0:00:01.619,0:00:03.089 Ten years ago, 0:00:03.089,0:00:06.897 I got a phone call that[br]changed my life. 0:00:06.897,0:00:10.849 At the time, I was [br]cardiologist at UCLA, 0:00:10.849,0:00:14.286 specializing in cardiac [br]imaging techniques. 0:00:14.286,0:00:19.815 The call came from a veterinarian[br]at the Los Angeles Zoo. 0:00:19.815,0:00:22.469 An elderly female chimpanzee 0:00:22.469,0:00:25.292 had woken up with a facial droop 0:00:25.292,0:00:28.628 and the veterinarians were worried[br]that she'd had a stroke. 0:00:28.628,0:00:31.653 They asked if I'd [br]come to the zoo 0:00:31.653,0:00:33.601 and image the animal's heart 0:00:33.601,0:00:37.291 to look for a possible[br]cardiac cause. 0:00:37.291,0:00:40.929 Now, to be clear, North American[br]zoos are staffed 0:00:40.929,0:00:45.058 by highly qualified, [br]board-certified veterinarians 0:00:45.058,0:00:49.727 who take outstanding [br]care of their animal patients. 0:00:49.727,0:00:53.813 But occasionally, they do reach into [br]the human medical community, 0:00:53.813,0:00:58.414 particularly for some [br]speciality consultation, 0:00:58.414,0:01:04.233 and I was one of the lucky physicians[br]who was invited in to help. 0:01:04.233,0:01:10.736 I had a chance to rule out[br]a stroke in this chimpanzee 0:01:10.736,0:01:16.800 and make sure that this gorilla [br]didn't have a torn aorta, 0:01:16.800,0:01:21.587 evaluate this macaw[br]for a heart murmur, 0:01:21.587,0:01:29.056 make sure that this California sea lion's[br]paricardium wasn't inflamed, 0:01:29.056,0:01:33.314 and in this picture, I'm listening[br]to the heart of a lion 0:01:33.314,0:01:36.931 after a lifesaving, [br]collaborative procedure 0:01:36.931,0:01:39.848 with veterinarians and physicians 0:01:39.848,0:01:44.165 where we drained 700 cc's of [br]fluid from the sac 0:01:44.165,0:01:48.569 in which this lion's [br]heart was contained. 0:01:48.569,0:01:53.382 And this procedure, which I have[br]done on many human patients, 0:01:53.382,0:02:02.733 was identical, with the exception[br]of that paw and that tail. 0:02:02.733,0:02:09.124 Now most of the time, I was working[br]at UCLA Medical Center with physicians, 0:02:09.124,0:02:14.158 discussing symptoms[br]and diagnoses and treatments 0:02:14.158,0:02:17.599 for my human patients, 0:02:17.599,0:02:20.677 but some of the time,[br]I was working at the Los Angeles Zoo 0:02:20.677,0:02:26.122 with veterinarians, discussing [br]symptoms and diagnoses and treatments 0:02:26.122,0:02:28.748 for their animal patients. 0:02:28.748,0:02:33.841 And occasionally, on [br]the very same day, 0:02:33.841,0:02:37.620 I went on rounds at [br]UCLA Medical Center 0:02:37.620,0:02:40.523 and at the Los Angeles Zoo. 0:02:40.523,0:02:46.861 And here's what started coming[br]into very clear focus for me. 0:02:46.861,0:02:51.167 Physicians and veterinarians[br]were essentially taking care 0:02:51.167,0:02:56.337 of the same disorders in their [br]animal and human patients: 0:02:56.337,0:03:00.850 congestive heart failure, brain tumors, 0:03:00.850,0:03:09.101 leukemia, diabetes, [br]arthritis, ALS, breast cancer, 0:03:09.101,0:03:14.241 even psychiatric syndromes[br]like depression, anxiety, 0:03:14.241,0:03:20.788 compulsions, eating disorders[br]and self-injury. 0:03:20.788,0:03:23.666 Now, I've got a confession to make. 0:03:23.666,0:03:30.515 Even though I studied comparative[br]physiology and evolutionary biology 0:03:30.515,0:03:32.598 as an undergrad -- 0:03:32.598,0:03:37.136 I had even written my senior [br]thesis on Darwinian theory -- 0:03:37.136,0:03:39.856 learning about the [br]significant overlap 0:03:39.856,0:03:42.592 between the disorders of [br]animals and humans, 0:03:42.592,0:03:48.311 it came as a much needed [br]wake-up call for me. 0:03:48.311,0:03:52.799 So I started wondering,[br]with all of these overlaps, 0:03:52.799,0:03:58.317 how was it that I had never[br]thought to ask a veterinarian, 0:03:58.317,0:04:00.844 or consult the veterinary literature, 0:04:00.844,0:04:05.173 for insights into one [br]of my human patients? 0:04:05.173,0:04:11.324 Why had I never, nor had any of my [br]physician friends and colleagues 0:04:11.324,0:04:16.667 whom I asked, ever attended [br]a veterinary conference? 0:04:18.327,0:04:24.443 For that matter, why was [br]any of this a surprise? 0:04:24.443,0:04:30.588 I mean, look, every single physician[br]accepts some biological connection 0:04:30.588,0:04:33.488 between animals and humans. 0:04:33.488,0:04:38.257 Every medication that we prescribe[br]or that we've taken ourselves 0:04:38.257,0:04:40.891 or we've given to our families[br] 0:04:40.891,0:04:44.471 has first been tested on an animal. 0:04:44.471,0:04:46.227 But there's something very different 0:04:46.227,0:04:52.832 about giving an animal a [br]medication or a human disease 0:04:52.832,0:04:56.777 and the animal developing [br]congestive heart failure 0:04:56.777,0:05:03.324 or diabetes or breast cancer [br]on their own. 0:05:03.324,0:05:05.955 Now, maybe some of the surprise 0:05:05.955,0:05:09.539 comes from the increasing[br]separation in our world 0:05:09.539,0:05:13.423 between the urban and the nonurban. 0:05:13.423,0:05:16.121 You know, we hear about these city kids 0:05:16.121,0:05:20.192 who think that wool grows on trees 0:05:20.192,0:05:24.256 or that cheese comes from a plant. 0:05:24.256,0:05:26.989 Well, today's human hospitals, 0:05:26.989,0:05:33.800 increasingly, are turning into these[br]gleaming cathedrals of technology. 0:05:33.810,0:05:38.717 And this creates a psychological[br]distance between the human patients 0:05:38.717,0:05:41.437 who are being treated there 0:05:41.437,0:05:45.934 and animal patients who[br]are living in oceans 0:05:45.934,0:05:49.452 and farms and jungles. 0:05:49.452,0:05:54.561 But I think there's an [br]even deeper reason. 0:05:54.561,0:06:01.294 Physicians and scientists, we accept[br]intellectually that our species, 0:06:01.294,0:06:05.035 Homo sapiens, is merely [br]one species, 0:06:05.035,0:06:10.506 no more unique or[br]special than any other. 0:06:10.506,0:06:15.522 But in our hearts, we don't [br]completely believe that. 0:06:16.572,0:06:20.866 I feel it myself when I'm [br]listening to Mozart 0:06:20.866,0:06:26.266 or looking at pictures of the [br]Mars Rover on my MacBook. 0:06:26.266,0:06:31.812 I feel that tug of [br]human exceptionalism, 0:06:31.812,0:06:36.370 even as I recognize the [br]scientifically isolating cost 0:06:36.370,0:06:42.746 of seeing ourselves as a[br]superior species, apart. 0:06:42.746,0:06:45.979 Well, I'm trying these days. 0:06:45.979,0:06:50.441 When I see a human patient[br]now, I always ask, 0:06:50.441,0:06:55.283 what do the animal doctors know[br]about this problem that I don't know? 0:06:55.283,0:07:00.745 And, might I be taking better [br]care of my human patient 0:07:00.745,0:07:05.918 if I saw them as a human[br]animal patient? 0:07:07.858,0:07:12.095 Here are a few examples of the [br]kind of exciting connections[br] 0:07:12.095,0:07:16.057 that this kind of [br]thinking has led me to. 0:07:16.057,0:07:18.894 Fear-induced heart failure. 0:07:18.894,0:07:21.398 Around the year 2000, 0:07:21.398,0:07:28.898 human cardiologists "discovered"[br]emotionally induced heart failure. 0:07:28.898,0:07:34.000 It was described in a gambling father [br]who had lost his life's savings 0:07:34.000,0:07:37.152 with a roll of the dice, 0:07:37.152,0:07:41.823 in a bride who'd[br]been left at the alter. 0:07:41.823,0:07:46.464 But it turns out, this [br]"new" human diagnosis 0:07:46.464,0:07:50.939 was neither new, nor[br]was it uniquely human. 0:07:50.939,0:07:56.867 Veterinarians had been diagnosing, [br]treating and even preventing 0:07:56.867,0:08:00.746 emotionally induced[br]symptoms in animals 0:08:00.746,0:08:06.650 ranging from monkeys to flamingos,[br]from to deer to rabbits, 0:08:06.650,0:08:09.708 since the 1970s. 0:08:10.968,0:08:14.334 How many human lives [br]might have been saved 0:08:14.334,0:08:17.939 if this veterinary knowledge[br]had been put into the hands 0:08:17.939,0:08:21.845 of E.R. docs and cardiologists? 0:08:23.055,0:08:25.517 Self-injury. 0:08:25.517,0:08:29.652 Some human patients [br]harm themselves. 0:08:29.652,0:08:33.352 Some pluck out patches of hair, 0:08:33.352,0:08:36.452 others actually cut themselves. 0:08:38.242,0:08:42.064 Some animal patients [br]also harm themselves. 0:08:42.064,0:08:45.544 There are birds that [br]pluck out feathers. 0:08:45.544,0:08:53.313 There are stallions that repetitively[br]bite their flanks until they bleed. 0:08:53.313,0:08:58.485 But veterinarians have very specific[br]and very effective ways 0:08:58.485,0:09:02.904 of treating and even[br]preventing self-injury 0:09:02.904,0:09:06.686 in their self-injuring animals. 0:09:06.686,0:09:09.733 Shouldn't this veterinary knowledge[br]be put into the hands 0:09:09.733,0:09:13.459 of psychotherapists and [br]parents and patients 0:09:13.459,0:09:16.437 struggling with self-injury? 0:09:17.497,0:09:22.332 Postpartum depression and [br]postpartum psychosis. 0:09:22.332,0:09:25.467 Sometimes, soon after giving birth, 0:09:25.467,0:09:27.891 some women become depressed, 0:09:27.891,0:09:32.197 and sometimes they become seriously [br]depressed and even psychotic. 0:09:32.197,0:09:34.761 They may neglect their newborn, 0:09:34.761,0:09:36.937 and in some extreme cases, 0:09:36.937,0:09:40.086 even harm the child. 0:09:40.086,0:09:44.312 Equine veterinarians also[br]know that occasionally, 0:09:44.312,0:09:47.433 a mare, soon after giving birth, 0:09:47.433,0:09:50.646 will neglect the foal,[br]refusing to nurse, 0:09:50.646,0:09:55.718 and in some instances,[br]kick the foal, even to death. 0:09:57.018,0:09:59.823 But veterinarians have devised 0:09:59.823,0:10:05.296 an intervention to deal with[br]this foal rejection syndrome 0:10:05.296,0:10:09.561 that involves increasing [br]oxytocin in the mare. 0:10:09.561,0:10:12.946 Oxytocin is the bonding hormone, 0:10:12.946,0:10:15.635 and this leads to renewed interest, 0:10:15.635,0:10:19.065 on the part of the mare, in her foal. 0:10:19.065,0:10:21.121 Shouldn't this information 0:10:21.121,0:10:24.461 be put into the hands of ob/gyn's 0:10:24.461,0:10:27.794 and family doctors and patients 0:10:27.794,0:10:33.156 who are struggling with postpartum[br]depression and psychosis? 0:10:35.306,0:10:37.653 Well, despite all of this promise, 0:10:37.653,0:10:45.461 unfortunately the gulf between[br]our fields remains large. 0:10:45.461,0:10:50.990 To explain it, I'm afraid I'm going [br]to have to air some dirty laundry. 0:10:50.990,0:10:55.095 Some physicians can be real snobs 0:10:55.095,0:10:57.649 about doctors who are not M.D.'s. 0:10:57.649,0:11:03.975 I'm talking about dentists and [br]optometrists and psychologists, 0:11:03.975,0:11:08.202 but maybe especially animal doctors. 0:11:08.202,0:11:12.075 Of course, most physicians[br]don't realize that it is harder 0:11:12.075,0:11:16.458 to get into vet school these[br]days than medical school, 0:11:16.458,0:11:18.742 and that when we go [br]to medical school, 0:11:18.742,0:11:21.355 we learn everything [br]there is to know 0:11:21.355,0:11:24.478 about one species, Homo sapiens, 0:11:24.478,0:11:28.785 but veterinarians need to learn[br]about health and disease 0:11:28.785,0:11:33.763 in mammals, amphibians,[br]reptiles, fish and birds. 0:11:33.763,0:11:38.447 So I don't blame the vets[br]for feeling annoyed 0:11:38.447,0:11:44.412 by my profession's[br]condescension and ignorance. 0:11:44.412,0:11:47.152 But here's one from the vets: 0:11:47.152,0:11:50.559 What do you call a veterinarian 0:11:50.559,0:11:56.416 who can only take [br]care of one species? 0:11:56.416,0:11:59.737 A physician. (Laughter) 0:11:59.737,0:12:05.946 Closing the gap has become [br]a passion for me, 0:12:05.946,0:12:08.547 and I'm doing this [br]through programs 0:12:08.547,0:12:11.689 like Darwin on Rounds at UCLA, 0:12:11.689,0:12:17.236 where we're bringing animal experts [br]and evolutionary biologists 0:12:17.236,0:12:21.388 and embedding them[br]on our medical teams 0:12:21.388,0:12:25.326 with our interns and our residents. 0:12:25.326,0:12:29.033 And through Zoobiquity conferences, 0:12:29.033,0:12:33.252 where we bring medical schools [br]together with veterinary schools 0:12:33.252,0:12:35.392 for collabortive discussions 0:12:35.392,0:12:38.193 of the shared diseases and disorders[br] 0:12:38.193,0:12:42.319 of animal and human patients. 0:12:42.319,0:12:45.162 At Zoobiquity conferences, 0:12:45.162,0:12:50.582 participants learn how treating[br]breast cancer in a tiger 0:12:50.582,0:12:53.535 can help us better treat breast cancer 0:12:53.535,0:12:56.846 in a kindergarten teacher; 0:12:56.846,0:13:01.709 how understanding polycystic[br]overies in a Holstein cow 0:13:01.709,0:13:03.943 can help us better take care 0:13:03.943,0:13:08.503 of a dance instructor [br]with painful periods; 0:13:08.503,0:13:13.152 and how better understanding the [br]treatment of separation anxiety 0:13:13.152,0:13:15.561 in a high-strung Sheltie 0:13:15.561,0:13:22.962 can help an anxious young child[br]struggling with his first days of school. 0:13:22.962,0:13:28.207 In the United States and now [br]internationally, at Zoobiquity conferences 0:13:28.207,0:13:35.076 physicians and veterinarians check [br]their attitudes and their preconceptions 0:13:35.076,0:13:41.100 at the door and come [br]together as colleagues, 0:13:41.100,0:13:46.965 as peers, as doctors. 0:13:46.965,0:13:52.385 After all, we humans [br]are animals, too, 0:13:52.385,0:13:55.845 and it's time for us physicians to embrace 0:13:55.845,0:14:00.392 our patients' and our own animal natures 0:14:00.392,0:14:02.530 and join veterinarians 0:14:02.530,0:14:07.518 in a species-spanning approach to health. 0:14:07.518,0:14:09.731 Because it turns out, 0:14:09.731,0:14:14.929 some of the best and [br]most humanistic medicine 0:14:14.929,0:14:20.469 is being practiced by doctors[br]whose patients aren't human. 0:14:20.469,0:14:23.851 And one of the best ways [br]we can take care 0:14:23.851,0:14:28.952 of the human patient is by [br]paying close attention 0:14:28.952,0:14:32.655 to how all the other [br]patients on the planet 0:14:32.655,0:14:39.312 live, grow, get sick and heal. 0:14:39.312,0:14:41.897 Thank you. 0:14:41.897,0:14:44.377 (Applause).