WEBVTT 00:00:01.619 --> 00:00:03.089 10 years ago, 00:00:03.089 --> 00:00:07.087 I got a phone call that changed my life. 00:00:07.087 --> 00:00:10.849 At the time, I was cardiologist at UCLA, 00:00:10.849 --> 00:00:14.286 specializing in cardiac imaging techniques. 00:00:14.286 --> 00:00:19.815 The call came from a veterinarian at the Los Angeles Zoo. 00:00:19.815 --> 00:00:22.469 An elderly female chimpanzee 00:00:22.469 --> 00:00:25.372 had woken up with a facial droop 00:00:25.372 --> 00:00:28.628 and the veterinarians were worried that she'd had a stroke. 00:00:28.628 --> 00:00:32.033 They asked if I 'd come to the zoo 00:00:32.033 --> 00:00:33.721 and image the animal's heart 00:00:33.721 --> 00:00:37.291 to look for a possible cardiac cause. 00:00:37.291 --> 00:00:40.929 Now, to be clear, North American zoos are staffed 00:00:40.929 --> 00:00:45.058 by highly qualified, board-certified veterinarians 00:00:45.058 --> 00:00:49.727 who take outstanding care of their animal patients. 00:00:49.727 --> 00:00:53.813 But occasionally, they do reach into the human medical community, 00:00:53.813 --> 00:00:58.414 particularly for some speciality consultation, 00:00:58.414 --> 00:01:04.233 and I was one of the lucky physicians who was invited in to help. 00:01:04.233 --> 00:01:10.736 I had a chance to rule out a stroke in this chimpanzee 00:01:10.736 --> 00:01:17.020 and make sure that this gorilla didn't have a torn aorta. 00:01:17.020 --> 00:01:21.777 Evaluate this macaw for a heart murmur. 00:01:21.777 --> 00:01:29.326 Make sure that this California sea lion's paracardium wasn't inflamed. 00:01:29.326 --> 00:01:33.314 And in this picture, I'm listening to the heart of a lion 00:01:33.314 --> 00:01:39.943 after a lifesaving, collaborative procedure with veteranarians and physicians 00:01:39.943 --> 00:01:44.165 where we drained 700 CCs of fluid from the sack 00:01:44.165 --> 00:01:48.569 in which this lion's heart was contained. 00:01:48.569 --> 00:01:53.382 And this procedure, which I have done on many human patients, 00:01:53.382 --> 00:02:02.733 was identical, with the exception of that paw and that tail. 00:02:02.733 --> 00:02:08.754 Now most of the time, I was working at UCLA Medical Center with physicians, 00:02:08.754 --> 00:02:14.348 discussing symptoms and diagnoses and treatments 00:02:14.348 --> 00:02:17.599 for my human patients. 00:02:17.599 --> 00:02:20.677 But some of the time, I was working at the Los Angeles Zoo 00:02:20.677 --> 00:02:26.372 with veterinarians, discussing symptoms and diagnoses and treatments 00:02:26.372 --> 00:02:29.048 for their animal patients. 00:02:29.048 --> 00:02:33.841 And occasionally, on the very same day, 00:02:33.841 --> 00:02:37.620 I went on rounds at UCLA Medical Center 00:02:37.620 --> 00:02:40.523 and at the Los Angeles Zoo. 00:02:40.523 --> 00:02:46.861 And here's what started coming into very clear focus for me. 00:02:46.861 --> 00:02:51.167 Physicians and veterinarians were essentially taking care 00:02:51.167 --> 00:02:56.337 of the same disorders in their animal and human patients: 00:02:56.337 --> 00:03:00.850 congestive heart failure, brain tumors, 00:03:00.850 --> 00:03:09.101 lukemia, diabetes, arthritis, ALS, breast cancer, 00:03:09.101 --> 00:03:12.641 even psychiatric syndromes like depression, anxiety, 00:03:12.641 --> 00:03:20.788 compulsions, eating disorders and self-injury. 00:03:20.788 --> 00:03:23.666 Now, I've got a confession to make. 00:03:23.666 --> 00:03:30.515 Even though I studied comparative physiology and evolutionary biology 00:03:30.515 --> 00:03:32.598 as an undergrad, 00:03:32.598 --> 00:03:37.316 I had even written my senior thesis on Darwinian theory, 00:03:37.316 --> 00:03:39.856 learning about the significant overlap 00:03:39.856 --> 00:03:42.592 between the disorders of animals and humans 00:03:42.592 --> 00:03:48.311 --it came as a much needed wake up call for me. 00:03:48.311 --> 00:03:52.799 So I started wondering, with all of these overlaps, 00:03:52.799 --> 00:03:58.317 how was it that I had never thought to ask a veterinarian, 00:03:58.317 --> 00:04:00.844 or consult the veterinary literature, 00:04:00.844 --> 00:04:05.043 for insights into one of my human patients? 00:04:05.043 --> 00:04:11.324 Why had I never, nor had any of my physician friends and colleagues 00:04:11.324 --> 00:04:18.847 whom I asked, ever attended a veterinary conference? 00:04:18.847 --> 00:04:24.443 For that matter, why was any of this a surprise? 00:04:24.443 --> 00:04:30.588 I mean look, every single physician accepts some biological connection 00:04:30.588 --> 00:04:33.488 between animals and humans. 00:04:33.488 --> 00:04:38.257 Every medication that we prescribe or that we've taken ourselves 00:04:38.257 --> 00:04:40.891 or we've given to our families 00:04:40.891 --> 00:04:44.471 has first been tested on an animal. 00:04:44.471 --> 00:04:46.227 But there's something very different 00:04:46.227 --> 00:04:52.832 about giving an animal a medication or a human disease 00:04:52.832 --> 00:04:56.777 and the animal developing congestive heart failure 00:04:56.777 --> 00:05:03.434 or diabetes or breats cancer on their own. 00:05:03.434 --> 00:05:05.985 Now maybe some of the surprise 00:05:05.985 --> 00:05:09.689 comes from the increasing separation in our world 00:05:09.689 --> 00:05:13.573 between the urban and the non-urban. 00:05:13.573 --> 00:05:16.321 You know, we hear about these city kids who 00:05:16.321 --> 00:05:20.192 think that wool grows on trees 00:05:20.192 --> 00:05:24.256 or that cheese comes from a plant. 00:05:24.256 --> 00:05:29.279 Well today's human hospitals, increasingly, are turning 00:05:29.279 --> 00:05:33.800 into these gleaming cathedrals of technology. 00:05:33.810 --> 00:05:39.147 And this creates a psychological distance between the human patients 00:05:39.147 --> 00:05:41.697 who are being treated there 00:05:41.697 --> 00:05:46.384 and animal patients who are living in oceans 00:05:46.384 --> 00:05:49.802 and farms and jungles. 00:05:49.802 --> 00:05:54.561 But I think there's an even deeper reason. 00:05:54.561 --> 00:06:01.294 Physicians and scientists, we accept, intellectually, that our species 00:06:01.294 --> 00:06:05.185 homo sapiens, is merely one species 00:06:05.185 --> 00:06:10.896 no more unique or special than any other. 00:06:10.896 --> 00:06:16.952 But in our hearts, we don't completely believe that. 00:06:16.952 --> 00:06:21.106 I feel it myself when I'm listening to Motzart 00:06:21.106 --> 00:06:26.436 or looking at pictures of the Mars Rover on my MacBook. 00:06:26.436 --> 00:06:31.812 I feel that tug of human exceptionalism, 00:06:31.812 --> 00:06:36.370 even as I recognize the scientifically isolating cost 00:06:36.370 --> 00:06:43.046 of seeing ourselves as a superior species, apart. 00:06:43.046 --> 00:06:45.979 Well, I'm trying these days. 00:06:45.979 --> 00:06:50.441 When I see a human patient now, I always ask, 00:06:50.441 --> 00:06:55.283 "what do the animal doctors know about this problem that I don't know?" 00:06:55.283 --> 00:07:01.055 and "might I be taking better care of my human patient 00:07:01.055 --> 00:07:08.358 if I saw them as a human animal patient?" 00:07:08.358 --> 00:07:12.395 Here are a few examples of the kind of exciting connections 00:07:12.395 --> 00:07:16.477 that this kind of thinking has led me to: 00:07:16.477 --> 00:07:19.084 fear-induced heart failure. 00:07:19.084 --> 00:07:21.398 Around the year 2000, 00:07:21.398 --> 00:07:28.898 human cardiologists "discovered" emotionally-induced heart failure. 00:07:28.898 --> 00:07:34.340 It was described in a gambling father who had lost his life's savings 00:07:34.340 --> 00:07:37.452 with the roll of the dice, 00:07:37.452 --> 00:07:41.823 in a bride who'd been left at the alter. 00:07:41.823 --> 00:07:46.464 But it turns out, this "new human diagnosis" 00:07:46.464 --> 00:07:50.939 was neither new, nor was it uniquely human. 00:07:50.939 --> 00:07:57.177 Veterinarians had been diagnosing, treating and even preventing 00:07:57.177 --> 00:08:00.746 emotionally-induced symptoms in animals, 00:08:00.746 --> 00:08:06.730 ranging from monkeys to flamingos, from to deer to rabbits, 00:08:06.730 --> 00:08:11.318 since the 1970s. 00:08:11.318 --> 00:08:14.424 How many human lives might have been saved 00:08:14.424 --> 00:08:17.939 if this veterinary knowledge had been put into the hands 00:08:17.939 --> 00:08:23.485 of ER docs and cardiologists? 00:08:23.485 --> 00:08:25.887 Self-injury. 00:08:25.887 --> 00:08:30.232 Some human patients harm themselves. 00:08:30.232 --> 00:08:33.892 Some pluck out patches of hair, 00:08:33.892 --> 00:08:38.292 others actually cut themselves. 00:08:38.292 --> 00:08:42.384 Some animal patients also harm themselves. 00:08:42.384 --> 00:08:45.884 There are birds that pluck out feathers. 00:08:45.884 --> 00:08:53.693 There are stallions that repetitively bite their flanks until they bleed. 00:08:53.693 --> 00:08:58.485 But veterinarians have very specific and very effective ways 00:08:58.485 --> 00:09:03.294 of treating and even preventing self-injury 00:09:03.294 --> 00:09:06.866 in their self-injuring animals. 00:09:06.866 --> 00:09:10.243 Shouldn't this veterinary knowledge be put into the hands 00:09:10.243 --> 00:09:13.459 of psychotherapists and parents and patients 00:09:13.459 --> 00:09:18.097 struggling with self-injury? 00:09:18.097 --> 00:09:22.602 Postpartum depression and postpartum psychosis. 00:09:22.602 --> 00:09:25.707 Sometimes, soon after giving birth 00:09:25.707 --> 00:09:28.081 some women become depressed. 00:09:28.081 --> 00:09:32.707 And sometimes, they become seriously depressed and even psychotic. 00:09:32.707 --> 00:09:35.121 They may neglect their newborn, 00:09:35.121 --> 00:09:36.937 and in some extreme cases, 00:09:36.937 --> 00:09:40.346 even harm the child. 00:09:40.346 --> 00:09:44.312 Equine veteranarians also know that occasionally, 00:09:44.312 --> 00:09:47.533 a mare, soon after giving birth, 00:09:47.533 --> 00:09:50.886 will neglect the foal, refusing to nurse, 00:09:50.886 --> 00:09:57.018 and in some instances, kick the foal, even to death. 00:09:57.018 --> 00:09:59.823 But veterinarians have divised 00:09:59.823 --> 00:10:05.656 an intervention to deal with this Foal Rejection syndrome 00:10:05.656 --> 00:10:09.991 that involves increasing oxytocin in the mare, 00:10:09.991 --> 00:10:12.946 oxytocin is the bonding hormone. 00:10:12.946 --> 00:10:15.635 And this leads to renewed interest, 00:10:15.635 --> 00:10:19.585 on the part of the mare, in her foal. 00:10:19.585 --> 00:10:21.121 Shouldn't this information 00:10:21.121 --> 00:10:24.631 be put into the hands of OBGYNs 00:10:24.631 --> 00:10:27.914 and family doctors and patients 00:10:27.914 --> 00:10:35.456 who are struggling with postpartum depression and psychosis? 00:10:35.456 --> 00:10:37.943 Well despite all of this promise, 00:10:37.943 --> 00:10:45.461 unfortunately, the gulf between our fields remains large. 00:10:45.461 --> 00:10:48.335 To explain it, I'm afraid I'm going to have to air 00:10:48.335 --> 00:10:51.050 some dirty laundry. 00:10:51.050 --> 00:10:55.285 Some physicians can be real snobs 00:10:55.285 --> 00:10:57.649 about doctors who are not MDs. 00:10:57.649 --> 00:11:03.975 I'm talking about dentists and optomitrists and psychologists. 00:11:03.975 --> 00:11:08.612 But maybe, especially, animal doctors. 00:11:08.612 --> 00:11:09.955 Of course, most physicians 00:11:09.955 --> 00:11:12.063 don't realize that it is harder 00:11:12.063 --> 00:11:16.758 to get into vet school these days than medical school. 00:11:16.758 --> 00:11:18.742 And that when we go to medical school, 00:11:18.742 --> 00:11:21.355 we learn everything there is to know 00:11:21.355 --> 00:11:24.648 about one species, homo sapiens. 00:11:24.648 --> 00:11:28.785 But veterinarians need to learn about health and disease 00:11:28.785 --> 00:11:34.163 in mammals, amphibians, reptiles, fish and birds. 00:11:34.163 --> 00:11:36.513 So I don't blame the vets 00:11:36.513 --> 00:11:38.777 for feeling annoyed by 00:11:38.777 --> 00:11:44.412 my profession's condescension and ignorance. 00:11:44.412 --> 00:11:47.152 But here's one from the vets: 00:11:47.152 --> 00:11:50.559 What do you call a veteranarian 00:11:50.559 --> 00:11:56.816 who can only take care of one species? 00:11:56.816 --> 00:12:00.207 A physician. 00:12:00.207 --> 00:12:06.406 Closing the gap has become a passion for me 00:12:06.406 --> 00:12:08.547 and I'm doing this through programs 00:12:08.547 --> 00:12:11.689 like Darwin on Rounds at UCLA, 00:12:11.689 --> 00:12:17.236 where we're bringing animal experts and evolutionary biologists 00:12:17.236 --> 00:12:21.388 and embedding them on our medical teams 00:12:21.388 --> 00:12:25.326 with our interns and our residents. 00:12:25.326 --> 00:12:29.033 And through Zoobiquity conferences, 00:12:29.033 --> 00:12:33.252 where we bring medical schools together with veterinary schools 00:12:33.252 --> 00:12:35.392 for collabortive discussions 00:12:35.392 --> 00:12:38.193 of the shared diseases and disorders 00:12:38.193 --> 00:12:42.319 of animal and human patients. 00:12:42.319 --> 00:12:45.162 At Zoobiquity conferences, 00:12:45.162 --> 00:12:51.062 participants learn how treating breast cancer in a tiger 00:12:51.062 --> 00:12:53.815 can help us better treat breast cancer 00:12:53.815 --> 00:12:56.846 in a kindergarten teacher. 00:12:56.846 --> 00:13:02.039 How understanding polycistic overies in a Holstein cow 00:13:02.039 --> 00:13:03.943 can help us better take care 00:13:03.943 --> 00:13:08.743 of a dance instructor with painful periods. 00:13:08.743 --> 00:13:13.152 And how better understanding the treatment of separation anxiety 00:13:13.152 --> 00:13:15.561 in a high-strung Sheltie 00:13:15.561 --> 00:13:22.962 can help an anxious young child, struggling with his first days of school. 00:13:22.962 --> 00:13:26.087 In the United States and now internationally, 00:13:26.087 --> 00:13:28.439 at Zoobiquity conferences, 00:13:28.439 --> 00:13:35.076 physicians and veterinarians check their attitudes and their preconceptions 00:13:35.076 --> 00:13:41.100 at the door and come together as colleagues 00:13:41.100 --> 00:13:46.965 as peers, as doctors. 00:13:46.965 --> 00:13:52.385 After all, we humans are animals, too. 00:13:52.385 --> 00:13:55.845 And it's time for us physicians to embrace 00:13:55.845 --> 00:14:00.392 our patients' and our own animal natures 00:14:00.392 --> 00:14:02.530 and join veterinarians 00:14:02.530 --> 00:14:08.238 in a species-spanning approach to health. 00:14:08.238 --> 00:14:10.161 Because it turns out, 00:14:10.161 --> 00:14:15.339 some of the best and most humanistic medicine 00:14:15.339 --> 00:14:20.469 is being practiced by doctors whose patients aren't human. 00:14:20.469 --> 00:14:23.851 And one of the best ways we can take care 00:14:23.851 --> 00:14:29.242 of the human patient is by paying close attention 00:14:29.242 --> 00:14:32.655 to how the all the other patients on the planet 00:14:32.655 --> 00:14:39.312 live, grow, get sick and heal. 00:14:39.312 --> 00:14:40.197 Thank you. 00:14:40.197 --> 00:14:44.377 (Applause).