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In September 1925, while the family of English composer, Herbert Howells, was on vacation in the English countryside, their son, nine-yer-old Michael Howells fell ill with polio and died in London three days later. Howells channeled his grief into the composition of the "Requiem," which drew heavily on an earlier, unpublished work. In this Medical Center Hour, fourth-year medical student and musician Rondy Michael Lazaro explores the historical context of polio in the 1930s and how the loss of Howells's young son played out in the composer's music. Mr. Lazaro conducts a chamber chorus in the performance of two movements from Howell's "Requiem."
Co-presented with the History of the Health Sciences Lecture Series
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
Over the past decade, several leading U.S. medical schools have developed courses combining art appreciation and clinical observation skills. Medical students venture from the clinical setting to the art gallery, where they are challenged by gallery educators and medical professors to observe and to articulate what they see in the art before them. Such courses aim to cultivate and deepen students' visual literacy, verbal facility, and tolerance for ambiguity with the expectation that more finely tuned visual observation and communication skills will help them to be better doctors.
Working with a task force in the UVA School of Medicine, Fralin Museum of Art academic curator Jordan Love has created and piloted The Clinician's Eye, an interactive workshop that aims to refine apprentice clinicians' skills through training in visual analysis. This Medical Center Hour invites audience members to participate—hands-on—in a version of this workshop.
A John F. Anderson Memorial Lecture
As our companion animals grow old and infirm, veterinarians and human caregivers alike face a complex and confusing array of choices and decisions. This Medical Center Hour explores some of the central moral challenges in end-of-life care for animals, from pain management and quality-of-life assessments to palliative treatment, hospice care, and making that final decision to hasten an animal's death. Considering this "last walk" with our pets, bioethicist Jessica Pierce and compassionate care advocate Susan Bauer-Wu borrow some ethical guideposts from the field of human bioethics (and offer a few in return).
A John F. Anderson Memorial Lecture
Co-presented with the Institute for Practical Ethics and Public Life, UVA
With health care reform on the near horizon and other social realities (aging, immigration, chronic conditions, quests for prevention and wellness) dramatically changing health care in the U.S., what kinds of doctors will our health care system (and its patients) require? Clearly, not just medical school curricula but also the selection process for medical students will be key determinants of whether we have physicians fully prepared to practice as the 21st century progresses. This Medical center hour addresses transformational changes underway in the pre-professional preparation and selection of the nation's medical students, including a new version of the MCAT exam, which goes "live" in 2015. What does this new MCAT signal for premedical students as they prepare for medical school? How might colleges and universities offer their premedical students academic experiences that will better equip them for medical school and medical practice in the 21st century?
Co-presented with the Institute for the Humanities and Global Cultures, UVa
A John F. Anderson Memorial Lecture
We hear almost daily about the rapidly increasing rate of type 2 diabetes in the U.S. population. Many pronouncements are dire, proclaiming an "epidemic," and most make it sound as though this problem is relatively new-just three or four decades old. Yet almost 100 years ago a small group of U.S. health care professionals was already warning that diabetes was "a public health problem," fated to become worse if nothing was done soon. But what did they mean by this? Why had they grown concerned? And what measures did they recommend to try and reverse the upward trend in diabetes rates? In this Medical Center Hour, historian Arleen Tuchman asks what we can learn from history that might help us understand better how we are framing the diabetes "crisis" today, and why. How do cultural assumptions about diabetes, and about the particular populations believed to be most at risk, influence not only our understanding of this disease but also our efforts to gain control over it?
Co-presented with the History of the Health Sciences Lecture Series
Some physicians are born to write, while others have writing thrust upon them. As one of the latter, 2013 Moore Lecturer Margaret Mohrmann discusses what she has learned from writing about doctoring. The act of articulating her experiences as a pediatrician and teacher has shown her, over time, much more about her encounters with patients, and about herself, than she could see at the time those events occurred - or even at the time she wrote about them. Rereading one's own stories and having others read (and co-construct) them can expose the "ghost" in the story - "the story's silent twin," as British novelist Jeanette Winterson puts it. What couldn't be said, or wasn't noticed, or was forgotten often gets written in anyway, quietly, between the lines and within word choices and narrative structures. The process of discovering what went unseen before cultivates in both writer and reader the practice of paying close, compassionate attention to what's happening now, an essential ingredient of good doctoring.
The Moore Lecture
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
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