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Where you live in a particular U.S. city determines your predicted life expectancy. Neighborhood is destiny, in a way. For example, in New Orleans, there is a twenty-five-year difference in life expectancy from one parish to another only three miles away. This pattern of great gaps in health status, even over short distances, repeats itself in New York, Chicago, the Bay Area, and many other American cities, with harsh consequences.
In 2005, Tulsa, Oklahoma was one of the first cities to recognize such dramatic neighborhood variations in life expectancy, with a fourteen-year difference in life expectancy between north Tulsa and midtown—and to take action. In this presentation, Dr. Gerard Clancy describes specific initiatives and lessons learned on the ten-year journey, from 2005 to 2015, to reverse these health disparities and improve the health of the people in north Tulsa. The successes of the past decade have inspired a new ten-year initiative in Tulsa focused on mental health system improvements.
Co-presented with the Brodie Medical Education Award Committee, the Academy of Distinguished Educators, and the Department of Medicine
On 13 September 2017, the University of Virginia proudly dedicates as Pinn Hall the medical education and research building formerly known as Jordan Hall. The building’s new name recognizes UVA medical graduate Vivian W. Pinn MD, Class of 1967, founding director of the Office of Research on Women’s Health at the National Institutes of Health. Dr. Pinn was the second African American woman to graduate from the School of Medicine and went on to a distinguished career in pathology and in medical leadership. One of the medical school’s four colleges bears Dr. Pinn’s name, and she is an active presence in Pinn College student life.
This Medical Center Hour celebrates Dr. Pinn and her accomplishments and calls attention to critical current issues of fair and full access for underrepresented minorities, especially African American women, as students, practitioners, and leaders in medicine but also as beneficiaries of health care. Individually and institutionally, what can we learn from Dr. Pinn to ensure that her legacy matters?
Co-presented with the Department of Medicine and the Generalist Scholars Program, in conjunction with UVA's dedication of Pinn Hall and the UVA medical students' celebration of Primary Care Week
A diverse population of caregivers working in clients' homes constitutes a vital link in our health care “system,” their services filling a gap between institutional care and what families are able to manage on their own. Who are these caregivers, what is their work, and what does their work mean—to them, to the clients and families they serve, to our larger society? Prompted by the recent documentary film, CARE, by Deirdre Fishel, which profiles five caregivers and their elderly clients, this Medical Center Hour inquires into the nature and lived experience of home-based caregiving for elders. What role will such home care play as our society ages and people seek to stay at home with complex, care-intensive medical conditions? How can we better value and compensate care workers and better support families who need their services? What about the sustainability of the home health caregiving economy and its workforce?
A John F. Anderson Memorial Lecture
Co-presented with the Department of Chaplaincy Services, UVA Health System
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
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
The caregiver—whether a family member pressed into service or an underpaid home-care aide—is a representative figure of our time. This status is paradoxical because actual caregivers (so often female) do their work largely out of sight and almost in secret. It is an uncanny representative figure whom we do not see.
Writer and scholar David Morris spent over a decade as caregiver for his late wife, Ruth, a medical librarian who in her mid-fifties began to show signs of dementia, most likely earlier-onset Alzheimer’s disease. In this Medical Center, Morris describes his experience but also uses his personal caregiving as a fulcrum for opening up larger questions about what biomedicine often overlooks in its molecular vision of illness. Desire is the neglected force that Morris sees as basic to illness, and it is the role of desire in illness that he seeks to clarify. Desire, it turns out, also offers an unanticipated common ground where health-care professionals—caregivers too in their medical role—may meet with patients and families in mutual, richer understanding.
A John F. Anderson Memorial Lecture
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"
We live in times when empathy—the ability to imagine how it feels to be inside the skin of another—seems to be in short supply. As a writer of poetry and memoir, Mark Doty believes that literature is one of the most powerful tools we have to come close to the subjectivity of another person. The practice of medicine, too, is a work of knowing—of learning who someone is, what they need, and how they might be healed. In this Medical Center Hour, Mr. Doty explores these ideas through writings that grew out of the crisis years of the AIDS epidemic in this country and in recent work concerned with love, time, and citizenship in the human community.
A John F. Anderson Memorial Lecture
Co-presented with the Creative Writing Program, Department of English
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
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
