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

Translator: Xusto Rodriguez Reviewer: Serv. de Norm. Lingüística U. de Santiago de Compostela

Ten years ago,

Hai dez anos

I got a phone call that changed my life.

recibín unha chamada telefónica que cambiou a miña vida.

At the time, I was cardiologist at UCLA,

Daquela, eu era cardióloga na UCLA [Universidade de California, Los Ángeles]

specializing in cardiac imaging techniques.

especializada en técnicas de imaxe cardíaca.

The call came from a veterinarian at the Los Angeles Zoo.

Quen me chamaba era un veterinario do Zoo de Los Ángeles.

An elderly female chimpanzee

Unha vella chimpancé

had woken up with a facial droop

espertara con parálise facial

and the veterinarians were worried that she'd had a stroke.

e aos veterinarios preocupábaos que fose un infarto cerebral.

They asked if I'd come to the zoo

Preguntáronme se podía ir ao zoo

and image the animal's heart

e facerlle un escáner ao corazón do animal

to look for a possible cardiac cause.

para procurar unha posible causa cardíaca.

Now, to be clear, North American zoos are staffed

Cómpre deixar claro que os zoos dos Estados Unidos

by highly qualified, board-certified veterinarians

contan con equipos veterinarios acreditados e altamente cualificados

who take outstanding care of their animal patients.

que coidan de maneira excelente dos seus pacientes animais.

But occasionally, they do reach into the human medical community,

Pero ás veces, diríxense á comunidade médica,

particularly for some speciality consultation,

especialmente para algunha consulta especializada,

and I was one of the lucky physicians who was invited in to help.

e eu fun un dos afortunados médicos aos que pediron axuda.

I had a chance to rule out a stroke in this chimpanzee

Puiden descartar o infarto cerebral no caso desta chimpancé

and make sure that this gorilla didn't have a torn aorta,

e asegurarme de que esta gorila non sufría unha esgazadura na aorta,

evaluate this macaw for a heart murmur,

avaliei este guacamaio por un posible sopro cardíaco,

make sure that this California sea lion's paricardium wasn't inflamed,

e comprobei que o pericardio deste león mariño non estaba inflamado.

and in this picture, I'm listening to the heart of a lion

Velaquí estou nesta foto, auscultando o corazón dun león

after a lifesaving, collaborative procedure

despois de salvármoslle a vida, nun procedemento colaborativo

with veterinarians and physicians

de veterinarios e médicos

where we drained 700 cc's of fluid from the sac

no que lle extraemos 700 cc de fluído

in which this lion's heart was contained.

do saco que envolve o seu corazón.

And this procedure, which I have done on many human patients,

E este procedemento, que xa practiquei en moitos pacientes humanos,

was identical, with the exception of that paw and that tail.

foi idéntico, coa excepción desa gadoupa e desa cola.

(Risos)

Now most of the time, I was working at UCLA Medical Center with physicians,

A maior parte do tempo eu traballaba con médicos no Centro Médico da UCLA,

discussing symptoms and diagnoses and treatments

debatendo síntomas, diagnósticos e tratamentos

for my human patients,

para os meus pacientes humanos;

but some of the time, I was working at the Los Angeles Zoo

pero ás veces traballaba con veterinarios no Zoo de Los Ángeles,

with veterinarians, discussing symptoms and diagnoses and treatments

debatendo síntomas, diagnósticos e tratamentos,

for their animal patients.

para os seus pacientes animais.

And occasionally, on the very same day,

E de cando en vez, no mesmo día

I went on rounds at UCLA Medical Center

pasaba visitas no Centro Médico da UCLA

and at the Los Angeles Zoo.

e no Zoo de Los Ángeles.

And here's what started coming into very clear focus for me.

E empecei a ver claramente unha cousa:

Physicians and veterinarians were essentially taking care

basicamente, os médicos e os veterinarios

of the same disorders in their animal and human patients:

atendían as mesmas doenzas nos seus pacientes humanos e animais:

congestive heart failure, brain tumors,

insuficiencias cardíacas conxestivas, tumores cerebrais,

leukemia, diabetes, arthritis, ALS, breast cancer,

leucemia, diabetes, artrite, esclerose lateral amiotrófica, cancro de peito,

even psychiatric syndromes like depression, anxiety,

incluso trastornos psiquiátricos, como depresión, ansiedade,

compulsions, eating disorders and self-injury.

compulsións, desordes alimentarias e autolesións.

Now, I've got a confession to make.

Ben, teño que facerlles unha confesión.

Even though I studied comparative physiology and evolutionary biology

Aínda que estudei fisioloxía comparada e bioloxía evolutiva

as an undergrad --

durante a universidade

I had even written my senior thesis on Darwinian theory --

--mesmo fixen a miña tese de grao sobre as teorías de Darwin--

learning about the significant overlap

aprender máis sobre as significativas coincidencias

between the disorders of animals and humans,

entre as enfermidades animais e humanas

it came as a much needed wake-up call for me.

foi un toque de atención moi necesario para min.

So I started wondering, with all of these overlaps,

E comecei a preguntarme como podía ser, con todas esas coincidencias,

how was it that I had never thought to ask a veterinarian,

que nunca lle pedise opinión a un veterinario

or consult the veterinary literature,

ou consultase bibliografía veterinaria.

for insights into one of my human patients?

para ter outra perspectiva sobre un dos meus pacientes humanos?

Why had I never, nor had any of my physician friends and colleagues

Por que ningún dos meus amigos ou colegas médicos

whom I asked, ever attended a veterinary conference?

asistimos nunca a unha conferencia veterinaria?

For that matter, why was any of this a surprise?

Aínda máis, por que debería sorprendernos?

I mean, look, every single physician accepts some biological connection

Todos os médicos aceptan algunhas conexións biolóxicas

between animals and humans.

entre os animais e os seres humanos.

Every medication that we prescribe or that we've taken ourselves

Todos os medicamentos que receitamos, que tomamos

or we've given to our families

ou que lle damos ás nosas familias

has first been tested on an animal.

probáronse antes nun animal.

But there's something very different

Pero hai unha gran diferenza

about giving an animal a medication or a human disease

entre darlle a un animal un medicamento ou inocularlle unha doenza humana

and the animal developing congestive heart failure

e que ese animal desenvolva por si mesmo insuficiencia cardíaca conxestiva,

or diabetes or breast cancer on their own.

diabetes ou cancro de peito.

Now, maybe some of the surprise

Se cadra, parte da sorpresa

comes from the increasing separation in our world

procede da separación crecente que o noso mundo fai

between the urban and the nonurban.

entre o urbano e o non urbano.

You know, we hear about these city kids

Escoitamos falar deses nenos urbanitas

who think that wool grows on trees

que pensan que a la medra nas árbores

or that cheese comes from a plant.

ou que o queixo sae dunha planta.

Well, today's human hospitals,

Os hospitais humanos de hoxe en día

increasingly, are turning into these gleaming cathedrals of technology.

estanse a transformar cada vez máis en lucentes catedrais da tecnoloxía.

And this creates a psychological distance between the human patients

E isto crea unha distancia psicolóxica entre os pacientes humanos

who are being treated there

que alí son tratados

and animal patients who are living in oceans

e os pacientes animais que viven nos océanos,

and farms and jungles.

nas granxas e nas selvas.

But I think there's an even deeper reason.

Pero eu penso que aínda hai unha razón máis profunda:

Physicians and scientists, we accept intellectually that our species,

os médicos e os científicos aceptamos intelectualmente que a nosa especie,

Homo sapiens, is merely one species,

o Homo sapiens, é só unha especie máis,

no more unique or special than any other.

nin máis única nin especial ca calquera outra.

But in our hearts, we don't completely believe that.

Pero no noso interior non acabamos de crelo.

I feel it myself when I'm listening to Mozart

Pásame a min mesma cando escoito a Mozart

or looking at pictures of the Mars Rover on my MacBook.

ou vexo no meu MacBook as fotos que fixo o Mars Rover.

I feel that tug of human exceptionalism,

Sinto esa chamada da excepcionalidade humana,

even as I recognize the scientifically isolating cost

aínda recoñecendo o custo cientificamente illante

of seeing ourselves as a superior species, apart.

de vernos como unha especie superior, á parte.

Well, I'm trying these days.

Ben, pero esta tempada estou intentándoo.

When I see a human patient now, I always ask,

Agora, cando vexo a un paciente humano, sempre me pregunto:

what do the animal doctors know about this problem that I don't know?

Que saben os médicos de animais sobre este problema que eu non sei?

And, might I be taking better care of my human patient

e mais: Podería coidar mellor ao meu paciente humano

if I saw them as a human animal patient?

se o vise como un paciente animal humano?

Here are a few examples of the kind of exciting connections

E velaquí algúns exemplos das suxestivas conexións

that this kind of thinking has led me to.

a que me levou este tipo de razoamento.

Fear-induced heart failure.

Insuficiencia cardíaca inducida por medo.

Around the year 2000,

Alá polo ano 2000, os cardiólogos de humanos "descubriron"

human cardiologists "discovered" emotionally induced heart failure.

a insuficiencia cardíaca emocionalmente inducida.

It was described in a gambling father who had lost his life's savings

Foi descrita nun pai adicto ao xogo que perdeu os aforros de toda a vida

with a roll of the dice,

nunha partida de dados,

in a bride who'd been left at the alter.

nunha noiva abandonada diante do altar.

But it turns out, this "new" human diagnosis

Pero resulta que este "novo" diagnóstico humano

was neither new, nor was it uniquely human.

nin era novo nin exclusivamente humano.

Veterinarians had been diagnosing, treating and even preventing

Os veterinarios xa levaban diagnosticando, tratando e incluso previndo

emotionally induced symptoms in animals

síntomas emocionalmente inducidos en animais,

ranging from monkeys to flamingos, from to deer to rabbits,

desde monos a flamengos, de cervos a coellos,

since the 1970s.

desde a década de 1970.

How many human lives might have been saved

Cantas vidas humanas poderían salvarse

if this veterinary knowledge had been put into the hands

se este coñecemento veterinario estivese ao dispor

of E.R. docs and cardiologists?

dos médicos de urxencias e dos cardiólogos?

Self-injury.

Autolesións.

Some human patients harm themselves.

Algúns pacientes humanos máncanse a si mesmos.

Some pluck out patches of hair,

Hainos que arrincan guechos de pelo,

others actually cut themselves.

hainos que se cortan.

Some animal patients also harm themselves.

Algúns pacientes animais tamén se mancan a si mesmos.

Hai paxaros que arrincan as plumas.

There are birds that pluck out feathers.

There are stallions that repetitively bite their flanks until they bleed.

Hai garañóns que morden as illargas unha e outra vez ata sangraren.

But veterinarians have very specific and very effective ways

Pero os veterinarios teñen formas moi específicas e efectivas

of treating and even preventing self-injury

de tratar e aínda previr as autolesións

in their self-injuring animals.

nos animais que se comportan así.

Shouldn't this veterinary knowledge be put into the hands

Non debería estar este coñecemento veterinario

of psychotherapists and parents and patients

ao dispor dos psicoterapeutas, dos pais e dos pacientes

struggling with self-injury?

que loitan coas autolesións?

Postpartum depression and postpartum psychosis.

Depresión posparto e psicose posparto.

Sometimes, soon after giving birth,

Por veces, ao pouco de dar a luz

some women become depressed,

algunhas mulleres caen na depresión,

and sometimes they become seriously depressed and even psychotic.

por veces en depresión grave, e aínda en estados psicóticos.

They may neglect their newborn,

Poden rexeitar ao seu propio fillo,

and in some extreme cases,

e en casos extremos

even harm the child.

chegar ata a mancalo.

Equine veterinarians also know that occasionally,

Os veterinarios de cabalos saben tamén que de cando en vez

a mare, soon after giving birth,

unha egua, pouco despois do parto,

will neglect the foal, refusing to nurse,

pode rexeitar o seu poldro, e negarse a aleitalo,

and in some instances, kick the foal, even to death.

e nalgúns casos, patealo ata matalo.

But veterinarians have devised

Pero os veterinarios idearon un tratamento

an intervention to deal with this foal rejection syndrome

para abordar esta síndrome de rexeitamento do poldro

that involves increasing oxytocin in the mare.

que implica aumentar a oxitocina da egua.

Oxytocin is the bonding hormone,

A oxitocina é a hormona da vinculación,

and this leads to renewed interest,

e provoca que a egua teña

on the part of the mare, in her foal.

un renovado interese no seu poldro.

Shouldn't this information

Non debería estar esta información

be put into the hands of ob/gyn's

ao dispor dos obstetras e xinecólogos,

and family doctors and patients

dos médicos de familia e dos pacientes

who are struggling with postpartum depression and psychosis?

que se enfrontan ás depresións e ás psicoses posparto?

Well, despite all of this promise,

A pesar do prometedor que é todo isto,

unfortunately the gulf between our fields remains large.

a distancia entre os nosos ámbitos segue sendo grande.

To explain it, I'm afraid I'm going to have to air some dirty laundry.

Para explicalo, moito me temo que vou ter que poñer a algúns en evidencia.

Some physicians can be real snobs

Hai médicos que poden ser auténticos snobs

about doctors who are not M.D.'s.

cos profesionais que non son titulados en Medicina.

I'm talking about dentists and optometrists and psychologists,

Refírome aos dentistas, optometristas e psicólogos,

but maybe especially animal doctors.

pero especialmente aos veterinarios.

Of course, most physicians don't realize that it is harder

Por suposto, a maior parte dos médicos non ten nin idea de que é máis difícil

to get into vet school these days than medical school,

entrar hoxe en día nunha Facultade de Veterinaria ca nunha de Medicina,

and that when we go to medical school,

e que cando imos para Medicina

we learn everything there is to know

aprendemos todo o que é relevante saber

about one species, Homo sapiens,

sobre unha especie, o Homo sapiens.

but veterinarians need to learn about health and disease

Pero os veterinarios deben aprender sobre a saúde e as enfermidades

in mammals, amphibians, reptiles, fish and birds.

de mamíferos, anfibios, réptiles, peixes e aves.

So I don't blame the vets for feeling annoyed

Así que non culpo aos veterinarios por sentírense molestos

by my profession's condescension and ignorance.

coa condescendencia e a ignorancia dos meus compañeiros de profesión.

But here's one from the vets:

Velaquí un chiste da parte dos veterinarios:

What do you call a veterinarian

Como se lle chama a un veterinario

who can only take care of one species?

que só sabe tratar unha especie?

(Risos)

A physician. (Laughter)

Médico

(Risos)

Closing the gap has become a passion for me,

Acurtar esta distancia converteuse na miña paixón,

and I'm doing this through programs

e estou facéndoo a través de programas

like Darwin on Rounds at UCLA,

como Darwin on Rounds, na UCLA.

where we're bringing animal experts and evolutionary biologists

no que invitamos a expertos en animais e a biólogos evolutivos

and embedding them on our medical teams

e os incorporamos aos nosos equipos médicos

with our interns and our residents.

canda os nosos internos e residentes.

And through Zoobiquity conferences,

E a través das conferencias Zoobiquity,

where we bring medical schools together with veterinary schools

nas que convidamos a facultades de Medicina e de Veterinaria

for collabortive discussions

para mantermos debates colaborativos

of the shared diseases and disorders

sobre as enfermidades e os trastornos

of animal and human patients.

compartidos polos pacientes humanos e animais.

At Zoobiquity conferences,

Nas conferencias Zoobiquity

participants learn how treating breast cancer in a tiger

os participantes aprenden como o tratamento dun cancro de peito nun tigre

can help us better treat breast cancer

pode axudarnos a tratar mellor o cancro de peito

in a kindergarten teacher;

dunha mestra de educación infantil;

how understanding polycystic overies in a Holstein cow

como o entender os ovarios poliquísticos dunha vaca Holstein

can help us better take care

pode axudarnos a mellorar o tratamento

of a dance instructor with painful periods;

dunha profesora de baile con menstruacións dolorosas;

and how better understanding the treatment of separation anxiety

e como entender mellor o tratamento da ansiedade de separación

in a high-strung Sheltie

nun can pastor das Illas Shetland moi nervioso

can help an anxious young child struggling with his first days of school.

pode servirlle a un neno ansioso que debe enfrontarse ao comezo das clases.

In the United States and now internationally, at Zoobiquity conferences

Nas conferencias Zoobiquity, primeiro nos EE. UU. e agora en todo o mundo,

physicians and veterinarians check their attitudes and their preconceptions

médicos e veterinarios abandonan as súas actitudes e preconceptos

at the door and come together as colleagues,

e reúnense como colegas,

as peers, as doctors.

como iguais, como doutores.

After all, we humans are animals, too,

Á fin de contas, os humanos somos tamén animais,

and it's time for us physicians to embrace

e xa é tempo de que nós, médicos,

our patients' and our own animal natures

asumamos a natureza animal dos nosos pacientes e a nosa propia

and join veterinarians

e nos unamos aos veterinarios

in a species-spanning approach to health.

nunha aproximación á saúde que abranga todas as especies.

Because it turns out,

Porque resulta que algunhas das mellores

some of the best and most humanistic medicine

e máis humanistas medicinas

is being practiced by doctors whose patients aren't human.

están sendo practicadas por doutores que teñen pacientes que non son humanos.

And one of the best ways we can take care

E un dos mellores xeitos de tratarmos

of the human patient is by paying close attention

ao paciente humano é prestándolle moita atención

to how all the other patients on the planet

a como todos os outros pacientes do planeta

live, grow, get sick and heal.

viven, crecen, enferman e sandan.

Thank you.

Moitas grazas.

(Applause).

(Aplausos)