What veterinarians know that doctors don't

10 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 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

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 CCs 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 the 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

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 the
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,

lukemia, diabetes,
arthritis, ALS, breast cancer,

even psychiatric symptoms 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 who 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 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 sapien, 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 t
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 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.

Veterinarians had been diagnosing,
treating, and even preventing

emotionally-induced
symptoms in animals,

ranging from monkeys to flamingos,
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 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 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

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).