What veterinarians know that doctors don't

What do you call a veterinarian that can only take care of one species? A physician. In a fascinating talk, Barbara Natterson-Horowitz shares how a species-spanning approach to health can improve medical care of the human animal — particularly when it comes to mental health.

Ten years ago,

I got a phone call that
changed my life.

At the time, I was
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'd had a stroke.

They asked if I'd
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 their 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 in 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 California sea lion's
paricardium wasn't inflamed,

and in this picture, I'm listening
to the heart of a lion

after a lifesaving,
collaborative procedure

with veterinarians and physicians

where we drained 700 cc's of
fluid from the sac

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 veterinarians, discussing
symptoms and 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 failure, brain tumors,

leukemia, diabetes,
arthritis, ALS, breast cancer,

even psychiatric syndromes
like depression, anxiety,

compulsions, eating disorders
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 veterinarian,

or consult the veterinary literature,

for insights into one
of my human patients?

Why had I never, nor had any of my
physician friends and colleagues

whom I asked, ever attended
a veterinary conference?

For that matter, why was
any of this a surprise?

I mean, look, every single physician
accepts some biological connection

between animals and humans.

Every medication that we prescribe
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 breast cancer
on their own.

Now, maybe some of the surprise

comes from the increasing
separation in our world

between the urban and the nonurban.

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,

increasingly, are turning into 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 Mozart

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 failure.

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 a roll of the dice,

in a bride who'd
been left at the alter.

But it turns out, this
"new" human diagnosis

was neither new, nor
was it uniquely human.

Veterinarians had been diagnosing,
treating and even preventing

emotionally induced
symptoms in animals

ranging from monkeys to flamingos,
from to deer to rabbits,

since the 1970s.

How many human lives
might have been saved

if this veterinary knowledge
had been put into the hands

of E.R. 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 until 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?

Postpartum depression and
postpartum psychosis.

Sometimes, soon after giving birth,

some women become depressed,

and sometimes they become seriously
depressed and even psychotic.

They may neglect their newborn,

and in some extreme cases,

even harm the child.

Equine veterinarians also
know that occasionally,

a mare, soon after giving birth,

will neglect the foal,
refusing to nurse,

and in some instances,
kick the foal, even to death.

But veterinarians have devised

an intervention to deal with
this foal rejection syndrome

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 foal.

Shouldn't this information

be put into the hands of ob/gyn's

and family doctors and patients

who are struggling with postpartum
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 M.D.'s.

I'm talking about dentists and
optometrists and psychologists,

but maybe especially animal doctors.

Of course, most physicians
don't realize that it is 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 know

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 veterinarian

who can only take
care of one species?

A physician. (Laughter)

Closing the gap has become
a passion 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 polycystic
overies in a Holstein 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 Sheltie

can help an anxious young child
struggling with his first days of school.

In the United States and now
internationally, at Zoobiquity conferences

physicians and veterinarians 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-spanning 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 all the other
patients on the planet

live, grow, get sick and heal.

Thank you.

(Applause).