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- Date:
- 2017-02-01
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- 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:
- 2018-02-21
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Tuberculosis continues to be one of the world's most deadly infectious diseases, killing almost two million people each year. In this Medical Center Hour, historian Christian McMillen explores TB's stubborn staying power by examining key aspects of the disease—including the rise of drug resistance and TB's resurgence with the HIV/AIDS epidemic—and detailing global efforts to control it since 1900. Co-presented with the History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library
- 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:
- 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
157. 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:
- 2019-03-13
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Anthropologist, activist, and priest Roshi Joan Halifax is the founder and head teacher of the Buddhist monastery, Upaya Zen Center. Seventeen years ago at Upaya, she pioneered a new form of bedside contemplative care known as "Being with Dying," which has since helped to illuminate and change the psychosocial, ethical, and spiritual care of the dying. Halifax's newest work probes what she calls five "edge states" of how we become involved with our fellow beings: altruism, empathy, integrity, respect, and engagement. In this Bice Memorial Lecture, she explores the risks and the opportunities for courage and compassion that persons in the helping professions encounter "at the edge." Bice Lecture, Co-presented with the School of Nursing, UVA
- 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:
- 2021-03-03
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Among the COVID-19 pandemic's lessons is an increased awareness of the hazards of old age. But only a fraction of that risk is biological. At a moment in history when most of us will live into old age, we've created a world that's almost entirely focused on childhood and adulthood. It's time now to define, design, and empower this new, nearly universal elderhood. In this Medical Center Hour, geriatrician and writer Louise Aronson draws on her clinical experience and creative abilities to reimagine and advocate for old age not as a disease but as a vital phase of being human, with implications for social and community life, technology, geroscience, and healthcare. How shall we now approach elderhood? Koppaka Family Foundation Lecture in Health Humanities
- 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:
- 2017-03-15
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2012-09-12
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In 1990, University of Pittsburgh Public Health Professor John C. Cutler delivered to the university's archives thousands of pages of documents and photographs about an unpublished research project that he ran in Guatemala for the U.S. and Guatemalan governments between 1946 and 1948. Duly cataloged, the files then sat in the library until the mid 2000s, when historian Susan Reverby began to read them as part of her book project on the Tuskegee syphilis studies. Who knew that the infamous U.S. Public Health Service Study of Untreated Syphilis in Tuskegee, Alabama, had an off shore successor? Unlike Tuskegee, the Guatemala studies led by Dr. Cutler involved actual inoculation of sexually transmitted diseases and the paying of sex workers to transmit disease. Unsuspecting and unconsenting prisoners, soldiers, mental patients, and sex workers participated; only some were treated if and when they became infected. In 2009, Professor Reverby returned to the Pittsburgh archive, and in 2010 she wrote up her findings on the Guatemala project. She shared her unpublished article with the late David Sencer, former director of the Centers for Disease Conrol (CDC), who gave the article to the current CDC leadership. The CDC prepared its own report and sent it, along with the Reverby article, up the chain of command to the White House. On Oct. 1, 2010, Health and Human Services Secretary Kathleen Sebelius and Secretary of State Hilary Rodham Clinton apologized to the Guatemalan government and President Obama telephoned then President Colom in Guatemala to explain. In the spotlight of worldwide media attention, presidential commissions in both countries undertook investigations, and survivors of the study filed suit against the U.S. government. The Guatemala study and its aftermath have urgently renewed debate about the ethics of clinical research involving human participants, especially research carried out with vulnerable populations and in the global arena. In this Medical Center Hour, Susan Reverby discusses how her discovery of the Guatemala study files set in motion international investigative and diplomatic processes and what we can learn from this ethically immoral use of medical science. Bioethicist John Arras, a member of the Presidential Commission for the Study of Bioethical Issues, will comment on the commission's investigation and its 2011 report, Ethically impossible: STD research in Guatemala from 1946 to 1948.
- 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:
- 2016-02-24
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2019-01-23
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- January 23, 2019 Joe Richman Since 1996, the Radio Diaries project has been giving people audio recorders and working with them to report on their own lives and histories. Collaborating with teens and octogenarians, persons with chronic and terminal illness, prisoners and prison guards, gospel preachers and bra saleswomen, the famous and the unknown, the project tells extraordinary stories of ordinary life. With stories aired on NPR, BBC, This American Life, and its own podcast, Radio Diaries has pioneered a new form of citizen journalism and, along the way, garnered every major award in broadcast journalism. This Medical Center Hour welcomes Radio Diaries’ founding director, Joe Richman, to share stories and draw parallels with health care practice, where, daily, clinicians traffic in the “extraordinary stories of ordinary life.” The Edward W. Hook Lecture in Medicine and the Arts / Medical Grand Rounds Co-presented with the Department of Medicine, UVA
- Date:
- 2017-09-27
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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"
- 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:
- 2013-11-06
- 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:
- 2016-03-23
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2015-10-07
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- 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:
- 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:
- 2015-02-18
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- When documentary filmmaker Kathy Leichter moved back into her childhood home after her mother's suicide, she discovered a hidden box of audiotapes. Sixteen years passed before she had the courage to delve into this trove, but there she unearthed what her mother had recorded about every aspect of her life--from the joys and challenges of her marriage to a state senator to her son's estrangement , as well as the highs and lows of living with bipolar disorder. Here one day is Ms. Leichter's emotionally candid film about a woman coping with mental illness, her family relationships, and the ripple effects of her suicide on those she loved. In this Medical center hour, Ms. Leichter offers her extraordinary award-winning film, speaks about the transformative nature of story, and shows how Here one day is helping to dissolve mental health stigma and to educate and support persons and families in communities and educational institutions across the country.
- Date:
- 2017-11-08
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- 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:
- 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:
- 2017-02-22
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- 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:
- 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
- Date:
- 2019-03-27
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Even as the University of Virginia and other medical schools across the U.S. prepare to graduate a new wave of physicians, what will be these doctors' roles and responsibilities in a health care system increasingly stressed by social and political pressures, cultural challenges, and financial shortfalls? And what will be—what should be—expected of physicians and the medical profession in years to come, in their practice, in communities, in policy circles, in the public square? In this Medical Center Hour, Dr. Christine Cassel, a longtime leader in medicine and medical education, offers her perspectives on what should be expected of physicians and other health professionals in coming years--in their practice, in their communities, in government and policy circles, and in the public square.
182. Learning from the suffering of patients: the empirical challenge of 21st century medicine (59:18)
- Date:
- 2019-02-27
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Twenty-first century physicians and other clinicians who are caring for patients in an era of unlimited knowledge, rapid knowledge turnover, and ever-more-sophisticated artificial intelligence (Watson!) increasingly need new skills and strategies. Such practitioners need too a renewed capacity for compassion. In this Medical Center Hour, eminent physician leader Dr. Steven Wartman, 2019 recipient of UVA's Brodie Medical Education Award, maps this critical juncture and challenges educators and other health professional leaders to reimagine and reengineer how we prepare doctors and other health care practitioners. The Brodie Medical Education Award Lecture
- 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:
- 2018-10-24
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- This Richardson Memorial Lecture's origins are the hospital death of infant Lola Jayden Fitch and her family's journey to evoke change. The hour is anchored in the stories of Lola's parents--her mother, who questioned her intuition, and her father, who chose to continue working in the hospital where Lola's death occurred--and in a review of medical staff communication errors that tragically affected Lola's care. How can we prevent communication breakdowns, improve teamwork, and foster greater transparency and true partnership with families to make health care better and safer, especially for the most vulnerable patients? How can Lola's Song and similar stories--those of patients, families, health professionals, and others--help us to accomplish this important work? www.lolassong.com The Jessie Stewart Richardson Memorial Lecture of the School of Medicine Co-presented with the Office of Quality and Performance Improvement, UVA Health System
- Date:
- 2016-01-27
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In the making of a doctor, the residency is the principal formative experience. Its three to nine years of supervised practical learning are the crucible in which medical graduates acquire specialty knowledge and skills, forge a professional identity, and develop the values, attitudes, and behaviors for a lifetime of practice. While there have long been tensions within and around residency, physician-historian Kenneth Ludmerer's new book, Let Me Heal, a history of residency in the U.S. since its 19th century origins, comes at a time when training programs are pressured as never before by government regulation, workforce changes, shifts in disease patterns and sites of care, and highly commercialized health care. In this Medical Center Hour, Dr. Ludmerer mines the history of residency for lessons to address current concerns about medical education and to assure we can make the best doctors for the 21st century. The Joan Echtenkamp Klein Memorial Lecture in the History of the Health Sciences Co-presented with the History of the Health Sciences Lecture Series
- Date:
- 2018-02-14
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2018-09-26
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In June 2018, Gov. Ralph Northam signed a budget bill that gives 400,000 low-income Virginians access to government health insurance through Medicaid. This action marked an upbeat, bipartisan close to a bitter, four-year battle in the General Assembly. An Affordable Care Act option, Medicaid expansion makes additional low-income persons in participating states eligible for care that is funded chiefly with federal dollars. Virginia’s decision to join 32 other participating states hinged on a legislative compromise with Republicans that imposes work requirements on Medicaid recipients. While a few other states have taken similar positions, debate about work requirements continues in government, policy circles, and the courts. This Medical Center Hour looks at Medicaid expansion in Virginia—to be implemented in January 2019—from policy, political, and health care perspectives, with a focus on what it means locally, in Charlottesville and Central Virginia. A John F. Anderson Memorial Lecture
- 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:
- 2018-10-03
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Thirty years ago, the medical school at East Carolina University created a readers' theater program in which short stories about medicine were adapted as theatrical scripts. Medical students performed a story by reading it aloud, then actors and audience--often a community group--together discussed the drama and the ethical and social issues it raised. These plays and post-performance discussions enlivened and changed how future physicians and audiences--prospective patients all--approached and learned from one another. The best way to learn about medical readers' theater? Just do it. In this Medical Center Hour, UVA medical student actors present a dramatic reading of physician-poet William Carlos Williams's 1938 short story, "A Face of Stone." Following the performance, the audience joins in, as everyone responds to and discusses the play and the ethical, social, and cultural concerns it explores. A John F. Anderson Memorial Lecture Co-presented with the Sloane Society for Medical Humanities, UVA
- 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
- Date:
- 2014-03-25
- Main contributors:
- University of Virginia. School of Medicine
- Date:
- 2016-11-09
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- 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:
- 2013-09-04
- 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:
- 2018-10-31
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- The year 2018 marks the centennial of the "Spanish" influenza pandemic, the world's deadliest event, killing at least 50 million persons worldwide. This pandemic's sudden emergence and high fatality are stark reminders of the threat influenza has posed to human health and society for more than a millennium. Unusual features of the 1918-1919 outbreak, such as the age-specific mortality pattern and unexpectedly high frequency of severe and fatal pneumonias, are still not fully understood. But the recent sequencing and reconstruction of the 1918 virus—work accomplished by NIH scientist Jeffery Taubenberger and colleagues—have yielded answers to crucial questions about the virus's origin and pathogenicity. In this Hayden-Farr Lecture at Medical Center Hour, Dr. Taubenberger summarizes key findings, considers yet-to-be answered questions about the 1918 influenza, and looks ahead to 21st century public health preparedness and the need to optimize preventive vaccines and vaccination strategies. The Hayden-Farr Lecture in Epidemiology and Virology/Medical Grand Rounds/History of the Health Sciences Lecture Co-presented with the Department of Medicine, Historical Collections in the Health Sciences Library, and Influenza! 1918-2018
- 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:
- 2015-11-11
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Over the last half-century, pain medicine has been defined by controversy: when is pain real? Does too-liberal, overly compassionate relief create addiction? Is chronic pain a legitimate basis for disability claims and long-term benefits? What should we do when end-of-life pain care resembles physician-assisted suicide or euthanasia? Professor Keith Wailoo explores the political and cultural history of these complex medical and social debates, examining how pain medicine emerged as a legitimate yet controversial field; how physicians, patients, politicians, and the courts have shaped ideas about pain and its relief; and how the question “who is in pain and how much relief do they deserve?” has become a microcosm of broader debates over disability, citizenship, liberalism, and conservatism in American society. Co-presented with History of the Health Sciences Lecture Series and the Institute for Practical Ethics and Public Life, UVA History of the Health Sciences Lecture
- 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:
- 2016-09-28
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Hospitals and clinics and safety-net organizations across the U.S. are increasingly challenged to provide medically appropriate care to undocumented and uninsured immigrants. These "patients without passports" do not qualify for public benefits that finance health care for low income persons and often lack other means to secure care for themselves and their families. In this Medical Center Hour, Nancy Berlinger, co-director of The Hastings Center’s Undocumented Patients project, explores the ethical and practical dimensions of health care access for this cohort of immigrants, drawing on data from Virginia and other states and on her work with New York City policymakers to improve health care access for vulnerable populations. UVA emergency medicine physician David Burt offers a local perspective. A John F. Anderson Memorial Lecture Co-presented with Institute for Practical Ethics and Public Life
- Date:
- 2017-03-22
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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