It looked like any of the number of procedural rooms that I had been in during the past four years of medical school. Behind a glass partition, there were rows of medications ranging from blood pressure drugs to birth control pills, many of which I had seen prescribed to my own patients. There was an x-ray machine in the corner, and a CT machine waiting next door. Various pieces of ventilating equipment were neatly stacked in metal bins and shelves lining the walls. It looked so familiar, that I could almost forget the reality: I was at the Detroit Zoo, and all of these medications and equipment were used to treat the exotic animals that reside there.
It was for this very reason–to understand the connections between human and animal health–that my classmate Kate Heckman and I developed a Comparative Medicine elective for upperclass medical students to take during their time in the Branches. The idea for comparative medicine, defined as the study of similarities and differences between animal and human medicine, is not new. It has been endorsed by famous physicians ranging from the historic Hippocrates to the more recent Dr. Virchow (who is known as “the father of modern pathology”). In fact, even the Center for Disease Control promotes the One Health Initiative, which aims to increase collaboration between physicians, veterinarians, and other health professionals.
Although there was a strong academic precedent for creating the course, I had a slightly different motivation in developing this elective. Growing up, I always had a wide range of academic interests. However, once in medical school, I was quickly overwhelmed by the sheer volume of information available for a medical student to study. Worried that I would be an incompetent physician if I did not commit to learning as much of it as possible, I focused all of my energy and time on studying human physiology, anatomy, and medicine; gradually, all of my other academic interests and passions fell to the wayside. I was worried that I was coming out of medical school less curious and less creative than I was when I started. The idea of developing a course in a field that interested me, but had little exposure to in medical school, seemed like the perfect opportunity to return to my roots and rekindle my passion for learning.
Although Kate and I had no prior experience with course development, we were mentored by Drs. Fox and Alsup, faculty within the medical school anatomy program, who helped us with the paperwork and administrative process of gaining course approval. Dr. Nemzek, a faculty member at the University of Michigan’s Unit for Laboratory Animal Medicine (ULAM) assisted us with curriculum development and connected us with various field experts for course lectures. Furthermore, with grant funding from the Medical School, we were able to cover the costs of educational sessions arranged at the Detroit Zoo and Michigan State University Veterinary School as well as fund a pet CPR certification course for students enrolled in the course. All of this exemplifies our Medical School’s approach to student-led projects; not only does Michigan encourage students to pursue their interests, but it provides the support and resources necessary to help them succeed.
In planning the lecture portion of our course’s curriculum, we found numerous physicians who, on top of their expertise in human medicine, had strong background knowledge in animal medicine and physiology. Our lectures included a discussion of how brain structure varies between species, and how this correlates to animal behavior led by Dr. Selwa, a neurologist. Dr. Green, an otolaryngologist, spoke on animal pharynx structure compared to human anatomy, explaining why humans can talk while other animals can’t. An emergency medicine physician held a Jeopardy-style trivia competition to teach about management of animal bites and stings. I was especially impressed that many of these lecturers studied comparative physiology and medicine on their own time, purely for their own interest. I was reassured to realize that being a good physician does not necessitate purely focusing one’s attention on human medical journals and literature.
However, my favorite parts of the course were the experiential learning trips that we arranged within the University of Michigan as well as community organizations and other academic centers. At Michigan, we visited the Unit for Laboratory Animal Medicine, where we learned about the ethics of animal research, the contributions that animal-based research has made to our understanding of human disease and medical care as well as the strengths and weaknesses of our current animal models of disease. I was pleasantly surprised to learn about the extent of research and effort that veterinarian staff at ULAM employ to give their animals a good quality of life, including strategies to provide social and intellectual enrichment.
We also arranged a trip to the highly renowned Michigan State University School of Veterinary Medicine. We were given a tour of the facilities and learned about innovations in animal medicine that could potentially lead to development of new treatments for human diseases in fields such as oncology and ophthalmology. At the anatomy lab, we were tested with labeling the joints of a full-scale horse model. As we struggled through the exercise, asking questions such as “Do horses have elbows… or are they just called ‘front knees?”, I was struck both by how limited my knowledge base in comparative anatomy was, and yet how many correlations there are between the bones and anatomical structures of a horse and those of a human (I also learned that the “front knee joint” is actually called the carpus). Most of all, I was impressed by the enthusiasm of the staff and faculty at the Veterinary School in teaching medical students. They shared their delight in the course and expressed the value that they felt could be gained by further collaboration between our two fields, and by this point in the course, I could not help but agree.
Our course ended with an afternoon spent with Dr. Duncan, the director of veterinary medicine at the Detroit Zoo. She gave a brief talk on the Zoo’s program for maintaining heart health in the great apes, during which I was surprised to discover that the heart disease processes that gorillas face are similar to those I had seen in many of my patients at the hospital, as were the treatments–although I have never had to sneak medications to my patients through juice boxes, as the veterinary staff do. We were then given a tour of the procedural facilities, where animals are given physical exams and are treated for various ailments. Once again, my classmates and I were amazed at the degree of overlap in the equipment and medications used at our hospital and here at the zoo. We also learned that, for animals with complex or highly specific disease processes, zoo veterinarians often consult their human medicine counterparts with expertise in the disease to help with management and treatment of the animals. It was a career opportunity that few of us realized existed, and many of us resolved to take part in someday.
During the yearlong process of developing the comparative medicine course, the question that I most frequently received from classmates, family, and friends was “why?” Why should medical students spend their time learning about animals, when there are so many human medicine topics to study? At the time, I would fumble for a response, mumbling something about “gaining a background for research” and “expanding our knowledge base.” But now, I would argue, why not? I came to medical school worried that if I didn’t focus all of my attention on human medicine, I would become a worse physician in the future. As I look forward to graduating in one month, I realize that the effect is actually the opposite. By taking time during my third and fourth years of medical school to explore my interests in narrative writing and comparative medicine, I have not only become a more well-rounded student, but I have found myself asking more questions, reading more books, and most importantly, enjoying learning and studying once again. Exploring passions that lie outside of strictly human medicine can allow for medical students and physicians to retain the curiosity and passion that allowed them to succeed academically, and will continue to serve them in their care of patients.
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Erika Steensma is a 4th year medical student at the University of Michigan. She will be staying at Michigan Medicine for her child neurology residency next year. When she isn’t at the hospital or studying, she enjoys running along the Huron River and baking for her friends.