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Chocolate has been special to human beings for millennia. In our time and culture as in earlier centuries and other cultures, claims abound regarding chocolate's health effects, positive and otherwise. What is it about chocolate—chemically and culturally—that makes it so distinctive in our diets, our emotional lives, our celebrations? Why do we love it so, and what does it do to/for us? In this Medical Center Hour, local chocolatier Tim Gearhart offers insights into chocolate's appeal and effects and gives a glimpse of the craft of artisan chocolate-making.
A John F. Anderson Memorial Lecture
The stethoscope, an extension of the clinician's ear, is perhaps modern medicine's most characteristic symbol. Through it, doctors listen for the body to disclose its secrets. Doctors must also listen to their patients' stories. In fact, as Oliver Sacks said, "The first act of medicine is listening to a personal story." But hasn't the clinician's ear lost much of its importance now that procedures and machines can give us more direct access to pathology?
In this Richardson Lecture, physician and poet John Coulehan affirms the importance of the clinician's aural attention in the clinical encounter and considers three aspects of the metaphorical clinical ear. First, listening to patients, an active process with vertical (deep listening) and horizontal (narrative) dimensions. Second, listening to the heart, the reflective core of clinical practice. And, finally, hearing the resonance of our own healing words. In medicine, the word can be an instrument of healing.
Co-presented with the Office of Quality and Performance Improvement, UVA Health System
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)
When academic medicine in the U.S. begins to reflect the remarkable diversity of the population it serves, we can potentially start narrowing critical gaps in cultural knowledge, the provision of health care, and the education and advancement of future physicians. Invoking the time-honored art of quilt-making as a metaphor, Dr. Wendi Wills El-Amin will engage the audience at this Medical Center Hour in exploring the urgent issue of minority diversity in academic medicine, including the opportunities that currently exist to craft new patterns and other opportunities we need to create in order to increase minority presence and engagement throughout academic medicine. UVA School of Medicine Associate Dean for Diversity Dr. Greg Townsend will offer a response.
Co-presented with the Office for Diversity, School of Medicine
A John F. Anderson Memorial Lecture
Early in her own training in psychology a decade ago, Casey Schwartz discovered that contemporary neuroscience and psychoanalysis are entangled in a conflict almost as old as the disciplines themselves. Many neuroscientists, if they think about psychoanalysis at all, view it as outdated, arbitrary, and subjective, while many psychoanalysts decry neuroscience as lacking the true texture of human experience. Yet some are now fighting passionately to bring the two fields together, including Mark Solms, a South African psychoanalyst, neuropsychologist, dream researcher, and towering presence in the effort to grow the hybrid discipline that he himself calls neuropsychoanalysis. Ms. Schwartz has written this story in her new book, In the Mind Fields: Exploring the New Science of Neuropsychoanalysis. In this Medical Center Hour, she tracks and interprets the ongoing struggle to define what we mean by the mind, the brain, and everything in between.
History of the Health Sciences Lecture
Co-presented with History of the Health Sciences Lecture Series and the Department of Psychiatry and Neurobehavioral Sciences
Dr. Romero shares insights regarding the increasingly important partnership of public health and primary care and the critical need for a strong, patient-centered primary care framework to improve health outcomes.
Co-presented with the Generalist Scholars Program and the Department of Public Health Sciences, UVA, in observance at UVA of Primary Care Week
With availability of medical interventions like cochlear implants to treat deafness, health professionals caring for deaf persons or helping families make reproductive choices about deafness (as in prenatal genetic screening) tend to work from biomedical rather than cultural understandings of deafness. Deaf Americans have produced a fascinating literary corpus over the last 200 years, both writing in English and creating stories and poems in American Sign Language. Similarly, the work of deaf visual artists illustrates powerfully how deafness may be construed as visual and conceptual gain rather than as hearing loss. These expressions of deaf culture also respond to the pathologization and medicalization of deafness in our society, resist the majority's assumptions and norms, and argue for the value of the deaf community and sign.
This Medical center hour explores deaf literature and visual art to suggest that a deeper understanding of deaf culture can help health professionals to provide better care and counsel, medically and ethically speaking, to deaf patients and their families.
Co-presented with the Department of English and the History of the Health Sciences Lecture Series, UVA
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
In 1858, young English surgeons Henry Gray and Henry VanDyke Carter published an illustrated anatomy textbook for medical students. Gray's Anatomy has never since been out of print, but little was known about its author and illustrator until acclaimed science writer Bill Hayes—inspired by a photograph of Henry Gray—pieced together their story in The Anatomist. This Medical Center Hour explores the medical, historical, and artistic significance of Gray's Anatomy and also Hayes's unforgettable year alongside medical students in the anatomy lab.
Co-presented with the History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library
Danny Quirk is a young artist specializing in photorealistic watercolors, painting what the camera cannot capture. Much of his work illustrates the intricacies of human anatomy. On canvas, he paints figures in classic poses (sometimes á la Renaissance anatomist Andreas Vesalius) in striking chiaroscuro lighting. But, more dramatically, he also paints on living subjects, representing on the body's surface the anatomical structures that lie beneath. In this Medical Center Hour, Danny Quirk talks about "dissecting" with a paintbrush—and while he's talking, he'll complete an anatomical drawing on a student volunteer.
Co-presented with the History of the Health Sciences Lecture Series
In recent years in the US, increasing workforce diversity has become a priority in health care and other industries. Many companies, including Fortune 500s, now recognize that having a diverse workforce improves both business and the bottom line—indeed, diversity is key to organizational excellence. In this Medical Center Hour, a panel of physicians explores whether UVA Health System's growing diversity can add value in a very different way: can our organization's greater diversity be a lever to mitigate bias in these increasingly fraught times?
A John F. Anderson Memorial Lecture
Understanding and responding to patients' complex health needs and challenges requires physicians--and all healthcare providers--to think creatively. Knowledge and information are not enough. We must prepare future physicians to think differently and to be mindful of how they think. But future physicians must also possess the skills of a creative artist, because, for many doctors on the clinical frontlines, medicine is a science-using creative art.
In this Medical Center Hour, emergency medicine physician, medical educator, and fiction writer Jay Baruch argues that necessary transformations in medicine and medical education will demand new interdisciplinary skills and methods--and essential contributions from artists, writers, designers, and humanities scholars.
The Moore Lecture of the School of Medicine
Dying in America is very different now from half a century ago. Before World War II, death usually occurred at home, often with no medical intervention. But with the bioscientific and medical advances that began in the 1950's, death became medicalized. In hospitals, it became possible to extend life. Often, patients were cured who would otherwise have died, but many endured protracted deaths in which suffering from treatment was worse than suffering from their fatal illness. Through the last decades of the 20th century, the medical and legal professions, medical ethicists, and the public began to consider ways to limit treatment, even to hasten death. It became generally accepted that all patients have the right to refuse life-sustaining treatment. Now, five U.S. states recognize physician-assisted suicide.
In this Medical center hour, physician and former New England Journal of Medicine editor-in-chief Marcia Angell traces the history of these changes, then inquires into where we stand now on dying--and where we go from here.
Co-presented with the History of the Health Sciences Lecture Series
Tuberculosis continues to be one of the world's most deadly infectious diseases, killing almost two million people each year. In this Medical Center Hour, historian Christian McMillen explores TB's stubborn staying power by examining key aspects of the disease—including the rise of drug resistance and TB's resurgence with the HIV/AIDS epidemic—and detailing global efforts to control it since 1900.
Co-presented with the History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library
There's much mythology surrounding eating disorders. Myth: these are time-imited illnesses that resolve when a woman leaves adolescence. Myth: only women experience eating disorders. In a society that reveres bodily thinness and now also celebrates the extremely "fit" body, at once lean and overtly muscular, an estimated 25 to 30 million Americans currently suffer from an eating disorder. Most eating disorders look nothing like the stereotypes suggested by sensational media coverage. The afflicted include men and women of all ages and all ethnicities. And so alongside this country's well-publicized obesity epidemic rages another, quite invisible epidemic of eating disorders. This Medical Center Hour addresses eating disorders and related questions from three perspectives. Speakers include a UVA student in recovery, a parent and national advocate, and the coordinator of the prevention program at UVA's Women's Center. What role does family play in eating disorders? How as health professionals do we ensure that patients get the best treatment? What treatments are most effective? How can we, health professionals and laypersons alike, best support someone who is suffering? What resources are available at UVA and how do we get involved?
A John F. Anderson Memorial Lecture
Co-presented with the Women's Center, UVA
"Germs have always traveled. the problem now is they can travel with the speed of a jet plane." So said physician and medical historian Howard Markel in recent days, commenting on the spread of Ebola outside West Africa. This Medical center hour takes stock of the rapidly evolving Ebola epidemic and the concomitant rise in global health security concerns. What is known of this unusual virus and the life-threatening hemorrhagic fever it triggers? How are sociopolitical and cultural conditions and healthcare infrastructural inadequacies in West Africia and elsewhere hindering medical and public health response? How are governmental and health care institutions in the U.S. responding as cases erupt outside West Africia? And, looking ahead, what are the prospects for vaccine development and fast-track clinical trials?
A John F. Anderson Memorial Lecture
Co-presented with the Department of Public Health Sciences and the Center for Global Health
Patients sometimes complain that they are neither heard by nor really known to their doctors especially, perhaps, subspecialists to whom they've been referred for particular procedures and fear that, as a result, they may receive substandard care. Similarly, in fast paced practice, some physicians, including said subspecialists, may find it difficult to know their patients as persons. Cardiologist Joseph Gascho M.D. met these challenges for himself and his patients by devising ways he could hear and know the persons in his care through the media of photography and poetry. This Medical Center Hour examines doctors' use of the arts to improve the care that patients receive. Dr. Gascho describes three projects that have helped him to bridge the patienthood personhood gulf, enabling him to better understand his patients as individuals and to give them whole person care. He is joined by physician Julia Connelly M.D. for whom photography has become a way to bring care and connection with nature to elderly persons, including nursing home residents.
Anthropologist, activist, and priest Roshi Joan Halifax is the founder and head teacher of the Buddhist monastery, Upaya Zen Center. Seventeen years ago at Upaya, she pioneered a new form of bedside contemplative care known as "Being with Dying," which has since helped to illuminate and change the psychosocial, ethical, and spiritual care of the dying. Halifax's newest work probes what she calls five "edge states" of how we become involved with our fellow beings: altruism, empathy, integrity, respect, and engagement. In this Bice Memorial Lecture, she explores the risks and the opportunities for courage and compassion that persons in the helping professions encounter "at the edge."
Bice Lecture, Co-presented with the School of Nursing, UVA
In this Medical Center Hour, Ellen Ficklen, the former editor of "Narrative Matters," takes us behind the scenes at Health Affairs to probe the close working relationship between authors and editors as manuscripts are sculpted and polished into essays that surgeon/author Atul Gawande describes as "some of health care's most stunning writing."
A John F. Anderson Memorial Lecture
Among the COVID-19 pandemic's lessons is an increased awareness of the hazards of old age. But only a fraction of that risk is biological. At a moment in history when most of us will live into old age, we've created a world that's almost entirely focused on childhood and adulthood. It's time now to define, design, and empower this new, nearly universal elderhood. In this Medical Center Hour, geriatrician and writer Louise Aronson draws on her clinical experience and creative abilities to reimagine and advocate for old age not as a disease but as a vital phase of being human, with implications for social and community life, technology, geroscience, and healthcare. How shall we now approach elderhood?
Koppaka Family Foundation Lecture in Health Humanities