TEDMED 2014
Barbara Natterson-Horowitz: What veterinarians know that physicians don't
芭芭拉·纳特逊-霍罗威茨: 医生不了解的兽医知识
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只可以治疗一种物种的兽医是什么？医生。在这场引人入胜的演讲中，芭芭拉·纳特逊-霍罗威茨介绍跨物种视角的医疗将能如何改善人类的医疗水平 — 尤其是在涉及精神健康时。
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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十年前，
00:15
I got a phone call that
changed my life.
changed my life.
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一个电话改变了我的一生。
00:18
At the time, I was
cardiologist at UCLA,
cardiologist at UCLA,
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那时，我是加州大学洛杉矶分校（UCLA）的心脏病学家，
00:22
specializing in cardiac
imaging techniques.
imaging techniques.
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专攻心脏成像技术。
00:26
The call came from a veterinarian
at the Los Angeles Zoo.
at the Los Angeles Zoo.
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电话来自洛杉矶动物园的兽医。
00:31
An elderly female chimpanzee
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一只高龄雌性黑猩猩
00:34
had woken up with a facial droop
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睡醒后面部下垂，
00:37
and the veterinarians were worried
that she'd had a stroke.
that she'd had a stroke.
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兽医担心她得了中风。
00:40
They asked if I'd
come to the zoo
come to the zoo
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他们问我能不能来动物园
00:43
and image the animal's heart
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给黑猩猩的心脏成像，
00:45
to look for a possible
cardiac cause.
cardiac cause.
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寻找可能的心脏病因。
00:49
Now, to be clear, North American
zoos are staffed
zoos are staffed
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要明确的是，北美的动物园都有
00:52
by highly qualified,
board-certified veterinarians
board-certified veterinarians
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高水平的经过认证的兽医，
00:57
who take outstanding
care of their animal patients.
care of their animal patients.
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他们极为出色地照料着他们的动物患者。
01:01
But occasionally, they do reach into
the human medical community,
the human medical community,
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但偶尔，他们会求助人类医疗社区，
01:05
particularly for some
speciality consultation,
speciality consultation,
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尤其是涉及专科问诊时，
01:10
and I was one of the lucky physicians
who was invited in to help.
who was invited in to help.
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而我就是被邀请帮忙的幸运者之一。
01:16
I had a chance to rule out
a stroke in this chimpanzee
a stroke in this chimpanzee
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我曾经有机会为这个黑猩猩排除中风可能，
01:22
and make sure that this gorilla
didn't have a torn aorta,
didn't have a torn aorta,
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为这个大猩猩排除主动脉撕裂的可能，
01:28
evaluate this macaw
for a heart murmur,
for a heart murmur,
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给这个金刚鹦鹉听心脏杂音，
01:33
make sure that this California sea lion's
paricardium wasn't inflamed,
paricardium wasn't inflamed,
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确认这只加州海狮的心包没有发炎，
01:41
and in this picture, I'm listening
to the heart of a lion
to the heart of a lion
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还有，在这张照片中，我在给一头狮子做心脏听音，
01:45
after a lifesaving,
collaborative procedure
collaborative procedure
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这是在兽医和医生的一起
01:48
with veterinarians and physicians
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关乎性命的合作行动之后，
01:51
where we drained 700 cc's of
fluid from the sac
fluid from the sac
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我们从包裹这只狮子心脏的囊袋中
01:56
in which this lion's
heart was contained.
heart was contained.
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引流出700cc的液体。
02:00
And this procedure, which I have
done on many human patients,
done on many human patients,
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还有这个操作，我在很多人类病患上进行过，
02:05
was identical, with the exception
of that paw and that tail.
of that paw and that tail.
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步骤是一样的，区别只是这里的爪子和尾巴。
02:14
Now most of the time, I was working
at UCLA Medical Center with physicians,
at UCLA Medical Center with physicians,
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大多数时候，我都是在UCLA医学中心与医生们工作，
02:21
discussing symptoms
and diagnoses and treatments
and diagnoses and treatments
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探讨症状，诊断，和治疗方案，
02:26
for my human patients,
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对象是我的人类患者们，
02:29
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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但偶尔，我也在洛杉矶动物园
02:32
with veterinarians, discussing
symptoms and diagnoses and treatments
symptoms and diagnoses and treatments
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和兽医们合作，探讨症状，诊断，和治疗方案，
02:38
for their animal patients.
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对象是他们的动物病患。
02:40
And occasionally, on
the very same day,
the very same day,
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少数情况下，在同一天里，
02:45
I went on rounds at
UCLA Medical Center
UCLA Medical Center
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我又要在UCLA医学中心工作，
02:49
and at the Los Angeles Zoo.
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还要去洛杉矶动物园工作。
02:52
And here's what started coming
into very clear focus for me.
into very clear focus for me.
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我开始逐渐清醒地认识到这一点。
02:58
Physicians and veterinarians
were essentially taking care
were essentially taking care
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医生和兽医其实是在处理
03:03
of the same disorders in their
animal and human patients:
animal and human patients:
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人类病患和动物病患中的同样问题：
03:08
congestive heart failure, brain tumors,
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充血性心力衰竭，脑瘤，
03:12
leukemia, diabetes,
arthritis, ALS, breast cancer,
arthritis, ALS, breast cancer,
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白血病，糖尿病，关节炎，“渐冻人症”医学名为肌萎缩侧索硬化症(ALS)，乳腺癌，
03:21
even psychiatric syndromes
like depression, anxiety,
like depression, anxiety,
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甚至还包括精神疾病，例如抑郁症，焦虑症，
03:26
compulsions, eating disorders
and self-injury.
and self-injury.
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强迫症，进食障碍，自虐等。
03:32
Now, I've got a confession to make.
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在这里，我要坦白。
03:35
Even though I studied comparative
physiology and evolutionary biology
physiology and evolutionary biology
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尽管我学过比较生理学和进化生物学，
03:42
as an undergrad --
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那是我读大学的时候 —
03:44
I had even written my senior
thesis on Darwinian theory --
thesis on Darwinian theory --
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我的毕业论文甚至都是关于达尔文理论的 —
03:49
learning about the
significant overlap
significant overlap
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动物疾病和人类疾病
03:51
between the disorders of
animals and humans,
animals and humans,
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存在明显重叠的这一认知，
03:54
it came as a much needed
wake-up call for me.
wake-up call for me.
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为我及时敲响了警钟。
04:00
So I started wondering,
with all of these overlaps,
with all of these overlaps,
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我开始想，有这么多重叠，
04:04
how was it that I had never
thought to ask a veterinarian,
thought to ask a veterinarian,
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我为什么从来没有想过请教兽医，
04:10
or consult the veterinary literature,
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或者是参考兽医学文献，
04:12
for insights into one
of my human patients?
of my human patients?
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来为我的人类病患提供见解？
04:17
Why had I never, nor had any of my
physician friends and colleagues
physician friends and colleagues
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为什么我从未，而我问过的医生同事们也从未，
04:23
whom I asked, ever attended
a veterinary conference?
a veterinary conference?
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参加过兽医学会议？
04:30
For that matter, why was
any of this a surprise?
any of this a surprise?
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就这点而言，有什么可让人奇怪的？
04:36
I mean, look, every single physician
accepts some biological connection
accepts some biological connection
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你看，每一名医生都同意动物和人类间
04:42
between animals and humans.
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存在某种生物学上的联系。
04:45
Every medication that we prescribe
or that we've taken ourselves
or that we've taken ourselves
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我们开过的每一种药，以及我们自己服过的药，
04:50
or we've given to our families
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以及我们给我们家人的药，
04:52
has first been tested on an animal.
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都是先在动物身上进行试验的。
04:56
But there's something very different
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但的确动物被动人为病变，与动物自身病变之间存在有很大的差异
04:58
about giving an animal a
medication or a human disease
medication or a human disease
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给动物用一种药物，或使其患上一种人类疾病 是一回事，
05:04
and the animal developing
congestive heart failure
congestive heart failure
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而动物们患自己特有的充血性心力衰竭，
05:08
or diabetes or breast cancer
on their own.
on their own.
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糖尿病，乳腺癌病是另一回事。
05:15
Now, maybe some of the surprise
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对此感到奇怪的部分原因，
05:17
comes from the increasing
separation in our world
separation in our world
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可能是我们社会中城镇与非城镇之间
05:21
between the urban and the nonurban.
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逐渐扩大的隔阂。
05:25
You know, we hear about these city kids
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我们常听说城里长大的孩子
05:28
who think that wool grows on trees
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以为羊毛长在树上，
05:32
or that cheese comes from a plant.
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或者奶酪来自植物。
05:36
Well, today's human hospitals,
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是的，今天人类的医院，
05:38
increasingly, are turning into these
gleaming cathedrals of technology.
gleaming cathedrals of technology.
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正在变为某种闪耀金光的科学殿堂。
05:45
And this creates a psychological
distance between the human patients
distance between the human patients
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这就使得在医院里治疗的
05:50
who are being treated there
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人类病患
05:53
and animal patients who
are living in oceans
are living in oceans
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和生活在海洋，农场，和丛林中的
05:57
and farms and jungles.
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动物病患之间在认知上出现了距离。
06:01
But I think there's an
even deeper reason.
even deeper reason.
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但我觉得还有更深的原因。
06:06
Physicians and scientists, we accept
intellectually that our species,
intellectually that our species,
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对于医生和科学家而言，我们理智上承认我们这个物种，
06:13
Homo sapiens, is merely
one species,
one species,
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智人(人类)，仅仅是物种之一，
06:17
no more unique or
special than any other.
special than any other.
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并不比其他物种更独特。
06:22
But in our hearts, we don't
completely believe that.
completely believe that.
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但在情感上，我们不完全这么想。
06:28
I feel it myself when I'm
listening to Mozart
listening to Mozart
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当我听莫扎特，或是当我在MacBook上
06:32
or looking at pictures of the
Mars Rover on my MacBook.
Mars Rover on my MacBook.
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看火星探测车传回的照片时，
06:38
I feel that tug of
human exceptionalism,
human exceptionalism,
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我就能感觉到一股人类特殊论，
06:43
even as I recognize the
scientifically isolating cost
scientifically isolating cost
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尽管我明白把人类看做与众不同的高等物种，
06:48
of seeing ourselves as a
superior species, apart.
superior species, apart.
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在科学上会有多么大的代价。
06:54
Well, I'm trying these days.
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如今，我正在努力。
06:57
When I see a human patient
now, I always ask,
now, I always ask,
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如今，当我看到人类病患时，我总是自问，
07:02
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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对这一情况，兽医会不会掌握我不了解的知识。
07:07
And, might I be taking better
care of my human patient
care of my human patient
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以及，如果我把他们(病人)视为“人类动物”病患，
07:12
if I saw them as a human
animal patient?
animal patient?
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我是不是能更好地医治他们？
07:19
Here are a few examples of the
kind of exciting connections
kind of exciting connections
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以下几个例子，是这类思考给我带来的
07:24
that this kind of
thinking has led me to.
thinking has led me to.
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奇妙的认识。
07:28
Fear-induced heart failure.
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恐惧引起的心力衰竭。
07:30
Around the year 2000,
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在2000年左右，
07:33
human cardiologists "discovered"
emotionally induced heart failure.
emotionally induced heart failure.
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人类心脏病专家“发现”了情绪诱导的心力衰竭。
07:40
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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该情况出现于一位好赌的父亲因为掷骰子赌博
07:46
with a roll of the dice,
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失去了一生的积蓄之后，
07:49
in a bride who'd
been left at the alter.
been left at the alter.
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以及一位新娘被遗弃在教堂门口之后。
07:53
But it turns out, this
"new" human diagnosis
"new" human diagnosis
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但后来发现，这一“新”的人类疾病
07:58
was neither new, nor
was it uniquely human.
was it uniquely human.
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既不新，也不是人类的特权。
08:02
Veterinarians had been diagnosing,
treating and even preventing
treating and even preventing
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兽医们诊断，治疗，甚至预防
08:08
emotionally induced
symptoms in animals
symptoms in animals
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动物中情绪引发的症状，
08:12
ranging from monkeys to flamingos,
from to deer to rabbits,
from to deer to rabbits,
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对象包括猴子，火烈鸟，鹿，兔子在内，
08:18
since the 1970s.
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从20世纪70年代就已经开始了。
08:22
How many human lives
might have been saved
might have been saved
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会有多少人的生命获得拯救，
08:26
if this veterinary knowledge
had been put into the hands
had been put into the hands
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如果这一兽医知识能传授给
08:29
of E.R. docs and cardiologists?
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急救室大夫和心脏病学家？
08:35
Self-injury.
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还有自虐。
08:37
Some human patients
harm themselves.
harm themselves.
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一些人类病人会伤害自己。
08:41
Some pluck out patches of hair,
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有的拔下一把把的毛发，
08:45
others actually cut themselves.
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有的甚至会割伤自己。
08:50
Some animal patients
also harm themselves.
also harm themselves.
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一些动物患者也会自我伤害。
08:54
There are birds that
pluck out feathers.
pluck out feathers.
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有的鸟会拔掉自己的羽毛，
08:57
There are stallions that repetitively
bite their flanks until they bleed.
bite their flanks until they bleed.
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有的马会不停地咬自己的侧腹，直到流血。
09:05
But veterinarians have very specific
and very effective ways
and very effective ways
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但兽医有很具体和有效的方法
09:10
of treating and even
preventing self-injury
preventing self-injury
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来治疗甚至预防自我伤害，
09:14
in their self-injuring animals.
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针对的是自我伤害的动物们。
09:18
Shouldn't this veterinary knowledge
be put into the hands
be put into the hands
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这些兽医的知识难道不应该传授给
09:21
of psychotherapists and
parents and patients
parents and patients
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心理医生，家长，
09:25
struggling with self-injury?
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和受自我伤害困扰的患者们？
09:29
Postpartum depression and
postpartum psychosis.
postpartum psychosis.
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还有产后抑郁症和产后精神病。
09:34
Sometimes, soon after giving birth,
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有时候，在生产后不久，
09:37
some women become depressed,
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一些女性会变得抑郁，
09:39
and sometimes they become seriously
depressed and even psychotic.
depressed and even psychotic.
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有时甚至严重抑郁，甚至患精神病。
09:44
They may neglect their newborn,
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她们会忽视自己的婴儿，
09:46
and in some extreme cases,
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在某些极端的病例中，
09:48
even harm the child.
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甚至会伤害孩子。
09:52
Equine veterinarians also
know that occasionally,
know that occasionally,
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马科兽医也知道偶尔地，
09:56
a mare, soon after giving birth,
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母马在生产之后，
09:59
will neglect the foal,
refusing to nurse,
refusing to nurse,
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会忽视马驹，拒绝抚养，
10:02
and in some instances,
kick the foal, even to death.
kick the foal, even to death.
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而在某些情况下，甚至会去踢马驹，致其死亡。
10:09
But veterinarians have devised
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但是兽医们发明了一种干预疗法
10:11
an intervention to deal with
this foal rejection syndrome
this foal rejection syndrome
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来处理这种拒绝抚养马驹的症状，
10:17
that involves increasing
oxytocin in the mare.
oxytocin in the mare.
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那就是提高母马的催产素水平。
10:21
Oxytocin is the bonding hormone,
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催产素是一种促进结合的荷尔蒙，
10:24
and this leads to renewed interest,
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这能使母马对马驹重新
10:27
on the part of the mare, in her foal.
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产生兴趣。
10:31
Shouldn't this information
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难道这一信息
10:33
be put into the hands of ob/gyn's
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不应传授给产科和妇科医生，传授给
10:36
and family doctors and patients
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正受产后抑郁症和精神病困扰的
10:39
who are struggling with postpartum
depression and psychosis?
depression and psychosis?
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患者们和家庭医生？
10:47
Well, despite all of this promise,
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可是，即便有这么多好处，
10:49
unfortunately the gulf between
our fields remains large.
our fields remains large.
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我们两个学科之间的鸿沟依旧不幸存在。
10:57
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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要解释这个现象，我可能要揭示一些黑暗面。
11:02
Some physicians can be real snobs
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一些医生真的是瞧不起
11:07
about doctors who are not M.D.'s.
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没有医学博士文凭的医生。
11:09
I'm talking about dentists and
optometrists and psychologists,
optometrists and psychologists,
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我是指牙医，眼科验光师，和心理学家，
11:15
but maybe especially animal doctors.
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但特别也指动物医生。
11:20
Of course, most physicians
don't realize that it is harder
don't realize that it is harder
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当然，绝大多医生不知道如今
11:24
to get into vet school these
days than medical school,
days than medical school,
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上兽医学校比上医学院还难。
11:28
and that when we go
to medical school,
to medical school,
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我们读医学院的话，
11:30
we learn everything
there is to know
there is to know
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我们要学习所有能学的知识，
11:33
about one species, Homo sapiens,
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只针对一种生物，智人，
11:36
but veterinarians need to learn
about health and disease
about health and disease
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但兽医需要学习的卫生和疾病，
11:40
in mammals, amphibians,
reptiles, fish and birds.
reptiles, fish and birds.
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对象是哺乳动物，两栖动物，鱼类，和鸟类。
11:45
So I don't blame the vets
for feeling annoyed
for feeling annoyed
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所以我不责怪兽医厌恶
11:50
by my profession's
condescension and ignorance.
condescension and ignorance.
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我这一职业的高傲和无知。
11:56
But here's one from the vets:
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这有一句兽医的话：
11:59
What do you call a veterinarian
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只可以治疗一种物种
12:02
who can only take
care of one species?
care of one species?
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的兽医是什么？
12:08
A physician. (Laughter)
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医生。（笑声）
12:11
Closing the gap has become
a passion for me,
a passion for me,
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缩小鸿沟是我的愿望，
12:17
and I'm doing this
through programs
through programs
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我正在通过例如UCLA的Darwin on Rounds(达尔文医疗查房)项目
12:20
like Darwin on Rounds at UCLA,
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来做到这点。
12:23
where we're bringing animal experts
and evolutionary biologists
and evolutionary biologists
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该项目中，我们将动物专家和进化生物学家
12:29
and embedding them
on our medical teams
on our medical teams
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安排到我们的医疗团队中，
12:33
with our interns and our residents.
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连同我们的实习生和住院医生一起工作。
12:37
And through Zoobiquity conferences,
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还有，通过跨物种共病(Zoobiquity)会议，
12:41
where we bring medical schools
together with veterinary schools
together with veterinary schools
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我们让医学院和兽医学校
12:45
for collabortive discussions
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一起参加合作性讨论，
12:47
of the shared diseases and disorders
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讨论动物病患和人类病患
12:50
of animal and human patients.
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共通的疾病和失调。
12:54
At Zoobiquity conferences,
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在跨物种共病(Zoobiquity)会议上，
12:57
participants learn how treating
breast cancer in a tiger
breast cancer in a tiger
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参会者们了解了为老虎治疗乳腺癌
13:02
can help us better treat breast cancer
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能如何帮助我们更好地治疗
13:05
in a kindergarten teacher;
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幼儿园教师的乳腺癌；
13:08
how understanding polycystic
overies in a Holstein cow
overies in a Holstein cow
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了解了明白荷斯坦牛的多囊卵巢综合征
13:13
can help us better take care
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能如何让我们更好的照顾
13:15
of a dance instructor
with painful periods;
with painful periods;
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痛经的舞蹈老师；
13:20
and how better understanding the
treatment of separation anxiety
treatment of separation anxiety
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以及了解了治疗敏感不安的喜乐蒂牧羊犬
13:25
in a high-strung Sheltie
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的分离焦虑
13:27
can help an anxious young child
struggling with his first days of school.
struggling with his first days of school.
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能如何让我们更好地帮助第一天上学感到焦虑的儿童。
13:34
In the United States and now
internationally, at Zoobiquity conferences
internationally, at Zoobiquity conferences
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在美国以及现在在全世界，在跨物种共病(Zoobiquity)会议上
13:40
physicians and veterinarians check
their attitudes and their preconceptions
their attitudes and their preconceptions
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医生和兽医将彼此之间的态度和成见
13:47
at the door and come
together as colleagues,
together as colleagues,
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抛在门外，团结成为同事，
13:53
as peers, as doctors.
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同行，医疗工作者。
13:58
After all, we humans
are animals, too,
are animals, too,
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毕竟，我们人类也是动物，
14:04
and it's time for us physicians to embrace
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是时候让我们医生坦承
14:07
our patients' and our own animal natures
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我们患者和我们自己的动物本性，
14:12
and join veterinarians
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加入兽医们一起
14:14
in a species-spanning approach to health.
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用跨物种的视角来看待医疗。
14:19
Because it turns out,
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因为事实是，
14:21
some of the best and
most humanistic medicine
most humanistic medicine
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一些最好的最人性化的医药
14:26
is being practiced by doctors
whose patients aren't human.
whose patients aren't human.
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是被医生用于不是人类的患者身上。
14:32
And one of the best ways
we can take care
we can take care
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而我们照料人类病患的最好方式之一
14:35
of the human patient is by
paying close attention
paying close attention
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就是要仔细关注
14:40
to how all the other
patients on the planet
patients on the planet
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地球上所有其他病患如何
14:44
live, grow, get sick and heal.
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生活，生长，生病，以及痊愈。
14:51
Thank you.
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谢谢。
14:53
(Applause).
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（掌声）
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