't realize that it's harder 158 99:59:59,999 --> 99:59:59,999 to get into vet school these days than medical school. 159 99:59:59,999 --> 99:59:59,999 And that when we go to medical school, 160 99:59:59,999 --> 99:59:59,999 we learn everything there is to konw 161 99:59:59,999 --> 99:59:59,999 about one species, homo sapiens. 162 99:59:59,999 --> 99:59:59,999 But veterinarians need to learn about health and disease. 163 99:59:59,999 --> 99:59:59,999 in mammals, amphibians, reptiles, fish and birds. 164 99:59:59,999 --> 99:59:59,999 So I don't blame the vets 165 99:59:59,999 --> 99:59:59,999 for feeling annoyed by 166 99:59:59,999 --> 99:59:59,999 my profession's condescension and ignorance. 167 99:59:59,999 --> 99:59:59,999 But here's one from the vets: 168 99:59:59,999 --> 99:59:59,999 What do you call a veteranarian 169 99:59:59,999 --> 99:59:59,999 who can only take care of one species? 170 99:59:59,999 --> 99:59:59,999 A physician. 171 99:59:59,999 --> 99:59:59,999 Closing the gap has become a passion for me 172 99:59:59,999 --> 99:59:59,999 and I'm doing this through programs 173 99:59:59,999 --> 99:59:59,999 like Darwin on Rounds at UCLA 174 99:59:59,999 --> 99:59:59,999 where we're bringing animal experts and evolutionary biologists 175 99:59:59,999 --> 99:59:59,999 and embedding them on our medical teams 176 99:59:59,999 --> 99:59:59,999 with our interns and our residents. 177 99:59:59,999 --> 99:59:59,999 And through Zoobiquity conferences 178 99:59:59,999 --> 99:59:59,999 where we bring medical schools together with veterinary schools 179 99:59:59,999 --> 99:59:59,999 for collabortive discussions 180 99:59:59,999 --> 99:59:59,999 of the shared diseases and disorders 181 99:59:59,999 --> 99:59:59,999 of animal and human patients. 182 99:59:59,999 --> 99:59:59,999 At Zoobiquity conferences, 183 99:59:59,999 --> 99:59:59,999 participants learn how treating breast cancer in a tiger 184 99:59:59,999 --> 99:59:59,999 can help us better treat breast cancer 185 99:59:59,999 --> 99:59:59,999 in a kindergarten teacher. 186 99:59:59,999 --> 99:59:59,999 How understanding polycistic overies in a holstein cow 187 99:59:59,999 --> 99:59:59,999 can help us better take care 188 99:59:59,999 --> 99:59:59,999 of a dance instructor with painful periods. 189 99:59:59,999 --> 99:59:59,999 And how better understanding the treatment of separation anxiety 190 99:59:59,999 --> 99:59:59,999 in a high-strung Sheltie 191 99:59:59,999 --> 99:59:59,999 can help a high strung child on his first days of school. 192 99:59:59,999 --> 99:59:59,999 In the United States and now internationally 193 99:59:59,999 --> 99:59:59,999 At Zoobiquity conferences, 194 99:59:59,999 --> 99:59:59,999 physicians and veterinarians check their attitudes and their preconceptions 195 99:59:59,999 --> 99:59:59,999 at the door and come together as colleagues 196 99:59:59,999 --> 99:59:59,999 as peers, as doctors. 197 99:59:59,999 --> 99:59:59,999 After all, we humans are animals, too. 198 99:59:59,999 --> 99:59:59,999 And it's time for us physicians to embrace 199 99:59:59,999 --> 99:59:59,999 our patients and our own animal natures 200 99:59:59,999 --> 99:59:59,999 and join veterinarians 201 99:59:59,999 --> 99:59:59,999 in a species-spannign approach to health. 202 99:59:59,999 --> 99:59:59,999 Because it turns out, 203 99:59:59,999 --> 99:59:59,999 some of the best and most humanistic medicine 204 99:59:59,999 --> 99:59:59,999 is being practiced by doctors whose patients aren't human. 205 99:59:59,999 --> 99:59:59,999 And one of the best ways we can take care 206 99:59:59,999 --> 99:59:59,999 of the human patient is by paying close attention 207 99:59:59,999 --> 99:59:59,999 to how the other patients on the planet 208 99:59:59,999 --> 99:59:59,999 live, grow, get sick and heal. 209 99:59:59,999 --> 99:59:59,999 Thank you. 210 99:59:59,999 --> 99:59:59,999 (Applause).