9:59:59.000,9:59:59.000
10 years ago,

9:59:59.000,9:59:59.000
I got a phone call that[br]changed my life.

9:59:59.000,9:59:59.000
At the time, I was [br]cardiologist at UCLA,

9:59:59.000,9:59:59.000
specializing in cardiac [br]imaging techniques.

9:59:59.000,9:59:59.000
The call came from a veterinarian[br]at the Los Angeles Zoo.

9:59:59.000,9:59:59.000
An elderly female chimpanzee

9:59:59.000,9:59:59.000
had woken up with a facial droop

9:59:59.000,9:59:59.000
and the veterinarians were worried[br]that she had had a stroke.

9:59:59.000,9:59:59.000
They asked if I could [br]come to the zoo

9:59:59.000,9:59:59.000
and image the animal's heart

9:59:59.000,9:59:59.000
to look for a possible cardiac cause.

9:59:59.000,9:59:59.000
Now, to be clear, North American

9:59:59.000,9:59:59.000
North American zoos [br]are staffed

9:59:59.000,9:59:59.000
by highly qualified, [br]board-certified veterinarians

9:59:59.000,9:59:59.000
who take outstanding [br]care of animal patients.

9:59:59.000,9:59:59.000
But occasionally, they do reach into [br]the human medical community,

9:59:59.000,9:59:59.000
particularly for some [br]speciality consultation,

9:59:59.000,9:59:59.000
and I was one of the lucky physicians[br]who was invited to help.

9:59:59.000,9:59:59.000
I had a chance to rule out[br]a stroke in this chimpanzee

9:59:59.000,9:59:59.000
and make sure that this gorilla [br]didn't have a torn aorta,

9:59:59.000,9:59:59.000
evaluate this macaw[br]for a heart murmur,

9:59:59.000,9:59:59.000
make sure that this californian sea lion's[br]paracardium wasn't inflammed,

9:59:59.000,9:59:59.000
and in this picture, I'm listening[br]to the heart of a lion

9:59:59.000,9:59:59.000
after a lifesaving collaborative procedure [br]with veteranarians and physicians.

9:59:59.000,9:59:59.000
We drained 700 CCs of [br]fluid from the sack

9:59:59.000,9:59:59.000
in which this lion's [br]heart was contained.

9:59:59.000,9:59:59.000
And this procedure, which I have[br]done on many human patients,

9:59:59.000,9:59:59.000
was identical with the exception[br]of that paw and that tail.

9:59:59.000,9:59:59.000
Now most of the time, I was[br]working at the UCLA Medical Center

9:59:59.000,9:59:59.000
with physicians, discussing symptoms[br]and diagnoses and treatments

9:59:59.000,9:59:59.000
for my human patients.

9:59:59.000,9:59:59.000
But some of the time, I was[br]working at the Los Angeles Zoo

9:59:59.000,9:59:59.000
i was working at the [br]Los Angeles Zoo with veteranarians

9:59:59.000,9:59:59.000
discussing symptoms, [br]diagnoses and treatments

9:59:59.000,9:59:59.000
for their animal patients.

9:59:59.000,9:59:59.000
And occasionally, on [br]the very same day,

9:59:59.000,9:59:59.000
I went on rounds at the [br]UCLA Medical Center

9:59:59.000,9:59:59.000
and at the Los Angeles Zoo,

9:59:59.000,9:59:59.000
and here's what started coming[br]into very clear focus for me.

9:59:59.000,9:59:59.000
Physicians and veterinarians[br]were essentially taking care

9:59:59.000,9:59:59.000
of the same disorders in :their [br]animal and human patients

9:59:59.000,9:59:59.000
congestive heart failure, brain tumors,

9:59:59.000,9:59:59.000
lukemia, diabetes, [br]arthritis, ALS, breast cancer,

9:59:59.000,9:59:59.000
even psychiatric symptoms like depression,

9:59:59.000,9:59:59.000
anxiety, compulsions, eating disorders[br]and self injury.

9:59:59.000,9:59:59.000
Now, I've got a confession to make.

9:59:59.000,9:59:59.000
Even though I studied comparative[br]physiology and evolutionary biology,

9:59:59.000,9:59:59.000
as an undergrad,

9:59:59.000,9:59:59.000
i had even written my senior thesis[br]on darwinian theory,

9:59:59.000,9:59:59.000
learning about the significant [br]overlap between

9:59:59.000,9:59:59.000
the disorders of animals and humans

9:59:59.000,9:59:59.000
it came as a much needed wake up call for me

9:59:59.000,9:59:59.000
so i started wondering,

9:59:59.000,9:59:59.000
with all of these overlaps,

9:59:59.000,9:59:59.000
how was it that i had never

9:59:59.000,9:59:59.000
thought to ask a veteranarian

9:59:59.000,9:59:59.000
or consult the veterinary literature

9:59:59.000,9:59:59.000
for insights into one [br]of my human patients?[br]

9:59:59.000,9:59:59.000
why had i never, nor [br]had any of my physicians friends

9:59:59.000,9:59:59.000
and colleagues, who i asked,

9:59:59.000,9:59:59.000
ever attended a veterinary conference?

9:59:59.000,9:59:59.000
for that matter, why was any of this a surprise?

9:59:59.000,9:59:59.000
i mean look, every single physicians

9:59:59.000,9:59:59.000
accepts some biological connection

9:59:59.000,9:59:59.000
between animals and huamns

9:59:59.000,9:59:59.000
every medication that we perscribe

9:59:59.000,9:59:59.000
or that we've taken ourselves

9:59:59.000,9:59:59.000
or we've given to our families

9:59:59.000,9:59:59.000
has first been tested on an animal

9:59:59.000,9:59:59.000
but there's something very different about

9:59:59.000,9:59:59.000
giving an animal a medication or a human disease

9:59:59.000,9:59:59.000
and the animal developing congestive heart failure

9:59:59.000,9:59:59.000
or diabetes or breats cancer on their own

9:59:59.000,9:59:59.000
now maybe some of the surprise

9:59:59.000,9:59:59.000
comes from the increasing

9:59:59.000,9:59:59.000
separation in our world

9:59:59.000,9:59:59.000
between the urban and the non-urban

9:59:59.000,9:59:59.000
you know, we hear about these city kids who

9:59:59.000,9:59:59.000
think that wool grows on trees

9:59:59.000,9:59:59.000
or that cheese comes from a plant

9:59:59.000,9:59:59.000
well today's human hospitals

9:59:59.000,9:59:59.000
are turning into increasingly

9:59:59.000,9:59:59.000
these gleaming cathedrals

9:59:59.000,9:59:59.000
of technology

9:59:59.000,9:59:59.000
and this creates a psychological

9:59:59.000,9:59:59.000
distance between the human[br]patients who are being treated there

9:59:59.000,9:59:59.000
and animal patients who[br]are living in oceans

9:59:59.000,9:59:59.000
and farms and jungles.

9:59:59.000,9:59:59.000
but i think there's an even deeper reason

9:59:59.000,9:59:59.000
physicians and scientists,

9:59:59.000,9:59:59.000
we accept intellectually that our species, [br]homo sapiens

9:59:59.000,9:59:59.000
is merely one species, no more unique

9:59:59.000,9:59:59.000
or special than any other

9:59:59.000,9:59:59.000
but in our hearts, we don't completely BELIEVE THAT

9:59:59.000,9:59:59.000
I feel it myself when I'm listening to motzart

9:59:59.000,9:59:59.000
or looking at pictures of[br]the Mars Rover

9:59:59.000,9:59:59.000
on my macbook

9:59:59.000,9:59:59.000
i feel that tug of human exceptionalism

9:59:59.000,9:59:59.000
even as i recognize the

9:59:59.000,9:59:59.000
scientifically isolating cost

9:59:59.000,9:59:59.000
of seeing ourselves as a

9:59:59.000,9:59:59.000
superior species apart

9:59:59.000,9:59:59.000
well, I'm trying these days

9:59:59.000,9:59:59.000
when i see a human patient now,

9:59:59.000,9:59:59.000
i always ask, "what do the animal[br]doctors know about this problem

9:59:59.000,9:59:59.000
that I don't know?"

9:59:59.000,9:59:59.000
and "might i be taking better care

9:59:59.000,9:59:59.000
of my human patient if I saw[br]them as a human animal patient?"

9:59:59.000,9:59:59.000
here are a few examples of the kind[br]of exciting connections[br]

9:59:59.000,9:59:59.000
that this kind of thinking [br]has led me to

9:59:59.000,9:59:59.000
fear induced heart fialure

9:59:59.000,9:59:59.000
around the year 2000,

9:59:59.000,9:59:59.000
human cardiologists discovered[br]emotionally induced heart failure

9:59:59.000,9:59:59.000
it was described in a gambling father [br]who had lost his life's savings

9:59:59.000,9:59:59.000
with the roll of a dice

9:59:59.000,9:59:59.000
in a bride who had [br]been left at the alter

9:59:59.000,9:59:59.000
but it turns out that this [br]"new human diagnosis"

9:59:59.000,9:59:59.000
was neither new, nor[br]was it uniquely human

9:59:59.000,9:59:59.000
veteranarians had been diagnosing

9:59:59.000,9:59:59.000
treating, and even preventing emotinally

9:59:59.000,9:59:59.000
induced symptoms in animals

9:59:59.000,9:59:59.000
ranging from monkeys to flamingos

9:59:59.000,9:59:59.000
to deer to rabits

9:59:59.000,9:59:59.000
since the 1970s

9:59:59.000,9:59:59.000
how many human lives might have been saved

9:59:59.000,9:59:59.000
if this veterinary knowledge had been

9:59:59.000,9:59:59.000
put into the hands of ER docs and cardiologists?

9:59:59.000,9:59:59.000
self injury

9:59:59.000,9:59:59.000
some human patients harm themselves

9:59:59.000,9:59:59.000
some pluck out patches of hair

9:59:59.000,9:59:59.000
others actually cut themselves

9:59:59.000,9:59:59.000
some animal patients also harm themselves

9:59:59.000,9:59:59.000
there are birds that pluck out feathers

9:59:59.000,9:59:59.000
there are stallions that repetitively[br]bite their flanks till they bleed

9:59:59.000,9:59:59.000
but veterinarians have very specific

9:59:59.000,9:59:59.000
and very effective ways of treating and even preventing self injury

9:59:59.000,9:59:59.000
in their self injuring animals

9:59:59.000,9:59:59.000
shouldn't this veterinary knowledge be

9:59:59.000,9:59:59.000
put into the hands of psychotherapists

9:59:59.000,9:59:59.000
and parents and patients

9:59:59.000,9:59:59.000
struggling with self injury

9:59:59.000,9:59:59.000
post pardem depression and post pardem psychosis

9:59:59.000,9:59:59.000
sometimes,

9:59:59.000,9:59:59.000
soon after giving birth, some women

9:59:59.000,9:59:59.000
become depressed and sometimes

9:59:59.000,9:59:59.000
they become seriously depressed and sometimes

9:59:59.000,9:59:59.000
psychotic

9:59:59.000,9:59:59.000
they may neglect ehri newborn

9:59:59.000,9:59:59.000
and in some extreme cases,

9:59:59.000,9:59:59.000
even harm the child

9:59:59.000,9:59:59.000
Equine veteranarians also

9:59:59.000,9:59:59.000
know that a mare, soon [br]after giving birth

9:59:59.000,9:59:59.000
will neglect the foul

9:59:59.000,9:59:59.000
refusing to nurture it

9:59:59.000,9:59:59.000
and in some instances

9:59:59.000,9:59:59.000
kick the foul even to death.

9:59:59.000,9:59:59.000
But veterinarians have divised

9:59:59.000,9:59:59.000
an intervention to deal with

9:59:59.000,9:59:59.000
this foul rejection syndrom

9:59:59.000,9:59:59.000
that involves increasing oxytocin in the mare

9:59:59.000,9:59:59.000
oxytocin is the bonding hormone

9:59:59.000,9:59:59.000
and this leads to renewed interest

9:59:59.000,9:59:59.000
on the part of the mare in her foul

9:59:59.000,9:59:59.000
shouldn't this information

9:59:59.000,9:59:59.000
be put into the hands of OBGYNs

9:59:59.000,9:59:59.000
and family doctors and patients

9:59:59.000,9:59:59.000
who are struggling with post pardem depression

9:59:59.000,9:59:59.000
and psychosis?

9:59:59.000,9:59:59.000
well despite all of this promise

9:59:59.000,9:59:59.000
unfortunately, the gulf between our fields

9:59:59.000,9:59:59.000
remains large

9:59:59.000,9:59:59.000
to explain it, I'm afraid

9:59:59.000,9:59:59.000
I'm going to have to air [br]some dirty laundry

9:59:59.000,9:59:59.000
some physicians can be [br]real snobs

9:59:59.000,9:59:59.000
about doctors who are not MDs

9:59:59.000,9:59:59.000
I'm talking about dentists

9:59:59.000,9:59:59.000
and optomitrists and psychologists

9:59:59.000,9:59:59.000
but maybe especially, animal doctors

9:59:59.000,9:59:59.000
of course, most physicians

9:59:59.000,9:59:59.000
don't realize that it's harder

9:59:59.000,9:59:59.000
to get into vet school these days

9:59:59.000,9:59:59.000
than medical school

9:59:59.000,9:59:59.000
and that when we go to medical school,

9:59:59.000,9:59:59.000
we learn everything there is to konw

9:59:59.000,9:59:59.000
about one species, homo sapiens

9:59:59.000,9:59:59.000
but veterinarians need to learn

9:59:59.000,9:59:59.000
about health and disease

9:59:59.000,9:59:59.000
in mammals, amphibians,

9:59:59.000,9:59:59.000
reptiles, fish and birds

9:59:59.000,9:59:59.000
so, i don't blame the vets

9:59:59.000,9:59:59.000
for feeling annoyed by

9:59:59.000,9:59:59.000
my profession's condescension

9:59:59.000,9:59:59.000
and ignorance

9:59:59.000,9:59:59.000
but here's one from the vets

9:59:59.000,9:59:59.000
what do you call a veteranarian

9:59:59.000,9:59:59.000
who can only take care of one species?

9:59:59.000,9:59:59.000
a physician.

9:59:59.000,9:59:59.000
closing the gap has become a passions for me

9:59:59.000,9:59:59.000
and I'm doing this through programs

9:59:59.000,9:59:59.000
like darwin on rounds at UCLA

9:59:59.000,9:59:59.000
where we're bringing animal experts and[br]evolutionary biologists

9:59:59.000,9:59:59.000
and embedding them on our medical teams

9:59:59.000,9:59:59.000
with our interns and our residents

9:59:59.000,9:59:59.000
and through zoobiquity conferences

9:59:59.000,9:59:59.000
where we bring medical schools together

9:59:59.000,9:59:59.000
with veterinary schools

9:59:59.000,9:59:59.000
for collabortive discussions

9:59:59.000,9:59:59.000
of the shared diseases and disorders

9:59:59.000,9:59:59.000
of animal and human patients

9:59:59.000,9:59:59.000
at zoobiquity conferences,

9:59:59.000,9:59:59.000
participants learn how treating

9:59:59.000,9:59:59.000
breast cancer in a tiger can

9:59:59.000,9:59:59.000
help us better treat breast cancer in a kindergarten teacher

9:59:59.000,9:59:59.000
how understanding polycistic overies in a hole steen cow

9:59:59.000,9:59:59.000
can help us better take care

9:59:59.000,9:59:59.000
of a dance instructor with painful periods

9:59:59.000,9:59:59.000
and how better understanding the

9:59:59.000,9:59:59.000
treatment of separation anxiety

9:59:59.000,9:59:59.000
in a high strung shelty

9:59:59.000,9:59:59.000
can help a high strung child on his first days of school

9:59:59.000,9:59:59.000
in the united states and now internationally

9:59:59.000,9:59:59.000
at zoobiquity conferences

9:59:59.000,9:59:59.000
physicians and veteranarians check

9:59:59.000,9:59:59.000
their attitudes and their preconceptions at the door

9:59:59.000,9:59:59.000
and come together as colleagues

9:59:59.000,9:59:59.000
as peers,

9:59:59.000,9:59:59.000
as doctors

9:59:59.000,9:59:59.000
after all, we humans

9:59:59.000,9:59:59.000
are animals, too

9:59:59.000,9:59:59.000
and it's time for us physicians to embrace

9:59:59.000,9:59:59.000
our patients and our own animal natures

9:59:59.000,9:59:59.000
and join veterinarians

9:59:59.000,9:59:59.000
in a species-spannign approach to health

9:59:59.000,9:59:59.000
because it turns out

9:59:59.000,9:59:59.000
some of the best and most humanistic medicine

9:59:59.000,9:59:59.000
is being practiced by doctors whose

9:59:59.000,9:59:59.000
patients aren't human

9:59:59.000,9:59:59.000
and one of the best ways we can take care

9:59:59.000,9:59:59.000
of the human patient is by paying close

9:59:59.000,9:59:59.000
attention to how the other patients on the planet

9:59:59.000,9:59:59.000
live, grow, get sick and heal

9:59:59.000,9:59:59.000
Thank you.

9:59:59.000,9:59:59.000
(Applause).