WEBVTT 00:00:01.643 --> 00:00:02.789 10 years ago, 99:59:59.999 --> 99:59:59.999 I got a phone call that changed my life. 99:59:59.999 --> 99:59:59.999 At the time, I was cardiologist at UCLA, 99:59:59.999 --> 99:59:59.999 specializing in cardiac imaging techniques. 99:59:59.999 --> 99:59:59.999 The call came from a veterinarian at the Los Angeles Zoo. 99:59:59.999 --> 99:59:59.999 An elderly female chimpanzee 99:59:59.999 --> 99:59:59.999 had woken up with a facial droop 99:59:59.999 --> 99:59:59.999 and the veterinarians were worried that she had had a stroke. 99:59:59.999 --> 99:59:59.999 They asked if I could come to the zoo 99:59:59.999 --> 99:59:59.999 and image the animal's heart 99:59:59.999 --> 99:59:59.999 to look for a possible cardiac cause. 99:59:59.999 --> 99:59:59.999 Now, to be clear, North American zoos are staffed 99:59:59.999 --> 99:59:59.999 by highly qualified, board-certified veterinarians 99:59:59.999 --> 99:59:59.999 who take outstanding care of animal patients. 99:59:59.999 --> 99:59:59.999 But occasionally, they do reach into the human medical community, 99:59:59.999 --> 99:59:59.999 particularly for some speciality consultation, 99:59:59.999 --> 99:59:59.999 and I was one of the lucky physicians who was invited to help. 99:59:59.999 --> 99:59:59.999 I had a chance to rule out a stroke in this chimpanzee 99:59:59.999 --> 99:59:59.999 and make sure that this gorilla didn't have a torn aorta. 99:59:59.999 --> 99:59:59.999 Evaluate this macaw for a heart murmur, 99:59:59.999 --> 99:59:59.999 make sure that this californian sea lion's paracardium wasn't inflamed. 99:59:59.999 --> 99:59:59.999 And in this picture, I'm listening to the heart of a lion 99:59:59.999 --> 99:59:59.999 after a lifesaving collaborative procedure with veteranarians and physicians. 99:59:59.999 --> 99:59:59.999 We drained 700 CCs of fluid from the sack 99:59:59.999 --> 99:59:59.999 in which this lion's heart was contained. 99:59:59.999 --> 99:59:59.999 And this procedure, which I have done on many human patients, 99:59:59.999 --> 99:59:59.999 was identical with the exception of that paw and that tail. 99:59:59.999 --> 99:59:59.999 Now most of the time, I was working at the UCLA Medical Center 99:59:59.999 --> 99:59:59.999 with physicians, discussing symptoms and diagnoses and treatments 99:59:59.999 --> 99:59:59.999 for my human patients. 99:59:59.999 --> 99:59:59.999 But some of the time, I was working at the Los Angeles Zoo 99:59:59.999 --> 99:59:59.999 i was working at the Los Angeles Zoo with veteranarians 99:59:59.999 --> 99:59:59.999 discussing symptoms, diagnoses and treatments 99:59:59.999 --> 99:59:59.999 for their animal patients. 99:59:59.999 --> 99:59:59.999 And occasionally, on the very same day, 99:59:59.999 --> 99:59:59.999 I went on rounds at the UCLA Medical Center 99:59:59.999 --> 99:59:59.999 and at the Los Angeles Zoo, 99:59:59.999 --> 99:59:59.999 and here's what started coming into very clear focus for me. 99:59:59.999 --> 99:59:59.999 Physicians and veterinarians were essentially taking care 99:59:59.999 --> 99:59:59.999 of the same disorders in :their animal and human patients 99:59:59.999 --> 99:59:59.999 congestive heart failure, brain tumors, 99:59:59.999 --> 99:59:59.999 lukemia, diabetes, arthritis, ALS, breast cancer, 99:59:59.999 --> 99:59:59.999 even psychiatric symptoms like depression, 99:59:59.999 --> 99:59:59.999 anxiety, compulsions, eating disorders and self injury. 99:59:59.999 --> 99:59:59.999 Now, I've got a confession to make. 99:59:59.999 --> 99:59:59.999 Even though I studied comparative physiology and evolutionary biology, 99:59:59.999 --> 99:59:59.999 as an undergrad, 99:59:59.999 --> 99:59:59.999 I had even written my senior thesis on darwinian theory, 99:59:59.999 --> 99:59:59.999 learning about the significant overlap 99:59:59.999 --> 99:59:59.999 between the disorders of animals and humans. 99:59:59.999 --> 99:59:59.999 It came as a much needed wake up call for me. 99:59:59.999 --> 99:59:59.999 So I started wondering, with all of these overlaps, 99:59:59.999 --> 99:59:59.999 how was it that I had never thought to ask a veterinarian, 99:59:59.999 --> 99:59:59.999 or consult the veterinary literature, 99:59:59.999 --> 99:59:59.999 for insights into one of my human patients? 99:59:59.999 --> 99:59:59.999 Why had I never, nor had any of my physician friends and colleagues who I asked, 99:59:59.999 --> 99:59:59.999 ever attended a veterinary conference? 99:59:59.999 --> 99:59:59.999 For that matter, why was any of this a surprise? 99:59:59.999 --> 99:59:59.999 I mean look, every single physician accepts some biological connection 99:59:59.999 --> 99:59:59.999 between animals and humans. 99:59:59.999 --> 99:59:59.999 Every medication that we prescribe or that we've taken ourselves 99:59:59.999 --> 99:59:59.999 or we've given to our families 99:59:59.999 --> 99:59:59.999 has first been tested on an animal. 99:59:59.999 --> 99:59:59.999 But there's something very different 99:59:59.999 --> 99:59:59.999 about giving an animal a medication or a human disease 99:59:59.999 --> 99:59:59.999 and the animal developing congestive heart failure 99:59:59.999 --> 99:59:59.999 or diabetes or breats cancer on their own. 99:59:59.999 --> 99:59:59.999 Now maybe some of the surprise 99:59:59.999 --> 99:59:59.999 comes from the increasing separation in our world 99:59:59.999 --> 99:59:59.999 between the urban and the non-urban. 99:59:59.999 --> 99:59:59.999 You know, we hear about these city kids who 99:59:59.999 --> 99:59:59.999 think that wool grows on trees 99:59:59.999 --> 99:59:59.999 or that cheese comes from a plant. 99:59:59.999 --> 99:59:59.999 Well today's human hospitals 99:59:59.999 --> 99:59:59.999 are turning into increasingly 99:59:59.999 --> 99:59:59.999 these gleaming cathedrals of technology. 99:59:59.999 --> 99:59:59.999 And this creates a psychological distance between the human patients 99:59:59.999 --> 99:59:59.999 who are being treated there 99:59:59.999 --> 99:59:59.999 and animal patients who are living in oceans 99:59:59.999 --> 99:59:59.999 and farms and jungles. 99:59:59.999 --> 99:59:59.999 But I think there's an even deeper reason. 99:59:59.999 --> 99:59:59.999 Physicians and scientists, we accept, intellectually that our species 99:59:59.999 --> 99:59:59.999 homo sapien, is merely one species 99:59:59.999 --> 99:59:59.999 no more unique or special than any other. 99:59:59.999 --> 99:59:59.999 But in our hearts, we don't completely believe that. 99:59:59.999 --> 99:59:59.999 I feel it myself when I'm listening to Motzart 99:59:59.999 --> 99:59:59.999 or looking at pictures of the Mars Rover on my MacBook. 99:59:59.999 --> 99:59:59.999 I feel that tug of human exceptionalism, 99:59:59.999 --> 99:59:59.999 even as I recognize the scientifically isolating cost 99:59:59.999 --> 99:59:59.999 of seeing ourselves as a superior species apart. 99:59:59.999 --> 99:59:59.999 Well, I'm trying these days. 99:59:59.999 --> 99:59:59.999 When I see a human patient now, I always ask, 99:59:59.999 --> 99:59:59.999 "what do the animal doctors know about this problem that I don't know?" 99:59:59.999 --> 99:59:59.999 and "Might I be taking better care of my human patient 99:59:59.999 --> 99:59:59.999 if I saw them as a human animal patient?" 99:59:59.999 --> 99:59:59.999 Here are a few examples of the kind of exciting connections 99:59:59.999 --> 99:59:59.999 that this kind of t thinking has led me to: 99:59:59.999 --> 99:59:59.999 fear-induced heart failure. 99:59:59.999 --> 99:59:59.999 Around the year 2000, 99:59:59.999 --> 99:59:59.999 human cardiologists "discovered" emotionally induced heart failure. 99:59:59.999 --> 99:59:59.999 It was described in a gambling father who had lost his life's savings 99:59:59.999 --> 99:59:59.999 with the roll of a dice, 99:59:59.999 --> 99:59:59.999 in a bride who had been left at the alter. 99:59:59.999 --> 99:59:59.999 But it turns out that this "new human diagnosis" 99:59:59.999 --> 99:59:59.999 was neither new, nor was it uniquely human. 99:59:59.999 --> 99:59:59.999 Veterinarians had been diagnosing, treating, and even preventing 99:59:59.999 --> 99:59:59.999 emotionally-induced symptoms in animals, 99:59:59.999 --> 99:59:59.999 ranging from monkeys to flamingos, to deer to rabbits, 99:59:59.999 --> 99:59:59.999 since the 1970s. 99:59:59.999 --> 99:59:59.999 How many human lives might have been saved 99:59:59.999 --> 99:59:59.999 if this veterinary knowledge had been put into the hands 99:59:59.999 --> 99:59:59.999 of ER docs and cardiologists? 99:59:59.999 --> 99:59:59.999 Self injury. 99:59:59.999 --> 99:59:59.999 Some human patients harm themselves. 99:59:59.999 --> 99:59:59.999 Some pluck out patches of hair. 99:59:59.999 --> 99:59:59.999 Others actually cut themselves. 99:59:59.999 --> 99:59:59.999 Some animal patients also harm themselves. 99:59:59.999 --> 99:59:59.999 There are birds that pluck out feathers. 99:59:59.999 --> 99:59:59.999 There are stallions that repetitively bite their flanks until they bleed. 99:59:59.999 --> 99:59:59.999 But veterinarians have very specific and very effective ways 99:59:59.999 --> 99:59:59.999 of treating and even preventing self-injury. 99:59:59.999 --> 99:59:59.999 In their self-injuring animals, 99:59:59.999 --> 99:59:59.999 shouldn't this veterinary knowledge be put into the hands 99:59:59.999 --> 99:59:59.999 of psychotherapists and parents and patients 99:59:59.999 --> 99:59:59.999 struggling with self-injury, 99:59:59.999 --> 99:59:59.999 post pardem depression and post pardem psychosis? 99:59:59.999 --> 99:59:59.999 Sometimes, soon after giving birth 99:59:59.999 --> 99:59:59.999 Some women become depressed, 99:59:59.999 --> 99:59:59.999 they become seriously depressed and sometimes psychotic. 99:59:59.999 --> 99:59:59.999 They may neglect their newborn, 99:59:59.999 --> 99:59:59.999 and in some extreme cases, 99:59:59.999 --> 99:59:59.999 even harm the child. 99:59:59.999 --> 99:59:59.999 Equine veteranarians also know that a mare, 99:59:59.999 --> 99:59:59.999 soon after giving birth, 99:59:59.999 --> 99:59:59.999 will neglect the foul, refusing to nurture it, 99:59:59.999 --> 99:59:59.999 and in some instances, kick the foul even to death. 99:59:59.999 --> 99:59:59.999 But veterinarians have divised 99:59:59.999 --> 99:59:59.999 an intervention to deal with this foul rejection syndrome 99:59:59.999 --> 99:59:59.999 that involves increasing oxytocin in the mare, 99:59:59.999 --> 99:59:59.999 oxytocin is the bonding hormone. 99:59:59.999 --> 99:59:59.999 And this leads to renewed interest 99:59:59.999 --> 99:59:59.999 on the part of the mare in her foul. 99:59:59.999 --> 99:59:59.999 Shouldn't this information 99:59:59.999 --> 99:59:59.999 be put into the hands of OBGYNs 99:59:59.999 --> 99:59:59.999 and family doctors and patients 99:59:59.999 --> 99:59:59.999 who are struggling with postpartum depression and psychosis? 99:59:59.999 --> 99:59:59.999 Well despite all of this promise, 99:59:59.999 --> 99:59:59.999 unfortunately, the gulf between our fields remains large. 99:59:59.999 --> 99:59:59.999 To explain it, I'm afraid I'm going to have to air 99:59:59.999 --> 99:59:59.999 some dirty laundry. 99:59:59.999 --> 99:59:59.999 Some physicians can be real snobs 99:59:59.999 --> 99:59:59.999 about doctors who are not MDs. 99:59:59.999 --> 99:59:59.999 I'm talking about dentists and optomitrists and psychologists 99:59:59.999 --> 99:59:59.999 and optomitrists and psychologists. 99:59:59.999 --> 99:59:59.999 But maybe especially, animal doctors. 99:59:59.999 --> 99:59:59.999 Of course, most physicians 99:59:59.999 --> 99:59:59.999 don't realize that it's harder 99:59:59.999 --> 99:59:59.999 to get into vet school these days than medical school. 99:59:59.999 --> 99:59:59.999 And that when we go to medical school, 99:59:59.999 --> 99:59:59.999 we learn everything there is to konw 99:59:59.999 --> 99:59:59.999 about one species, homo sapiens. 99:59:59.999 --> 99:59:59.999 But veterinarians need to learn about health and disease. 99:59:59.999 --> 99:59:59.999 in mammals, amphibians, reptiles, fish and birds. 99:59:59.999 --> 99:59:59.999 So I don't blame the vets 99:59:59.999 --> 99:59:59.999 for feeling annoyed by 99:59:59.999 --> 99:59:59.999 my profession's condescension and ignorance. 99:59:59.999 --> 99:59:59.999 But here's one from the vets: 99:59:59.999 --> 99:59:59.999 What do you call a veteranarian 99:59:59.999 --> 99:59:59.999 who can only take care of one species? 99:59:59.999 --> 99:59:59.999 A physician. 99:59:59.999 --> 99:59:59.999 Closing the gap has become a passion for me 99:59:59.999 --> 99:59:59.999 and I'm doing this through programs 99:59:59.999 --> 99:59:59.999 like Darwin on Rounds at UCLA 99:59:59.999 --> 99:59:59.999 where we're bringing animal experts and evolutionary biologists 99:59:59.999 --> 99:59:59.999 and embedding them on our medical teams 99:59:59.999 --> 99:59:59.999 with our interns and our residents. 99:59:59.999 --> 99:59:59.999 And through Zoobiquity conferences 99:59:59.999 --> 99:59:59.999 where we bring medical schools together with veterinary schools 99:59:59.999 --> 99:59:59.999 for collabortive discussions 99:59:59.999 --> 99:59:59.999 of the shared diseases and disorders 99:59:59.999 --> 99:59:59.999 of animal and human patients. 99:59:59.999 --> 99:59:59.999 At Zoobiquity conferences, 99:59:59.999 --> 99:59:59.999 participants learn how treating breast cancer in a tiger 99:59:59.999 --> 99:59:59.999 can help us better treat breast cancer 99:59:59.999 --> 99:59:59.999 in a kindergarten teacher. 99:59:59.999 --> 99:59:59.999 How understanding polycistic overies in a holstein cow 99:59:59.999 --> 99:59:59.999 can help us better take care 99:59:59.999 --> 99:59:59.999 of a dance instructor with painful periods. 99:59:59.999 --> 99:59:59.999 And how better understanding the treatment of separation anxiety 99:59:59.999 --> 99:59:59.999 in a high-strung Sheltie 99:59:59.999 --> 99:59:59.999 can help a high strung child on his first days of school. 99:59:59.999 --> 99:59:59.999 In the United States and now internationally 99:59:59.999 --> 99:59:59.999 At Zoobiquity conferences, 99:59:59.999 --> 99:59:59.999 physicians and veterinarians check their attitudes and their preconceptions 99:59:59.999 --> 99:59:59.999 at the door and come together as colleagues 99:59:59.999 --> 99:59:59.999 as peers, as doctors. 99:59:59.999 --> 99:59:59.999 After all, we humans are animals, too. 99:59:59.999 --> 99:59:59.999 And it's time for us physicians to embrace 99:59:59.999 --> 99:59:59.999 our patients and our own animal natures 99:59:59.999 --> 99:59:59.999 and join veterinarians 99:59:59.999 --> 99:59:59.999 in a species-spannign approach to health. 99:59:59.999 --> 99:59:59.999 Because it turns out, 99:59:59.999 --> 99:59:59.999 some of the best and most humanistic medicine 99:59:59.999 --> 99:59:59.999 is being practiced by doctors whose patients aren't human. 99:59:59.999 --> 99:59:59.999 And one of the best ways we can take care 99:59:59.999 --> 99:59:59.999 of the human patient is by paying close attention 99:59:59.999 --> 99:59:59.999 to how the other patients on the planet 99:59:59.999 --> 99:59:59.999 live, grow, get sick and heal. 99:59:59.999 --> 99:59:59.999 Thank you. 99:59:59.999 --> 99:59:59.999 (Applause).