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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
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
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
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
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
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
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
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
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
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.