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Emily Levine does for science what Jon Stewart does for news: she critiques it, she makes it relevant, she makes it funny. She brings her experiences as a patient in search of a diagnosis and a curative path to physical health and notes that in order to regain metaphysical health, she had to enter a universe of randomness, uncertainty, and turbulence. She reasons that only quantum physics and chaos theory can make sense of this new universe, and possibly of medicine today.
A John F. Anderson Memorial Lecture
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
Physician Orders for Scope of Treatment (POST) is an initiative gaining acceptance across the country as a way for patients and families to ensure that care at the end of life is not only consistent with a patient's preferences, as expressed in a treating physician's orders, but also is consistent throughout the health care system, including across institutional boundaries. A completed POST form is an instrument that travels with the patient from one health care setting to another, as, for instance, from a nursing home to a hospital, and should be honored in all venues. Unlike traditional advance directives, POST is a physician's order, and is to be followed as such. Implementing POST is a process being handled state by state, with Oregon in the lead. In Virginia, pilot studies are underway in different regions of the Commonwealth and different hospital systems, with different forms and protocols. What's happening with POST in Central Virginia and at UVA? Are all of us-patients, physicians and other clinicians, and administrators alike-ready for POST?
A John F. Anderson Memorial Lecture
Co-presented with the UVA Medical Center's Office of Patient/Family Education and Communication and the Compassionate Care Initiative, School of Nursing
Columbine. Virginia Tech. Ft. Hood. Huntsville. Tucson. Aurora. Newtown. The Navy Yard. Charleston. Roseburg. Gun violence, including a relentless raft of mass shootings, is epidemic today in the U.S., threatening individual safety and public health and wellbeing. The grim tally for 2015, says the Washington Post, is 294 mass shootings in 274 days. Many shooters are said to have undiagnosed or undertreated mental illness in their background.
How does psychopathology contribute to violent behavior, particularly involving firearms, over a person's life course and in the social environment? How accurate and useful are clinicians’ predictions of violence in their patients? What is an appropriate role for clinicians as “gun gatekeepers” and for mental health services generally, as part of a public-health solution to gun violence? This Medical Center Hour reviews research related to these urgent questions and explores implications for clinicians and other mental-health stakeholders.
Co-presented with the Institute for Law, Psychiatry, and Public Policy and the School of Law, UVA
A John F. Anderson Memorial Lecture
In 1943, Albert Schatz, a young PhD student at New Jersey's Rutgers Agricultural College, was working on a wartime project testing bacteria from farmyard soil when he discovered streptomycin, a new antibiotic that was the first effective drug against the global killer tuberculosis. Schatz’s professor, Selman Waksman, claimed all credit for the discovery, calling Schatz a mere bench worker, and secretly enriched himself with royalties once the drug was patented by pharmaceutical manufacturer Merck. Schatz fought back in what was one of the most vicious battles ever for credit of a major scientific discovery. Schatz won the title of "co- discoverer" and a share of the royalties, but, in 1952, Waksman alone was awarded a Nobel Prize. Schatz disappeared into academic obscurity.
This Medical Center Hour features journalist Peter Pringle, whose recent book Experiment Eleven probes this gripping, scandalous story and its diverse global repercussions— for scientific inquiry and mentoring, for research ethics, and for the evolution of Big Pharma.
Co-presented with the History of the Health Sciences Lecture Series, Claude Moore Health Sciences Library
Instructions for how to operate the Fairchild machine, used to record aluminum transcription discs. This was recorded at the Fairchild manufacturer's studio by the African-American linguist Lorenzo Dow Turner, with whom A.K. Davis, Jr. had corresponded about his work using the Fairchild machine for his fieldwork.
Elwood, William A, Kulish, Mykola, Hill, Oliver W., 1907-2007
Summary:
Part one. Civil rights attorney Oliver Hill and law professor A.E. Dick Howard discuss the Constitutional Revision Commission of Virginia in 1968 in front of the Capitol in Richmond. They go over Virginia Constitution history, including how the 1902 Constitution was written with the intent to discriminate against African Americans. Mr. Hill speaks about Massive Resistance, and Mr. Howard comments on awkward interpretations of the Virginia Constitution that let public schools close to avoid integration in the 1950s. The 1968 Virginia Constitution finally included an antidiscrimination clause. Mr. Hill and Mr. Howard relate the reasons why they went into constitutional law. Part two. Continuation of discussion about the 1968 Constitutional Revision Commission of Virginia.
In 1984, Ronald Reagan’s reelection campaign introduced the theme “Morning in America," promoting an image of the U.S. as a hopeful nation moving toward a better future. As one campaign advertisement asserted, “It’s morning again in America, and under the leadership of President Reagan, our country is prouder and stronger and better.” Fast forward to 2016. “Hopeful” or making the country “prouder" aren't descriptors most Americans would apply to either this presidential campaign or the contenders. One day post-election, what do experts think will be the “better future” under our new President and Congress? And how might the new President’s health care agenda be felt in the Commonwealth of Virginia?
A John F. Anderson Memorial Lecture
Part one. Journalist Brandy Ayers describes the Willie Brewster murder trial, which featured the shooting of indicted killer Damon Strange by Jimmy Glenn Knight in the courthouse during the grand jury hearing. He also discusses how the jury commission worked in Alabama. Part two. Mr. Ayers calls for a new style of politics wherein all factions come together for total mobilization. He believes that the American dream is not real for African Americans.
Footage of Tuskegee, Alabama. At 10:55, William Elwood interviews Allan Parker in his yard. Parker was a banker in Tuskegee who fought for desegregation and voter registration. Parker describes his involvement with the Tuskegee Civic Association. He wanted to preserve the public school system for all races and didn't support private white schools. Parker also discusses the role of lawyers in the civil rights movement.
Elwood, William A, Morgan, Charles, 1930-2009, Kulish, Mykola
Summary:
Part one. Attorney Charles Morgan and US Congressman John Lewis discuss many topics, including: Alabama legally disenfranchising African Americans with voting registration requirements like the poll tax and literacy tests; Reynolds v. Sims, the one-man, one-vote case; Bull Connor; Lewis being jailed because he was with an interracial group using public transportation; Lewis being beaten in Montgomery; Freedom Rides; the voter registration drive; Brown v. Board of Education; the importance of the Christian Church, the one place where African Americans could have control; Lewis meeting Dr. King and Rev. Abernathy. Part two. Morgan and Lewis continue their conversation, agreeing that in spite of symbols like the Confederate Flag flying over the Alabama Capitol, things are better because African Americans are allowed into positions of power. They discuss the racism deeply embedded in American society, as well as the most important aspect of the civil rights movement, its law-based nonviolence. Lewis recalls his involvement in the Student Nonviolent Coordinating Committee and the difficulties he had meeting with white activists like Morgan because it was against the law. Part three. Morgan and Lewis describe the 1960s civil rights movement as a family, especially on the inside, and its informal, organic progress. They say that historians ignore Charles Hamilton Houston because they are ignorant of much of history. They review Sweatt v. Painter. Part four. Morgan and Lewis remark upon Charles Houston and suggest that integration is still, in the 1980s, in the embryonic stage. Lewis reminisces about the Sears and Roebuck catalog being his wish book as a child; he wanted to buy incubator to have chickens because he used to preach to the family's chickens. The two men talk about the Voter Education Project and the vote as a tool of liberation. They say that voter registration really did work because white politicians started speaking to African Americans and, at low levels of government, African Americans were starting to get elected. Part five. The relationship between Lewis and Morgan is discussed. Footage of Lewis walking to Capitol building to cast vote, then exiting the Capitol building after vote. Footage of Congressional office building.h
Alice Dreger’s newest book, Galileo’s Middle Finger: Heretics, Activists, and the Search for Justice in Science, had its origins in social and scientific controversies having to do with the politics of sex, especially social and medical treatment of so-called intersex individuals. Ms. Dreger’s investigations into this aspect of human identity and intersex rights engaged her with both sides of a heated debate and also with issues of freedom and justice in science. As she says, “Science and social justice require each other to be healthy, and both are critically important to human freedom. . . . [P]ursuit of evidence is probably the most pressing moral imperative of our time. All of our work as scholars, activities, and citizens of democracy depends on it. Yet it seems that, especially when questions of human identity are concerned, we’ve built up a system in which scientists and social justice advocates are fighting in ways that poison the soil on which both depend. It’s high time we think about this mess we’ve created, about what we’re doing to each other and to democracy itself.”
In this Medical Center Hour, Ms. Dreger addresses these concerns—for science, justice, and academic freedom—at a time when pursuit of knowledge can clash with established interests, worldviews, and ideas about social progress.
Co-presented with the History of the Health Sciences Lecture Series
Part one. Footage of Charlottesville house at 407 Ridge Street. At 1:00, interview with Frances Brand in her art gallery in Charlottesville. She describes her series of paintings, called "Firsts," as a tribute to important individuals within the Charlottesville community, especially people she considered exemplars of civil rights advocacy. She remembers her subjects and their achievements. At 13:30, discussion with three Charlottesville city school board members. One, Henry Mitchell, was a part of the NAACP's 1956 lawsuit to desegregate Charlottesville schools. He describes the aftermath of the desegregation ruling and the commonwealth's policy of Massive Resistance. Part two. Three members of the Charlottesville city school board, including Grace Tinsley, Henry Mitchell, and Clifford Bennett, discuss present day (1987) problems in Charlottesville city schools, especially concerning African American student self-image. At 15:10, footage of paintings of Charlottesville notables by Frances Brand. Part three. Grace Tinsley, Henry Mitchell, and Clifford Bennett recall the history of the Charlottesville city school board and the changes in race relations over the years.
Part one. Footage of the NAACP Legal Defense and Educational Fund offices including that of civil rights attorney, professor, and NAACP director counsel Julius L. Chambers. Part two. Mr. Chambers discusses the origins of the NAACP Legal Defense Fund, Charles Hamilton Houston, Thurgood Marshall, Jack Greenberg, important cases in fund history, the Keyes principle, and employment cases like Duke Power. Part three. Chambers recalls the most important civil rights case that grew out of his practice, Swann v. Charlotte-Mecklenburg Board of Education in the US Supreme Court, which became known as the busing case. He talks about current concerns of the fund, responding to Reagan administration challenges to civil rights, developing protection for the poor. Part four. Some 1987 fund work in cases dealing with discrimination against the poor. More footage of fund offices.
In a year that has seen gun violence in the U.S. escalate even more—consider the almost-daily gun deaths on the streets of Chicago or the recent Las Vegas massacre—this Medical Center Hour looks anew at this urgent public health problem. Distinguished bioethicist Steven Miles presents a comprehensive status report on gun deaths (homicides and suicides), including issues of gun supply, the relevance of mental illness, race, and poverty to firearm deaths, the effects of gun law reforms, and the prospects for better prevention of gun violence.
A John F. Anderson Memorial Lecture
Part one. Civil rights attorney Charles Morgan remembers Freedom Summer of 1964 and recalls hearing when Chaney, Schwerner, and Goodman were missing. Mr. Morgan says that the system of justice in the South did not work against African American individuals, it worked against all African Americans as a group. He explains how all parts of justice system work together and how public interest lawyers succeeded in changing the law on jury cases in the South. Part two. Mr. Morgan believes that you must integrate colors, creeds, cultures etc., or change and understanding will never happen. Mr. Morgan points out that there were no African American prisons in the South before the Civil War because all African Americans were imprisoned [by slavery]. The civil rights movement was a revolution in the sense that it changed the entire structure of law and altered much of American life. Voter registration wasn't the law until around 1900, and America still hasn't recovered from the fact that fewer people vote because of it. Part three. Mr. Morgan reviews the history of the impact of slavery, segregation, and population centers. Southern legislatures around 1900 were not based on population, and cities were underrepresented. Mr. Morgan talks about Baker v. Carr, Reynolds v. Sims, Gray v. Sanders. Sims was about reapportioning the Alabama state legislature, and Sanders was about reapportioning the congressional districts, where the phrase "one person, one vote" was first used. Television helped to confront all Americans with the problems of the South. Part four. Morgan quotes Congressman John Lewis, "Whatever happened to the civil rights movement? It got elected." Lewis suffered 40 arrests and multiple skull fractures. At 2:48, footage of Washington, DC.
First identified in 1947 and first known to cause human illness in 1953, Zika virus was seldom seen during the next 60 years. Starting in 2013, however, sizable outbreaks of human infection occurred, and in 2015 Zika appeared in the Americas, first in Brazil, then much more widely. The mosquito-borne virus also began making dramatic headlines. Zika was discovered to be transmissible during pregnancy, with serious, even devastating neurological injury to the baby, and transmissible between sexual partners, with risks to a fetus in the event of pregnancy. Earlier this year, the World Health Organization declared Zika a global public health emergency.
The 2016 Hayden-Farr Lecture by Dr. Lyle Petersen, Incident Manager for Zika Response at the Centers for Disease Control and Prevention, is an update on Zika--the science and the medical, public, health, environmental, social, and ethical implications that make this disease an urgent global challenge.
The Hayden-Farr Lecture in Epidemiology and Virology/Medical Grand Rounds
Co-presented with the Department of Medicine and the Office of the Hospital Epidemiologist, UVA Health System
Part one. Civil rights attorney Samuel Wilbert Tucker recites lyrics to an unknown song and talks about patriotism. At 13:30, Tucker and Elwood go for a walk. Part two. Stills of Tucker family photographs. Interview begins at 7:30 in Tucker's law office in Alexandria, VA. Subjects of discussion include Tucker's mother and father and Parker Grey school alumni. Part three. Tucker talks about his own education, his elementary school teachers, especially teacher Rozier D. Lyles and the naming of the Lyles Crouch elementary school. Mr. Tucker started the program for adult night classes at the Parker Grey elementary school.
Since passage of the Patient Protection and Affordable Care Act (ACA) in 2010, this particular road to health care reform in the U.S. has been riddled with political potholes and subject to slowdowns as a result of legislative and judicial challenges. But with the Supreme Court's landmark stamp of constitutional approval this past June and with President Obama's reelection on 6 November, it is now clear that some form of "Obamacare" is here to stay, at least for four more years. Indeed, repeal of the ACA may no longer be a top Republican priority, as House Speaker John Boehner noted on 8 November: "The election changes that-Obamacare is the law of the land." So what's ahead as we implement the ACA? In this Medical Center Hour, Washington and Lee law professor and ACA expert Timothy Jost and University of Virginia health policy analyst Carolyn Engelhard outline what must be accomplished in order to realize this ambitious overhaul of our health care system. And what will be the responsibilities of and implications for academic health centers like UVA as the ACA takes effect?
Co-presented with the Sadie Lewis Webb Program in Law and Health, the Institute for Practical Ethics and Public Life, the Department of Public Health Sciences, and the Bioethics and Health Policy Medical Student Interest Group
A John F. Anderson Memorial Lecture
Have you ever received an unsolicited email from a publisher you’ve never heard of inviting you to submit a paper to a journal with a generic-but-believable-sounding name or a conference abroad or at an airport hotel? These publishers may advertise their journals as “open access” and promise to make your work visible to well-known indices; they may claim “impact factors” and editorial board members who are leaders in their field. All that’s required of you is a modest fee—an "author’s processing charge"—and these publishers can deliver the lifeblood of any academic career: a peer-reviewed publication. There’s just one catch: the journals are fake.
These journals are labeled "predatory," and they are sometimes associated with the broader open-access movement. This Medical Center Hour tours the strange world of predatory publishing and describes some of its more outrageous excesses. But, as Brandon Butler will argue, the fake journals are just a distraction. The academy today faces more serious challenges as it wrestles with how best to share research and knowledge. How should academia confront the predatory moves of its most well-established publishing partners and take better advantage of open access?
A John F. Anderson Memorial Lecture
Health care information can confuse doctors and patients alike. What are the risks and benefits of mammograms, of aggressive blood pressure control, of EKGs, of lung cancer screening, of heart stents? When patients can’t accurately answer these questions, they find it difficult to have sensible conversations about their health care with their doctors. And lack of comprehensible medical information not only interferes with shared decision-making between physician and patient but can also lead to over-screening and over-treatment, with deleterious consequences for patients as well as for the health care delivery system and medical reform.
In this Medical Center Hour, internist Andy Lazris and scientist Erik Rifkin assess this challenging situation and then present, as one solution, a novel decision aid called a Benefit Risk Characterization Theater (BRCT). When health care information is conveyed simply, factually, and in a non-numerical format, true shared decisions become possible. They offer BRCTs to explain the risks/benefits of some common medical interventions and demonstrate how this approach can improve health care delivery, lead to greater patient satisfaction, and result in less over-treatment, one of the main drivers of low-value health care cost.
Co-presented with the Department of Medicine
Viewing women through an androcentric lens, Western medicine from Hippocrates and Galen forward explained women's behavior from headache to "troublemaking" as unhealthful signs of "hysteria," a suffocating madness believed due to a wandering womb. Centuries, even millennia before Freud asked, "What do women really want?" medical men assumed they knew what women with hysteria needed, and that remedy was pelvic massage to "paroxysm." By the late nineteenth century, with manufacture of electrified massage instruments, doctors could deliver said therapy more quickly and efficiently. This medical treatment, the Victorian social milieu in which it was prevalent (and popular), and (mis)understandings of female sexuality, intimacy, and inequality are the subjects of young American playwright Sarah Ruhl's comedy, In the Next Room or The Vibrator Play (2010). This Medical Center Hour's panelists explore a rich mix of ideas having to do with women, medicine, and The Vibrator Play.
Offered in conjunction with LiveArts' production of "In the Next Room or The Vibrator Play", 1-23 March
In this Medical center hour, prize-winning writer Leslie Jamison inquires into the phenomenon of empathy. It may be something more fraught then we often imagine it to be. Empathy isn't just an instinctive reaction but a more complicated blend of intuition and decision. And it's not neccessarily an unequivocal good. It can mislead. It can exhaust. Ms. Jamison draws on her experiences as a standardized patient, working with and observing student doctors getting "trained" in the practice of empathy, as well as her experiences as a journalist, inhabiting a vexed state of empathy for her subjects, to consider a variety of perspectives on what makes for good empathy and what good it can do.
A John F. Anderson Memorial Lecture