ABOUT THE SPEAKER
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.

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 speaker
Barbara Natterson-Horowitz | Speaker | TED.com
TEDMED 2014

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

Barbara Natterson-Horowitz: O que saben os veterinarios e os médicos ignoran

Filmed:
1,611,219 views

Como se lle chama a un veterinario que só sabe tratar unha especie? Médico. Nunha charla fascinante, Barbara Natterson-Horowitz amósanos como unha aproximación á saúde que abranga todas as especies pode mellorar os tratamentos médicos que recibe o animal humano --especialmente no referido á saúde mental.
- 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

Double-click the English transcript below to play the video.

00:13
Ten years ago,
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Hai dez anos
00:15
I got a phone call that
changed my life.
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recibín unha chamada telefónica
que cambiou a miña vida.
00:18
At the time, I was
cardiologist at UCLA,
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Daquela, eu era cardióloga na UCLA
[Universidade de California, Los Ángeles]
00:22
specializing in cardiac
imaging techniques.
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especializada en técnicas
de imaxe cardíaca.
00:26
The call came from a veterinarian
at the Los Angeles Zoo.
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Quen me chamaba era un veterinario
do Zoo de Los Ángeles.
00:31
An elderly female chimpanzee
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Unha vella chimpancé
00:34
had woken up with a facial droop
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espertara con parálise facial
00:37
and the veterinarians were worried
that she'd had a stroke.
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e aos veterinarios preocupábaos
que fose un infarto cerebral.
00:40
They asked if I'd
come to the zoo
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Preguntáronme se podía ir ao zoo
e facerlle un escáner ao corazón do animal
00:43
and image the animal's heart
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00:45
to look for a possible
cardiac cause.
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para procurar unha posible causa cardíaca.
00:49
Now, to be clear, North American
zoos are staffed
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Cómpre deixar claro que os zoos
dos Estados Unidos
00:52
by highly qualified,
board-certified veterinarians
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contan con equipos veterinarios
acreditados e altamente cualificados
00:57
who take outstanding
care of their animal patients.
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que coidan de maneira excelente
dos seus pacientes animais.
01:01
But occasionally, they do reach into
the human medical community,
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Pero ás veces, diríxense
á comunidade médica,
01:05
particularly for some
speciality consultation,
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especialmente para algunha
consulta especializada,
e eu fun un dos afortunados médicos
aos que pediron axuda.
01:10
and I was one of the lucky physicians
who was invited in to help.
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01:16
I had a chance to rule out
a stroke in this chimpanzee
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Puiden descartar o infarto cerebral
no caso desta chimpancé
e asegurarme de que esta gorila
non sufría unha esgazadura na aorta,
01:22
and make sure that this gorilla
didn't have a torn aorta,
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01:28
evaluate this macaw
for a heart murmur,
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avaliei este guacamaio
por un posible sopro cardíaco,
01:33
make sure that this California sea lion's
paricardium wasn't inflamed,
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e comprobei que o pericardio
deste león mariño non estaba inflamado.
01:41
and in this picture, I'm listening
to the heart of a lion
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Velaquí estou nesta foto,
auscultando o corazón dun león
01:45
after a lifesaving,
collaborative procedure
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despois de salvármoslle a vida,
nun procedemento colaborativo
01:48
with veterinarians and physicians
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de veterinarios e médicos
01:51
where we drained 700 cc's of
fluid from the sac
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no que lle extraemos 700 cc de fluído
01:56
in which this lion's
heart was contained.
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do saco que envolve o seu corazón.
02:00
And this procedure, which I have
done on many human patients,
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E este procedemento, que xa practiquei
en moitos pacientes humanos,
02:05
was identical, with the exception
of that paw and that tail.
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foi idéntico, coa excepción desa gadoupa
e desa cola.
(Risos)
A maior parte do tempo eu traballaba
con médicos no Centro Médico da UCLA,
02:14
Now most of the time, I was working
at UCLA Medical Center with physicians,
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02:21
discussing symptoms
and diagnoses and treatments
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debatendo síntomas,
diagnósticos e tratamentos
02:26
for my human patients,
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para os meus pacientes humanos;
pero ás veces traballaba con veterinarios
no Zoo de Los Ángeles,
02:29
but some of the time,
I was working at the Los Angeles Zoo
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02:32
with veterinarians, discussing
symptoms and diagnoses and treatments
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debatendo síntomas,
diagnósticos e tratamentos,
02:38
for their animal patients.
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para os seus pacientes animais.
02:40
And occasionally, on
the very same day,
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E de cando en vez, no mesmo día
02:45
I went on rounds at
UCLA Medical Center
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pasaba visitas no Centro Médico da UCLA
02:49
and at the Los Angeles Zoo.
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e no Zoo de Los Ángeles.
02:52
And here's what started coming
into very clear focus for me.
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E empecei a ver claramente unha cousa:
02:58
Physicians and veterinarians
were essentially taking care
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basicamente, os médicos e os veterinarios
03:03
of the same disorders in their
animal and human patients:
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atendían as mesmas doenzas
nos seus pacientes humanos e animais:
03:08
congestive heart failure, brain tumors,
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insuficiencias cardíacas conxestivas,
tumores cerebrais,
03:12
leukemia, diabetes,
arthritis, ALS, breast cancer,
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leucemia, diabetes, artrite, esclerose
lateral amiotrófica, cancro de peito,
03:21
even psychiatric syndromes
like depression, anxiety,
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incluso trastornos psiquiátricos,
como depresión, ansiedade,
03:26
compulsions, eating disorders
and self-injury.
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compulsións, desordes alimentarias
e autolesións.
03:32
Now, I've got a confession to make.
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Ben, teño que facerlles unha confesión.
03:35
Even though I studied comparative
physiology and evolutionary biology
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Aínda que estudei fisioloxía comparada
e bioloxía evolutiva
03:42
as an undergrad --
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durante a universidade
03:44
I had even written my senior
thesis on Darwinian theory --
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--mesmo fixen a miña tese de grao
sobre as teorías de Darwin--
03:49
learning about the
significant overlap
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aprender máis sobre
as significativas coincidencias
03:51
between the disorders of
animals and humans,
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entre as enfermidades animais e humanas
03:54
it came as a much needed
wake-up call for me.
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foi un toque de atención
moi necesario para min.
04:00
So I started wondering,
with all of these overlaps,
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E comecei a preguntarme como podía ser,
con todas esas coincidencias,
04:04
how was it that I had never
thought to ask a veterinarian,
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que nunca lle pedise opinión
a un veterinario
04:10
or consult the veterinary literature,
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ou consultase bibliografía veterinaria.
04:12
for insights into one
of my human patients?
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para ter outra perspectiva
sobre un dos meus pacientes humanos?
04:17
Why had I never, nor had any of my
physician friends and colleagues
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Por que ningún dos meus amigos
ou colegas médicos
04:23
whom I asked, ever attended
a veterinary conference?
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asistimos nunca
a unha conferencia veterinaria?
04:30
For that matter, why was
any of this a surprise?
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Aínda máis, por que debería sorprendernos?
04:36
I mean, look, every single physician
accepts some biological connection
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Todos os médicos aceptan
algunhas conexións biolóxicas
04:42
between animals and humans.
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entre os animais e os seres humanos.
04:45
Every medication that we prescribe
or that we've taken ourselves
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Todos os medicamentos que receitamos,
que tomamos
04:50
or we've given to our families
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ou que lle damos ás nosas familias
04:52
has first been tested on an animal.
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probáronse antes nun animal.
04:56
But there's something very different
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Pero hai unha gran diferenza
04:58
about giving an animal a
medication or a human disease
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entre darlle a un animal un medicamento
ou inocularlle unha doenza humana
05:04
and the animal developing
congestive heart failure
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e que ese animal desenvolva por si mesmo
insuficiencia cardíaca conxestiva,
05:08
or diabetes or breast cancer
on their own.
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diabetes ou cancro de peito.
05:15
Now, maybe some of the surprise
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Se cadra, parte da sorpresa
05:17
comes from the increasing
separation in our world
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procede da separación crecente
que o noso mundo fai
05:21
between the urban and the nonurban.
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entre o urbano e o non urbano.
05:25
You know, we hear about these city kids
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Escoitamos falar deses nenos urbanitas
05:28
who think that wool grows on trees
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que pensan que a la medra nas árbores
05:32
or that cheese comes from a plant.
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ou que o queixo sae dunha planta.
05:36
Well, today's human hospitals,
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Os hospitais humanos de hoxe en día
05:38
increasingly, are turning into these
gleaming cathedrals of technology.
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estanse a transformar cada vez máis
en lucentes catedrais da tecnoloxía.
05:45
And this creates a psychological
distance between the human patients
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E isto crea unha distancia psicolóxica
entre os pacientes humanos
05:50
who are being treated there
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que alí son tratados
05:53
and animal patients who
are living in oceans
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e os pacientes animais
que viven nos océanos,
05:57
and farms and jungles.
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nas granxas e nas selvas.
06:01
But I think there's an
even deeper reason.
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Pero eu penso que aínda hai
unha razón máis profunda:
06:06
Physicians and scientists, we accept
intellectually that our species,
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os médicos e os científicos aceptamos
intelectualmente que a nosa especie,
06:13
Homo sapiens, is merely
one species,
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o Homo sapiens, é só unha especie máis,
06:17
no more unique or
special than any other.
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nin máis única nin especial
ca calquera outra.
06:22
But in our hearts, we don't
completely believe that.
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Pero no noso interior
non acabamos de crelo.
06:28
I feel it myself when I'm
listening to Mozart
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Pásame a min mesma cando escoito a Mozart
06:32
or looking at pictures of the
Mars Rover on my MacBook.
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ou vexo no meu MacBook
as fotos que fixo o Mars Rover.
06:38
I feel that tug of
human exceptionalism,
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Sinto esa chamada
da excepcionalidade humana,
06:43
even as I recognize the
scientifically isolating cost
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aínda recoñecendo o custo
cientificamente illante
06:48
of seeing ourselves as a
superior species, apart.
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de vernos como unha especie superior,
á parte.
06:54
Well, I'm trying these days.
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Ben, pero esta tempada estou intentándoo.
06:57
When I see a human patient
now, I always ask,
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Agora, cando vexo a un paciente humano,
sempre me pregunto:
07:02
what do the animal doctors know
about this problem that I don't know?
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Que saben os médicos de animais
sobre este problema que eu non sei?
07:07
And, might I be taking better
care of my human patient
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e mais: Podería coidar mellor
ao meu paciente humano
07:12
if I saw them as a human
animal patient?
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se o vise como un paciente animal humano?
07:19
Here are a few examples of the
kind of exciting connections
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E velaquí algúns exemplos
das suxestivas conexións
07:24
that this kind of
thinking has led me to.
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a que me levou este tipo de razoamento.
07:28
Fear-induced heart failure.
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Insuficiencia cardíaca inducida por medo.
07:30
Around the year 2000,
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Alá polo ano 2000,
os cardiólogos de humanos "descubriron"
07:33
human cardiologists "discovered"
emotionally induced heart failure.
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a insuficiencia cardíaca
emocionalmente inducida.
07:40
It was described in a gambling father
who had lost his life's savings
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Foi descrita nun pai adicto ao xogo
que perdeu os aforros de toda a vida
07:46
with a roll of the dice,
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nunha partida de dados,
07:49
in a bride who'd
been left at the alter.
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nunha noiva abandonada diante do altar.
07:53
But it turns out, this
"new" human diagnosis
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Pero resulta que este
"novo" diagnóstico humano
07:58
was neither new, nor
was it uniquely human.
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nin era novo nin exclusivamente humano.
08:02
Veterinarians had been diagnosing,
treating and even preventing
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Os veterinarios xa levaban diagnosticando,
tratando e incluso previndo
08:08
emotionally induced
symptoms in animals
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síntomas emocionalmente inducidos
en animais,
08:12
ranging from monkeys to flamingos,
from to deer to rabbits,
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desde monos a flamengos,
de cervos a coellos,
08:18
since the 1970s.
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desde a década de 1970.
08:22
How many human lives
might have been saved
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Cantas vidas humanas poderían salvarse
08:26
if this veterinary knowledge
had been put into the hands
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se este coñecemento veterinario
estivese ao dispor
08:29
of E.R. docs and cardiologists?
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dos médicos de urxencias
e dos cardiólogos?
08:35
Self-injury.
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Autolesións.
08:37
Some human patients
harm themselves.
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Algúns pacientes humanos
máncanse a si mesmos.
08:41
Some pluck out patches of hair,
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Hainos que arrincan guechos de pelo,
08:45
others actually cut themselves.
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hainos que se cortan.
08:50
Some animal patients
also harm themselves.
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Algúns pacientes animais
tamén se mancan a si mesmos.
Hai paxaros que arrincan as plumas.
08:54
There are birds that
pluck out feathers.
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08:57
There are stallions that repetitively
bite their flanks until they bleed.
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Hai garañóns que morden as illargas
unha e outra vez ata sangraren.
09:05
But veterinarians have very specific
and very effective ways
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Pero os veterinarios teñen formas
moi específicas e efectivas
09:10
of treating and even
preventing self-injury
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de tratar e aínda previr as autolesións
09:14
in their self-injuring animals.
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nos animais que se comportan así.
09:18
Shouldn't this veterinary knowledge
be put into the hands
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Non debería estar
este coñecemento veterinario
09:21
of psychotherapists and
parents and patients
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ao dispor dos psicoterapeutas,
dos pais e dos pacientes
09:25
struggling with self-injury?
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que loitan coas autolesións?
09:29
Postpartum depression and
postpartum psychosis.
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Depresión posparto e psicose posparto.
09:34
Sometimes, soon after giving birth,
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Por veces, ao pouco de dar a luz
09:37
some women become depressed,
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algunhas mulleres caen na depresión,
09:39
and sometimes they become seriously
depressed and even psychotic.
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por veces en depresión grave,
e aínda en estados psicóticos.
09:44
They may neglect their newborn,
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Poden rexeitar ao seu propio fillo,
09:46
and in some extreme cases,
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e en casos extremos
09:48
even harm the child.
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chegar ata a mancalo.
09:52
Equine veterinarians also
know that occasionally,
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Os veterinarios de cabalos saben tamén
que de cando en vez
09:56
a mare, soon after giving birth,
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unha egua, pouco despois do parto,
09:59
will neglect the foal,
refusing to nurse,
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pode rexeitar o seu poldro,
e negarse a aleitalo,
10:02
and in some instances,
kick the foal, even to death.
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e nalgúns casos, patealo ata matalo.
10:09
But veterinarians have devised
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Pero os veterinarios idearon un tratamento
10:11
an intervention to deal with
this foal rejection syndrome
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para abordar esta síndrome
de rexeitamento do poldro
10:17
that involves increasing
oxytocin in the mare.
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que implica aumentar a oxitocina da egua.
10:21
Oxytocin is the bonding hormone,
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A oxitocina é a hormona da vinculación,
10:24
and this leads to renewed interest,
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e provoca que a egua teña
10:27
on the part of the mare, in her foal.
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un renovado interese no seu poldro.
10:31
Shouldn't this information
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Non debería estar esta información
10:33
be put into the hands of ob/gyn's
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ao dispor dos obstetras e xinecólogos,
10:36
and family doctors and patients
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dos médicos de familia e dos pacientes
10:39
who are struggling with postpartum
depression and psychosis?
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que se enfrontan ás depresións
e ás psicoses posparto?
10:47
Well, despite all of this promise,
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A pesar do prometedor que é todo isto,
10:49
unfortunately the gulf between
our fields remains large.
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a distancia entre os nosos ámbitos
segue sendo grande.
10:57
To explain it, I'm afraid I'm going
to have to air some dirty laundry.
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Para explicalo, moito me temo que vou ter
que poñer a algúns en evidencia.
11:02
Some physicians can be real snobs
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Hai médicos que poden ser auténticos snobs
11:07
about doctors who are not M.D.'s.
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cos profesionais que non son
titulados en Medicina.
11:09
I'm talking about dentists and
optometrists and psychologists,
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Refírome aos dentistas, optometristas
e psicólogos,
11:15
but maybe especially animal doctors.
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pero especialmente aos veterinarios.
11:20
Of course, most physicians
don't realize that it is harder
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Por suposto, a maior parte dos médicos
non ten nin idea de que é máis difícil
11:24
to get into vet school these
days than medical school,
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entrar hoxe en día nunha Facultade
de Veterinaria ca nunha de Medicina,
11:28
and that when we go
to medical school,
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e que cando imos para Medicina
11:30
we learn everything
there is to know
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aprendemos todo o que é relevante saber
11:33
about one species, Homo sapiens,
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sobre unha especie, o Homo sapiens.
11:36
but veterinarians need to learn
about health and disease
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Pero os veterinarios deben aprender
sobre a saúde e as enfermidades
11:40
in mammals, amphibians,
reptiles, fish and birds.
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de mamíferos, anfibios, réptiles,
peixes e aves.
11:45
So I don't blame the vets
for feeling annoyed
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Así que non culpo aos veterinarios
por sentírense molestos
11:50
by my profession's
condescension and ignorance.
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coa condescendencia e a ignorancia
dos meus compañeiros de profesión.
11:56
But here's one from the vets:
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Velaquí un chiste
da parte dos veterinarios:
11:59
What do you call a veterinarian
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Como se lle chama a un veterinario
12:02
who can only take
care of one species?
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que só sabe tratar unha especie?
(Risos)
12:08
A physician. (Laughter)
164
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Médico
(Risos)
12:11
Closing the gap has become
a passion for me,
165
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Acurtar esta distancia converteuse
na miña paixón,
12:17
and I'm doing this
through programs
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e estou facéndoo a través de programas
12:20
like Darwin on Rounds at UCLA,
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como Darwin on Rounds, na UCLA.
12:23
where we're bringing animal experts
and evolutionary biologists
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no que invitamos a expertos en animais
e a biólogos evolutivos
12:29
and embedding them
on our medical teams
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e os incorporamos
aos nosos equipos médicos
12:33
with our interns and our residents.
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canda os nosos internos e residentes.
12:37
And through Zoobiquity conferences,
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E a través das conferencias Zoobiquity,
12:41
where we bring medical schools
together with veterinary schools
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nas que convidamos a facultades
de Medicina e de Veterinaria
12:45
for collabortive discussions
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para mantermos debates colaborativos
12:47
of the shared diseases and disorders
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sobre as enfermidades e os trastornos
12:50
of animal and human patients.
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compartidos polos pacientes humanos
e animais.
12:54
At Zoobiquity conferences,
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Nas conferencias Zoobiquity
12:57
participants learn how treating
breast cancer in a tiger
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os participantes aprenden como
o tratamento dun cancro de peito nun tigre
13:02
can help us better treat breast cancer
178
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pode axudarnos a tratar mellor
o cancro de peito
13:05
in a kindergarten teacher;
179
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dunha mestra de educación infantil;
13:08
how understanding polycystic
overies in a Holstein cow
180
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4863
como o entender os ovarios poliquísticos
dunha vaca Holstein
13:13
can help us better take care
181
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pode axudarnos a mellorar o tratamento
13:15
of a dance instructor
with painful periods;
182
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4560
dunha profesora de baile
con menstruacións dolorosas;
13:20
and how better understanding the
treatment of separation anxiety
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4649
e como entender mellor
o tratamento da ansiedade de separación
13:25
in a high-strung Sheltie
184
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2409
nun can pastor das Illas Shetland
moi nervioso
13:27
can help an anxious young child
struggling with his first days of school.
185
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7401
pode servirlle a un neno ansioso que debe
enfrontarse ao comezo das clases.
13:34
In the United States and now
internationally, at Zoobiquity conferences
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Nas conferencias Zoobiquity, primeiro
nos EE. UU. e agora en todo o mundo,
13:40
physicians and veterinarians check
their attitudes and their preconceptions
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médicos e veterinarios abandonan
as súas actitudes e preconceptos
13:47
at the door and come
together as colleagues,
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6024
e reúnense como colegas,
13:53
as peers, as doctors.
189
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como iguais, como doutores.
13:58
After all, we humans
are animals, too,
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5420
Á fin de contas, os humanos
somos tamén animais,
14:04
and it's time for us physicians to embrace
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e xa é tempo de que nós, médicos,
asumamos a natureza animal
dos nosos pacientes e a nosa propia
14:07
our patients' and our own animal natures
192
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4547
14:12
and join veterinarians
193
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e nos unamos aos veterinarios
14:14
in a species-spanning approach to health.
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nunha aproximación á saúde
que abranga todas as especies.
14:19
Because it turns out,
195
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2213
Porque resulta que algunhas das mellores
14:21
some of the best and
most humanistic medicine
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5198
e máis humanistas medicinas
14:26
is being practiced by doctors
whose patients aren't human.
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están sendo practicadas por doutores
que teñen pacientes que non son humanos.
14:32
And one of the best ways
we can take care
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3382
E un dos mellores xeitos de tratarmos
14:35
of the human patient is by
paying close attention
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ao paciente humano é prestándolle
moita atención
14:40
to how all the other
patients on the planet
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a como todos os outros
pacientes do planeta
14:44
live, grow, get sick and heal.
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6657
viven, crecen, enferman e sandan.
14:51
Thank you.
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Moitas grazas.
14:53
(Applause).
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(Aplausos)

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ABOUT THE SPEAKER
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.

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 speaker
Barbara Natterson-Horowitz | Speaker | TED.com

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