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During the enlightenment, from 1765, the Habsburg Empire capital of Vienna underwent massive transformations in urban design and appearance, from the introduction of sewer systems and streetlights to urbanization of suburbs and construction of public facilities, including parks, all guided by principles we now consider fundamental to creating healthy, green, livable cities. Habsburg Emperor Joseph II (1780-1790), a reformer with almost utopian (and quite Jeffersonian) ideas about architecture and health, extended these massive changes by contructing Vienna's medical district, including the general hospital, the military hospital, an institute for the mentally ill, and the medical-surgical military academy Josephinum. What does it mean to "construct for health" in designing cities and landscapes, public and private spaces, and health care facilities? This Medical center hour examines the Vienna Project as an important design-and-health precedent. How might we in the twenty-first century enlist design professionals and health professionals together in more deliberate, collaborative efforts to improve public and personal health and well being?
Co-presented with the History of the Health Sciences Lecture Series, the Center for Design + Health (School of Architecture), the Eleanor Crowder Bjoring Center for Nursing Historical Inquiry (School of Nursing), and the Department of Public Health Sciences and the Center for Biomedical Ethics and Humanities (School of Medicine), as part of the interprofessional symposium “Constructing for Health: A Global Nod to Nightingale,” funded by the Buckner W. Clay Endowment for the Humanities (College and Graduate School of Arts and Sciences)
Southern Appalachia often provides a folksy backstory to our national mythology—a tale of coal miners, moonshining, bluegrass, and ballads. But Appalachia is a real place that figures fundamentally in this country's heritage and destiny.
Its rugged mountains are rich in natural resources while its remote communities are home to some of the nation's most fiercely proud people and most persistent poverty. This region has endowed American culture—and the University of Virginia—with a wealth of gifts and innovations but itself faces staggering difficulties. Embracing Appalachia is challenging, especially now, as the coal industry disappears and crises of poor health, environmental degradation, and poverty deepen.
This Medical Center Hour with West Virginia coalfields native David Gordon probes our particular connections to Appalachia and how the enduring tragedy of this place is a “canary in the coalmine” for the rest of our nation.
Is "healthy Appalachia" possible? What will it take? What must we do?
Co-presented with the Center for Global Health, Institute for the Humanities and Global Cultures (Global South Initiative), Department of Public Health Sciences, and Healthy Appalachia Institute
Over the past decade, several leading U.S. medical schools have developed courses combining art appreciation and clinical observation skills. Medical students venture from the clinical setting to the art gallery, where they are challenged by gallery educators and medical professors to observe and to articulate what they see in the art before them. Such courses aim to cultivate and deepen students' visual literacy, verbal facility, and tolerance for ambiguity with the expectation that more finely tuned visual observation and communication skills will help them to be better doctors.
Working with a task force in the UVA School of Medicine, Fralin Museum of Art academic curator Jordan Love has created and piloted The Clinician's Eye, an interactive workshop that aims to refine apprentice clinicians' skills through training in visual analysis. This Medical Center Hour invites audience members to participate—hands-on—in a version of this workshop.
A John F. Anderson Memorial Lecture
Growing enthusiasm in medicine and in the population at large for early diagnosis has engaged many doctors in a systematic search for abnormalitites in persons who are well. While physicians, patients, and the press tend to focus on the potential benefits, Dr. H. Gilbert Welch in his work has exposed the often-ignored harm associated with this practice: overdiagnosis. Diagnoses of a great many conditions, including high blood pressure, osteoporosis, diabetes (and prediabetes), and even cancer, have skyrocketed in recent years, yet many individuals so labeled are destined never to develop symptoms, much less die, from their conditions. They are overdiagnosed. And overdiagnosed patients as Dr. Welch points out in the Medical Center Hour, cannot benefit from treatment since there is nothing to fix. But they can be harmed. Understanding the trade-offs involved is critical, Dr. Welch argues, so that health care systems don't further narrow the definition of "normal" and, ironically, turn more and more well persons into patients.
Co-presented with the Department of Public Health Sciences, School of Medicine; the Sadie Lewis Webb Program in Health Law, School of Law; and the Institute for Practical Ethics and Public Life, UVA
As a UVA undergraduate (Class of 2010), Pennsylvania native Matthew Miller had a catastrophic, near fatal cycling accident on the Blue Ridge Parkway while training for an Ironman triathlon. He lost control of his bike as a caravan of classic cars passed by in the opposite lane; Miller plowed into an oncoming Porsche, breaking every bone in his face. Pulitzer Prize winning journalist Michael Vitez's articles about Miller for The Philadephia Inquirer (reprinted in the Charlottesville Daily Progress) led to his book, The road back: a story of grit and grace (2012). This compelling narrative of Miller's remarkable survival and recovery. He is now a third year medical student at the University of Pennsylvania not only celebrates the strength and resiliency of the human spirit but also vividly attests to the power of medicine at its best. This Medical center hour, with Michael Vitez and UVA surgeon J. Forrest Calland, one of Miller's doctors, suggests that the best way to explore and explain what's happening in medicine may be to tell stories of ordinary people, patients and professionals meeting extraordinary challenges.
A John F. Anderson Memorial Lecture
Musicologist April Greenan outlines use of music in western medicine as an agent of both healing and prevention, reviewing data documenting music's beneficial effects on patients, and suggests ways that health professionals might purposefully employ music in patient care. How might doctors guide patients to use music on their own in managing pain, anxiety, depression, the side-effects of chemotherapy? Given the ubiquity and affordability of recorded music today, might it represent a cost-effective way to help improve health care and health?
A John F. Anderson Memorial Lecture
One of medicine’s open secrets is that some patients request reassignment, or degrade, belittle, or harass health care professionals based on those professionals' race or ethnicity. Such patient conduct can raise thorny ethical, legal, and clinical challenges, and can be painful, confusing, and scarring for the physicians and other clinicians involved. This widely practiced, yet scarcely acknowledged, phenomenon poses a fundamental dilemma for law, medicine, and ethics. It also raises hard questions about how we should think about identity, health, and individual autonomy in the healthcare context and how we manage communication around representations of racial and ethnic bias. In this Koppaka Lecture, Drs. Lo and Paul-Emile will discuss their framework for considering and addressing this phenomenon.
The Koppaka Family Foundation Lecture in Medical Humanities
Even as the University of Virginia and other medical schools across the U.S. prepare to graduate a new wave of physicians, what will be these doctors' roles and responsibilities in a health care system increasingly stressed by social and political pressures, cultural challenges, and financial shortfalls? And what will be—what should be—expected of physicians and the medical profession in years to come, in their practice, in communities, in policy circles, in the public square? In this Medical Center Hour, Dr. Christine Cassel, a longtime leader in medicine and medical education, offers her perspectives on what should be expected of physicians and other health professionals in coming years--in their practice, in their communities, in government and policy circles, and in the public square.
Thirty-five years after the discovery of AIDS, the story of this disease and the momentous scientific, medical, political, and social changes it occasioned is rich and complicated, even sensational. In 1981, Dr. Michael Gottlieb, a young UCLA immunologist, saw--and published a New England Journal of Medicine article about--a cluster of five cases of immune dysfunction and unusual opportunistic infections in gay men. Not long after, as personal physician to Hollywood actor and AIDS patient Rock Hudson, Dr. Gottlieb became the medical face of this terrifying epidemic.
In this Medical Grand Rounds/Medical Center Hour, Dr. Bruce Hillman, a medical school classmate of Michael Gottlieb, probes the war of egos, money, academic power, and Hollywood clout that advanced AIDS research in its first decade even as it compromised the medical scientist who discovered the disease. Dr. Hillman draws on interviews with Dr. Gottlieb and others to chronicle one of the most important and contentious medical discoveries of our time.
Medical Grand Rounds/History of the Health Sciences Lecture
Co-presented with the Department of Medicine and the History of the Health Sciences Lecture Series of Historical Collections, Claude Moore Health Sciences Library