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In the summer of 1816, an eighteen-year-old English girl on a lark in Switzerland with a married man and her stepsister began writing a story that would outlive her by centuries. Mary Shelley's novel, Frankenstein, published in 1818, still fascinates and confounds us today, told and retold in so many genres that even those who have never read the original know the story. This Medical Center Hour marks Frankenstein's 200th anniversary by exploring two of the many reasons for its apparent immortality. First, this novel probes the central quest of medicine and biology: What is life? Second, it asks—but leaves for us to answer—the essential ethical question: Should we as human beings manipulate the spark of life?
Co-presented with the History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library
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
In the spotlight for years now, health care that is truly equitable and patient-centered and delivered by a diverse, well-integrated team remains a goal—in most sites, it's not yet everyday reality. Individuals and institutions—including health professional schools as well as centers of clinical practice—continue to work toward this goal. But this effort cannot depend just on recruiting more diverse learners, reorganizing clinical environments, or deploying didactics aimed at eliminating biased attitudes and behaviors. Rather, it’s a matter of redesigning health professional education—curriculum, assessment strategies, learning environments—to prepare a thoroughly diverse workforce ready to counter health disparities. To actually realize diversity’s benefits, we must eschew a colorblind philosophy and embrace principles of equity pedagogy.
In this Medical Center Hour, Dr. Catherine Lucey explores equity pedagogy and how it may help to counter the structural racism and inequitable learning environments of traditional medical school. Such a fundamental change in our pedagogy may be necessary to improve health outcomes for patients of all cultures, colors, creeds, and means and, along the way, establish work environments where clinicians, teachers, and scientists of many backgrounds and professional preparations can all flourish.
A John F. Anderson Memorial Lecture / Medical Education Grand Rounds
Co-presented with the Office of Medical Education
Neurologist Oliver Sacks (1933-2016) was a legend in his own time—as a physician but also as a writer whose work probed medicine, science, and the arts and as a tireless explorer of both the natural world and the human condition. His clinical tales, published in the medical literature and mass media alike, found a wide audience across medicine and society. Behind these tales, which stretched the case history to illuminate and celebrate the person who was marked, and often rendered remarkable, by neuropsychological illness, flared Sacks's own curiosity, an insatiable urge to question and a generous capacity for paying meticulous attention.
In this inaugural Hook Lecture in Medicine and the Arts, writer and photographer Bill Hayes, who was Sacks's late-life partner, offers insights into Oliver Sacks as a person and a physician whose creative nature and prodigious output enriched medicine and culture across a long and productive life. A writer and photographic artist in his own right, Hayes addresses the place of curiosity and creativity in Sacks's practice and his own, especially how, for both, interest in and radical openness to a fellow human being are paramount.
The Edward W. Hook Lecture in Medicine and the Arts / Medical Grand Rounds
Co-presented with the Department of Medicine, with which the Medical Center Hour shares a fund established by the late Edward W. Hook MD MACP whereby the arts can generously enrich medical education and training.
Our society is aging, and, thanks partly to the science and success of advanced health care, the journey into one’s last years is often long and richly rewarding. But our medicalization of aging also means that older adults are longtime patients entangled in complex, costly, fragmented, and sometimes ad-libbed “systems” of individualized care that are challenging for them and their caregivers to navigate. When elders’ health and functional status changes, ways of managing their care may come undone, just when robust attention is most needed to effect transitions in their care—and the goals of care.
In this Medical Center Hour, distinguished gerontologist Mary Naylor offers her pioneering approach to the design, evaluation, and dissemination of health care innovations that has at once improved outcomes for chronically ill older adults and their caregivers and lowered health care costs. Her collaborative work with an interprofessional team has yielded the Transitional Care Model, a cost-effective model led by an advanced-practice nurse that improves the transitions of frail elders as they move through both their final years and our fractured health care system.
The Zula Mae Baber Bice Memorial Lecture, School of Nursing
The Koppaka Family Foundation Lecture in Medical Humanities, School of Medicine
Co-presented with the School of Nursing and the Center for Biomedical Ethics and Humanities, School of Medicine
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
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
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 opioid epidemic is currently exacting a terrible toll on the health, lives, safety, and livelihood of persons and communities across Virginia, the Appalachian region, and, indeed, much of North America. What is being done to address this crisis at the levels of policy and practice in the Commonwealth of Virginia and in Charlottesville-Albemarle and environs? In this Medical Center Hour, the Honorable William A. Hazel Jr MD, Secretary of Health and Human Resources for the Commonwealth, discusses Virginia’s five-pronged approach to the epidemic and the impact of that approach to date. He is joined in this conversation by a primary care physician and community mental health professionals.
The Jessie Stewart Richardson Memorial Lecture of the School of Medicine
Co-presented with the Office of Quality and Performance Improvement, UVA Health System
The Affordable Care Act (ACA) has brought transformational changes to the healthcare system, including, in some ACA programs, movement away from a pay-for-volume system to pay-for-performance or outcome. Three programs exemplify this approach: readmission penalties, no payment for selected hospital-acquired conditions (HACs), and value-based purchasing. To date, the HAC nonpayment program has targeted prevention of central-line-associated bloodstream infections, catheter-associated urinary tract infections, selected surgical site infections, and methicillin-resistant Staphylococcus aureus (MRSA) or Clostridium difficile infections. With better understanding, improved procedural practices, and closer monitoring, more of these infections are proving preventable; infection rates, including for MRSA, have dramatically decreased. In this Medical Center Hour, distinguished medical epidemiologist Dr. William Jarvis discusses these successes, including their financial implications, and how further collaboration between clinicians and infection control programs can prevent even more hospital-acquired conditions.
The Hayden-Farr Lecture in Epidemiology and Virology/Medical Grand Rounds
Co-presented with the Department of Medicine, UVA