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An oral history interview with Dr. Linda R. Thompson, conducted via Zoom by the Claude Moore Health Sciences Library on November 15, 2021. This interview is part of the Medical Alumni Stories Oral History Project, a joint effort of the Claude Moore Health Sciences Library and the UVA Medical Alumni Association and Medical School Foundation.
Linda Ruth Thompson was born in 1941 in Bristol, Tennessee. She attended King College (now King University) in Bristol, TN, and graduated Magna cum Laude in 1962. Thompson attended the University of Virginia School of Medicine and graduated from medical school in 1966; she was one of three women who graduated in the Class of 1966. After graduation, Thompson completed a rotating internship at the State University of Iowa Hospital in 1967, and then returned to UVA for a residency in psychiatry (1967-1971). She served as the Chief Resident during her final year of residency and also as an Instructor in Psychiatry (1970-1971). Following her residency, she worked as a staff psychiatrist at the Northern Virginia Mental Health Institute in Fairfax, VA, before going into private practice in the Washington, DC, area.
Dr. Thompson pursued psychoanalytic training at the Washington Psychoanalytic Institute, and graduated from the psychoanalysis program in 1983. In 1984, she moved to the Tri-Cities area of northeastern Tennessee and southwestern Virginia, where she has maintained a general psychiatric practice since 1984. Thompson also worked as a consultant until 2014, primarily with regional mental health centers, and she attended psychiatric patients at local community hospitals. In 2016, Thompson published a book about her experiences with breast cancer, which she was diagnosed with and treated for in 2007 and 2008. She continues to practice medicine part-time in Bristol, TN, and writes about issues in modern healthcare. In addition to her book Surviving Breast Cancer, Thompson is the author of two additional books: Return to Asylums: A Prescription for the American Mental Health System, published in 2016, and Old School Medicine: Lower Tech Care to Improve the High Tech Future of Healthcare, published in 2018.
This is a shortened version of the oral history interview conducted with Dr. Thompson in November 2021. The full length interview remains restricted until 2047.
An oral history interview with Dr. Maurice Apprey, conducted on May 12, 2022. This interview is part of a joint effort of the Claude Moore Health Sciences Library and the UVA Medical Alumni Association and Medical School Foundation.
Maurice Apprey was born in Ghana, West Africa. He received a B.S. in Psychology, Philosophy, and Religion from the College of Emporia, Kansas, and graduated in 1974. Dr. Apprey was one of a small number of students who trained under Anna Freud at the Hampstead Clinic in London, from which he graduated in 1979. After studying phenomenological psychological research and hermeneutics with Amedeo Giorgi at the Saybrook Institute in San Franciso, CA, Dr. Apprey received a Ph.D. in Human Science Research. He later pursued a doctorate in Executive Management from the Weatherhead School of Management at Case Western Reserve University.
In 1980, Dr. Apprey joined the faculty of the UVA School of Medicine in the department of Psychiatry and Neurobehavioral Sciences. In 1982, he was appointed Assistant Dean of Student Affairs. His work with current and aspiring medical students continued for two and a half decades, and he was later appointed the Associate Dean of Diversity at the School of Medicine (in 1992) and the Associate Dean of Student Support (in 2003). During these years, Dr. Apprey was highly effective in increasing the number of students from under-represented backgrounds at medical school through initiatives like the Medical Academic Advancement Program (MAAP). He taught undergraduates, medical students, residents in psychiatry and psychology, and hospital chaplains, among others. In 2007, Dr. Apprey was invited to become Dean of the Office of African-American Affairs for the University of Virginia. He accepted and served in that role until his retirement in 2022.
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
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
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
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
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
In a year that has seen gun violence in the U.S. escalate even more—consider the almost-daily gun deaths on the streets of Chicago or the recent Las Vegas massacre—this Medical Center Hour looks anew at this urgent public health problem. Distinguished bioethicist Steven Miles presents a comprehensive status report on gun deaths (homicides and suicides), including issues of gun supply, the relevance of mental illness, race, and poverty to firearm deaths, the effects of gun law reforms, and the prospects for better prevention of gun violence.
A John F. Anderson Memorial Lecture
Opiate abuse and addiction in the U.S. population have reached epidemic proportions, with one result being that primary care practices increasingly see patients for whom addiction is the presenting, or exacerbating, problem. But are primary care practitioners actively engaged in treating addiction? Unfortunately, no, says Dr. Hughes Melton, a primary care physician and Virginia's Chief Deputy Commissioner of Public Health and Preparedness. They lack the practical training and helpful mindset to approach addiction, but, also, addiction is more than a medical problem, with multiple stakeholders beyond patient and family, doctor, and clinic.
In this Medical Center Hour, Dr. Melton and two Generalist Scholars--students preparing for careers in primary care--consider what primary care practitioners need in order to care effectively for this urgent population health problem: practical skills and informed attitudes, to be sure, but also the will and nuanced capabilities to be robust social leaders in the community.
A John F. Anderson Memorial Lecture
Co-presented with the Generalist Scholars Program and the Department of Public Health Sciences in observance of Primary Care Week at UVA
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