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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
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
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
"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
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.
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
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
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
