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Part one. History professor Jeff Norrell talks in Kelly Ingram Park in Birmingham, Alabama, across the street from the 16th St. Baptist Church, about demonstrations there in 1963. He remarks on the children and student participants in the demonstrations and the confrontations between demonstrators and police in early May. He talks about what Birmingham is like in 1987, what the park and the church represent, and how downtown Birmingham has changed. Part two. Mr. Norrell recalls cases heard at the old Birmingham federal courthouse, like Steele v. Louisville and Nashville Railroad Company, and the Birmingham College case. He also talks about attorney Arthur Shores, the rise of African American political power in Birmingham, and voting rights cases from Birmingham. Part three. Mr. Norrell discusses the Confederate Flag on the Birmingham courthouse and what it represents to different people. Other topics include Gomillion v. Lightfoot, gerrymandering in Tuskegee, and the importance of Tuskegee. Footage of Birmingham. At 16:22, Reuben Davis footage begins. Mr. Davis speaks about living in Birmingham before and after desegregation and the New South.
Adverse events and poor patient outcomes occur for all doctors, regardless of subspecialty, regardless of educational and training pedigree, and despite best intentions. Such occurrences often exact a significant and sometimes lasting emotional toll on doctors, even apart from any culpability or potential medicolegal ramifications. In this Medical center hour Dr. Farnaz Gazoni demonstrates that adverse events in clinical care and their impact on physicians have substantial, widespread repercussions affecting quality of care and patient safety. But her research and experience show too that, by simply cultivating awareness of this issue, health care institutions and individual practitioners are taking important first steps toward culture change.
The Jessie Stewart Richardson Memorial Lecture, School of Medicine
In observance of National Quality Week (19-25 October), and co-presented with the Patient Safety Committee, UVA Health System
Questions about transplant candidate suitability and priority made headlines earlier this year, when 10-year-old Sarah Murnaghan's parents went to court (and to the media) to request that their daughter, dying of cystic fibrosis, be placed on the eligibility list for a lung transplant. The court's decision, UNOS's followup (Sarah got a new, fictitious birthdate to qualify to receive adult lungs), and Sarah's two double-lung procedures galvanized the transplant community, bioethicists, policymakers, and the public alike.
Even as efforts continue to increase the organ supply, what should we do about our allocation systems? In this Medical Center Hour, three experts engage the medical, legal, and ethical questions raised by the Sarah Murnaghan case.
Co-presented with the Institute for Practical Ethics and Public Life
A John F. Anderson Memorial Lecture
Over the last decade, the number of reports urging American universities to expose their health professional students to interprofessional education (IPE), so that those who will practice together may learn together, has exceeded the number of actual IPE experiences in most nursing and medical students' entire curricula. In 2013, strong new calls for interprofessional education came from the Institute of Medicine and the Josiah Macy Jr. Foundation. What does this mean for the University of Virginia's Schools of Nursing and Medicine, our students, our health systems, and the patients and families we serve? If we were to push the envelope on IPE, where might we best focus our efforts? How might we lead in preparing the next generation of nurses and physicians for better collaboration and team-based care?
The Zula Mae Baber Bice Memorial Lecture, School of Nursing
Part one. Civil rights activist and history professor John Hope Franklin did historical research for the Brown v. Board of Education cases. He wrote opposition papers, vetted briefs for historical accuracy, and answered history questions from the lawyers. He describes the slow development of state segregation policies and laws, the 14th amendment and schools, the political climate regarding race issues in the late 19th century, and the suppression of African American voters in the South. Part two. Mr. Franklin describes the suppression of African Americans in the South via state legislation. He talks about the elaborate disenfranchisement of African Americans using restrictions regarding real estate, literacy, voting, etc. He mentions Plessy v. Ferguson, the Oklahoma State Constitution of 1915, and the cases about election primaries during the 1920s. Part three. Mr. Franklin contends that the irregular application of Jim Crow laws allowed the system of segregation to be challenged. He says that Brown defending attorney John W. Davis, like other complacent segregationists, expected to win the Brown case because he believed that everybody accepted the naturalness and permanence of a separate society. Mr. Franklin discusses Charles Houston and his legacy. Mr. Franklin tells the story about segregation in higher education in Oklahoma. Part four. Mr. Franklin recounts his participation in the Lyman Johnson case. Franklin says that Brown was a reaffirmation of the national ideal of equality, but like the framers of the 14th amendment, the Supreme Court escaped having to enforce the ideal. Mr. Franklin tells about his experiences as a field researcher in 1934 for the Fisk University/Charles S. Johnson study of the tenancy of African American cotton farmers in Texas and Mississippi.
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.
Part one. Footage of exteriors of houses (and William Elwood) until 8:55. Then civil rights attorney Fred Gray discusses Alabama lawyers, Arthur Shores, and becaming a lawyer in order to try civil rights cases. Gray had to go to law school outside of Alabama as African American schools in Alabama didn't offer what he wanted. He taught himself Alabama state law while in Ohio. Gray describes developing strategies for his civil rights cases. He also talks about the Montgomery bus boycott. Part two. Mr. Gray recalls his 1954 defense of an African American juvenile arrested on Montgomery bus (before the Rosa Parks arrest). Gray talked to Rosa the day before she was arrested and represented her in court. Mr. Gray remarks that Montgomery bus cases like Browder v. Gayle were the first major application of Brown's meaning. Gray describes the difficulty of registering African American voters because registrars would go missing, even after the courts ordered them to register African Americans. To avoid the impact of African American voters, Alabama redrew Tuskegee boundaries to include only white people. Mr. Gray explains Tuskegee gerrymandering and Gomillion v. Lightfoot. Part three. Mr. Gray goes over details of Gomillion v. Lightfoot, recalls how Tuskegee Institute was no longer within the city of Tuskegee because of the new boundaries. Mr. Gray discusses Lee v. Macon County Board of Education, a school discrimination case that managed to include all public schooling in Alabama. Gray explains how litigating the rights of students in order to end segregation also meant dealing with the rights of teachers. Although the Alabama African American teachers associations weren't part of the original suit, they joined the case. Part four. Mr. Gray acknowledges the Bicentennial of the Constitution in 1987, and he discusses how the Constitution was not written to include African Americans. It is the 13th, 14th, and 15th amendments and various civil rights acts that make the Constitution a living document for African Americans. Gray talks about the Tuskegee Civic Association and gives a lot of credit to local banker Allan Parker. Mr. Gray also covers rehearsing the Gomillion case and the immediate result of Gomillion.
We hear much these days about the widening gap in America between the rich and the poor, the haves and the have-nots. Inequality is all around us, and it exacts a serious toll on health. The poor die sooner. Blacks die sooner. And poor urban blacks die sooner than almost all other Americans. Indeed, there is a 35-year difference in life expectancy between America's wealthiest (and healthiest) and poorest (and sickest) neighborhoods.
Internist David Ansell MD has worked for four decades in hospitals serving Chicago's poorest communities. While he's witnessed first-hand the structural violence—racism, economic exploitation, and discrimination—responsible for the "death gap," he argues that geography need not be destiny. In this Medical Center Hour, Dr. Ansell outlines how we can address this national health crisis and act to remedy the circumstances that rob many Americans of their dignity and their lives.
Co-presented with Alpha Omega Alpha National Medical Honor Society, UVA chapter
On 13 June 2013, the U.S. Supreme Court struck down patents on the hereditary breast and ovarian cancer (BRCA) genes. One company, Utah-based Myriad Genetics, claimed ownership of those genes and both marketed and processed the test for them. Myriad now controls the genetic data of all the persons tested for BRCA.
In the wake of the 9-0 ruling against Myriad, there's considerable debate about who owns this genetic information and who should control it. Should it be held by a private company or in a commons? Should control rest with the BRCA+ community? "Free the Data," a new grass-roots campaign, brings voices of BRCA+ individuals and biomedical investigators alike into this debate. In this Medical Center Hour, documentary filmmaker Joanna Rudnick, together with law and medical experts from UVA, discuss what's at stake in freeing the data.
Co-presented with the Institute for Practical Ethics and Public Life, the Department of Public Health Sciences, and the Cancer Center's Breast Care Program, UVA
The Hollingsworth Lecture in Practical Ethics
We've long known about books' ability to comfort, but can they have the power to heal? At a time when burnout is rife among practicing physicians and other clinicians, health care organizations are introducing systemic changes, including wellness programs. Beyond this, though, what might individual clinicians do to stave off burnout and fuel emotional resilience? New research suggests burnout relief may be as close at hand as a good novel. Reading for pleasure--especially, reading literary fiction--seems to enhance empathy and combat emotional exhaustion and depersonalization, thereby improving doctors' abilities to connect with the persons who are their patients and find joy in their work. Indeed, if reading for relaxation makes such a difference, should reading literature be a prescribed part of physician education and training? In this Medical Center Hour, Drs. Daniel Marchalik and Hunter Groninger examine emerging research on books' benefits for doctors and trace their own experience with the Literature and Medicine track at the Georgetown University School of Medicine.
Amid the current opioid epidemic in the U.S., discourse around addicts and addiction can be overwhelmingly negative, pessimistic, and hopeless, reinforcing negative stereotypes. Even in health care, negativity about addiction prevails, making it more challenging for clinicians and organizations to respond with appropriate care, services, and resources. The toll of addiction is staggering. But while statistical and fiscal analyses of the national epidemic can also overwhelm and add to the negativity, might we gain a different view of addiction by accessing the particular experience of it, as it affects individuals and also their families? To know better what is at stake and how to foster recovery, this Medical Center Hour turns to poets Kate Daniels and Owen Lewis for their response to addiction when it strikes close to heart and home. How can writing serve to access the lived experience of addiction—in this case, addiction inside the family circle—and how might writing aid in recovery, for everyone involved?
January 23, 2019
Joe Richman
Since 1996, the Radio Diaries project has been giving people audio recorders and working with them to report on their own lives and histories. Collaborating with teens and octogenarians, persons with chronic and terminal illness, prisoners and prison guards, gospel preachers and bra saleswomen, the famous and the unknown, the project tells extraordinary stories of ordinary life. With stories aired on NPR, BBC, This American Life, and its own podcast, Radio Diaries has pioneered a new form of citizen journalism and, along the way, garnered every major award in broadcast journalism. This Medical Center Hour welcomes Radio Diaries’ founding director, Joe Richman, to share stories and draw parallels with health care practice, where, daily, clinicians traffic in the “extraordinary stories of ordinary life.”
The Edward W. Hook Lecture in Medicine and the Arts / Medical Grand Rounds
Co-presented with the Department of Medicine, UVA
Whistle Words is a multimedia project helping women reclaim their sense of self after a life-changing cancer diagnosis--with the simple aid of a pen. Charlottesville-based Whistle Words offers writing workshops for women in and after cancer treatment. Being part of this project as an adjunct or follow-up to treatment can make a real difference in participants' outlook and healing, as demonstrated by women's writings in the recently published anthology, Truth: Voices of Women Changed by Cancer. In this Medical Center Hour, Whistle Words' co-founder Charlotte Matthews and UVA nurse/breast cancer survivor/workshop participant Susan Goins-Eplee introduce Whistle Words and explore the healing power of writing.
A John F. Anderson Memorial Lecture
Part one. Judge Constance Baker Motley recalls her childhood and education, including her first experience with Jim Crow. The Gaines case in 1938 influenced her to become a lawyer. Clarence Blakeslee, a white philanthropist in Connecticut, paid for her law school tuition. She joined the NAACP Legal Defense Fund in 1945 as a clerk. She discusses the legal strategy to target southern graduate schools with enforcement of the Gaines decision. Part two. Judge Motley recalls the NAACP Legal Defense Fund campaign to address the lack of adequate graduate and professional schools for African American students in the South. She discusses the background of several higher education cases, including the 1946 Sweatt case in Texas and the Sipuel case in Oklahoma. The next step in the strategy was to bring suits in elementary and secondary education. Five of these cases culminated in the Brown v. Board of Education decision. She also reviews the immediate history of civil rights following the Brown decision. Part three. Motley describes the grassroots revolution for civil rights after the Brown decision as a surprise to the legal strategists at the NAACP. New laws on the state level reasserting discrimination were also an obstacle for Motley and her NAACP colleagues. In 1961 she represented James Meredith in his fight to enter the University of Mississippi; she also represented Charlayne Hunter Gault and Hamilton Holmes in their fights to enter the University of Georgia. She recalls the first case she ever tried in 1949 in Mississippi. Part four. The judge shares her memories of the early days of the NAACP Legal Defense Fund, especially hearing stories by Thurgood Marshall about Charles Hamilton Houston and William Hastie. She heard Houston and Marshall argue the restrictive covenant cases at the US Supreme Court. During this visit to Washington DC, she and her African American comrades were not allowed to stay in DC hotels. She recalls the important cases devised or tried by Houston. Part five. Judge Motley lists the many changes since the Brown decision.
Part one: Civil rights attorney James Nabrit discusses childhood and segregation in Augusta, Georgia. He covers his law practice in Texas and how he fought to have one Democratic primary instead of two (one for whites, one for African Americans). He left Texas because Mordecai Johnson wanted him to come to Howard University. There, he taught in the law school and became dean, then secretary of the university, then president. He recounts how the news of Jack Johnson’s boxing victory in Augusta, Georgia was greeted by the taunting and burning of an African American man who was celebrating. Part two. Nabrit recalls how the civil rights struggle developed and touches upon African American economic development. He details his preparation for civil rights cases. He declares that winning court cases is not the same thing as achieving civil rights victory. Part three. Nabrit talks about Charles Houston and his contributions. Houston tried cases, met with people, spoke out, organized people. Houston is the one who connected all the lawyers together. Nabrit acknowledges the contributions of the lodges, like the Elks, the Moose. Nabrit elaborates on work he did on behalf of President Lyndon Johnson, like serving at the United Nations as deputy ambassador. Nabrit explains why he worked on Oklahoma civil rights cases. Part four. Nabrit extemporizes on ways to work the legal system. Part five. Stills of photographs. Part six. Mr. Nabrit had to work every summer while in school. His father would not give him money because Nabrit chose to study law instead of becoming a preacher. He discusses his appointment to the United Nations and President Lyndon Johnson. Unidentified woman at 11:46 talks about the background of Mr. Nabrit and why Elwood interviewed him. Still photographs at 13:30, many of Nabrit with various US presidents and officials.
Nalini Nadkarni is known as "The Queen of the Rainforest Canopy," being a pioneer in the field of forest canopy research and in public engagement about the plants and animals that live in the treetops. Her interest in rainforest dynamics and in the response of rainforests to disturbances such as harvesting, fire, and climate change has led her to invite input from experts in diverse other fields that also study disruption and recovery--economics, neuroscience, refugee studies, human development, and traffic engineering, to name a few. Exchanges with these experts have given Professor Nadkarni novel insights into theory and models that foster better understanding of disturbance, recovery, and resilience.
Unexpectedly, in 2015, this work also proved personally useful as Professor Nadkarni recovered from extensive trauma sustained when she fell 50 feet from the top of a tree while doing forest canopy fieldwork. In this Medical Center Hour/Medical Grand Rounds, she shares her insights and offers applications for medicine--especially, to the specifics of critical care, and, more generally, to healing.
Medical Grand Rounds / A John F. Anderson Memorial Lecture
Co-presented with the Department of Medicine
Since its creation in 1999, the same year the Institute of Medicine issued its landmark report, To err is human, the Richardson Memorial Lecture has sparked and sustained conversation at the University of Virginia on the sensitive subject of medical error. The annual lectures ever since have brought to UVA noted experts on medical mistakes, communication about error, and the importance of clinicians' attending carefully to patients as persons. Collectively, the Richardson Lectures have provided opportunities for students, clinicians, educators, and administrators to learn better how to prevent medical errors, communicate about them when they do happen, improve quality of care in complex clinical systems, and assure patients and families of the best possible care and outcomes. The 2013 Richardson Lecturer is internationally known patient-safety expert Dr. Peter J. Pronovost, whose scientifically validated checklist protocol, developed at the Johns Hopkins University, is improving patient safety in health care institutions across the US and the world.
Co-presented with the Patient Safety Committee, UVA Health System
Part one. Civil right attorney Juanita Mitchell gives a brief history of the life of Charles Hamilton Houston. She describes Houston's legal case to admit Donald Gaines Murray to the University of Maryland School of Law. Houston used the equal protection clause from the 14th amendment against states that did not admit African American students to their schools. Ms. Mitchell gives a vivid account of this court case. Houston encouraged Maryland lawyers like Mitchell to use the US Constitution to sue Jim Crow out of Maryland laws, which they did. Part two. Ms. Mitchell describes what it was like to be African American in the South during the era of Jim Crow. She recounts living in the African American ghetto in Baltimore during the 1930s. Ms. Mitchell, after graduating from the University of Pennsylvania in 1931, worked for the NAACP. She recalls lynchings near Baltimore and how the NAACP tried to organize African American citizens to write to their government representatives to outlaw lynching. Part three. Ms. Mitchell remarks upon the inspiring character of Houston. She tells the story of W. Ashby Hawkins' successful legal argument in 1913 against Baltimore's new municipal segregation residential order, which was like Apartheid. She talks about the heroism of her mother, who served as president of the NAACP. She also talks about the civil rights work of her husband, Clarence Mitchell, especially concerning the Fair Employment Practice Committee. Part four. Because the NAACP could not get tax exempt status for work being done by lawyers, the Legal Defense Fund was started, with Thurgood Marshall at its helm. Ms. Mitchell remembers filing case after case in Maryland led by the NAACP Legal Defense Fund. She recalls working with Robert Carter and Jack Greenberg. Ms. Mitchell got her law degree because Houston suggested she do so, and she was the first African American student to write for the law review at the University of Maryland School of Law. She describes what it was like in Baltimore during and after the Brown court case, especially on the day the decision was announced. Part five. Ms. Mitchell remembers the funeral of Houston in 1950. She gives her opinion of why people don't know about Houston. She believes that the civil rights movement really began with Africans jumping off slave ships.
Part one. Civil rights attorney Joseph Rauh talks about his clerkships to the US Supreme Court for both Justices Cardozo and Frankfurter. He discusses the 1941 Executive Order by President Franklin Roosevelt, called the Fair Employment Act, which Rauh wrote. During World War II, he worked as Gen. MacArthur's secretary and in the Lend-Lease Administration. He recalls the founding of the Americans for Democratic Action in 1947. He tells anecdotes about working with A. Philip Randolph. Part two. Mr. Rauh remembers, during the 1940s, African Americans and whites could not eat together in a restaurant in Washington DC. The District was a segregated city until the Supreme Court ruled otherwise. Mr. Rauh talks about his acquaintance with Charles Hamilton Houston. Mr. Rauh describes Houston's work in the Steele case. He explains the new civil rights platform adopted at the 1948 Democratic Convention. Part three. Mr. Rauh comments on President Truman's civil rights record. He states that the best US President for civil rights is Lyndon Johnson and the worst is Ronald Reagan. Mr. Rauh credits Charles Houston with the first use of the argument of state action in discrimination cases. He recounts his dealings with NAACP lobbyist Clarence Mitchell, especially their efforts in passing the Civil Rights Act of 1957. Mr. Rauh recalls President John Kennedy, when proposing what would become the Civil Rights Act of 1964, pointing out the irony that Alabama Sheriff Bull Connor did more for civil rights than anybody else. Mr. Rauh tell stories about civil rights champion President Johnson working to pass legislation. Part four. Mr. Rauh describes the Voting Rights Act of 1965 and its effects on the nation's history using the example of the defeat of Robert Bork's nomination to the Supreme Court in 1987 primarily by Senators elected by African American constituents from the South. The first meaningful civil rights legislation since Reconstruction was the Act of 1964. Mr. Rauh suggests reasons for why Charles Houston is not well known.
Part one. Civil rights activist Modjeska Simkins discusses her childhood in South Carolina and the influence of her grandmother, who was a slave. She tells vivid stories of her family's ordeals with slavery and post-Civil War freedom and discrimination. Part two. Ms. Simkins shares stories about her family's experience with racial discrimination. She talks about people using the Bible to support their prejudices and why she quit the church. She explains the power structure among rich white people, poor white people, and African Americans. She recalls when NAACP lawyers like Thurgood Marshall would come down to South Carolina to try a case and stay in her house because they couldn't stay in any hotels. She tells how African American schools didn't have buses or fuel for heat. Part three. Ms. Simkins talks about her education. She recalls encounters with the Ku Klux Klan and her fearless attitude toward the Klan. She returns to a discussion of the power structure in the South, both when she was a child and in 1985. She expresses her opinion of Robert Bork. Part four. Ms. Simkins talks about her work with the NAACP. She talks about the salary case, transportation case, and the vote case in South Carolina. Her home was the center of South Carolina civil rights legislation in a way because out-of-town African Americans could only stay in private homes. The militia was called out in South Carolina; she remembers cannons on Statehouse grounds. She chats about Judge J. Waites Waring and Thurgood Marshall.
Part one. Civil rights attorney Charles Todd Duncan discusses his involvement with the Brown v. Board of Education cases when he worked in the law office of Frank D. Reeves. He did much research on the history of African American codes. He was straight out of law school and was mainly a helper and errand-runner on the case, but he likes to remember that he was the one who personally physically filed the Brown case at the US Supreme Court. He mentions Charles Black. Mr. Duncan talks about Brown's impact, as well as what it didn't affect. Part two. Mr. Duncan helped out on the Brown case at the New York City NAACP Legal Defense Fund offices. He participated in strategy and decision-making sessions there and describes what these sessions were like. He recounts how the five Brown cases were chosen to take to the Supreme Court for very specific reasons.
With malaria a real threat to American troops' fighting fitness, the U.S. government during World War II mounted an all-out hunt for a malaria cure. Tropical-disease researchers with the Rockefeller Foundation took the lead on a secret project that adopted German research models and methods, including use of institutionalized Americans—inmates in six mental hospitals and several large prisons—both for culturing the parasites that cause malaria (there was no animal model) and for testing experimental drugs against the disease. After thousands of failed starts (and much human harm), the researchers had their "magic bullet": a German antimalarial compound captured in battle. This drug, reformulated in the U.S., is chloroquine, one of the most important pharmaceuticals ever made to fight malaria.
In this Medical Center Hour, public health journalist Karen Masterson and infectious diseases specialist Dr. Richard Pearson delve into this tale of secret science in the service of war efforts and into research that was conducted before promulgation of federal rules and regulations governing human participation in biomedical research.
Co-presented with the History of the Health Sciences Lecture Series of Historical Collections, Claude Moore Health Sciences Library
Deborah Salem Smith's acclaimed play Love alone is the story of what happens after a routine medical procedure goes tragically wrong. A medical malpractice lawsuit ensues, and the lives of both the patient's family and the doctor charged with her care are transformed. The play tracks the fallout in both homes. It is a portrait of how each family grieves and heals. These questions were central in the construction of the plot: Is forgiveness a single act or a daily act? Is it unconditional? Who has the right to forgive? Does forgiveness require remorse or an apology by the offender? Do lawsuits empower victims and thus aid the grieving process, or do they disrupt grieving? Does proving negligence make a victim more prepared to forgive? What does a lawsuit mean for the doctor sued, and for his or her personal journey of recovering from the unexpected death of a patient? George Bernard Shaw famously quipped, "We have not lost faith, but we have transferred it from God to the medical profession." What are the implications and burdens of such faith? This Medical Center Hour explores Love Alone with the playwright and local actors but also with a physician who has written on doctors' efforts to deal with their own mistakes.
A John F. Anderson Memorial Lecture
At a time of sweeping transitions in health care, medical students and young physicians are eager for guidance as to how best to apply their knowledge and skills in caring for patients. In clinical settings, and especially in primary care, who might be the best role models for young trainees to emulate? What skills and traits do the best clinicians use to create healing relationships with patients? How do clinicians become "healers" -that is, practitioners effective in making the patient-professional relationship itself have active therapeutic potential? Professor Larry Churchill and colleagues at Vanderbilt University School of Medicine have examined these matters, interviewing both clinicians and patients on the vital question of what actually makes for a therapeutic encounter, even in the context of a stressed and changing health care system.
In this Medical Center Hour, Professor Churchill will present his studies' findings as a prelude to disscussion of the implications for medical ethics and medical education and for establishing truly "patient-centered" practices.
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
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
Twenty-first century physicians and other clinicians who are caring for patients in an era of unlimited knowledge, rapid knowledge turnover, and ever-more-sophisticated artificial intelligence (Watson!) increasingly need new skills and strategies. Such practitioners need too a renewed capacity for compassion. In this Medical Center Hour, eminent physician leader Dr. Steven Wartman, 2019 recipient of UVA's Brodie Medical Education Award, maps this critical juncture and challenges educators and other health professional leaders to reimagine and reengineer how we prepare doctors and other health care practitioners.
The Brodie Medical Education Award Lecture
Why do modern Americans eat so much sugar, and to what effect? This Medical Center Hour offers dual perspectives on the sweet stuff, what it does to/in us, and its many meanings in history and for health. UVA historian David Singerman and UVA physician Jennifer Kirby examine sugar’s impact on the body—past and present, historically, socially, physiologically, and nutritionally.
When it comes to matters of health, environment, and urban history, lessons of the past are often forgotten by Americans. However, in many ways, fears from American epidemics in the last 150 years have all become acute again with the COVID-19 pandemic. Working at the intersection of public health and urban/environmental history, architect Sara Jensen Carr investigates how shifts in the American urban landscape were driven by health concerns, and how these have led to this inflection point between living in the pandemic and a post-pandemic future. She's joined by urban and environmental planner Tim Beatley in this Medical Center Hour that addresses the "topography of wellness" in our urban public spaces even as we anticipate COVID-driven design changes.
History of the Health Sciences Lecture
Co-presented with Historical Collections, Claude Moore Health Sciences Library; Center for Design + Health, School of Architecture; and University of Virginia Press
Physician-writer Samuel Shem's iconic black humor-laced novel, The House of God (1978), written while he was a resident, was an exposé of medicine's often-heartless training culture at the time. The book became unofficial required reading for generations of persons going into medicine. His most recent novel, Man's 4th Best Hospital (2020), appeared when clinician morale was low, burnout rampant, and physician suicide on the rise; if anything, the COVID pandemic has exacerbated these conditions. In this Hook Lecture, Shem discusses how his books arose out of perceived injustice to take the measure of medicine's culture, and how he has used fiction both to resist injustice and to call upon doctors, nurses, and others to reclaim their once-humane calling.
Edward W. Hook Memorial Lecture in Medicine and the Arts
Medicine Grand Rounds
Co-presented with the Department of Medicine and with generous support from the School of Medicine's Anderson Lectures
"Give a [wo]man a mask and [s]he will tell you the truth." –Oscar Wilde
Since 2010, Walter Reed National Military Medical Center's therapeutic arts program has engaged brain-injured and traumatized military veterans in hands-on mask making. Even as they conceal the face, these soldiers' masks vividly reveal secret suffering, declare deeply felt identity and patriotism, signal spiritual wounds and moral strengths, externalize guilt or grief. Making a mask can help its creator to (re)claim identity, and to heal. In this AOA Lecture, physician-educator Mark Stephens and art therapist Melissa Walker discuss the construction of masks as an artful means of recognizing oneself and reflecting on identity, not just for wounded warriors but also for healthcare professionals.
Co-presented with Alpha Omega Alpha national medical honor society, UVA Chapter
In this Bice Memorial Lecture, Rebecca Rimel looks back on a life in leadership—in her case, serving 26 years as president and CEO of The Pew Charitable Trusts, an innovative and influential public charity involved in health and human services, the arts, public opinion research, and environmental, public health, and national economic policy. Ms. Rimel's service at Pew was anchored in nursing, built upon an exemplary career in healthcare and on what she learned and practiced as a nurse at UVA—management under pressure, clear communication, purpose and motivation, empathy and caring.
Zula Mae Baber Bice Memorial Lecture co-presented with the School of Nursing
Part one. Judge Higginbotham asserts that the United States Constitution was not revelant to African Americans when it was written except to further enslave them. Judge Higginbotham offers a legal history of the colonies and slavery. Slavery was not codified until 1660, Virginia was the mother of slavery, and Virginia law in the early 1800s made it illegal to teach African Americans to read and write. Judge Higginbotham talks about Charles Coatsworth Pinckney, Judge Ruffin, and how America's success was only possible via slave labor. Part two. Judge Higginbotham's history lesson continues. The 14th amendment was intended to take racism out of American society via due process, but it became the primary instrument to help corporations and everyone else but African Americans. Plessy v. Ferguson codified the separate but equal doctrine, which extended discrimination from trains to just about everywhere else, as the Supreme Court had said it was “reasonable” to do so. The warped interpretation of the 14th amendment impacted women as well. The US Constitution was also originally meaningless to women. Higginbotham discusses Justice Harlan's dissent in Plessy. Part three. Judge Higginbotham explains that Brown v. Board of Education was brought about by earlier cases. Brown was the ninth inning victory compared to all the work that had gone before in civil rights, including Gaines v. Missouri, Sweatt v. Painter, and McLaurin v. Oklahoma. Higginbotham discusses Collins Seitz, first state judge to order desegregation of a school. He also talks about Charles Hamilton Houston, William Hastie, Thurgood Marshall, and Howard University Law School. Part four. Judge Higginbotham recalls the Marian Anderson incident in Philadelphia in 1939. He also discusses the extension of legal strategy in civil rights cases beyond education into employment and voting rights, as in Smith v. Allwright. Higginbotham details the extensive pattern of violence in the South and the manipulation of the voter registration process. For example, registrars would ask African Americans for absurd qualification information, such as the number of gallons of water in the ocean. Judge Higginbotham recalls cases about labor unions, railways, housing rights, restrictive covenants in the 1940s, and fair housing in 1968. Part five. Judge Higginbotham's advice to young people: don't try to save the entire world, try to save the people next to you. Higginbotham discusses Powell v. Alabama, the Scottsboro case, Brown v. Mississippi, and John W. Davis.
Part one. J. Clay Smith talks about Charles Hamilton Houston as the architect of the modern civil rights movement. From 3:50 to 10:40, footage of Houston and William Hastie portraits. From 10:40 to end, Alvin J. Bronstein interviewed in his office. As a young lawyer Mr. Bronstein traveled south in 1964 for Freedom Summer. He was sent to St. Augustine, Florida to work on a law suit that would force hotels to serve African Americans. He then went to Mississippi and stayed for five years as a trial lawyer in Macomb where there had been 37 church bombings. He set up offices around the South as part of the Lawyers Constitutional Defense Committee funded by the ACLU. In 1968, civil rights cases in Mississippi had changed from defense of African Americans to cases advocating for rights. Part two. After Mississippi Mr. Bronstein went to Harvard for three years, then down to New Orleans, where he set up a training program for young African American lawyers. In 1972, he started the ACLU National Prison Project after the Attica prison riot. Mr. Bronstein describes what happened at Attica State Prison in New York. He explains the connection between civil rights and prisoner rights movements. He discusses what prisoner rights are or should be, the state of prisoner rights law in the mid-1980s, the death penalty, and incarceration rates. He says that poor people and people of color make up the prison population, and incarceration is not cost-effective. Part three. Mr. Bronstein recalls Judge Harold Cox in Mississippi referring to African Americans as chimpanzees while in court; the same judge presided over the trial of law enforcement officers for killing Chaney, Schwerner, Goodman in Mississippi in 1967, and he expressed outrage at the defendants and said the guilty verdict rendered was the proudest moment of his career. Lolis Elie, Nils Douglas, and Robert Collins were lawyers who practiced together but couldn't take the same taxi or eat in the same restaurant; now, these lawyers are highly placed judges in Mississippi. Mr. Bronstein says that Scandinavian countries have the best example of an incarceration system and that allowing prisoners to maintain contact with families is an important part of rehabilitation. Mr. Bronstein discusses a famous case called Battle v. Anderson.
Elwood, William A, Higginbotham, A. Leon (Aloyisus Leon), 1928-1998
Summary:
Part one. Civil rights attorney Louis Redding recalls his family, childhood, and going to Brown University. Part two. Mr. Redding tells his family’s history at Brown. After Harvard Law School, he returned to still segregated Delaware to practice law. Immediately, he tried to abolish separation based on race in courtrooms. He discussed the Parker case, its background, African American admission to University of Delaware, and Judge Collins Seitz. Part three. Redding says that he would not have filed the Parker case if he didn't know that Judge Collins Seitz would get the case. In Gebhart v. Belton, the public school case, Redding used testimony from psychology and sociology experts about how separate but equal was inherently detrimental to African American children. He also comments on Jack Greenberg, Burton v. Wilmington Parking Authority, and the day the Brown v. Board of Education decision was announced. Part four. The day the Brown decision became public, Redding heard the news on the radio while driving and crashed into the car in front of him. Mr. Redding discusses the Burton case, Charles Hamilton Houston, Thurgood Marshall, William Hastie, William Robert Ming. He also tells how John W. Davis, the lawyer defending separate but equal, wept during arguments in front of the Supreme Court in the Brown case. Part five. Charles Hamilton Houston. Advice to young lawyers. At 9:00 until end, still photos.
When the First Nations of Big River and Ahtahkakoop in Canada's Saskatchewan province realized they had an HIV epidemic within their rural communities, their leadership and health centers rallied community members to determine the social and structural issues behind the epidemic. One of the driving factors proved to be injection drug use. Big River and Ahtahkakoop then developed culturally competent, community-based care to address the intertwined issues of HIV, hepatitis C, and substance use. In this presentation, spokespersons from these two communities describe how they took on these epidemics and discuss the solutions that have worked for them. What can other communities struggling similarly with substance abuse and related infectious disease outbreaks learn from these First Nations' grassroots responses? Are there lessons here for communities in Virginia, where, on average, three people die each day from opioid overdose?
Co-presented with the Department of Medicine and the Center for Global Health, in conjunction with the conference, "Best Practices in Community Mobilization in Response to Substance Use and Related Epidemics"
Part one. Civil rights activist Gardner Bishop talks about meeting with Charles Hamilton Houston to get money for a lawyer to represent the Consolidated Parents Group. Houston sent a letter on the group's behalf to newspapers, then offered to take the case himself for free. Mr. Bishop talks about the case, how Houston became ill and asked James Nabrit to take over for him. Houston asked Mr. Bishop to visit him in the hospital just before he died. Mr. Bishop talks about hosting Consolidated Parents Group meetings in his basement. Part two. Mr. Bishop recalls meeting James Nabrit, who changed case to include enrolling black students in an all-white school. Mr. Bishop speaks of his amazement at the wonderful condition and facilities of the school in the white neighborhood. He also visited a school in a black neighborhood, and it was crowded and dilapidated. Mr. Bishop remembers visiting the Supreme Court to hear the Consolidated Parents Group case. He was one of the pallbearers for Houston.
In the making of a doctor, the residency is the principal formative experience. Its three to nine years of supervised practical learning are the crucible in which medical graduates acquire specialty knowledge and skills, forge a professional identity, and develop the values, attitudes, and behaviors for a lifetime of practice. While there have long been tensions within and around residency, physician-historian Kenneth Ludmerer's new book, Let Me Heal, a history of residency in the U.S. since its 19th century origins, comes at a time when training programs are pressured as never before by government regulation, workforce changes, shifts in disease patterns and sites of care, and highly commercialized health care. In this Medical Center Hour, Dr. Ludmerer mines the history of residency for lessons to address current concerns about medical education and to assure we can make the best doctors for the 21st century.
The Joan Echtenkamp Klein Memorial Lecture in the History of the Health Sciences
Co-presented with the History of the Health Sciences Lecture Series
Andreas Vesalius, long hailed as "the father of modern anatomy," is slipping into oblivion. The likes of Gray's Anatomy (the book), Netter's Atlas, plasticized dissected bodies, and online visible human specimens having eclipsed his splendidly illustrated book, On the Fabric of the Human Body (1543), as our definitive anatomy text. Vesalius's recent 500th birthday anniversary gives us a chance not only to celebrate this Renaissance genius, but also to consider how his accomplishments in the study of human anatomy helped medicine to become "modern."
Co-presented with the History of the Health Sciences Lecture Series
Social and cultural factors, as well as biomedical ones, shape the way we understand and react to diseases. In the case of a disease associated with sex, social and cultural factors figure especially prominently in its history. Since moral and religious views influence almost everything connected with sex, including sexually transmitted infections (STI), syphilis can be an excellent case study to help us appreciate disease in a broader human context. This Medical Center Hour delves into the story of syphilis in America, from colonial times to the present; it looks back too at the origins and spread of the disease in Europe. How did medical science come to understand syphilis and develop treatments for it? What about public health protections against this socially stigmatized STI from prevention campaigns and quarantine of infected persons (usually, women only) to mandated reporting of infections? To what extent does syphilis's identity as an infection popularly associated with sex and sin complicate our response to it and to persons who contract and suffer with it? Finally, how might American social and cultural stigmas around syphilis have contributed to the intentions behind and conduct of the U.S. Public Health Service's unethical research studies at Tuskegee (1932-1972) and in Guatemala (1946-1948)?
Co-presented with the History of the Health Sciences Lecture Series
Does some aspect of our personality survive bodily death? Long a philosophical and theological question, in the 20th century this became the subject of scientific research. Fifty years ago, in 1967, Ian Stevenson, then chair of UVA's Department of Psychiatry, created a research unit—now named the Division of Perceptual Studies—to study what, if anything, of the human personality survives after death. Dr. Stevenson's own research investigated hundreds of accounts of young children who claimed to recall past lives.
In this Medical Center Hour, faculty from the Division of Perceptual Studies highlight the unit's work since its founding, including studies of purported past lives, near-death experiences, and mind-brain interactions in phenomena such as deep meditation, veridical out-of-body experiences, deathbed visions, apparent communication from deceased persons, altered states of consciousness, and terminal lucidity in persons with irreversible brain damage. As the division enters its second half-century, what are its research priorities and partnerships?
History of the Health Sciences Lecture
Co-presented with Historical Collections, Claude Moore Health Sciences Library and the Department of Psychiatry and Neurobehavioral Sciences, UVA
Theresa Brown became a nurse-who-writes quite accidentally: she had a bad experience at work, wrote it down, and sent what she'd written to the New York Times. To her surprise, the newspaper published it, to great acclaim. From that column came the contract for Ms. Brown's first book, Critical Care, and she also began writing regularly for the Times, proud to have this chance to give voice to the often under-recognized nursing profession.
Only lately, though, while writing her second book, The Shift, did Ms. Brown realize not just how much her nursing gives shape to her writing, but also how her writing influences her nursing. There's much to mull over in health care and usually not much time to do that. Writing forces Ms. Brown to reflect. She learns both positives and negatives about her nursing work in the process of putting that work into words. In this Medical Center Hour, Ms. Brown talks about how writing, which she loves, makes her a better nurse.
The Catherine Strader McGehee Memorial Lecture of the School of Nursing
Co-presented with the School of Nursing, the Virginia Festival of the Book, and Hospital Drive
Hospitals and clinics and safety-net organizations across the U.S. are increasingly challenged to provide medically appropriate care to undocumented and uninsured immigrants. These "patients without passports" do not qualify for public benefits that finance health care for low income persons and often lack other means to secure care for themselves and their families. In this Medical Center Hour, Nancy Berlinger, co-director of The Hastings Center’s Undocumented Patients project, explores the ethical and practical dimensions of health care access for this cohort of immigrants, drawing on data from Virginia and other states and on her work with New York City policymakers to improve health care access for vulnerable populations. UVA emergency medicine physician David Burt offers a local perspective.
A John F. Anderson Memorial Lecture
Co-presented with Institute for Practical Ethics and Public Life
The year 2018 marks the centennial of the "Spanish" influenza pandemic, the world's deadliest event, killing at least 50 million persons worldwide. This pandemic's sudden emergence and high fatality are stark reminders of the threat influenza has posed to human health and society for more than a millennium. Unusual features of the 1918-1919 outbreak, such as the age-specific mortality pattern and unexpectedly high frequency of severe and fatal pneumonias, are still not fully understood. But the recent sequencing and reconstruction of the 1918 virus—work accomplished by NIH scientist Jeffery Taubenberger and colleagues—have yielded answers to crucial questions about the virus's origin and pathogenicity. In this Hayden-Farr Lecture at Medical Center Hour, Dr. Taubenberger summarizes key findings, considers yet-to-be answered questions about the 1918 influenza, and looks ahead to 21st century public health preparedness and the need to optimize preventive vaccines and vaccination strategies.
The Hayden-Farr Lecture in Epidemiology and Virology/Medical Grand Rounds/History of the Health Sciences Lecture
Co-presented with the Department of Medicine, Historical Collections in the Health Sciences Library, and Influenza! 1918-2018
This Richardson Memorial Lecture's origins are the hospital death of infant Lola Jayden Fitch and her family's journey to evoke change. The hour is anchored in the stories of Lola's parents--her mother, who questioned her intuition, and her father, who chose to continue working in the hospital where Lola's death occurred--and in a review of medical staff communication errors that tragically affected Lola's care.
How can we prevent communication breakdowns, improve teamwork, and foster greater transparency and true partnership with families to make health care better and safer, especially for the most vulnerable patients? How can Lola's Song and similar stories--those of patients, families, health professionals, and others--help us to accomplish this important work?
www.lolassong.com
The Jessie Stewart Richardson Memorial Lecture of the School of Medicine
Co-presented with the Office of Quality and Performance Improvement, UVA Health System
Lucy Kalanithi is many things. Physician. Professor. Writer, and speaker. Mother. Widow. She was married for nine years to Dr. Paul Kalanithi, a young neurosurgeon diagnosed with advanced lung cancer, the illness that claimed his life in 2015 at age thirty-seven. As he struggled, suffered, and worried, Paul wrote. His memoir—When Breath Becomes Air, for which Lucy wrote the epilogue—became a bestseller after it was published in 2016.
In this Medical Center Hour, which is also the School of Nursing's annual Bice Memorial Lecture, Dr. Lucy Kalanithi talks with UVA Nursing Professor Ken White about the Kalanithis' challenging journey to the end of Paul's life and how Paul and Lucy did not avoid suffering but, rather, leaned into it and created meaning from it.
The Zula Mae Baber Bice Memorial Lecture
Co-presented with the School of Nursing