1
00:00:01,619 --> 00:00:02,789
10 years ago,

2
00:00:03,062 --> 00:00:07,087
I got a phone call that
changed my life.

3
00:00:07,087 --> 00:00:10,849
At the time, I was 
cardiologist at UCLA,

4
00:00:10,849 --> 00:00:14,286
specializing in cardiac 
imaging techniques.

5
00:00:14,286 --> 00:00:19,815
The call came from a veterinarian
at the Los Angeles Zoo.

6
00:00:19,815 --> 00:00:22,469
An elderly female chimpanzee

7
00:00:22,469 --> 00:00:25,372
had woken up with a facial droop

8
00:00:25,372 --> 00:00:28,628
and the veterinarians were worried
that she'd had a stroke.

9
00:00:28,628 --> 00:00:32,033
They asked if I 'd 
come to the zoo

10
00:00:32,033 --> 00:00:33,721
and image the animal's heart

11
00:00:33,721 --> 00:00:37,291
to look for a possible
cardiac cause.

12
00:00:37,291 --> 00:00:40,929
Now, to be clear, North American
zoos are staffed

13
00:00:40,929 --> 00:00:45,058
by highly qualified, 
board-certified veterinarians

14
00:00:45,058 --> 00:00:49,727
who take outstanding 
care of animal patients.

15
00:00:49,727 --> 00:00:53,813
But occasionally, they do reach into 
the human medical community,

16
00:00:53,813 --> 00:00:58,414
particularly for some 
speciality consultation,

17
00:00:58,414 --> 00:01:04,233
and I was one of the lucky physicians
who was invited in to help.

18
00:01:04,233 --> 00:01:10,736
I had a chance to rule out
a stroke in this chimpanzee

19
00:01:10,736 --> 00:01:17,020
and make sure that this gorilla 
didn't have a torn aorta.

20
00:01:17,020 --> 00:01:21,777
Evaluate this macaw
for a heart murmur.

21
00:01:21,777 --> 00:01:29,326
Make sure that this Californian sea lion's
paracardium wasn't inflamed.

22
00:01:29,326 --> 00:01:33,504
And in this picture, I'm listening
to the heart of a lion

23
00:01:33,504 --> 00:01:39,943
after a lifesaving collaborative procedure 
with veteranarians and physicians

24
00:01:39,943 --> 00:01:44,165
where we drained 700 CCs of 
fluid from the sack

25
00:01:44,165 --> 00:01:48,569
in which this lion's 
heart was contained.

26
00:01:48,569 --> 00:01:53,382
And this procedure, which I have
done on many human patients,

27
00:01:53,382 --> 00:02:02,733
was identical, with the exception
of that paw and that tail.

28
00:02:02,733 --> 00:02:08,314
Now most of the time, I was
working at UCLA Medical Center

29
00:02:08,314 --> 00:02:14,348
with physicians, discussing symptoms
and diagnoses and treatments

30
00:02:14,348 --> 00:02:17,599
for my human patients.

31
00:02:17,599 --> 00:02:20,677
But some of the time, I was
working at the Los Angeles Zoo

32
00:02:20,677 --> 00:02:26,372
with veterinarians, discussing 
symptoms, diagnoses and treatments

33
00:02:26,372 --> 00:02:29,048
for their animal patients.

34
00:02:29,048 --> 00:02:33,841
And occasionally, on 
the very same day,

35
00:02:33,841 --> 00:02:37,620
I went on rounds at 
UCLA Medical Center

36
00:02:37,620 --> 00:02:40,523
and at the Los Angeles Zoo,

37
00:02:40,523 --> 00:02:46,861
and here's what started coming
into very clear focus for me.

38
00:02:46,861 --> 00:02:51,167
Physicians and veterinarians
were essentially taking care

39
00:02:51,167 --> 00:02:56,337
of the same disorders in their 
animal and human patients

40
00:02:56,337 --> 00:03:00,850
congestive heart failure, brain tumors,

41
00:03:00,850 --> 00:03:09,101
lukemia, diabetes, 
arthritis, ALS, breast cancer,

42
00:03:09,101 --> 00:03:12,641
even psychiatric syndromes
like depression, anxiety,

43
00:03:12,641 --> 00:03:20,788
compulsions, eating disorders
and self injury.

44
00:03:20,788 --> 00:03:23,666
Now, I've got a confession to make.

45
00:03:23,666 --> 00:03:30,515
Even though I studied comparative
physiology and evolutionary biology

46
00:03:30,515 --> 00:03:32,598
as an undergrad,

47
00:03:32,598 --> 00:03:37,316
I had even written my senior 
thesis on Darwinian theory,

48
00:03:37,316 --> 00:03:39,856
learning about the 
significant overlap

49
00:03:39,856 --> 00:03:42,592
between the disorders of 
animals and humans

50
00:03:42,592 --> 00:03:48,311
--it came as a much needed 
wake up call for me.

51
00:03:48,311 --> 00:03:52,799
So I started wondering,
with all of these overlaps,

52
00:03:52,799 --> 00:03:58,317
how was it that I had never
thought to ask a veterinarian,

53
00:03:58,317 --> 00:04:00,844
or consult the veterinary literature,

54
00:04:00,844 --> 00:04:05,043
for insights into one 
of my human patients?

55
00:04:05,043 --> 00:04:11,324
Why had I never, nor had any of my 
physician friends and colleagues

56
00:04:11,324 --> 00:04:18,847
whom I asked, ever attended 
a veterinary conference?

57
00:04:18,847 --> 00:04:24,443
For that matter, why was 
any of this a surprise?

58
00:04:24,443 --> 00:04:30,588
I mean look, every single physician
accepts some biological connection

59
00:04:30,588 --> 00:04:33,488
between animals and humans.

60
00:04:33,488 --> 00:04:38,257
Every medication that we prescribe
or that we've taken ourselves

61
00:04:38,257 --> 00:04:40,891
or we've given to our families


62
00:04:40,891 --> 00:04:44,621
has first been tested on an animal.

63
00:04:44,621 --> 00:04:46,227
But there's something very different

64
00:04:46,227 --> 00:04:52,832
about giving an animal a 
medication or a human disease

65
00:04:52,832 --> 00:04:56,777
and the animal developing 
congestive heart failure

66
00:04:56,777 --> 00:05:03,434
or diabetes or breats cancer 
on their own.

67
00:05:03,434 --> 00:05:05,985
Now maybe some of the surprise

68
00:05:05,985 --> 00:05:09,689
comes from the increasing
separation in our world

69
00:05:09,689 --> 00:05:13,573
between the urban and the non-urban.

70
00:05:13,573 --> 00:05:16,321
You know, we hear about 
these city kids who

71
00:05:16,321 --> 00:05:20,192
think that wool grows on trees

72
00:05:20,192 --> 00:05:24,256
or that cheese comes from a plant.

73
00:05:24,256 --> 00:05:29,279
Well today's human hospitals
increasingly are turning

74
00:05:29,279 --> 00:05:33,800
into these gleaming cathedrals
of technology.

75
00:05:33,810 --> 00:05:39,147
And this creates a psychological
distance between the human patients

76
00:05:39,147 --> 00:05:41,697
who are being treated there

77
00:05:41,697 --> 00:05:46,384
and animal patients who
are living in oceans

78
00:05:46,384 --> 00:05:49,802
and farms and jungles.

79
00:05:49,802 --> 00:05:54,561
But I think there's an 
even deeper reason.

80
00:05:54,561 --> 00:06:01,294
Physicians and scientists, we accept,
intellectually, that our species

81
00:06:01,294 --> 00:06:05,185
homo sapiens, is merely 
one species

82
00:06:05,185 --> 00:06:10,896
no more unique or
special than any other.

83
00:06:10,896 --> 00:06:16,952
But in our hearts, we don't 
completely believe that.

84
00:06:16,952 --> 00:06:21,106
I feel it myself when I'm 
listening to Motzart

85
00:06:21,106 --> 00:06:26,436
or looking at pictures of the 
Mars Rover on my MacBook.

86
00:06:26,436 --> 00:06:31,812
I feel that tug of 
human exceptionalism,

87
00:06:31,812 --> 00:06:36,370
even as I recognize the 
scientifically isolating cost

88
00:06:36,370 --> 00:06:43,046
of seeing ourselves as a
superior species, apart.

89
00:06:43,046 --> 00:06:45,979
Well, I'm trying these days.

90
00:06:45,979 --> 00:06:50,441
When I see a human patient
now, I always ask,

91
00:06:50,441 --> 00:06:55,283
"what do the animal doctors know
about this problem that I don't know?"

92
00:06:55,283 --> 00:07:01,055
and "Might I be taking better 
care of my human patient

93
00:07:01,055 --> 00:07:08,358
if I saw them as a human
animal patient?"

94
00:07:08,358 --> 00:07:12,395
Here are a few examples of the 
kind of exciting connections


95
00:07:12,395 --> 00:07:16,477
that this kind of 
thinking has led me to:

96
00:07:16,477 --> 00:07:19,084
fear-induced heart failure.

97
00:07:19,084 --> 00:07:21,398
Around the year 2000,

98
00:07:21,398 --> 00:07:28,898
human cardiologists "discovered"
emotionally induced heart failure.

99
00:07:28,898 --> 00:07:34,340
It was described in a gambling father 
who had lost his life's savings

100
00:07:34,340 --> 00:07:37,452
with the roll of a dice,

101
00:07:37,452 --> 00:07:41,823
in a bride who'd
been left at the alter.

102
00:07:41,823 --> 00:07:46,464
But it turns out this 
"new human diagnosis"

103
00:07:46,464 --> 00:07:50,939
was neither new, nor
was it uniquely human.

104
00:07:50,939 --> 00:07:57,177
Veterinarians had been diagnosing, 
treating and even preventing

105
00:07:57,177 --> 00:08:00,746
emotionally-induced
symptoms in animals,

106
00:08:00,746 --> 00:08:06,730
ranging from monkeys to flamingos,
from to deer to rabbits,

107
00:08:06,730 --> 00:08:11,318
since the 1970s.

108
00:08:11,318 --> 00:08:14,424
How many human lives 
might have been saved

109
00:08:14,424 --> 00:08:17,939
if this veterinary knowledge had 
been put into the hands

110
00:08:17,939 --> 00:08:23,485
of ER docs and cardiologists?

111
00:08:23,485 --> 00:08:25,887
Self-injury.

112
00:08:25,887 --> 00:08:30,232
Some human patients 
harm themselves.

113
00:08:30,232 --> 00:08:33,892
Some pluck out patches of hair,

114
00:08:33,892 --> 00:08:38,292
others actually cut themselves.

115
00:08:38,292 --> 00:08:42,384
Some animal patients 
also harm themselves.

116
00:08:42,384 --> 00:08:45,884
There are birds that 
pluck out feathers.

117
00:08:45,884 --> 00:08:53,693
There are stallions that repetitively
bite their flanks until they bleed.

118
00:08:53,693 --> 00:08:58,485
But veterinarians have very specific
and very effective ways

119
00:08:58,485 --> 00:09:03,294
of treating and even
preventing self-injury

120
00:09:03,294 --> 00:09:06,866
in their self-injuring animals.

121
00:09:06,866 --> 00:09:10,243
Shouldn't this veterinary knowledge
be put into the hands

122
00:09:10,243 --> 00:09:13,459
of psychotherapists and 
parents and patients

123
00:09:13,459 --> 00:09:18,097
struggling with self-injury?

124
00:09:18,097 --> 00:09:22,602
Postpartum depression and 
postpartum psychosis.

125
00:09:22,602 --> 00:09:25,707
Sometimes, soon after giving birth

126
00:09:25,707 --> 00:09:28,081
some women become depressed.

127
00:09:28,081 --> 00:09:32,707
And sometimes, they become seriously 
depressed and even psychotic.

128
00:09:32,707 --> 00:09:35,121
They may neglect their newborn,

129
00:09:35,121 --> 00:09:36,937
and in some extreme cases,

130
00:09:36,937 --> 00:09:40,346
even harm the child.

131
00:09:40,346 --> 00:09:45,522
Equine veteranarians also
know that occasionally,

132
00:09:45,522 --> 00:09:47,533
a mare, soon after giving birth,

133
00:09:47,533 --> 00:09:51,936
will neglect the foal,
refusing to nurse,

134
00:09:51,936 --> 00:09:57,018
and in some instances,
kick the foal, even to death.

135
00:09:57,018 --> 00:09:59,823
But veterinarians have divised

136
00:09:59,823 --> 00:10:05,656
an intervention to deal with
this Foal Rejection syndrome

137
00:10:05,656 --> 00:10:09,991
that involves increasing 
oxytocin in the mare,

138
00:10:09,991 --> 00:10:12,946
oxytocin is the bonding hormone.

139
00:10:12,946 --> 00:10:15,635
And this leads to renewed interest

140
00:10:15,635 --> 00:10:19,585
on the part of the mare in her foul.

141
00:10:19,585 --> 00:10:21,121
Shouldn't this information

142
00:10:21,121 --> 00:10:24,631
be put into the hands of OBGYNs

143
00:10:24,631 --> 00:10:27,914
and family doctors and patients

144
00:10:27,914 --> 00:10:35,456
who are struggling with postpartum
depression and psychosis?

145
00:10:35,456 --> 00:10:37,943
Well despite all of this promise,

146
00:10:37,943 --> 00:10:45,461
unfortunately, the gulf between
our fields remains large.

147
00:10:45,461 --> 00:10:48,335
To explain it, I'm afraid I'm 
going to have to air

148
00:10:48,335 --> 00:10:51,050
some dirty laundry.

149
00:10:51,050 --> 00:10:55,285
Some physicians can 
be real snobs

150
00:10:55,285 --> 00:10:57,649
about doctors who are not MDs.

151
00:10:57,649 --> 00:11:04,095
I'm talking about dentists and 
optomitrists and psychologists

152
00:11:04,095 --> 00:11:05,625
and optomitrists and psychologists.

153
00:11:05,625 --> 00:11:08,612
But maybe especially, animal doctors.

154
00:11:08,612 --> 00:11:09,955
Of course, most physicians

155
00:11:09,955 --> 00:11:12,063
don't realize that it's harder

156
00:11:12,063 --> 00:11:16,758
to get into vet school these
days than medical school.

157
00:11:16,758 --> 00:11:18,742
And that when we go 
to medical school,

158
00:11:18,742 --> 00:11:21,355
we learn everything there is to konw

159
00:11:21,355 --> 00:11:24,648
about one species, homo sapiens.

160
00:11:24,648 --> 00:11:28,785
But veterinarians need to learn
about health and disease.

161
00:11:28,785 --> 00:11:34,163
in mammals, amphibians,
reptiles, fish and birds.

162
00:11:34,163 --> 00:11:36,513
So I don't blame the vets

163
00:11:36,513 --> 00:11:38,777
for feeling annoyed by

164
00:11:38,777 --> 00:11:44,412
my profession's condescension
and ignorance.

165
00:11:44,412 --> 00:11:47,152
But here's one from the vets:

166
00:11:47,152 --> 00:11:50,559
What do you call a veteranarian

167
00:11:50,559 --> 00:11:56,816
who can only take care of one species?

168
00:11:56,816 --> 00:12:00,207
A physician.

169
00:12:00,207 --> 00:12:06,406
Closing the gap has become 
a passion for me

170
00:12:06,406 --> 00:12:08,757
and I'm doing this 
through programs

171
00:12:08,757 --> 00:12:11,689
like Darwin on Rounds at UCLA

172
00:12:11,689 --> 00:12:17,236
where we're bringing animal experts 
and evolutionary biologists

173
00:12:17,236 --> 00:12:21,388
and embedding them on 
our medical teams


174
00:12:21,388 --> 00:12:25,326
with our interns and our residents.

175
00:12:25,326 --> 00:12:29,033
And through Zoobiquity conferences

176
00:12:29,033 --> 00:12:33,252
where we bring medical schools 
together with veterinary schools

177
00:12:33,252 --> 00:12:35,392
for collabortive discussions

178
00:12:35,392 --> 00:12:38,193
of the shared diseases and disorders


179
00:12:38,193 --> 00:12:42,319
of animal and human patients.

180
00:12:42,319 --> 00:12:45,162
At Zoobiquity conferences,

181
00:12:45,162 --> 00:12:51,062
participants learn how treating
breast cancer in a tiger

182
00:12:51,062 --> 00:12:53,815
can help us better 
treat breast cancer

183
00:12:53,815 --> 00:12:56,846
in a kindergarten teacher.

184
00:12:56,846 --> 00:13:02,039
How understanding polycistic
overies in a holstein cow

185
00:13:02,039 --> 00:13:03,943
can help us better take care

186
00:13:03,943 --> 00:13:08,743
of a dance instructor with painful periods.

187
00:13:08,743 --> 00:13:13,152
And how better understanding the 
treatment of separation anxiety

188
00:13:13,152 --> 00:13:15,561
in a high-strung Sheltie

189
00:13:15,561 --> 00:13:22,962
can help a high strung child 
on his first days of school.

190
00:13:22,962 --> 00:13:26,087
In the United States and 
now internationally

191
00:13:26,087 --> 00:13:28,439
At Zoobiquity conferences,


192
00:13:28,439 --> 00:13:35,076
physicians and veterinarians check
their attitudes and their preconceptions

193
00:13:35,076 --> 00:13:41,100
at the door and come 
together as colleagues

194
00:13:41,100 --> 00:13:46,965
as peers, as doctors.

195
00:13:46,965 --> 00:13:52,385
After all, we humans 
are animals, too.

196
00:13:52,385 --> 00:13:55,845
And it's time for us 
physicians to embrace

197
00:13:55,845 --> 00:14:00,392
our patients and 
our own animal natures

198
00:14:00,392 --> 00:14:02,530
and join veterinarians

199
00:14:02,530 --> 00:14:08,238
in a species-spannign approach to health.

200
00:14:08,238 --> 00:14:10,161
Because it turns out,

201
00:14:10,161 --> 00:14:15,339
some of the best and 
most humanistic medicine

202
00:14:15,339 --> 00:14:20,469
is being practiced by doctors whose
patients aren't human.

203
00:14:20,469 --> 00:14:24,441
And one of the best ways 
we can take care

204
00:14:24,441 --> 00:14:29,242
of the human patient is by 
paying close attention

205
00:14:29,242 --> 00:14:32,655
to how the other 
patients on the planet

206
00:14:32,655 --> 00:14:39,312
live, grow, get sick and heal.

207
00:14:39,312 --> 00:14:40,197
Thank you.

208
00:14:40,197 --> 00:14:44,377
(Applause).