- Date:
- 2015-02-11
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Fifty years ago President Lyndon B. Johnson envisioned a Great Society, an America free from poverty and racial injustice and full of equality of opportunity and social mobility for all. Many legislative planks of his Great society platform--civil and voting rights, educational opportunity, fair housing practices, urban planning, mass transit, and health care --represent what we today consider "social determinants of health." This Medical center hour with bioethicist Erika Blacksher reviews how Americans are faring today in relation to key aspirations of LBJ's Great Society, especially those that bear on health. Americans generally live shorter, less healthy lives than their counterparts in peer nations, and within the U.S. health varies dramatically among social and economic groups and from region to region. What ethical concerns are raised by significant health disparities? Are such disparities unjust, as many in public health assume? If so, what are our responsibilites, and what ethical limits might constrain our pursuit of a more equitable distribution of health? Co-presented with the History of the Health Sciences Lecture Series and the Institute for Practical Ethics and Public Life
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- Date:
- 2015-02-04
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Dying in America is very different now from half a century ago. Before World War II, death usually occurred at home, often with no medical intervention. But with the bioscientific and medical advances that began in the 1950's, death became medicalized. In hospitals, it became possible to extend life. Often, patients were cured who would otherwise have died, but many endured protracted deaths in which suffering from treatment was worse than suffering from their fatal illness. Through the last decades of the 20th century, the medical and legal professions, medical ethicists, and the public began to consider ways to limit treatment, even to hasten death. It became generally accepted that all patients have the right to refuse life-sustaining treatment. Now, five U.S. states recognize physician-assisted suicide. In this Medical center hour, physician and former New England Journal of Medicine editor-in-chief Marcia Angell traces the history of these changes, then inquires into where we stand now on dying--and where we go from here. Co-presented with the History of the Health Sciences Lecture Series
- Date:
- 2015-01-21
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2014-11-12
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- At a time when lesbian, gay, bisexual, and transgender (LGBT) individuals enjoy ever greater social acceptance and legal protection, transgender teens and young adults still face challenges on many fronts. Simply negotiating adolescence isn't easy, and gender identity issues can complicate matters. Health care for transgender youth is in transition, as the population becomes better understood. In this Medical Center Hour, a panel of pediatricians makes the case for increased cultural competency in medicine and society alike to help give transgender teens a safe medical home and help them to lead satisfying, successful lives.
- Date:
- 2014-11-05
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- During the enlightenment, from 1765, the Habsburg Empire capital of Vienna underwent massive transformations in urban design and appearance, from the introduction of sewer systems and streetlights to urbanization of suburbs and construction of public facilities, including parks, all guided by principles we now consider fundamental to creating healthy, green, livable cities. Habsburg Emperor Joseph II (1780-1790), a reformer with almost utopian (and quite Jeffersonian) ideas about architecture and health, extended these massive changes by contructing Vienna's medical district, including the general hospital, the military hospital, an institute for the mentally ill, and the medical-surgical military academy Josephinum. What does it mean to "construct for health" in designing cities and landscapes, public and private spaces, and health care facilities? This Medical center hour examines the Vienna Project as an important design-and-health precedent. How might we in the twenty-first century enlist design professionals and health professionals together in more deliberate, collaborative efforts to improve public and personal health and well being? Co-presented with the History of the Health Sciences Lecture Series, the Center for Design + Health (School of Architecture), the Eleanor Crowder Bjoring Center for Nursing Historical Inquiry (School of Nursing), and the Department of Public Health Sciences and the Center for Biomedical Ethics and Humanities (School of Medicine), as part of the interprofessional symposium “Constructing for Health: A Global Nod to Nightingale,” funded by the Buckner W. Clay Endowment for the Humanities (College and Graduate School of Arts and Sciences)
- Date:
- 2014-10-29
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2014-10-22
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2014-10-15
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- "Germs have always traveled. the problem now is they can travel with the speed of a jet plane." So said physician and medical historian Howard Markel in recent days, commenting on the spread of Ebola outside West Africa. This Medical center hour takes stock of the rapidly evolving Ebola epidemic and the concomitant rise in global health security concerns. What is known of this unusual virus and the life-threatening hemorrhagic fever it triggers? How are sociopolitical and cultural conditions and healthcare infrastructural inadequacies in West Africia and elsewhere hindering medical and public health response? How are governmental and health care institutions in the U.S. responding as cases erupt outside West Africia? And, looking ahead, what are the prospects for vaccine development and fast-track clinical trials? A John F. Anderson Memorial Lecture Co-presented with the Department of Public Health Sciences and the Center for Global Health
- Date:
- 2014-10-08
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2014-10-01
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In summer 2013, UVA landscape architecture graduate students Harriett Jameson and Asa Eslocker travelled to Sardinia, Okinawa, and Loma Linda, California, three landscapes with the highest life expectancy in the world, to explore these places' physical, spatial, and material qualities-topography, plant communitites,urban form-and also the personal attachments that seniors in these sites have to their cultural landscapes. The people in these locales have long been studied for their genetics, diets, and recreation habits. But until Ms. Jameson and Mr. Eslocker arrived, no one had inquired into or demonstrated in these settings the critical role of place in healthy longevity. Through study of these distinctive landscapes and the personal stories of elderly residents, the pair arrived at insights that may help communities rethink and redesign public landscapes to cultivate a culture of health and well being that spans infancy through old age. In this Medical center hour, Ms. Jameson and Mr. Eslocker focus on how place contributes to healthy aging and preview parts of their full-length documentary film, Landscapes of longevity, which will premiere in Charlottesville in November. A John F. Anderson Memorial Lecture Co-presented with the Center for Design + Health, School of Architecture, UVA
- Date:
- 2014-09-24
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Growing enthusiasm in medicine and in the population at large for early diagnosis has engaged many doctors in a systematic search for abnormalitites in persons who are well. While physicians, patients, and the press tend to focus on the potential benefits, Dr. H. Gilbert Welch in his work has exposed the often-ignored harm associated with this practice: overdiagnosis. Diagnoses of a great many conditions, including high blood pressure, osteoporosis, diabetes (and prediabetes), and even cancer, have skyrocketed in recent years, yet many individuals so labeled are destined never to develop symptoms, much less die, from their conditions. They are overdiagnosed. And overdiagnosed patients as Dr. Welch points out in the Medical Center Hour, cannot benefit from treatment since there is nothing to fix. But they can be harmed. Understanding the trade-offs involved is critical, Dr. Welch argues, so that health care systems don't further narrow the definition of "normal" and, ironically, turn more and more well persons into patients. Co-presented with the Department of Public Health Sciences, School of Medicine; the Sadie Lewis Webb Program in Health Law, School of Law; and the Institute for Practical Ethics and Public Life, UVA
- Date:
- 2014-09-17
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Acclaimed physician-writer Christine Montross (Body of work, 2007; and Falling into the fire, 2013) discusses how diving deeply into her most challenging patient encounters has led her to the ancient concept of "abiding" as a lost tenet of patient care. A psychiatrist and medical educator, Dr. Montross speaks in defense of repugnance, and encourages physicians and doctors-in-training to acknowlege, rather than suppress the discomforts which naturally arise in the practice of medicine. A John F. Anderson Memorial Lecture
- Date:
- 2014-09-10
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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.
- Date:
- 2014-04-02
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Despite their reliance on technical knowledge that requires mastery, medicine, law, and business are all deeply human professions. Medicine is more than body repair, law more than legal systems, business more than the physics of money. While professional education necessarily must be at the cutting edge of technical expertise, it must remember too the human nature—including the values, emotions, and richly complicated lives—of professionals and professional organizations. In this Medical Center Hour, Professor Ed Freeman from UVA's Darden School of Business demonstrates how the creative arts and humanities can be embedded in professional education to address and actively teach ethical conduct in professional life and leadership of complex professional organizations. What lessons in course design, student engagement, and classroom outcomes might medical educators draw from Professor Freeman's courses, "Business Ethics through Literature" and "Leadership, Ethics, and Theater"? A John F. Anderson Memorial Lecture Co-presented with the Institute for Practical Ethics and Public Life, UVA
- Date:
- 2014-03-26
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- How should we imagine the history of distraction? Is it true that the internet has made us distracted in a way that we never have been before? And, if it has, is that necessarily bad? What is distraction, anyway? In this Medical center hour, East Asian cultural historian Shigehisa Kuriyama suggests that comparative reflection on images of skulls and skeletons can offer us illuminating insight into these questions, and into the entwining of distraction with art, anatomy, curiosity, and early modern global trade. Co-presented with the History of the Health Sciences Lecture Series, Claude Moore Health Sciences Library
- Date:
- 2014-03-25
- Main contributors:
- University of Virginia. School of Medicine
- Date:
- 2014-03-19
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In its emphasis on instrumentality, on the patient as something to be acted upon, and on the doctor as an abstracted agent of diagnosis and treatment, medicine often neglects the practitioner's involvement in the clinical scene. Recent attempts to direct attention to this aspect of practice have been stymied by medicine's nearly exclusive reliance on a quantitative, positivist disposition, with which humanist scholarship has had difficulty gaining traction. The narrative medicine movement, as articulated by Dr. Rita Charon of Columbia University College of Physicians and Surgeons, has gained widespread attention within the medical academy. But physician and literature scholar Dr. Terrence Holt argues that, for all its positive features (and despite Dr. Charon's efforts to define it otherwise), narrative medicine as applied remains committed to an interventional model that is at odds with the strengths of the humanities. Drawing on readings of texts such as Shakespeare's King Lear, Coleridge's Rime of the Ancient Mariner, Shelley's Frankenstein, and the poetry of John Keats, Dr. Holt contends that the value of the humanities in medical education and practice is not as an intervention but as a diagnostic modality—and that the proper first object of diagnosis may not be the patient, but the physician. The Ellis Moore Lecture of the School of Medicine
- Date:
- 2014-03-12
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Primum non nocere--"first, do no harm"--is a fundamental principle of medical practice, expressing both the hope and humility of physicians. It cautions doctors that even with the best intentions may come unwarranted consequences. One present-day application of this principle has to do with efforts to eliminate hospital-acquired infections. When we define such infections as inevitable if regrettable collateral damage wherever complex care is provided to very sick patients, we create a rationale for paying for them and institutionalize their harm. And we may lose sight of their tragic human and economic costs, and of clinicians' own involvement. The annual Richardson memorial lecture addresses the human toll of medical error and calls for improved patient safety. In this Richardson lecture, Dr. Richard Shannon challenges the academic medical center not only to create safer systems that prevent bloodstream infections but also to invest every frontline worker with the capability and responsibility to see and solve problems before they propagate into error. Importantly, this is about more than safety. It is about culture change, creating a culture of habitual excellence in everything we do. Safety is simply the unassailable starting point. Another foundational medical principle applies: Cura te ipsum--"physician, heal thyself." Co-presented with the Patient Safety Committee, UVA Health System
- Date:
- 2014-03-05
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- American medical education can be proud of its accomplishments. Its graduates populate a sophisticated medical system that often sets global standards in teaching and self-regulation. doctors the world over compete to train and practice in the U.S. There are nearly three applicants for every one place in U.S. medical schools. Things are good. But are they? The U.S. medical system is now by far the world's most expensive, a drag on the economy and a major contributor to accumulating national debt. Physician-writer Atul Gawande notes that the doctor's most expensive instrument is the pen, ordering costly, and sometimes unnecessary, diagnostics and therapeutics. We import a quarter of our doctors, yet major portions of the country are short of physicians. All is not well in medical education. In this Brodie Medical Education Lecture, distinguished physician and health policy expert Dr. Fitzhugh Mullan addresses the technical, cultural, and moral challenges facing American medical education today, and how they go straight to the soul of medicine. Co-presented with the Brodie Medical Education Committee, the Department of Medicine, and the Academy of Distinguished Educators, as part of UVA's Medical Education Week
- Date:
- 2014-02-26
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- The Diagnostic and statistical manual of mental disorders (DSM) is perhaps the most contested document in American medicine, vital for the organization and funding of psychiatric research and mental health care, yet perennially criticized both from within and behond the mental health community. Heated debate accompanied the 2013 publication of the manual's fifth edition, DSM-5. Critics charged that the new edition masks political interests (e.g. interests of psychiatrists and pharmaceutical companies) under the guise of science at patients' expense. DSM-5 defenders championed the inclusiveness and transparency of the review process and evidence-base behind the manual's diagnostic decisions. In this Medical center hour, psychiatrist and theologian Warren Kinghorn argues for a mediating alternative: that the DSM may be best understood as neither an apolitical "encyclopedia" of psychopathology nor a political cloak for psychatric power, but rather as a working document of a living moral tradition. In this case the tradition-constituted discourse allows for appreciation of the DSM as a useful scientific document that reflects the moral assumptions and convictions of the communities that created and continue to sustain it. Co-presented with the History of the Health Sciences Lecture Series
- Date:
- 2014-02-12
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- At a time when lesbian, gay, bisexual, and transgender (LGBT) individuals enjoy unprecedented social acceptance and legal protection, many LGBT elders face the daily challenges of aging isolated from family, detached from the larger LGBT community, and ignored by mainstream aging initiatives. These elders are more likely to be single, childless, financially insecure, fearful of encountering bias in health care settings, and socially isolated. And the continuing silence surrounding LGBT elders has left many of them underserved and at risk. This Medical Center Hour makes the case that increased cultural competency measures are necessary within medicine and society to help older LGBT persons overcome barriers to successful aging and to ensure that we are all taking good care of our LGBT elders. A John F. Anderson Memorial Lecture co-presented with qMD A John F. Anderson Memorial Lecture co-presented with qMD
- Date:
- 2014-02-05
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2014-01-29
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In 1858, young English surgeons Henry Gray and Henry VanDyke Carter published an illustrated anatomy textbook for medical students. Gray's Anatomy has never since been out of print, but little was known about its author and illustrator until acclaimed science writer Bill Hayes—inspired by a photograph of Henry Gray—pieced together their story in The Anatomist. This Medical Center Hour explores the medical, historical, and artistic significance of Gray's Anatomy and also Hayes's unforgettable year alongside medical students in the anatomy lab. Co-presented with the History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library
- Date:
- 2013-11-06
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-10-30
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-10-23
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-10-16
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- What would it mean to name pain not as alien to human existence but as one of the defining conditions of being human? In this presentation, three experts--in disability studies, bioethics, and the cultural study of pain and pain medicine--consider our complicated attitudes toward pain, especially as we regard it in others. A John F. Anderson Memorial Lecture
- Date:
- 2013-10-09
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-10-02
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Physician-author Lisa Sanders, who writes the popular "Diagnosis" column in The New York Times Magazine and "Think Like a Doctor" blog for the New York Times, probes the crucial exchanges between doctor and patient that are at the heart of every medical mystery and its solution. The Koppaka Family Foundation Lecture in Medical Humanities
- Date:
- 2013-09-25
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Musicologist April Greenan outlines use of music in western medicine as an agent of both healing and prevention, reviewing data documenting music's beneficial effects on patients, and suggests ways that health professionals might purposefully employ music in patient care. How might doctors guide patients to use music on their own in managing pain, anxiety, depression, the side-effects of chemotherapy? Given the ubiquity and affordability of recorded music today, might it represent a cost-effective way to help improve health care and health? A John F. Anderson Memorial Lecture
- Date:
- 2013-09-18
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-09-11
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Dr. Romero shares insights regarding the increasingly important partnership of public health and primary care and the critical need for a strong, patient-centered primary care framework to improve health outcomes. Co-presented with the Generalist Scholars Program and the Department of Public Health Sciences, UVA, in observance at UVA of Primary Care Week
- Date:
- 2013-09-04
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Dr. Aaron Vinik recounts his journey through the golden years of biomedical and clinical research as he has studied and tested regeneration of pancreatic islet cells and nerve fibers. There are lessons here for coming generations of physician-scientists--about discovery, about collaboration, about being mentored, about, as Ralph Waldo Emerson suggests, venturing where there is no path and leaving a trail. The Alpha Omega Alpha Lecture of the School of Medicine
- Date:
- 2013-04-03
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-03-20
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-03-13
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-02-27
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-02-20
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-02-13
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-02-06
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- There's much mythology surrounding eating disorders. Myth: these are time-imited illnesses that resolve when a woman leaves adolescence. Myth: only women experience eating disorders. In a society that reveres bodily thinness and now also celebrates the extremely "fit" body, at once lean and overtly muscular, an estimated 25 to 30 million Americans currently suffer from an eating disorder. Most eating disorders look nothing like the stereotypes suggested by sensational media coverage. The afflicted include men and women of all ages and all ethnicities. And so alongside this country's well-publicized obesity epidemic rages another, quite invisible epidemic of eating disorders. This Medical Center Hour addresses eating disorders and related questions from three perspectives. Speakers include a UVA student in recovery, a parent and national advocate, and the coordinator of the prevention program at UVA's Women's Center. What role does family play in eating disorders? How as health professionals do we ensure that patients get the best treatment? What treatments are most effective? How can we, health professionals and laypersons alike, best support someone who is suffering? What resources are available at UVA and how do we get involved? A John F. Anderson Memorial Lecture Co-presented with the Women's Center, UVA
- Date:
- 2013-01-30
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2013-01-23
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2012-11-14
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2012-11-07
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- RN-MD collaboration in health care (or the lack thereof) is one of the more vexed issues facing our struggling health care system. Yet it rarely gets addressed in a substantive and purposeful way. The problem begins with the training of nurses and doctors. Nursing schools have seldom taught the nuts and bolts of working with physicians. Medical schools have taught future doctors almost nothing about working with nurses. Often the result in clinical practice is that each group finds the other difficult. Even so, nurse-physician collaboration is what makes health care possible, and good collaboration makes high quality care much more likely. In this Medical center hour, nurse and author Theresa Brown considers new, potentially revolutionary initiatives in health professional education, including at UVA, that bring nursing and medical students together as learners. Will interprofessional education lead to better RN-MD collaboration in practice and, as a result, to better patient care? The Zula Mae Baber Bice Memorial Lecture Co-presented with the School of Nursing
- Date:
- 2012-10-24
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- The design of sustainable, just, and economically feasible environments for human health and well-being is one of the most urgent needs of the 21st century on a global scale. Aging populations, environmental pollution, rapid urbanization, increased poverty, rising health care costs, the need for preventive medicine, and new developments in social and medical science have created a host of design challenges and opportunities. In this Medical Center Hour, Tim Beatley and Reuben Rainey, co-directors of the UVA School of Architecture's new Center for Design and Health, explore ways designers and planners are meeting these challenges at a variety of scales, ranging from patient-centered health care facilities to healthy neighborhoods and cities.
- Date:
- 2012-10-17
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2012-10-10
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- As a UVA undergraduate (Class of 2010), Pennsylvania native Matthew Miller had a catastrophic, near fatal cycling accident on the Blue Ridge Parkway while training for an Ironman triathlon. He lost control of his bike as a caravan of classic cars passed by in the opposite lane; Miller plowed into an oncoming Porsche, breaking every bone in his face. Pulitzer Prize winning journalist Michael Vitez's articles about Miller for The Philadephia Inquirer (reprinted in the Charlottesville Daily Progress) led to his book, The road back: a story of grit and grace (2012). This compelling narrative of Miller's remarkable survival and recovery. He is now a third year medical student at the University of Pennsylvania not only celebrates the strength and resiliency of the human spirit but also vividly attests to the power of medicine at its best. This Medical center hour, with Michael Vitez and UVA surgeon J. Forrest Calland, one of Miller's doctors, suggests that the best way to explore and explain what's happening in medicine may be to tell stories of ordinary people, patients and professionals meeting extraordinary challenges. A John F. Anderson Memorial Lecture
148. Echoes of the heart, a cardiologist discovers his patients through poetry and photography (1:01:48)
- Date:
- 2012-10-03
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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.
- Date:
- 2012-09-26
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2012-09-19
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- With the aging of our nation's practicing physicians and the recent, steep decline in medical graduates choosing careers in primary care for adults, U.S. patients today are hard pressed to find a primary care doctor. And the already impressive gap between supply and demand of primary care physicians will likely widen once more than 30 million people gain access to health insurance under the Affordable Care Act. The urgent shortage of primary care physicians compounds this country's already significant health care challenges regarding access, delivery, and cost of care. In an era when all of health care is undergoing potentially transformative change, what will be the role of primary care doctors? For patients, what will be the "value added" of having a primary care M.D.? What roles will other primary providers (physician assistants, nurse practitioners) play? Is the primary care physician an endangered species, or a key participant in a newly configured primary care team? How can we devise, model, deploy, and teach new ways of delivering primary care that are team based, interprofessionally collaborative, effective, and satisfying to patients and practitioners alike? In this Medical Center Hour, family doctor and medical journalist Susan Okie draws on her recent Perspective article in the New England Journal of Medicine to explore the prospects ahead for the primary care physician. Two of UVA's primary care physicians: one a mid career family medicine physician and teacher, the other a medical student planning a primary care career offer their perspectives as well. Co-presented with the Generalist Scholars Program in observance at UVA of Primary Care Week