Barbara Natterson-Horowitz: What veterinarians know that doctors don't

Summary

A cardiologist at UCLA recounts his transformative experience treating animals at the Los Angeles Zoo, revealing striking similarities in diseases between humans and animals. He advocates for a collaborative approach, 'Zoobiquity', to bridge the gap between human medicine and veterinary science, highlighting shared challenges like heart failure and psychiatric disorders. This interdisciplinary exchange could enhance treatments and deepen our understanding of health across species.

Takeaways

• 🐒 The speaker, a cardiologist, was called to the Los Angeles Zoo to help diagnose a chimpanzee's facial droop, highlighting the intersection of human and animal medicine.
• 🏥 Despite having highly qualified veterinarians, zoos sometimes seek human medical expertise for specialty consultations.
• 👩‍⚕️ The speaker found that both physicians and veterinarians deal with similar disorders in their patients, such as heart failure, tumors, and psychiatric conditions.
• 🧬 There's a significant overlap in diseases between animals and humans, which was a wake-up call for the speaker despite their background in comparative physiology.
• 🤔 The speaker questioned why human medical professionals don't consult veterinarians or veterinary literature for insights into human health.
• 🌳 The increasing separation between urban and nonurban lifestyles may contribute to the lack of integration between human and animal medicine.
• 🧠 There's a psychological barrier due to human exceptionalism that makes it difficult to see ourselves as part of the animal kingdom, despite scientific evidence.
• 🔍 The speaker now considers what veterinarians might know that could benefit human patients and explores the concept of 'human animal patients'.
• 💔 Emotionally induced heart failure was 'discovered' in humans in 2000, but veterinarians had been diagnosing and treating it in animals since the 1970s.
• 🐎 Veterinarians have developed effective interventions for conditions like postpartum depression in animals, which could potentially benefit human medicine.
• 🤝 The speaker is passionate about bridging the gap between human and animal medicine through programs like 'Darwin on Rounds' and 'Zoobiquity conferences'.

Q & A

What was the initial reason for the cardiologist's visit to the Los Angeles Zoo?

The cardiologist was called to the zoo to image the heart of an elderly female chimpanzee who had woken up with a facial droop, as the veterinarians were concerned she might have had a stroke.

How does the speaker describe the veterinarians at North American zoos?

The speaker describes the veterinarians at North American zoos as highly qualified, board-certified professionals who take outstanding care of their animal patients.

What was a surprising realization the speaker had while working with both human and animal patients?

The speaker was surprised to find that physicians and veterinarians were essentially dealing with the same disorders in their respective patients, such as congestive heart failure, brain tumors, leukemia, diabetes, arthritis, ALS, breast cancer, and even psychiatric syndromes.

Why did the speaker feel that the overlap in disorders between humans and animals was a wake-up call?

The speaker had studied comparative physiology and evolutionary biology, yet the significant overlap in disorders between animals and humans was not something they had considered before, prompting a reevaluation of their approach to medicine.

What was the speaker's initial reaction to the realization of the similarities in diseases between humans and animals?

The speaker felt that this realization was a much-needed wake-up call and started to question why they had never thought to consult veterinarians or the veterinary literature for insights into human patients.

What is one example the speaker gives of a condition that is not unique to humans but was 'discovered' by human cardiologists?

Fear-induced heart failure is an example given. While human cardiologists 'discovered' it around the year 2000, veterinarians had been diagnosing and treating it in animals since the 1970s.

How does the speaker suggest that the knowledge of veterinarians could benefit human medicine?

The speaker suggests that by incorporating veterinary knowledge, such as treatments for self-injury or postpartum depression in animals, human medicine could potentially save lives and improve patient care.

What is the Zoobiquity conference and what is its purpose?

The Zoobiquity conference is an event where medical schools are brought together with veterinary schools to discuss the shared diseases and disorders of animal and human patients, with the aim of fostering collaboration and learning between the two fields.

What is the Darwin on Rounds program and how does it work?

Darwin on Rounds is a program at UCLA where animal experts and evolutionary biologists are embedded on medical teams with interns and residents to promote interdisciplinary learning and collaboration.

What does the speaker believe is one of the main barriers to collaboration between physicians and veterinarians?

The speaker believes that one of the main barriers is the attitude of some physicians who can be snobbish about non-M.D. doctors, especially veterinarians, despite the fact that veterinarians have to learn about a wide range of species and conditions.

How does the speaker conclude the importance of considering humans as animals in the context of medicine?

The speaker concludes by emphasizing that humans are also animals and that physicians should embrace this fact, collaborate with veterinarians, and learn from the treatment of other species to improve human medicine.

Outlines

00:00

🐵 Human-Animal Medical Overlap

The speaker, a cardiologist, recounts a pivotal phone call that led to their involvement with the Los Angeles Zoo, where they discovered a significant overlap between human and animal medical conditions. They reflect on their experiences diagnosing and treating various animals, highlighting the similarities in disorders between species. The realization that both physicians and veterinarians deal with the same health issues, such as heart failure, brain tumors, and psychiatric conditions, prompts the speaker to question why there is a lack of integration between human and veterinary medicine. The speaker confesses to an inherent bias towards human exceptionalism, despite acknowledging the biological connections between humans and animals.

05:05

🌆 Bridging the Urban-Rural Divide

The speaker explores the potential reasons behind the separation between human and veterinary medicine, suggesting that urbanization and technological advancements in human hospitals have created a psychological distance. They also delve into the concept of human exceptionalism and how it may contribute to the reluctance to learn from veterinary practices. The speaker then provides examples of how veterinary knowledge could benefit human medicine, such as the treatment of fear-induced heart failure, self-injury, and postpartum depression. They argue for a more collaborative approach between the fields, suggesting that human medicine could greatly benefit from the insights gained from treating animals.

10:09

🤝 Closing the Gap Between Medicine and Veterinary Science

The speaker discusses the challenges in bridging the gap between human medicine and veterinary science, including the attitudes of some physicians towards veterinarians. They emphasize the broader knowledge base required of veterinarians compared to human doctors, who only focus on one species. The speaker shares their passion for closing this gap through initiatives like 'Darwin on Rounds' and 'Zoobiquity conferences,' which foster collaboration and knowledge exchange between medical and veterinary professionals. They conclude by advocating for a species-spanning approach to health, recognizing the value of veterinary medicine in enhancing human healthcare and the importance of understanding our shared animal nature.

Keywords

💡Cardiologist

A cardiologist is a medical professional specializing in the diagnosis and treatment of heart conditions. In the script, the speaker is a cardiologist who was called upon to image the heart of a chimpanzee at the Los Angeles Zoo, highlighting the interdisciplinary nature of medical expertise and its application beyond human medicine.

💡Veterinarian

A veterinarian is a professional who practices veterinary medicine by treating animals. The script mentions veterinarians at the Los Angeles Zoo who recognized the potential health issues in an elderly chimpanzee and sought help from a human cardiologist, indicating a collaborative approach to animal healthcare.

💡Comparative Physiology

Comparative physiology is the study of the functioning of organisms, often to draw parallels between different species. The speaker mentions having studied comparative physiology, which laid the groundwork for understanding the similarities in diseases between animals and humans, a central theme of the video.

💡Evolutionary Biology

Evolutionary biology examines the processes that have generated the diversity of life on Earth. The speaker's background in evolutionary biology is relevant as it provides a scientific basis for the shared disorders between animals and humans, emphasizing our common evolutionary heritage.

💡Human Exceptionalism

Human exceptionalism is the belief that humans are superior to other species. The script discusses how this belief can create a psychological distance between human and animal medicine, despite the biological similarities and the potential for cross-species medical insights.

💡Zoobiquity

Zoobiquity refers to the concept of viewing human health in the context of the broader animal kingdom. The term is used in the script to describe conferences and programs that bridge the gap between human and veterinary medicine, fostering a more holistic approach to health.

💡Emotionally Induced Heart Failure

Emotionally induced heart failure is a condition where emotional stress can lead to heart problems. The script reveals that while human cardiologists 'discovered' this in the year 2000, veterinarians had been diagnosing and treating it in animals since the 1970s, illustrating the potential for human medicine to learn from veterinary practices.

💡Self-Injury

Self-injury refers to the act of deliberately causing harm to oneself. The script discusses how both human patients and animal patients can exhibit self-injury behaviors, suggesting that veterinary knowledge on treating self-injury in animals could benefit human mental health practices.

💡Postpartum Depression

Postpartum depression is a type of mood disorder that can affect women after childbirth. The speaker mentions parallels between postpartum depression in humans and foal rejection syndrome in horses, where veterinarians have developed interventions that could inform human medical treatments.

💡Oxytocin

Oxytocin is a hormone that plays a role in social bonding and is associated with maternal behavior. In the script, the speaker discusses how increasing oxytocin levels can help mares bond with their foals, which could have implications for understanding and treating postpartum depression in humans.

💡Interdisciplinary Collaboration

Interdisciplinary collaboration involves experts from different fields working together to solve problems. The script emphasizes the importance of such collaboration between physicians and veterinarians to enhance understanding of shared diseases and improve treatments across species.

Highlights

A cardiologist was called to the Los Angeles Zoo to image a chimpanzee's heart for a possible stroke.

North American zoos sometimes seek human medical expertise for specialty consultations.

The speaker helped diagnose various animals, highlighting the similarity in medical procedures between humans and animals.

Physicians and veterinarians often deal with the same disorders in their patients.

The realization of significant overlap in animal and human disorders was a wake-up call for the speaker.

The speaker questioned why human medical professionals don't consult veterinarians or veterinary literature.

Every medication prescribed to humans has been tested on animals first.

The psychological distance between urban humans and animals may contribute to the separation of medical fields.

The speaker feels human exceptionalism despite recognizing its scientific limitations.

The speaker now considers what veterinarians know when treating human patients.

Fear-induced heart failure was 'discovered' in humans but has been known in animals since the 1970s.

Veterinarians have effective treatments for self-injury in animals, which could benefit human patients.

Postpartum depression in humans might benefit from veterinary knowledge of foal rejection syndrome.

The gap between human medicine and veterinary medicine is significant despite the potential for collaboration.

Some physicians are snobbish about non-M.D. doctors, including veterinarians.

Veterinarians are knowledgeable about a wider range of species than human doctors.

The speaker is passionate about closing the gap between human and veterinary medicine.

Programs like Darwin on Rounds and Zoobiquity conferences are fostering collaboration between medical and veterinary fields.

Zoobiquity conferences show how treating animals can improve human medicine.

Physicians and veterinarians should work together as colleagues for a species-spanning approach to health.

Some of the best humanistic medicine is practiced by doctors whose patients aren't human.

By observing other species, we can improve how we treat human patients.

Transcripts

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).