TEDMED 2014
Barbara Natterson-Horowitz: What veterinarians know that physicians don't
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What do you call a veterinarian who 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.
Barbara Natterson-Horowitz - Cardiologist
Barbara Natterson-Horowitz, Professor of Medicine in the Division of Cardiology at UCLA Medical School, provides a unique perspective on how human well-being, including mental health, can be improved by insights into animal health. Full bio
Barbara Natterson-Horowitz, Professor of Medicine in the Division of Cardiology at UCLA Medical School, provides a unique perspective on how human well-being, including mental health, can be improved by insights into animal health. Full bio
Double-click the English transcript below to play the video.
00:13
Ten years ago,
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I got a phone call that
changed my life.
changed my life.
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At the time, I was
cardiologist at UCLA,
cardiologist at UCLA,
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specializing in cardiac
imaging techniques.
imaging techniques.
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The call came from a veterinarian
at the Los Angeles Zoo.
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.
that she'd had a stroke.
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They asked if I'd
come to the zoo
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.
cardiac cause.
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Now, to be clear, North American
zoos are staffed
zoos are staffed
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by highly qualified,
board-certified veterinarians
board-certified veterinarians
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who take outstanding
care of their animal patients.
care of their animal patients.
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But occasionally, they do reach into
the human medical community,
the human medical community,
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particularly for some
speciality consultation,
speciality consultation,
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and I was one of the lucky physicians
who was invited in to help.
who was invited in to help.
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I had a chance to rule out
a stroke in this chimpanzee
a stroke in this chimpanzee
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and make sure that this gorilla
didn't have a torn aorta,
didn't have a torn aorta,
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evaluate this macaw
for a heart murmur,
for a heart murmur,
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make sure that this California sea lion's
paricardium wasn't inflamed,
paricardium wasn't inflamed,
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and in this picture, I'm listening
to the heart of a lion
to the heart of a lion
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after a lifesaving,
collaborative procedure
collaborative procedure
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with veterinarians and physicians
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where we drained 700 cc's of
fluid from the sac
fluid from the sac
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in which this lion's
heart was contained.
heart was contained.
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And this procedure, which I have
done on many human patients,
done on many human patients,
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was identical, with the exception
of that paw and that tail.
of that paw and that tail.
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Now most of the time, I was working
at UCLA Medical Center with physicians,
at UCLA Medical Center with physicians,
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discussing symptoms
and diagnoses and treatments
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
I was working at the Los Angeles Zoo
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with veterinarians, discussing
symptoms and diagnoses and treatments
symptoms and diagnoses and treatments
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for their animal patients.
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And occasionally, on
the very same day,
the very same day,
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I went on rounds at
UCLA Medical Center
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.
into very clear focus for me.
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Physicians and veterinarians
were essentially taking care
were essentially taking care
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of the same disorders in their
animal and human patients:
animal and human patients:
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congestive heart failure, brain tumors,
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leukemia, diabetes,
arthritis, ALS, breast cancer,
arthritis, ALS, breast cancer,
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even psychiatric syndromes
like depression, anxiety,
like depression, anxiety,
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compulsions, eating disorders
and self-injury.
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
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 --
thesis on Darwinian theory --
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learning about the
significant overlap
significant overlap
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between the disorders of
animals and humans,
animals and humans,
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it came as a much needed
wake-up call for me.
wake-up call for me.
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So I started wondering,
with all of these overlaps,
with all of these overlaps,
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how was it that I had never
thought to ask a veterinarian,
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?
of my human patients?
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Why had I never, nor had any of my
physician friends and colleagues
physician friends and colleagues
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whom I asked, ever attended
a veterinary conference?
a veterinary conference?
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For that matter, why was
any of this a surprise?
any of this a surprise?
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I mean, look, every single physician
accepts some biological connection
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
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
medication or a human disease
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and the animal developing
congestive heart failure
congestive heart failure
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or diabetes or breast cancer
on their own.
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
separation in our world
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between the urban and the nonurban.
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You know, we hear about these city kids
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who 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,
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increasingly, are turning into these
gleaming cathedrals of technology.
gleaming cathedrals of technology.
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And this creates a psychological
distance between the human patients
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
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.
even deeper reason.
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Physicians and scientists, we accept
intellectually that our species,
intellectually that our species,
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Homo sapiens, is merely
one species,
one species,
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no more unique or
special than any other.
special than any other.
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But in our hearts, we don't
completely believe that.
completely believe that.
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I feel it myself when I'm
listening to Mozart
listening to Mozart
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or looking at pictures of the
Mars Rover on my MacBook.
Mars Rover on my MacBook.
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I feel that tug of
human exceptionalism,
human exceptionalism,
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even as I recognize the
scientifically isolating cost
scientifically isolating cost
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of seeing ourselves as a
superior species, apart.
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,
now, I always ask,
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what do the animal doctors know
about this problem that I don't know?
about this problem that I don't know?
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And, might I be taking better
care of my human patient
care of my human patient
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if I saw them as a human
animal patient?
animal patient?
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Here are a few examples of the
kind of exciting connections
kind of exciting connections
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that this kind of
thinking has led me to.
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.
emotionally induced heart failure.
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It was described in a gambling father
who had lost his life's savings
who had lost his life's savings
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with a roll of the dice,
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in a bride who'd
been left at the alter.
been left at the alter.
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But it turns out, this
"new" human diagnosis
"new" human diagnosis
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was neither new, nor
was it uniquely human.
was it uniquely human.
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Veterinarians had been diagnosing,
treating and even preventing
treating and even preventing
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emotionally induced
symptoms in animals
symptoms in animals
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ranging from monkeys to flamingos,
from to deer to rabbits,
from to deer to rabbits,
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since the 1970s.
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How many human lives
might have been saved
might have been saved
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if this veterinary knowledge
had been put into the hands
had been put into the hands
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of E.R. docs and cardiologists?
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Self-injury.
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Some human patients
harm themselves.
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.
also harm themselves.
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There are birds that
pluck out feathers.
pluck out feathers.
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There are stallions that repetitively
bite their flanks until they bleed.
bite their flanks until they bleed.
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But veterinarians have very specific
and very effective ways
and very effective ways
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of treating and even
preventing self-injury
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
be put into the hands
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of psychotherapists and
parents and patients
parents and patients
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struggling with self-injury?
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Postpartum depression and
postpartum psychosis.
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.
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 veterinarians also
know that occasionally,
know that occasionally,
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a mare, soon after giving birth,
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will neglect the foal,
refusing to nurse,
refusing to nurse,
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and in some instances,
kick the foal, even to death.
kick the foal, even to death.
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But veterinarians have devised
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an intervention to deal with
this foal rejection syndrome
this foal rejection syndrome
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that involves increasing
oxytocin in the mare.
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 ob/gyn's
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and family doctors and patients
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who are struggling with postpartum
depression and psychosis?
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.
our fields remains large.
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To explain it, I'm afraid I'm going
to have to air some dirty laundry.
to have to air some dirty laundry.
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Some physicians can be real snobs
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about doctors who are not M.D.'s.
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I'm talking about dentists and
optometrists and psychologists,
optometrists and psychologists,
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but maybe especially animal doctors.
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Of course, most physicians
don't realize that it is harder
don't realize that it is harder
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to get into vet school these
days than medical school,
days than medical school,
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and that when we go
to medical school,
to medical school,
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we learn everything
there is to know
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
about health and disease
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in mammals, amphibians,
reptiles, fish and birds.
reptiles, fish and birds.
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So I don't blame the vets
for feeling annoyed
for feeling annoyed
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by my profession's
condescension and ignorance.
condescension and ignorance.
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But here's one from the vets:
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What do you call a veterinarian
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who can only take
care of one species?
care of one species?
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A physician. (Laughter)
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Closing the gap has become
a passion for me,
a passion for me,
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and I'm doing this
through programs
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
and evolutionary biologists
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and embedding them
on our medical teams
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
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
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 polycystic
overies in a Holstein cow
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;
with painful periods;
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and how better understanding the
treatment of separation anxiety
treatment of separation anxiety
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in a high-strung Sheltie
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can help an anxious young child
struggling with his first days of school.
struggling with his first days of school.
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In the United States and now
internationally, at Zoobiquity conferences
internationally, at Zoobiquity conferences
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physicians and veterinarians check
their attitudes and their preconceptions
their attitudes and their preconceptions
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at the door and come
together as colleagues,
together as colleagues,
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as peers, as doctors.
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After all, we humans
are animals, too,
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
most humanistic medicine
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is being practiced by doctors
whose patients aren't human.
whose patients aren't human.
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And one of the best ways
we can take care
we can take care
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of the human patient is by
paying close attention
paying close attention
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to how all the other
patients on the planet
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).
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ABOUT THE SPEAKER
Barbara Natterson-Horowitz - CardiologistBarbara Natterson-Horowitz, Professor of Medicine in the Division of Cardiology at UCLA Medical School, provides a unique perspective on how human well-being, including mental health, can be improved by insights into animal health.
Why you should listen
Barbara Natterson-Horowitz is a cardiologist whose patients include gorillas, lions, wallabies and humans. Her medical rounds sometimes take place at the Los Angeles Zoo, or might include veterinarians in a discussion of human health at the Ronald Reagan UCLA Medical Center, but always channel the perspective of Charles Darwin. A professor in UCLA’s Division of Cardiology and in the Department of Ecology and Evolutionary Biology, Natterson-Horowitz's medical specialty is cardiac imaging -- but her academic passion is the evolutionary connection between human and animal bodies and minds. In 2012, she co-authored the book Zoobiquity: The Astonishing Connection Between Human and Animal Health, advocating a “One Health” approach to medicine. She founded the Zoobiquity Conferences to bring veterinarians and physicians together for “species-spanning” debates and collaborations.
More profile about the speakerBarbara Natterson-Horowitz | Speaker | TED.com