 Okay, all right, well let's get started. So our first talk today is by a good friend of mine, Dr. Barbara Natterson Horowitz, who's a professor of medicine at UCLA in cardiology. And one more thing I wanna say is that in addition to a fascinating book called Zubiquity, which we'll be talking about this concept today, she and another friend and colleague of mine, Dan Bloemstein, have been spearheading an evolutionary medicine program at UCLA. And we just got the approval and we actually started a minor this year and we're gonna hopefully keep moving and building on that. So UCLA is gonna be one of those places for people interested in evolutionary medicine, which includes this ancestral health concept. So let's put your hands together and give a warm welcome to Dr. Natterson. Thanks, thanks Erin. Yeah, it's actually been really exciting. I've been a cardiologist at UCLA for over 20 years and recently really in the last five or six years through the writing of this book and some research that I got interested and I've had a chance to start engaging with some colleagues that are north of Charles Young Drive, psychologists, anthropologists, evolutionary biologists. And it's really been transformative for me as a physician, as a cardiologist. So I'm really thrilled to be here and hope to offer a little bit of a different perspective. So it's August, but July, which thank God is over, is kind of the scariest month in a teaching hospital. And there's an expression, never get sick in July. And that's because the intern who's taking care of you a week ago was a doctor. And so we spent a lot of time with our interns in July and I just came off service and so I had a chance to talk with my interns and I asked them all, year after year, one question. I ask them a lot of questions, but there's one question I love to ask them, because it's my interest. I say, what do you think the connection is between human and animal health? And they all give the same answer. And by the way, this is the answer that 99% of all physicians will give. They say infections, infectious disease, what are called zoonoses. These pathogens that pass between animals and humans and humans and animals. And we then have a conversation about, in fact, the important connections between animal and human health around infectious diseases. We talk about the phenomenon of animals as sentinels for human infectious diseases. We have a conversation about this reality that 60 to 70% of the emerging infections that are gonna affect human populations from avian flu and Ebola to West Nile virus emerge from the animal reservoir. But 10 years ago, I got a phone call that changed my life and massively expanded my perspective on this question, what is the connection between animal and human health? 10 years ago, I was working as a cardiologist here at UCLA. I was taking care of people with heart attacks and high cholesterol. And then I got a telephone call from the head veterinarian at the Los Angeles Zoo. He had, there was a chimpanzee who had woken up with a facial droop. And they were worried that she had had a stroke and they asked if I'd come and do a cardiac ultrasound to look for a cardiac cause. And I should tell you that zoos and aquariums around North America are staffed by highly qualified board certified veterinarians who take great care of their patients. But sometimes they do reach into the human medical community. And I was one of these lucky physicians who had this experience. I remember the first procedure that I did on this chimpanzee. I came in with my probe, put it in the back of her throat, turned it to its proper position. Whoops, sorry. And this is what I saw. Over here on the left, I saw a four chambered beating heart. This is a chimpanzee. And I'm not gonna point out the details except to say that she had in her right atrium a collection of echoes of blood clots. And as soon as I saw this, I realized it reminded me of an echo that I'd seen on a human patient about two weeks before. These two great apes, one chimpanzee and one homo sapiens, had the same form of infiltrative heart failure. And I'd taken care of this kind of heart failure for 25 years. I mean, I had really, I knew a lot about it. And in all of those years, it had never even occurred to me to think about spontaneously occurring diseases, this form of heart failure in non-humans. Now I tell you that with some embarrassment because I certainly knew intellectually. I mean, I studied evolutionary biology as an undergrad. I wrote my thesis on Darwinian theory. I knew that we shared a common ancestor with chimps a blink ago. And I think everybody encountered this nature, this famous cover. And yet I realized that in all of the years that I'd been taking care of human patients, I hadn't done much thinking about naturally occurring animal diseases. But I had this experience, I was being called to the zoo occasionally to let's say in this instance, I'm ruling out a torn aorta in a gorilla. This was a macaw that had a heart murmur and they wanted me to assess that. This is an echocardiogram from a California condor who had a ruptured tricuspid valve leaflet. This was a sea lion who had developed constrictive pericarditis. This is an echocardiogram of a taper's heart. This taper had lower extremity edema. And in this picture I'm listening to the heart of a lion after a procedure. It was a collaborative procedure involving veterinarians and physicians in which we drained her pericardial sac of about 700 cc's of fluid. And this is actually the procedure we did. It's called a pericardiaectomy and I've done it on a lot of human patients. I have to say with the exception of this, which is a tail and this, which is a lion's foot, the procedures were absolutely identical, beginning to end. And so I began thinking more and more about this connection between animal and human health and why was it that I had never thought about this? And as I began talking to colleagues, friends, family members, I have a lot of physicians in my families, I realized that for many physicians, thinking about animal health was just thinking about infections and yet there was this massive other perspective. And I quickly learned that I was not the first physician to think of this. In fact, if you think about it, if you actually start to study this, you realize that this is knowledge that was known and essentially forgotten or lost as human medicine has become more technological, more financially driven, more elitist, we've lost the connection to our animal roots. But one of the fathers of modern medicine, Rudolf Verkau, the physicians in the group certainly recognize his name, wrote in the 19th century, between animal and human medicine, there is no dividing line, nor should there be. The object is different, but the experience obtained constitutes the basis of all medicine. And his disciple, Sir William Osler, also considered one of the founders of modern medicine, himself practiced both human and veterinary medicine as one of the founders of the School of Veterinary Medicine at McGill. So I started getting interested in this and although I was practicing human cardiology and teaching medical students and attending in the ICU, I started a project on the side. Essentially I looked for human diagnoses in the veterinary literature. And I looked in the domestic animal literature, the wild animal literature, and also the fossil record. I was interested in understanding whether there was an ancient component to these questions. A sampling of the questions I asked, do animals get breast cancer? What about sudden cardiac death? Hodgkin's lymphoma, melanoma, brain tumors, these are just random. I had about, I think 400 by the time I started the book. Sexual dysfunction, leukemia, aortic dissection, sexually transmitted diseases. And of course the answer, it's probably not surprising in a way to this group was yes, but I have to tell you, I've given this talk to many physicians, medical students, and typically when I show this slide, there is a lot of noise in the room, laughter, it's news to most physicians. We tend to think that our diseases are unique, our human diseases are special. Well this began opening up my mind to thinking about human disease from a different perspective, to thinking about disease as an expression of vulnerability. And knowing that Hodgkin's lymphoma or breast cancer or brain tumors or sudden cardiac death or congenital heart disease was being seen in extant wild animals. Forced me to ask the question, what shared characteristic do we have with these non-human animals that make us vulnerable to disease? This by the way is not the type of question that's typically asked on rounds in a teaching hospital. So it was a little bit risky for me, fortunately I had made full professor a year before I started writing this book and I have to say that it's not the straight and narrow but increasingly as I've collaborated with other folks, I'm finding that there are other physicians who are thinking this way. But what I know is that human practitioners, and I'm talking about physicians and others but mostly physicians, have a limited exposure to the range of non-human species that have the same disorders that we do. That we have a limited scope of clinical concern, we know very little about veterinary medicine and wildlife biology. And physicians for the most part know nothing about the collaborative opportunities that exist and the translational implications of these. And first and foremost, last and foremost, physicians for the most part don't realize that evolutionary biology can be transformative for human medicine. Perhaps the most important point I can make today for this group is to point out that thinking about naturally occurring disease in wild animals and domestic animals and comparing it to the same disorders in human beings encourages us to encounter this nature nurture question from an expanded, deeper way. To realize that we can no longer ask the question is it nature and nurture, that that is really a false dichotomy. That with a landscape of epigenetics in a world where we understand how multifactorial diseases, that in fact we know that our environment is affecting who we are genetically and that in turn who we are is impacting our environment. It's not nature versus nurture, it's more of a kind of mobius loop. And so I have become passionate about thinking of ways to encourage my very brilliant and well-intentioned colleagues to expand their perspectives and teach me and think in a broader way. Step one, I wanna expose physicians and educate them to the concept of the human patient as a human animal patient. And I'm starting to do that by making my talks very relevant to what they do. So for example, if I'm giving a talk to a group of cardiologists, I talked to them about heart disease. I point out for example, that a torn aorta, something called an aortic dissection which kills thousands of Americans every year, by the way it took the life of Albert Einstein, Lucille Ball, John Ritter, I'm just naming prominent people. But it also happens to be the leading cause of death among certain non-human animals including adult, it's one of the leading causes of death among adult male gorillas. I talk to groups of oncologists frequently and I point out that cancer is not uniquely human, we know that. This is a picture of Ted Kennedy Jr. when he was 12 years old and I remember this picture because I was 12 years old when he was 12 years old and my father, who was a physician, told me that this little boy had cancer. He had osteosarcoma, which is a bone cancer that affects teenagers. It also is very common among large breed dogs, mastiff, St. Bernard's and Golden's have a pretty high incidence of it as well. Again, trying to make these connections to expand the boundary of human medicine. In the obituary in the New York Times where Steve Jobs twice the term rare is used to describe the pancreatic islet cell cancer that he succumbed to and it is rare in human beings but it is hardly rare in a broader sense. It's seen in a number of dog breeds and wild ferrets and some other domestic animals. And finally, about a year, year and a half ago Angelina Jolie went public with the fact that she had had a BRCA1 mutation which made her susceptible to breast cancer. She had a family history of breast cancer and she underwent a prophylactic mastectomy. And so I try to make the connection that the BRCA1 mutation and the vulnerability to breast cancer is not unique to humans either. In fact, veterinarians and wildlife biologists know that all of the big cats, tigers, leopards, but particularly jaguars, Venezuelan and Argentinian jaguars have a high incidence of breast and even breast ovarian cancer and that is seen in association with the BRCA1 mutation. Again, connections, pushing boundaries. I'm gonna come back to this in a moment but just to say that, of course, obesity is not unique to humans, we know that. There are some surprises, it's not too surprising that the animals that live in our homes that we under-exercise and overfeed as we under-exercise and overfeed ourselves are getting fatter. But there are some surprising perspectives on the non-human obesity epidemics that I'll share with you in just a moment. But this kind of connection extends even beyond physical illness. I was in, when I was in the midst of this fact-finding mission, I was in cardiology clinic and I saw a young woman who was having palpitations and as I put my stethoscope on her chest to auscultate her heart and listen to her heartbeat, I noticed that on her left, the interior surface of her left forearm, she had these well-heeled scars. I recognized that she had been a cutter or was and she talked openly about it. And I looked into the veterinary literature skeptically. I thought for sure self-injury would have to be uniquely human. Years later, I look back on that, I think how naive was I to think that it would be uniquely human. And I learned that animals from dogs, to stallions, to birds do self-injure under a variety of circumstances. This, for example, is a picture on the left is a woman who's got a disorder called trichotillomania. This is a condition where people start to pluck out their hair. The eyelashes are the most typical target, but it can be any hair at all. I was fascinated to learn that there are certain birds, particularly parrots who have something called feather-plucking disorder and under similar conditions of stress and isolation, these birds begin plucking out their feathers much in the same pattern that human trichotillomaniacs pluck out their hair. Finally, I saw a young woman who was an inpatient in our eating disorders unit at UCLA. I was seeing her for a slowed heart rate, which can be a complication of anorexia nervosa. And so I asked the question, could an animal ever develop an eating disorder? Again, skeptical that the answer would be yes. And I learned that, of course, humans are not the only animal that can have eating affected by environment. When we are stressed, some humans respond by under-eating to stress, some humans respond by overeating in response to stress. Some eating disorders emerge around social stress, for example. Well, I learned that there is a phenomenon on a syndrome called the thin-south syndrome that's seen among female pigs, particularly though it can be seen in male pigs as well, when they're transitioning from nursing to an independent state. Some of them respond to the stress by ceasing their eating. They stop having an estrus, they stop going into estrus, so they stop cycling. Their hair and skin can change. And these are similar to human anorexia nervosa. On the other end of the spectrum, there are great apes and some marine mammals as well. And these are captive, all three of these are captive situations, who respond to social stress by self-inducing vomiting. And then they consume the emesis. It's called regurgitation and re-ingestion. Is this bulimia nervosa? No, it's not bulimia nervosa, but is there a connection, presumably, between these disorders? I think so, and I think it's worth having physicians and psychiatrists, psychotherapists, parents and patients being aware that having an eating response, an eating change in response to stress is not uniquely human. There is something to learn. Step two, I think we need to demonstrate how basic comparative knowledge can lead to an expanded perspective, and most importantly, to novel hypotheses. To go back to the obesity issue, again, I was not surprised to learn that zoo animals and dogs and cats living in our homes are getting fatter. That made sense to me. What was surprising was when I encountered first a journal article called The Plurality of Non-Human Obesity Epidemics, which kind of categorized all of these domestic, but then some feral examples, some wild examples of obesity, some populations that seem to be getting fatter. Why is this important? Because as the idea of environmental factors affecting the human obesity epidemic, these ideas are out there, but they are not really embraced by mainstream human medicine. Introduce the reality that non-human animals, non-human wild animals may be getting fatter, and all of a sudden, the most sort of critically thinking physician investigator has to begin asking whether endocrine disrupting chemicals or antibiotics or other environmental factors could be impacting eating patterns, metabolic function across species. Am I saying that this is the case? No, but what I am saying is it's not a good idea for people who are researching in one area to live in a single species silo. We need to have this information. As a cardiologist, I had one example which really shows the potential for this kind of comparative knowledge to spark novel hypotheses. One day I was asked to do an ultrasound on a little tiny monkey called a tamarind. And I went in, and this is the type of tamarind, it's not my patient, but her name was Spitz Boomin, and as I was examining her, I came closer and I started making eye contact with her. The veterinarian asked that I step back, that I was scaring her and told me that I might give her capturmyopathy. So it turns out that wild animals, some wild animals from monkeys to shorebirds to langomorphs to rabbits to some hoof stalk, they can have a fear-induced sudden death syndrome. Some wildlife biologists, for example, who can and net wild animals describe an up to 10% kill rate due to this noise and stress and fear. Well, it turns out this is not unique to wild animals and it's not unique to humans. 1994, January the 17th, Los Angeles experienced our last big earthquake, that was the Northridge Quake. And a year later some colleagues published this in the New England Journal showing the number of cardiovascular deaths on that date and then the same date in the three years prior. Clearly, fear-induced sudden death exists in humans but is not uniquely human. When I presented this at cardiology ground rounds at UCLA, it led to some physician investigator friends of mine who are involved with electrophysiology to ask a simple question. If non-human animals can experience fear-induced sudden death, is there a phylogeny of sudden death? And if we can characterize who's getting it and who's not, can we begin thinking about why one species is more vulnerable and another less vulnerable? This kind of hypothesis is not possible if a cardiologist doesn't know that the phenomenon exists outside of our species. And this is an example of a early, early, early example of a phylogeny. We must expose practitioners to the natural world, to the fields of ecology, zoology, and most importantly environmental science. To do that, I've been trying to create some educational initiatives. One of them is the Zubiquity Conference, where I bring together veterinary schools and their faculty together with folks from public health and the medical school to talk about the shared disorders and the shared vulnerabilities of different species. This is the handshake that I wanna see duplicated around the world. On the right here is my dean, this is Jean Washington, he's the dean of UCLA School of Medicine, and that's Benny Osborne, who recently retired as dean of the UC Davis School of Veterinary Medicine. Our subsequent conferences, we've had Michael Laramore, who's the current dean of UC Davis Vet School. And at these conferences, we bring together faculty so that we can discuss, for example, we bring together veterinary cardiologists and human cardiologists, and we discuss atrial fibrillation in a apollosa and in a pilot. We look at oncologists, veterinary and human, look at lymphoma in a llama and lymphoma in a human. We, these are a sampling of some of the cases we've looked at, fainting in a thoroughbred horse and a high school athlete, compulsive disorder in a polar bear and a novelist, anxiety in a dog and a little boy, et cetera. We're trying to cover a spectrum of disorders. We are doing these now, we've done two of them at UCLA, along with UC Davis. We did our last one in New York, which was the Wildlife Conservation Society. We had a lot of wildlife biologists and vets there, and many, many very prominent physicians. Stanford held a zubiquity conference several months ago. We have an environment and human health, human and animal health one coming up in Seattle, which is a collaboration between the vet school up in Pullman and University of Washington School of Veterinary Medicine. Boston's doing one. We have one that's being organized out of the University of Utrecht in September in Australia. So it is gaining traction, but primarily what we need to do is bring physicians into this conversation because we have to promote scientific collaboration between physicians, wildlife biologists, vets, ecologists, evolutionary biologists, environmentalists, and others. We talk a lot about translational medicine these days. And when we use that term, almost always we're talking about one thing, taking research that's being done in the laboratory, that is at the bench, and bringing it to the bedside. I propose that there is a second and equally important form of translational research, which is in essence the opposite. It represents the elastic recoil back from this kind of reductionism. It is a species spanning way of being translational, making comparisons, looking for environmental linkages, developing novel hypotheses, and bringing those back to the human bedside. I show this quote only because I work at the Ronald Reagan UCLA Medical Center. We have a brand new hospital that was named for Ronald Reagan. It was built in response to the 1994 quake which destroyed a lot of our hospital. It was considered unusable. But it was 25 years ago, 27 years ago, that Ronald Reagan stood at the Brandenburg Gate in Berlin and he said the famous words, Mr. Gorbachev, tear down that wall. So since I work at the Ronald Reagan Medical Center, I thought I would borrow those words and turn them toward the less concrete, but no less real wall that has divided human and animal medicine, human medicine from environmental studies, from ecology, from zoology. And I say we need to begin breaking down those walls. And if we do, I think we can improve the health not only of human beings, but of all the patients on the planet. So I'm done. And I'd love to hear your thoughts and questions. Thank you. Yeah, please line up at the mics. We have two mics here to set up for you, thanks. So one of the things on the path to discovering nutritional treatments for some things I was dealing with ran across an interesting phenomenon which was a animal supplement feed company created a baker's yeast based fermentate that's fed to animals, works really well in that field. And it turned out that workers were using it at home and having much lower insurance claims for being sick and out of work. And they claim that they reduce their insurance rates. And I was wondering if you had heard of any other things nutritionally that seem to be working for animals that work well for humans on either direction. Right, so I don't know of any commercial products per se, but it's interesting. This is one of the questions. By the way, I worked with a co-author on this book. So when I say we, I'm talking about the incredible Catherine Bowers who helped me with this. But wherever we went to vet schools to we researched for several years, we asked the question, are there any technologies or products or practices that are being done on the, when we asked animal experts that you use yourself as a human being? And we had a variety of answers to that question. There were a number of folks who were using behavioral techniques, clicker training, for example, on their children, in a benign way. We did find that the one area where people were talking about this a lot was in the area of the microbiome and issues with C. diff. And we know now that fecal transplantation, which of course is becoming very popular on the human side, it originated, the concept of it really originated in the animal world. And the concept that if you visit farms and talk to farm vets, if they have an animal who's been treated for some infectious process with an antibiotic and they develop a C. diff or a kind of a colitis, an antibiotic induced colitis, that they just, they have rumen donators who give them this healthy rumen, or they just put them back in the pasture and they graze on land that has fecal material as well and that this restores the normal floor on the health. So that's a very concrete way in which something from the veterinary side is coming to the human side. Many of your examples were about zoo animals or domesticated animals. And I was wondering how you then disentangle sort of the human inputs, such as the food, the environment, to those animals from what might be naturally occurring. That's probably the most important question that can be asked. And what's exciting is that when I give this talk, it forces people to think about that and to think in a sophisticated way. Because I mean, and the question usually comes up around behavioral problems, self-injury, compulsions, that kind of stuff, which you do see more in captive animals for sure. But what's interesting is to kind of blow that up and turn the lights on and say, well, wait a minute, do wild animals ever engage in what are called stereotypies? So sort of the kind of, like when I get nervous, sometimes I go like this, right? Or sometimes I twirl my hair. It's a self-soothing. And we all do little tiny things. And so do animals. If you watch wild animals, they do all kinds of things when they get stressed, they soothe themselves. So one of the important aspects to me about asking that question and answering it is it allows us to say, okay, it's not that captivity causes these things. It's not that what we're doing in the environment is causing X disease or Y disease. What we can say is that we have a vulnerability. We like, let's say, the tamarin who self-injured the sun have a vulnerability. But the environment amplifies it. So it shifts it, it allows us to refine the concept of association and moving away from causal to the amplification of vulnerability, let's say. So this is a little bit of a sociological question, but it amplifies some of the questions asked earlier. So just like you're trying to break down the wall between veterinary and human medicine, we're trying to break down the wall between dietary and lifestyle, interventions and medicine as potentially complementary efforts in health. I'm curious, in the zoo-biquity community are there people looking at dietary and lifestyle interventions in animals? I assume there must be because there's been a movement in zoos toward more natural diets and environmental situations, but I'm curious how much work is going on now. Yeah, we are focusing, at every one of our zoo-biquity conferences, we have at least one session on obesity and the one in Australia is all about obesity, which was their choice, but I totally think it's great. Obesity and metabolic perturbation. So the thing that I learned quickly on one of the chapters in the book is called Fat Planet, which is looking at this issue, is that if you ask, and I've been a doctor for a long time and I've seen a lot of obese patients, when I see an obese patient, I try to be compassionate and connect, but ultimately I say, you know what, you need to make some changes, you need to change what you're eating, you need to exercise more, and the perspective in modern medicine is to talk to the patient as an individual and to ask them to take responsibility, and that's a good thing, but it doesn't work very well. If you see a veterinarian and ask them, well, because we talked with vets who deal with obesity in a variety of settings, and you ask them, what do you do with your obese patients? They say, well, the first thing we do is we look at the environment, and we ask, what is it about where they're living that's turned, it's an obesogenic environment? And so they do things like they make it harder for the animal to find their food. They create a landscape that's healthier. Obviously, we can't completely do that in human medicine, but I do think we can, from a legislation, from a kind of public health perspective, shift how we think about it, and that will do two things. One, I think it might be more effective in dealing with the human obesity epidemic, but secondly, I also think it's more compassionate because there is a lot of blame, and there are some people who just can't make it happen, and not only can they not make it happen and they're dealing with horrible health effects, they also feel really crummy about themselves. So I think there's a lot we can learn from the veterinary side, but I like this look to the environment first and the individual second. I have a cat, and he's a very special cat, and when we first got him, we realized that he would eat things in the house, and he would ingest them, and he would actually swallow them, and we were trying to figure out what to do, and he was also very high strung, and I thought back to my history before I found paleo, I was very insulin hypersensitive, and if I ate a lot of carbs, I would be extremely hungry, and we started looking at the foods and a lot of grain in the foods. We finally got him on a grain-free food, and that really, really helped after we had sort of gone grain-free. We thought, gee, maybe this would help him also, but having given up cashmere because that was his favorite thing, now he's actually much better, but the other thing is there are differences too. So I noticed that even in the grain-free cat foods, there's still like peas and carrots and things that we think, well, that's good for people, so it would be good for animals, and I don't think that animals, that cats in the wild eat peas and carrots, and it would be great if we could have more foods, more animal foods that really took into account what's really healthy for that animal, because I think it would make a big difference to the animal health. It's really interesting that you're bringing this up because there's a big problem with cat obesity and with cat diabetes, and these are all the domestic cats, et cetera, but it turns out the optimal diet, and these are experts in the field of cat nutrition is a very low carb, they should be eating very, very low carb and higher protein, and the vets laughingly, lovingly call that the catkin's diet, but it actually is where feline nutrition is going. So there's only one other type of animal out there that typically wears shoes besides humans being horses specifically, so I know that there's been a lot of findings that taking shoes off horses has improved health and behavior in those cases. Is there a sort of a veterinary equivalent of podiatry or is that sort of something that they don't need because they don't run into problems with feet and things like that? Another one of my favorite topics, which we didn't get to write about in the book, but yeah, so they get this thing called laminitis, horses get this laminitis, and laminitis, as you appropriately said, causes not only physical problems, it causes emotional problems, and it's one of the causes of psychiatric disturbances in horses. And this veterinary, particularly equine orthopedics is one of the areas that has already been translational to the human side. Some of it is through stem cells, but some of it is through really a kind of sports medicine approach. So it's an area of a lot of interest and that we're gonna probably feature in one of our subiquity conferences with podiatrists and some equine vets. Prince Kat was put on a paleo diet and no longer had to take epilepsy medicine and was able to reduce the Prozac. The question I have is if we compare animals of the same age and the wild and captivity, what do disease rates look like? Another one of my favorite questions, and it's not known, what is the incidence? But the one example I can give you at the Stanford Conference, Karen Terrio, who's a veterinary, she's a wildlife vet, and she works in the field of cheetahs and helicobacter. So helicobacter, you probably know, is the bacteria that is associated with ulcers. Right before the discovery of helicobacter, we thought that ulcers were caused by stress. And then we learned that in fact, when you're colonized with helicobacter pylori, your incidence of developing a gastric ulcer is much, much higher. So it turns out the treatment is actually an antimicrobial treatment. Well, Karen works with both captive and wild cheetah populations, and she's actually looked at the gastric juices for evidence of H. pylori. H. pylori colonizes the GI tracts of both captive and wild cheetahs, but wild cheetahs never get these ulcers. So this is, I mean, it's very hard to do this research. You can imagine the kind of training and funding, but she's doing it. She's a remarkable person, and I heard her present. So that's one little tiny window into that question. But getting at that question, I think would illuminate, I mean, every single question in human medicine. It's just hard to get there. Well, thank you, Dr. Natterson. One announcement I forgot to make a little earlier. I recognize that the Wi-Fi has been problematic, or maybe it's been out today. Apparently the Berkeley-wide, the whole campus-wide problem and the Berkeley campus people are working on that. Hopefully that'll be resolved as soon as possible. And our next talk will begin promptly at 11, so don't go too far, unless you're going to bankrupt for the other talk.