1 99:59:59,999 --> 99:59:59,999 10 years ago, 2 99:59:59,999 --> 99:59:59,999 I got a phone call that changed my life. 3 99:59:59,999 --> 99:59:59,999 At the time, I was cardiologist at UCLA, 4 99:59:59,999 --> 99:59:59,999 specializing in cardiac imaging techniques. 5 99:59:59,999 --> 99:59:59,999 The call came from a veterinarian at the Los Angeles Zoo. 6 99:59:59,999 --> 99:59:59,999 An elderly female chimpanzee 7 99:59:59,999 --> 99:59:59,999 had woken up with a facial droop 8 99:59:59,999 --> 99:59:59,999 and the veterinarians were worried that she had had a stroke. 9 99:59:59,999 --> 99:59:59,999 They asked if I could come to the zoo 10 99:59:59,999 --> 99:59:59,999 and image the animal's heart 11 99:59:59,999 --> 99:59:59,999 to look for a possible cardiac cause. 12 99:59:59,999 --> 99:59:59,999 Now, to be clear, North American 13 99:59:59,999 --> 99:59:59,999 North American zoos are staffed 14 99:59:59,999 --> 99:59:59,999 by highly qualified, board-certified veterinarians 15 99:59:59,999 --> 99:59:59,999 who take outstanding care of animal patients. 16 99:59:59,999 --> 99:59:59,999 But occasionally, they do reach into the human medical community, 17 99:59:59,999 --> 99:59:59,999 particularly for some speciality consultation, 18 99:59:59,999 --> 99:59:59,999 and I was one of the lucky physicians who was invited to help. 19 99:59:59,999 --> 99:59:59,999 I had a chance to rule out a stroke in this chimpanzee 20 99:59:59,999 --> 99:59:59,999 and make sure that this gorilla didn't have a torn aorta, 21 99:59:59,999 --> 99:59:59,999 evaluate this macaw for a heart murmur, 22 99:59:59,999 --> 99:59:59,999 make sure that this californian sea lion's paracardium wasn't inflammed, 23 99:59:59,999 --> 99:59:59,999 and in this picture, I'm listening to the heart of a lion 24 99:59:59,999 --> 99:59:59,999 after a lifesaving collaborative procedure with veteranarians and physicians. 25 99:59:59,999 --> 99:59:59,999 We drained 700 CCs of fluid from the sack 26 99:59:59,999 --> 99:59:59,999 in which this lion's heart was contained. 27 99:59:59,999 --> 99:59:59,999 And this procedure, which I have done on many human patients, 28 99:59:59,999 --> 99:59:59,999 was identical with the exception of that paw and that tail. 29 99:59:59,999 --> 99:59:59,999 Now most of the time, I was working at the UCLA Medical Center 30 99:59:59,999 --> 99:59:59,999 with physicians, discussing symptoms and diagnoses and treatments 31 99:59:59,999 --> 99:59:59,999 for my human patients. 32 99:59:59,999 --> 99:59:59,999 But some of the time, I was working at the Los Angeles Zoo 33 99:59:59,999 --> 99:59:59,999 i was working at the Los Angeles Zoo with veteranarians 34 99:59:59,999 --> 99:59:59,999 discussing symptoms, diagnoses and treatments 35 99:59:59,999 --> 99:59:59,999 for their animal patients. 36 99:59:59,999 --> 99:59:59,999 And occasionally, on the very same day, 37 99:59:59,999 --> 99:59:59,999 I went on rounds at the UCLA Medical Center 38 99:59:59,999 --> 99:59:59,999 and at the Los Angeles Zoo, 39 99:59:59,999 --> 99:59:59,999 and here's what started coming into very clear focus for me. 40 99:59:59,999 --> 99:59:59,999 Physicians and veterinarians were essentially taking care 41 99:59:59,999 --> 99:59:59,999 of the same disorders in :their animal and human patients 42 99:59:59,999 --> 99:59:59,999 congestive heart failure, brain tumors, 43 99:59:59,999 --> 99:59:59,999 lukemia, diabetes, arthritis, ALS, breast cancer, 44 99:59:59,999 --> 99:59:59,999 even psychiatric symptoms like depression, 45 99:59:59,999 --> 99:59:59,999 anxiety, compulsions, eating disorders and self injury. 46 99:59:59,999 --> 99:59:59,999 Now, I've got a confession to make. 47 99:59:59,999 --> 99:59:59,999 Even though I studied comparative physiology and evolutionary biology, 48 99:59:59,999 --> 99:59:59,999 as an undergrad, 49 99:59:59,999 --> 99:59:59,999 i had even written my senior thesis on darwinian theory, 50 99:59:59,999 --> 99:59:59,999 learning about the significant overlap between 51 99:59:59,999 --> 99:59:59,999 the disorders of animals and humans 52 99:59:59,999 --> 99:59:59,999 it came as a much needed wake up call for me 53 99:59:59,999 --> 99:59:59,999 so i started wondering, 54 99:59:59,999 --> 99:59:59,999 with all of these overlaps, 55 99:59:59,999 --> 99:59:59,999 how was it that i had never 56 99:59:59,999 --> 99:59:59,999 thought to ask a veteranarian 57 99:59:59,999 --> 99:59:59,999 or consult the veterinary literature 58 99:59:59,999 --> 99:59:59,999 for insights into one of my human patients? 59 99:59:59,999 --> 99:59:59,999 why had i never, nor had any of my physicians friends 60 99:59:59,999 --> 99:59:59,999 and colleagues, who i asked, 61 99:59:59,999 --> 99:59:59,999 ever attended a veterinary conference? 62 99:59:59,999 --> 99:59:59,999 for that matter, why was any of this a surprise? 63 99:59:59,999 --> 99:59:59,999 i mean look, every single physicians 64 99:59:59,999 --> 99:59:59,999 accepts some biological connection 65 99:59:59,999 --> 99:59:59,999 between animals and huamns 66 99:59:59,999 --> 99:59:59,999 every medication that we perscribe 67 99:59:59,999 --> 99:59:59,999 or that we've taken ourselves 68 99:59:59,999 --> 99:59:59,999 or we've given to our families 69 99:59:59,999 --> 99:59:59,999 has first been tested on an animal 70 99:59:59,999 --> 99:59:59,999 but there's something very different about 71 99:59:59,999 --> 99:59:59,999 giving an animal a medication or a human disease 72 99:59:59,999 --> 99:59:59,999 and the animal developing congestive heart failure 73 99:59:59,999 --> 99:59:59,999 or diabetes or breats cancer on their own 74 99:59:59,999 --> 99:59:59,999 now maybe some of the surprise 75 99:59:59,999 --> 99:59:59,999 comes from the increasing 76 99:59:59,999 --> 99:59:59,999 separation in our world 77 99:59:59,999 --> 99:59:59,999 between the urban and the non-urban 78 99:59:59,999 --> 99:59:59,999 you know, we hear about these city kids who 79 99:59:59,999 --> 99:59:59,999 think that wool grows on trees 80 99:59:59,999 --> 99:59:59,999 or that cheese comes from a plant 81 99:59:59,999 --> 99:59:59,999 well today's human hospitals 82 99:59:59,999 --> 99:59:59,999 are turning into increasingly 83 99:59:59,999 --> 99:59:59,999 these gleaming cathedrals 84 99:59:59,999 --> 99:59:59,999 of technology 85 99:59:59,999 --> 99:59:59,999 and this creates a psychological 86 99:59:59,999 --> 99:59:59,999 distance between the human patients who are being treated there 87 99:59:59,999 --> 99:59:59,999 and animal patients who are living in oceans 88 99:59:59,999 --> 99:59:59,999 and farms and jungles. 89 99:59:59,999 --> 99:59:59,999 but i think there's an even deeper reason 90 99:59:59,999 --> 99:59:59,999 physicians and scientists, 91 99:59:59,999 --> 99:59:59,999 we accept intellectually that our species, homo sapiens 92 99:59:59,999 --> 99:59:59,999 is merely one species, no more unique 93 99:59:59,999 --> 99:59:59,999 or special than any other 94 99:59:59,999 --> 99:59:59,999 but in our hearts, we don't completely BELIEVE THAT 95 99:59:59,999 --> 99:59:59,999 I feel it myself when I'm listening to motzart 96 99:59:59,999 --> 99:59:59,999 or looking at pictures of the Mars Rover 97 99:59:59,999 --> 99:59:59,999 on my macbook 98 99:59:59,999 --> 99:59:59,999 i feel that tug of human exceptionalism 99 99:59:59,999 --> 99:59:59,999 even as i recognize the 100 99:59:59,999 --> 99:59:59,999 scientifically isolating cost 101 99:59:59,999 --> 99:59:59,999 of seeing ourselves as a 102 99:59:59,999 --> 99:59:59,999 superior species apart 103 99:59:59,999 --> 99:59:59,999 well, I'm trying these days 104 99:59:59,999 --> 99:59:59,999 when i see a human patient now, 105 99:59:59,999 --> 99:59:59,999 i always ask, "what do the animal doctors know about this problem 106 99:59:59,999 --> 99:59:59,999 that I don't know?" 107 99:59:59,999 --> 99:59:59,999 and "might i be taking better care 108 99:59:59,999 --> 99:59:59,999 of my human patient if I saw them as a human animal patient?" 109 99:59:59,999 --> 99:59:59,999 here are a few examples of the kind of exciting connections 110 99:59:59,999 --> 99:59:59,999 that this kind of thinking has led me to 111 99:59:59,999 --> 99:59:59,999 fear induced heart fialure 112 99:59:59,999 --> 99:59:59,999 around the year 2000, 113 99:59:59,999 --> 99:59:59,999 human cardiologists discovered emotionally induced heart failure 114 99:59:59,999 --> 99:59:59,999 it was described in a gambling father who had lost his life's savings 115 99:59:59,999 --> 99:59:59,999 with the roll of a dice 116 99:59:59,999 --> 99:59:59,999 in a bride who had been left at the alter 117 99:59:59,999 --> 99:59:59,999 but it turns out that this "new human diagnosis" 118 99:59:59,999 --> 99:59:59,999 was neither new, nor was it uniquely human 119 99:59:59,999 --> 99:59:59,999 veteranarians had been diagnosing 120 99:59:59,999 --> 99:59:59,999 treating, and even preventing emotinally 121 99:59:59,999 --> 99:59:59,999 induced symptoms in animals 122 99:59:59,999 --> 99:59:59,999 ranging from monkeys to flamingos 123 99:59:59,999 --> 99:59:59,999 to deer to rabits 124 99:59:59,999 --> 99:59:59,999 since the 1970s 125 99:59:59,999 --> 99:59:59,999 how many human lives might have been saved 126 99:59:59,999 --> 99:59:59,999 if this veterinary knowledge had been 127 99:59:59,999 --> 99:59:59,999 put into the hands of ER docs and cardiologists? 128 99:59:59,999 --> 99:59:59,999 self injury 129 99:59:59,999 --> 99:59:59,999 some human patients harm themselves 130 99:59:59,999 --> 99:59:59,999 some pluck out patches of hair 131 99:59:59,999 --> 99:59:59,999 others actually cut themselves 132 99:59:59,999 --> 99:59:59,999 some animal patients also harm themselves 133 99:59:59,999 --> 99:59:59,999 there are birds that pluck out feathers 134 99:59:59,999 --> 99:59:59,999 there are stallions that repetitively bite their flanks till they bleed 135 99:59:59,999 --> 99:59:59,999 but veterinarians have very specific 136 99:59:59,999 --> 99:59:59,999 and very effective ways of treating and even preventing self injury 137 99:59:59,999 --> 99:59:59,999 in their self injuring animals 138 99:59:59,999 --> 99:59:59,999 shouldn't this veterinary knowledge be 139 99:59:59,999 --> 99:59:59,999 put into the hands of psychotherapists 140 99:59:59,999 --> 99:59:59,999 and parents and patients 141 99:59:59,999 --> 99:59:59,999 struggling with self injury 142 99:59:59,999 --> 99:59:59,999 post pardem depression and post pardem psychosis 143 99:59:59,999 --> 99:59:59,999 sometimes, 144 99:59:59,999 --> 99:59:59,999 soon after giving birth, some women 145 99:59:59,999 --> 99:59:59,999 become depressed and sometimes 146 99:59:59,999 --> 99:59:59,999 they become seriously depressed and sometimes 147 99:59:59,999 --> 99:59:59,999 psychotic 148 99:59:59,999 --> 99:59:59,999 they may neglect ehri newborn 149 99:59:59,999 --> 99:59:59,999 and in some extreme cases, 150 99:59:59,999 --> 99:59:59,999 even harm the child 151 99:59:59,999 --> 99:59:59,999 Equine veteranarians also 152 99:59:59,999 --> 99:59:59,999 know that a mare, soon after giving birth 153 99:59:59,999 --> 99:59:59,999 will neglect the foul 154 99:59:59,999 --> 99:59:59,999 refusing to nurture it 155 99:59:59,999 --> 99:59:59,999 and in some instances 156 99:59:59,999 --> 99:59:59,999 kick the foul even to death. 157 99:59:59,999 --> 99:59:59,999 But veterinarians have divised 158 99:59:59,999 --> 99:59:59,999 an intervention to deal with 159 99:59:59,999 --> 99:59:59,999 this foul rejection syndrom 160 99:59:59,999 --> 99:59:59,999 that involves increasing oxytocin in the mare 161 99:59:59,999 --> 99:59:59,999 oxytocin is the bonding hormone 162 99:59:59,999 --> 99:59:59,999 and this leads to renewed interest 163 99:59:59,999 --> 99:59:59,999 on the part of the mare in her foul 164 99:59:59,999 --> 99:59:59,999 shouldn't this information 165 99:59:59,999 --> 99:59:59,999 be put into the hands of OBGYNs 166 99:59:59,999 --> 99:59:59,999 and family doctors and patients 167 99:59:59,999 --> 99:59:59,999 who are struggling with post pardem depression 168 99:59:59,999 --> 99:59:59,999 and psychosis? 169 99:59:59,999 --> 99:59:59,999 well despite all of this promise 170 99:59:59,999 --> 99:59:59,999 unfortunately, the gulf between our fields 171 99:59:59,999 --> 99:59:59,999 remains large 172 99:59:59,999 --> 99:59:59,999 to explain it, I'm afraid 173 99:59:59,999 --> 99:59:59,999 I'm going to have to air some dirty laundry 174 99:59:59,999 --> 99:59:59,999 some physicians can be real snobs 175 99:59:59,999 --> 99:59:59,999 about doctors who are not MDs 176 99:59:59,999 --> 99:59:59,999 I'm talking about dentists 177 99:59:59,999 --> 99:59:59,999 and optomitrists and psychologists 178 99:59:59,999 --> 99:59:59,999 but maybe especially, animal doctors 179 99:59:59,999 --> 99:59:59,999 of course, most physicians 180 99:59:59,999 --> 99:59:59,999 don't realize that it's harder 181 99:59:59,999 --> 99:59:59,999 to get into vet school these days 182 99:59:59,999 --> 99:59:59,999 than medical school 183 99:59:59,999 --> 99:59:59,999 and that when we go to medical school, 184 99:59:59,999 --> 99:59:59,999 we learn everything there is to konw 185 99:59:59,999 --> 99:59:59,999 about one species, homo sapiens 186 99:59:59,999 --> 99:59:59,999 but veterinarians need to learn 187 99:59:59,999 --> 99:59:59,999 about health and disease 188 99:59:59,999 --> 99:59:59,999 in mammals, amphibians, 189 99:59:59,999 --> 99:59:59,999 reptiles, fish and birds 190 99:59:59,999 --> 99:59:59,999 so, i don't blame the vets 191 99:59:59,999 --> 99:59:59,999 for feeling annoyed by 192 99:59:59,999 --> 99:59:59,999 my profession's condescension 193 99:59:59,999 --> 99:59:59,999 and ignorance 194 99:59:59,999 --> 99:59:59,999 but here's one from the vets 195 99:59:59,999 --> 99:59:59,999 what do you call a veteranarian 196 99:59:59,999 --> 99:59:59,999 who can only take care of one species? 197 99:59:59,999 --> 99:59:59,999 a physician. 198 99:59:59,999 --> 99:59:59,999 closing the gap has become a passions for me 199 99:59:59,999 --> 99:59:59,999 and I'm doing this through programs 200 99:59:59,999 --> 99:59:59,999 like darwin on rounds at UCLA 201 99:59:59,999 --> 99:59:59,999 where we're bringing animal experts and evolutionary biologists 202 99:59:59,999 --> 99:59:59,999 and embedding them on our medical teams 203 99:59:59,999 --> 99:59:59,999 with our interns and our residents 204 99:59:59,999 --> 99:59:59,999 and through zoobiquity conferences 205 99:59:59,999 --> 99:59:59,999 where we bring medical schools together 206 99:59:59,999 --> 99:59:59,999 with veterinary schools 207 99:59:59,999 --> 99:59:59,999 for collabortive discussions 208 99:59:59,999 --> 99:59:59,999 of the shared diseases and disorders 209 99:59:59,999 --> 99:59:59,999 of animal and human patients 210 99:59:59,999 --> 99:59:59,999 at zoobiquity conferences, 211 99:59:59,999 --> 99:59:59,999 participants learn how treating 212 99:59:59,999 --> 99:59:59,999 breast cancer in a tiger can 213 99:59:59,999 --> 99:59:59,999 help us better treat breast cancer in a kindergarten teacher 214 99:59:59,999 --> 99:59:59,999 how understanding polycistic overies in a hole steen cow 215 99:59:59,999 --> 99:59:59,999 can help us better take care 216 99:59:59,999 --> 99:59:59,999 of a dance instructor with painful periods 217 99:59:59,999 --> 99:59:59,999 and how better understanding the 218 99:59:59,999 --> 99:59:59,999 treatment of separation anxiety 219 99:59:59,999 --> 99:59:59,999 in a high strung shelty 220 99:59:59,999 --> 99:59:59,999 can help a high strung child on his first days of school 221 99:59:59,999 --> 99:59:59,999 in the united states and now internationally 222 99:59:59,999 --> 99:59:59,999 at zoobiquity conferences 223 99:59:59,999 --> 99:59:59,999 physicians and veteranarians check 224 99:59:59,999 --> 99:59:59,999 their attitudes and their preconceptions at the door 225 99:59:59,999 --> 99:59:59,999 and come together as colleagues 226 99:59:59,999 --> 99:59:59,999 as peers, 227 99:59:59,999 --> 99:59:59,999 as doctors 228 99:59:59,999 --> 99:59:59,999 after all, we humans 229 99:59:59,999 --> 99:59:59,999 are animals, too 230 99:59:59,999 --> 99:59:59,999 and it's time for us physicians to embrace 231 99:59:59,999 --> 99:59:59,999 our patients and our own animal natures 232 99:59:59,999 --> 99:59:59,999 and join veterinarians 233 99:59:59,999 --> 99:59:59,999 in a species-spannign approach to health 234 99:59:59,999 --> 99:59:59,999 because it turns out 235 99:59:59,999 --> 99:59:59,999 some of the best and most humanistic medicine 236 99:59:59,999 --> 99:59:59,999 is being practiced by doctors whose 237 99:59:59,999 --> 99:59:59,999 patients aren't human 238 99:59:59,999 --> 99:59:59,999 and one of the best ways we can take care 239 99:59:59,999 --> 99:59:59,999 of the human patient is by paying close 240 99:59:59,999 --> 99:59:59,999 attention to how the other patients on the planet 241 99:59:59,999 --> 99:59:59,999 live, grow, get sick and heal 242 99:59:59,999 --> 99:59:59,999 Thank you. 243 99:59:59,999 --> 99:59:59,999 (Applause).