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