The LA zoo experience

Richard Wright, M.D. is currently Director of the Heart Institute at Saint John’s Health Center in Santa Monica, and Chairman at the Pacific Heart Institute. Dr. Wright shares an unusual period in his practice when he served as the cardiologist for the Great Apes at the Los Angeles Zoo. His experiences show how we are more akin to these creatures than we think.

More than a decade ago I received an inquiry generated by the Los Angeles Zoo with a simple question: would I be interested in doing a heart failure consultation on a male orangutan?  It turns out that a female orangutan at another facility was ready to be mated, however each animal needed to undergo health screening, and the Los Angeles orangutan had an abnormal chest x-ray that suggested the presence of heart failure.  I was delighted at the prospect.

Arrangements were made for me to travel to the zoo to perform a complete physical examination and specialized heart tests on the orangutan in question. A full physical examination involves such close contact with a great ape, however, that it is considered unsafe for medical professionals unless the animal is under general anesthesia. Thus the “patient” was darted with a blow dart using an injectable sedative, and as soon as adequate sedation was achieved, we rushed into its cage to put the orangutan under general anesthesia - no different than the kind administered to humans.  He was then transported to the medical facility at the zoo and the examinations began.

We completed a full cardiac study, including a transesophageal echo on the orangutan.  The exam confirmed that severe weakness of the heart muscle was present and the proposed breeding was abandoned.  Instead, cardiac medications were begun.

After that evaluation, I had the good fortune of returning to the zoo dozens of times for similar assessments of all of the apes: gorillas, orangutans, and chimpanzees.  I treated atrial fibrillation in a chimp, and performed CPR on a gorilla that had suffered a heart attack. The most interesting exam was on the alpha dominant silverback gorilla Caesar, a beast that was at that time the largest such animal in captivity.  At 18 years of age, he weighed 741 pounds, with a 32 -inch neck and 16-inch wrists. His enormous hands and fingers dwarfed anything I have ever seen. Fortunately, his heart and aorta exams were normal.

It was a privilege to be able to hold and be so close to our genetic cousins, and to understand that they too can suffer from the ravages of the same heart diseases that afflict us - coronary artery disease, heart attacks, heart failure, and heart rhythm disorders.  Heart medications are now regularly administered to these apes and I know of a gorilla that has undergone coronary artery stenting and another that has an implanted pacemaker/defibrillator.

After being the cardiologist at the zoo for a decade, I turned the reins over to a cardiology colleague so as to have more time for my Homo sapien patients. My time at the zoo was unbelievably educational and humbling, and will forever be cherished by me and the heart team that assisted in the diagnosis and care of these ever-so-special animals.  It is gratifying to realize that the same advances that have revolutionized cardiology care are now being used to help these truly great apes.