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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.
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
Marijuana has had a rocky and peculiar history in the United States. The early history of marijuana prohibition is fairly well known, thanks in part to a classic work on the subject, The Marijuana Conviction, co-authored by Richard J. Bonnie while he was associate director of a commission apppointed by Richard Nixon. In 1972, to the surprise of many, the commission recommended decriminalizing marijuana use, but it also rejected the idea of legalization, expressing major concerns about the public health consequences of doing so. While loosening marijuana laws became a mainstream policy idea through the Ford and Carter admisistrations, in the Reagan White House, a policy of "zero tolerance" took hold and evolved into a new and costly war on all illegal drugs. Millions of marijuana arrests ensued. As the drug war's costs accumulated in the early 21st century, support for decriminalizing marijuana returned. Some states defied the federal government by legalizing medical use. Then, suddenly, in 2012, voter initiatives in Colorado and Washington legalized marijuana for recreational use and, in 2014, voters in Washington DC did the same, with legalization in the District due to take effect 26 February 2015. The worries raised by the commission in 1972 are back, complicated by the challenges of implementing the law. This Medical center hour's principal speaker, who has both chronicled this story and been a player in it for more than four decades, will reflect on why marijuana prohibition suddenly collapsed and on what should happen next.
Co-presented with the History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library
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
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
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
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
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.
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
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
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
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
Oral history interview with UVA Law professor and alum D. Ruth Buck (1985) who recalls her time as a law student and discusses her experiences teaching Legal Research and Writing.
Fred Reno interviews Aileen Sevier, the Vice President of Strategy & Marketing for Early Mountain Vineyards. They discuss how her career pivoted into the wine industry, her approach to Wine Clubs, the process of sitting for the Master of Wine diploma, and more.
Fred Reno interviews Andrew Hodson, the owner and founder of Veritas Vineyard and Winery. They discuss his journey to found his winery and make a mark on Virginia winemaking with the help of his family.
Fred Reno interviews Christine, Dennis, and Nathan Vrooman of Ankida Ridge Vineyards. They discuss their journey to plant a vineyard, create delicious wines, and their approach to sustainable farming.
Fred Reno interviews Bruce Zoecklein, Professor Emeritus of Enology at Virginia Polytechnic Institute and State University. They discuss his early career and his move from teaching in California to teaching in Virginia. They also discuss his thoughts on hybrid grapes, the differences between wine growing on the west and east coast, and more.
Fred Reno interviews Ben Jordan, the winemaker for Early Mountain Vineyards. They discuss how his wine career moved from California to Virginia, his thoughts on hybrid grapes, Early Mountain Vineyard’s Petit Manseng, and more.
Fred Reno interviews Chelsey Blevins, the winemaker at Fifty-Third Winery and Vineyard. They discuss her entry into the wine industry, some of the notable Virginia winemakers she has worked with, and more.
Fred Reno interviews Bill Curtis, owner of Tastings Restaurant, Wine Bar and Wine Shop in Charlottesville, Virginia. They discuss his approach to cooking, the pioneers of Virginia winegrowing, and more.
Fred Reno interviews Chris Hill, a noted and accomplished Viticulturalist in Virginia. Some of the notable vineyards Chris Hill has partnered with are Michael Shaps Winery, Pollack Vineyards, Barren Ridge Vineyards, Veritas Vineyard and Winery, King Family Vineyards, Keswick Vineyards, Lovingston Winery, and Pippin Hill Farm and Vineyards.
Fred Reno interviews the minds behind Common Wealth Crush Company. Ben Jordan, Tim Jordan, and Patt Eagan discuss their beginnings in the wine industry and what led them to open a winemaker studio in downtown Waynesboro, Virginia.
Fred Reno interviews Claude Thibaut, the founder and winemaker of Thibaut-Janisson. They discuss his connections to Champagne and his insights into the Virginia wine-growing industry during the early 2000s, and more.
Fred Reno interviews Chris Pearmund, the owner of Pearmund Cellars. They discuss how he started in the wine industry, his journey to learning about wine and winemaking, and more.
Fred Reno interviews Cory Craighill, of Septenary Winery, and Ashleigh White, of Glen Manor Vineyards. They discuss the beginnings of their careers in the wine industry, in addition to their opinions on the present and future of Virginia wines, while providing a perspective on the industry from the younger generation.
Fred Reno interviews Damien Blanchon, the winemaker and vineyard manager of Afton Mountain Vineyards. They discuss his journey to discovering wine, his unique approach to vineyard management, and more.
This is the final part of Fred Reno’s interviews about Dennis Horton after his passing. Dennis Horton was a leader of Virginia viticulture and the founder of Horton Vineyards. In this episode, Fred Reno interviews Sharon Horton (Dennis’ wife), Shannon Horton (their daughter), and Caitlin Horton (their granddaughter) as they reflect on Dennis and his legacy.
This is the second part of Fred Reno’s interviews with Virginia wine professionals about Dennis Horton after his passing. Dennis Horton was a leader of Virginia viticulture and the founder of Horton Vineyards. In this episode, Fred Reno interviews Jenni McCloud, Luca Paschina, and Lucie Morton on Horton’s legacy.
This is the first part of Fred Reno’s interviews with Virginia wine professionals about Dennis Horton after his passing. Dennis Horton was a leader of Virginia viticulture and the founder of Horton Vineyards. In this episode, Fred Reno interviews Bruce Zoecklein and Mike Heny on Horton’s legacy.
Fred Reno interviews Gabriele Rausse, who the New York Times calls the father of the modern-day Virginia wine industry. Rausse describes the early beginnings of what is a 44-year journey in wine making and propagating plants. He recounts how he came to Virginia to help the Zonin family establish Barboursville Vineyards and make a significant contribution to the growth and quality of Virginia wine production.
Fred Reno interviews Elizabeth & Tony Smith, owners of Afton Mountain Vineyards. They discuss the process of selecting a site to plant, the history of the role of winemaker at Afton Mountain Vineyards, their purchase of the Historic Brand label of The Monticello Wine Company, and more.
In this second and final segment of Fred Reno’s interview with Gabriele, they dig deeper into the reasons why Rausse left Jefferson Vineyard in 1995 and took the position of Director of the Grounds and Gardens at Monticello.
Fred Reno interviews Jake Busching of Jake Busching Wines and Hark Vineyards. They discuss his work for Jefferson Vineyards, his work with Chris Hill and Aaron Hark, his affection for working with Cabernet Franc, and more.
Fred Reno interviews Jason Murray, the owner and winemaker for Arterra Winery. They discuss his approach to growing and making “Clean Wine,” and much more.
Fred Reno interviews Jenni McCloud, owner of Chrysalis Vineyards at the AG District. They discuss the background and history of the Norton grape, which was propagated in Richmond, Virginia in the 1820s. They also discuss her commitment to the land and how the Ag District became an entity recognized by the state.
Fred Reno interviews Jeff White, the winemaker and founder of Glen Manor Vineyards. They discuss his work with Professor Tony Wolf and Jim Law, the importance of elevation for vineyard sites in Virginia, working with his niece, and more.
Fred Reno interviews Jim Law, Founder/Winemaker of Linden Vineyards. Law discusses and reflects on his career as he approaches 40 years of winegrowing.
Fred Reno interviews Jon Wehner of Chatham Vineyards at Church Creek. They discuss his early years working in his family's vineyard, the ways climate change has impacted wine growing since he started in the late 1990s, and more.
Fred Reno interviews Joy Ting of the Winemakers Research Exchange and Joy Ting Wine. They discuss her work with the Winemakers Research Exchange (WRE), share stories of her work within the Virginia wine industry, and offer their opinions about the future of wine growing in Virginia and the role of hybrids.
Fred Reno interviews Luca Paschina, general manager and winemaker for Barboursville Vineyards. They cover his youth in Italy, his professional beginnings in the Napa Valley and Upstate New York, as well as Southern and Northern Italy, and his move to working with Barboursville Vineyards in Virginia, where he has been for the past 30 years.
Fred Reno interviews Kirsty Harmon, the winemaker and general manager of Blenheim Vineyards. They discuss her education in Enology, her work with Patricia Kluge and Gabriele Rausse, as well as Dave Matthews and his involvement with Blenheim Vineyards, and more.
Fred Reno interviews Lee Hartman, the winemaker for Bluestone Vineyard. They discuss what sets the Shenandoah Valley apart as a Virginia wine-growing region, the meaning behind the name Bluestone, and more.
Fred Reno interviews Justin Rose, the winemaker for Rosemont Vineyards. They discuss his beginning experiences with wine making, his successful Vermouth project, his work with sparkling wine, and more.
Fred Reno interviews Kirk Wiles, CEO and Co-Founder of Paradise Springs Winery. They discuss the challenges he faced starting his winery, his experience producing wine both in California and Virginia, and more.
Fred Reno interviews Matthieu Finot, the winemaker for King Family Vineyards. They discuss his experiences making wine around the world, his transition to making wine in Virginia, the Winemakers Research Exchange, and more.
Fred Reno interviews Lucie Morton, world-renowned ampelographer and viticulturalist. They discuss her background and education in winegrowing, her affinity for hybrid grapes, how she discovered a grape disease, and more.
Fred Reno interviews Michael Shaps, the founder and owner of Shaps Wineworks. They discuss his prior work at Jefferson Vineyards, his interest in the wines of Burgundy, his education at the Lycée Viticole de Beaune in France, and the Virginia wine industry.
Fred Reno interviews Nate Walsh, the founder and winegrowers of Walsh Family Wines. They discuss his early experience in the wine industry, his various work around Virginia, and his ideas on the future of winegrowing in Virginia and the impacts he has seen from Climate Change.
Fred Reno interviews Mike Heny, the winemaker for Michael Shaps Wineworks. They discuss the beginnings of his interest in wine, his take on hybrid grapes in Virginia, and more.
Fred Reno interviews Rutger de Vink, the founder of RDV Vineyards, and Josh Grainer, the winemaker at RDV. They discuss De Vink’s experience working with Jim Law, of Linden Vineyards, as well as the background of their bestselling wine and Virginia terroir.
Fred Reno interviews Patrick Duffeler, owner and founder, and Matthew Meyer, winemaker, of Williamsburg Winery. They discuss what drew them to wine, thoughts on Climate Change and its impact on wine growing, the art of tasting wine, and more.
Fred Reno interviews Sharon Horton of Horton Vineyards. They discuss Dennis and Sharon’s journey from starting a small hobby vineyard and how that transformed into a full-time pursuit in winegrowing. They also touch on Norton grapes and how winemaking has become a family endeavor with their daughter.
Fred Reno interviews Tim and Peter Rausse, the sons of Gabriele Rausse of Gabriele Rausse Winery. They discuss various experiences they had growing up on a vineyard, and their journey into joining the family business of wine.
Fred Reno interviews Stephen Barnard, winemaker and vineyard manager for Keswick Vineyards. They discuss his move from South Africa to Virginia, the deep historical roots of some of Keswick’s property, his love of Cabernet Franc, and more.
Fred Reno interviews Professor Tony Wolf, Director of Agricultural Research & Extension Center for Virginia Tech University. They discuss his reasons for pursuing viticulture, his insights into what the future for Virginia winegrowing may look like, and more.
Fred Reno interviews Scott Elliff, the owner and founder of DuCard Vineyards. They discuss supporting philanthropy through the wine industry, sales strategy, creating the greenest Virginia winery, in addition to much more.
Fred Reno interviews Shepard Rouse, Founder/Winemaker of Rockbridge Winery. They discuss his experience in the wine industry, both in California and Virginia.
Oral history interview with Christopher Slobogin, class of 1977, regarding his work as ILPPP’s second mental health law fellow. Slobogin discusses the founding years of the institute, his work with the Western State Hospital and Forensic Psychiatry Clinic in the late 1970s, and the impact of ILPPP on his scholarship and career.
Oral history interview with John Petrila, class of 1976, regarding his work as ILPPP’s first mental health law fellow. Petrila discusses the founding years of the institute and its impact on his career.
Oral history interview with UVA Law professor John T. Monahan regarding his work with the Institute of Law, Psychiatry, and Public Policy. Monahan, a psychologist, was hired to teach at the Law School in 1980 and has worked closely with Richard J. Bonnie and ILPPP since then. He has directed two research networks for the John D. and Catherine T. MacArthur Foundation related to mental health law.
Oral history interview with UVA Law alum (1969) and professor emeritus Richard J. Bonnie in which he recalls the early years of the Institute of Law, Psychiatry, and Public Policy and the budding field of mental health law during the 1970s.
Oral history interview with Paul Appelbaum regarding his work with the Institute of Law, Psychiatry, and Public Policy. Appelbaum founded the Law & Psychiatry program at the University of Massachusetts in 1985 and has worked closely with ILPPP since that time. Appelbaum is now the Elizabeth K. Dollard Professor of Psychiatry, Medicine and Law and director of the Division of Law, Ethics and Psychiatry at Columbia University.
Oral history interview with Janet I. Warren regarding her involvement with the Institute of Law, Psychiatry, and Public Policy starting in 1981. She discusses her work providing training on conducting forensic evaluations for the courts, serving as the UVA liaison to the FBI Behavioral Sciences Unit, and conducting research for the Boy Scouts of America. She is now Professor Emerita of Psychiatry and Neurobehavioral Sciences at UVA.
Oral history interview with W. Lawrence Fitch regarding his work with the Institute of Law, Psychiatry, and Public Policy in the 1980s and 1990s as well as the institute’s impact on the field of mental health law. From 1982-1994, Fitch served as an associate professor at UVA Law and director of the Forensic Evaluation Training and Research Center at the Institute.
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
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
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
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
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
When academic medicine in the U.S. begins to reflect the remarkable diversity of the population it serves, we can potentially start narrowing critical gaps in cultural knowledge, the provision of health care, and the education and advancement of future physicians. Invoking the time-honored art of quilt-making as a metaphor, Dr. Wendi Wills El-Amin will engage the audience at this Medical Center Hour in exploring the urgent issue of minority diversity in academic medicine, including the opportunities that currently exist to craft new patterns and other opportunities we need to create in order to increase minority presence and engagement throughout academic medicine. UVA School of Medicine Associate Dean for Diversity Dr. Greg Townsend will offer a response.
Co-presented with the Office for Diversity, School of Medicine
A John F. Anderson Memorial Lecture
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
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
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
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
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
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
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)
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
Chocolate has been special to human beings for millennia. In our time and culture as in earlier centuries and other cultures, claims abound regarding chocolate's health effects, positive and otherwise. What is it about chocolate—chemically and culturally—that makes it so distinctive in our diets, our emotional lives, our celebrations? Why do we love it so, and what does it do to/for us? In this Medical Center Hour, local chocolatier Tim Gearhart offers insights into chocolate's appeal and effects and gives a glimpse of the craft of artisan chocolate-making.
A John F. Anderson Memorial Lecture
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
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
How might the creative arts, as a symbolic and emotional language, help improve well-being in late life? Anne Basting is an acclaimed practitioner and advocate of using the arts to address issues in aging. In this Medical Center Hour, she explores her own creative research and the most promising new practices for improving the lives of elders and caregivers alike.
The Koppaka Family Foundation Lecture in the Medical Humanities
Co-presented with the Southern Gerontological Society Annual Meeting
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
Early in her own training in psychology a decade ago, Casey Schwartz discovered that contemporary neuroscience and psychoanalysis are entangled in a conflict almost as old as the disciplines themselves. Many neuroscientists, if they think about psychoanalysis at all, view it as outdated, arbitrary, and subjective, while many psychoanalysts decry neuroscience as lacking the true texture of human experience. Yet some are now fighting passionately to bring the two fields together, including Mark Solms, a South African psychoanalyst, neuropsychologist, dream researcher, and towering presence in the effort to grow the hybrid discipline that he himself calls neuropsychoanalysis. Ms. Schwartz has written this story in her new book, In the Mind Fields: Exploring the New Science of Neuropsychoanalysis. In this Medical Center Hour, she tracks and interprets the ongoing struggle to define what we mean by the mind, the brain, and everything in between.
History of the Health Sciences Lecture
Co-presented with History of the Health Sciences Lecture Series and the Department of Psychiatry and Neurobehavioral Sciences
The first global wave of reform in modern medical education occurred early in the 20th century, following the Flexner report. The second wave came in the latter half of that same century, led by innovations in problem-based learning and community orientation. Recently, the Lancet Commission called for a third wave of reform to create transformative system-based medical education that is socially accountable. This may be a fine aspiration, but is it possible? How can we translate new understandings from neuroscience, sociology, and the sciences of learning to meet this aspiration? In doing so, may we also transform research on medical education from eminence-based to evidence-based medical education? How accountable are we prepared to be for the results of our efforts? And to whom?
In his Brodie Medical Education Award Lecture, Dr. Paul Worley draws on evidence from medical schools around the world to explore these critical questions and consider the challenge that social accountability brings to academic medicine's combined research, education, and service mission.
The Brodie Medical Education Award Lecture
Co-presented with the Department of Medicine and the Brodie Medical Education Award Committee, in association with the School of Medicine’s Medical Education Week, 29 February-4 March 2016.
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
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
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.
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
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
Danny Quirk is a young artist specializing in photorealistic watercolors, painting what the camera cannot capture. Much of his work illustrates the intricacies of human anatomy. On canvas, he paints figures in classic poses (sometimes á la Renaissance anatomist Andreas Vesalius) in striking chiaroscuro lighting. But, more dramatically, he also paints on living subjects, representing on the body's surface the anatomical structures that lie beneath. In this Medical Center Hour, Danny Quirk talks about "dissecting" with a paintbrush—and while he's talking, he'll complete an anatomical drawing on a student volunteer.
Co-presented with the History of the Health Sciences Lecture Series
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
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
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
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"
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
In this Medical Center Hour, award-winning journalist Meera Subramanian explores the human and global health implications of India’s ravaged environmental landscape. Her new book, A River Runs Again: India's Natural World in Crisis, investigates five environmental crises by profiling ordinary people and micro-enterprises determined to guide India and its burgeoning population into a healthier future. An organic farmer revives dead land; villagers resuscitate a river run dry; cook-stove designers seek a smokeless fire; biologists bring vultures back from the brink of extinction; and, in one of India’s poorest states, a bold young woman teaches adolescent girls the fundamentals of sexual health. In these individual stories resides hope for a nation and its people and the potential for a sustainable and more prosperous world.
A John F. Anderson Memorial Lecture/Exploring the Global South
Co-presented with the Center for Global Health, Institute for the Humanities and Global Cultures (Global South Initiative), Department of Public Health Sciences, and Virginia Quarterly Review
