- 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
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- Date:
- 2013-03-20
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- We hear almost daily about the rapidly increasing rate of type 2 diabetes in the U.S. population. Many pronouncements are dire, proclaiming an "epidemic," and most make it sound as though this problem is relatively new-just three or four decades old. Yet almost 100 years ago a small group of U.S. health care professionals was already warning that diabetes was "a public health problem," fated to become worse if nothing was done soon. But what did they mean by this? Why had they grown concerned? And what measures did they recommend to try and reverse the upward trend in diabetes rates? In this Medical Center Hour, historian Arleen Tuchman asks what we can learn from history that might help us understand better how we are framing the diabetes "crisis" today, and why. How do cultural assumptions about diabetes, and about the particular populations believed to be most at risk, influence not only our understanding of this disease but also our efforts to gain control over it? Co-presented with the History of the Health Sciences Lecture Series
- Date:
- 2014-02-26
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- The Diagnostic and statistical manual of mental disorders (DSM) is perhaps the most contested document in American medicine, vital for the organization and funding of psychiatric research and mental health care, yet perennially criticized both from within and behond the mental health community. Heated debate accompanied the 2013 publication of the manual's fifth edition, DSM-5. Critics charged that the new edition masks political interests (e.g. interests of psychiatrists and pharmaceutical companies) under the guise of science at patients' expense. DSM-5 defenders championed the inclusiveness and transparency of the review process and evidence-base behind the manual's diagnostic decisions. In this Medical center hour, psychiatrist and theologian Warren Kinghorn argues for a mediating alternative: that the DSM may be best understood as neither an apolitical "encyclopedia" of psychopathology nor a political cloak for psychatric power, but rather as a working document of a living moral tradition. In this case the tradition-constituted discourse allows for appreciation of the DSM as a useful scientific document that reflects the moral assumptions and convictions of the communities that created and continue to sustain it. Co-presented with the History of the Health Sciences Lecture Series
- 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:
- 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
- Date:
- 2016-02-17
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Our bodies are malleable, changing with age and the demands we place on them. And throughout our life, how we stand—our posture—defines us as healthy or ill, able or disabled, beautiful or ugly, even human or not human. The history of posture is also the history of our reading of human anatomy. From the ancients to the moderns, how the body’s anatomy is understood has shaped understandings of what is human (did Neanderthal Man “stand up straight” or slouch?), what is beautiful (“Posture Queen” competitions in 20th century America), what is patriotic (no slouching in ranks!). What we ascribe to upright posture is very much being the perfect human, today and projected into the past. In this Medical Center Hour, distinguished scholar Sander Gilman reflects on how our understanding of posture figures in the history of anatomy and how the history of anatomy has helped craft our understanding of posture. What do shifting cultural perspectives on bodily uprightness tell us about the claims society makes with respect to who we are and what we are able to do? Co-presented with the History of the Health Sciences Lecture Series, Claude Moore Health Sciences Library; and the Institute for Practical Ethics and Public Life. This program is also offered in conjunction with UVA's second biennial disability studies symposium, "Disability Across the Disciplines," 19 February 2016.
- 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:
- 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:
- 2012-11-14
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
- Date:
- 2012-11-07
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- 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
711. 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:
- 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:
- 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:
- 2015-01-21
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Andreas Vesalius, long hailed as "the father of modern anatomy," is slipping into oblivion. The likes of Gray's Anatomy (the book), Netter's Atlas, plasticized dissected bodies, and online visible human specimens having eclipsed his splendidly illustrated book, On the Fabric of the Human Body (1543), as our definitive anatomy text. Vesalius's recent 500th birthday anniversary gives us a chance not only to celebrate this Renaissance genius, but also to consider how his accomplishments in the study of human anatomy helped medicine to become "modern." Co-presented with the History of the Health Sciences Lecture Series
- Date:
- 2013-04-03
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Some physicians are born to write, while others have writing thrust upon them. As one of the latter, 2013 Moore Lecturer Margaret Mohrmann discusses what she has learned from writing about doctoring. The act of articulating her experiences as a pediatrician and teacher has shown her, over time, much more about her encounters with patients, and about herself, than she could see at the time those events occurred - or even at the time she wrote about them. Rereading one's own stories and having others read (and co-construct) them can expose the "ghost" in the story - "the story's silent twin," as British novelist Jeanette Winterson puts it. What couldn't be said, or wasn't noticed, or was forgotten often gets written in anyway, quietly, between the lines and within word choices and narrative structures. The process of discovering what went unseen before cultivates in both writer and reader the practice of paying close, compassionate attention to what's happening now, an essential ingredient of good doctoring. The Moore Lecture
- 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:
- 2014-03-05
- 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:
- 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:
- 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:
- 2016-03-16
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Theresa Brown became a nurse-who-writes quite accidentally: she had a bad experience at work, wrote it down, and sent what she'd written to the New York Times. To her surprise, the newspaper published it, to great acclaim. From that column came the contract for Ms. Brown's first book, Critical Care, and she also began writing regularly for the Times, proud to have this chance to give voice to the often under-recognized nursing profession. Only lately, though, while writing her second book, The Shift, did Ms. Brown realize not just how much her nursing gives shape to her writing, but also how her writing influences her nursing. There's much to mull over in health care and usually not much time to do that. Writing forces Ms. Brown to reflect. She learns both positives and negatives about her nursing work in the process of putting that work into words. In this Medical Center Hour, Ms. Brown talks about how writing, which she loves, makes her a better nurse. The Catherine Strader McGehee Memorial Lecture of the School of Nursing Co-presented with the School of Nursing, the Virginia Festival of the Book, and Hospital Drive
- 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:
- 1986
- Main contributors:
- Conklin, Gary.
- Summary:
- Documentary revealing the personality of composer, writer Paul Bowles, American expatriate living in Morocco.
