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10 years ago,
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I got a phone call that
changed my life.
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At the time, I was
cardiologist at UCLA,
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specializing in cardiac
imaging techniques.
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The call came from a veterinarian
at the Los Angeles Zoo.
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An elderly female chimpanzee
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had woken up with a facial droop
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and the veterinarians were worried
that she'd had a stroke.
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They asked if I 'd
come to the zoo
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and image the animal's heart
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to look for a possible
cardiac cause.
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Now, to be clear, North American
zoos are staffed
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by highly qualified,
board-certified veterinarians
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who take outstanding
care of animal patients.
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But occasionally, they do reach into
the human medical community,
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particularly for some
speciality consultation,
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and I was one of the lucky physicians
who was invited in to help.
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I had a chance to rule out
a stroke in this chimpanzee
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and make sure that this gorilla
didn't have a torn aorta.
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Evaluate this macaw
for a heart murmur.
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Make sure that this Californian sea lion's
paracardium wasn't inflamed.
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And in this picture, I'm listening
to the heart of a lion
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after a lifesaving collaborative procedure
with veteranarians and physicians
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where we drained 700 CCs of
fluid from the sack
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in which this lion's
heart was contained.
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And this procedure, which I have
done on many human patients,
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was identical, with the exception
of that paw and that tail.
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Now most of the time, I was
working at UCLA Medical Center
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with physicians, discussing symptoms
and diagnoses and treatments
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for my human patients.
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But some of the time, I was
working at the Los Angeles Zoo
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with veterinarians, discussing
symptoms, diagnoses and treatments
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for their animal patients.
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And occasionally, on
the very same day,
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I went on rounds at
UCLA Medical Center
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and at the Los Angeles Zoo,
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and here's what started coming
into very clear focus for me.
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Physicians and veterinarians
were essentially taking care
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of the same disorders in their
animal and human patients
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congestive heart failure, brain tumors,
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lukemia, diabetes,
arthritis, ALS, breast cancer,
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even psychiatric syndromes
like depression, anxiety,
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compulsions, eating disorders
and self injury.
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Now, I've got a confession to make.
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Even though I studied comparative
physiology and evolutionary biology
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as an undergrad,
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I had even written my senior
thesis on Darwinian theory,
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learning about the
significant overlap
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between the disorders of
animals and humans
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--it came as a much needed
wake up call for me.
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So I started wondering,
with all of these overlaps,
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how was it that I had never
thought to ask a veterinarian,
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or consult the veterinary literature,
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for insights into one
of my human patients?
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Why had I never, nor had any of my
physician friends and colleagues
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whom I asked, ever attended
a veterinary conference?
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For that matter, why was
any of this a surprise?
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I mean look, every single physician
accepts some biological connection
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between animals and humans.
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Every medication that we prescribe
or that we've taken ourselves
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or we've given to our families
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has first been tested on an animal.
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But there's something very different
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about giving an animal a
medication or a human disease
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and the animal developing
congestive heart failure
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or diabetes or breats cancer
on their own.
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Now maybe some of the surprise
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comes from the increasing
separation in our world
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between the urban and the non-urban.
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You know, we hear about
these city kids who
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think that wool grows on trees
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or that cheese comes from a plant.
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Well today's human hospitals
increasingly are turning
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into these gleaming cathedrals
of technology.
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And this creates a psychological
distance between the human patients
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who are being treated there
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and animal patients who
are living in oceans
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and farms and jungles.
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But I think there's an
even deeper reason.
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Physicians and scientists, we accept,
intellectually, that our species
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homo sapiens, is merely
one species
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no more unique or
special than any other.
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But in our hearts, we don't
completely believe that.
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I feel it myself when I'm
listening to Motzart
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or looking at pictures of the
Mars Rover on my MacBook.
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I feel that tug of
human exceptionalism,
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even as I recognize the
scientifically isolating cost
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of seeing ourselves as a
superior species, apart.
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Well, I'm trying these days.
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When I see a human patient
now, I always ask,
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"what do the animal doctors know
about this problem that I don't know?"
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and "Might I be taking better
care of my human patient
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if I saw them as a human
animal patient?"
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Here are a few examples of the
kind of exciting connections
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that this kind of
thinking has led me to:
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fear-induced heart failure.
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Around the year 2000,
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human cardiologists "discovered"
emotionally induced heart failure.
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It was described in a gambling father
who had lost his life's savings
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with the roll of a dice,
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in a bride who'd
been left at the alter.
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But it turns out this
"new human diagnosis"
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was neither new, nor
was it uniquely human.
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Veterinarians had been diagnosing,
treating and even preventing
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emotionally-induced
symptoms in animals,
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ranging from monkeys to flamingos,
from to deer to rabbits,
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since the 1970s.
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How many human lives
might have been saved
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if this veterinary knowledge had
been put into the hands
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of ER docs and cardiologists?
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Self-injury.
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Some human patients
harm themselves.
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Some pluck out patches of hair,
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others actually cut themselves.
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Some animal patients
also harm themselves.
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There are birds that
pluck out feathers.
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There are stallions that repetitively
bite their flanks until they bleed.
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But veterinarians have very specific
and very effective ways
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of treating and even
preventing self-injury
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in their self-injuring animals.
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Shouldn't this veterinary knowledge
be put into the hands
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of psychotherapists and
parents and patients
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struggling with self-injury?
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Postpartum depression and
postpartum psychosis.
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Sometimes, soon after giving birth
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some women become depressed.
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And sometimes, they become seriously
depressed and even psychotic.
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They may neglect their newborn,
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and in some extreme cases,
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even harm the child.
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Equine veteranarians also
know that occasionally,
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a mare, soon after giving birth,
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will neglect the foal,
refusing to nurse,
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and in some instances,
kick the foal, even to death.
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But veterinarians have divised
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an intervention to deal with
this Foal Rejection syndrome
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that involves increasing
oxytocin in the mare,
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oxytocin is the bonding hormone.
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And this leads to renewed interest,
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on the part of the mare, in her foal.
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Shouldn't this information
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be put into the hands of OBGYNs
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and family doctors and patients
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who are struggling with postpartum
depression and psychosis?
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Well despite all of this promise,
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unfortunately, the gulf between
our fields remains large.
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To explain it, I'm afraid I'm
going to have to air
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some dirty laundry.
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Some physicians can
be real snobs
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about doctors who are not MDs.
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I'm talking about dentists and
optomitrists and psychologists
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But maybe especially, animal doctors.
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Of course, most physicians
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don't realize that it is harder
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to get into vet school these
days than medical school.
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And that when we go
to medical school,
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we learn everything
there is to know
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about one species, homo sapiens.
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But veterinarians need to learn
about health and disease
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in mammals, amphibians,
reptiles, fish and birds.
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So I don't blame the vets
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for feeling annoyed by
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my profession's condescension
and ignorance.
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But here's one from the vets:
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What do you call a veteranarian
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who can only take
care of one species?
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A physician.
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Closing the gap has become
a passion for me
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and I'm doing this
through programs
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like Darwin on Rounds at UCLA,
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where we're bringing animal experts
and evolutionary biologists
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and embedding them on
our medical teams
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with our interns and our residents
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and through Zoobiquity conferences,
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where we bring medical schools
together with veterinary schools
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for collabortive discussions
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of the shared diseases and disorders
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of animal and human patients.
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At Zoobiquity conferences,
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participants learn how treating
breast cancer in a tiger
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can help us better
treat breast cancer
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in a kindergarten teacher.
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How understanding polycistic
overies in a Holstein cow
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can help us better take care
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of a dance instructor
with painful periods.
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And how better understanding the
treatment of separation anxiety
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in a high-strung Sheltie
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can help an anxious young
child on his first days of school.
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In the United States and
now internationally,
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at Zoobiquity conferences,
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physicians and veterinarians check
their attitudes and their preconceptions
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at the door and come
together as colleagues
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as peers, as doctors.
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After all, we humans
are animals, too.
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And it's time for us
physicians to embrace
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our patients' and
our own animal natures
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and join veterinarians
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in a species-spanning
approach to health.
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Because it turns out,
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some of the best and
most humanistic medicine
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is being practiced by doctors whose
patients aren't human.
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And one of the best ways
we can take care
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of the human patient is by
paying close attention
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to how the all other
patients on the planet
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live, grow, get sick and heal.
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Thank you.
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(Applause).
Csaba Lóki
There migh be a typo in the English original at 12:57
"overies" -> "ovaries"