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Medicine, Compassion, And Hospital(ity): Snapshots in Italian History

9/12/2017

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By: Taylor Eisenstein

Upon visiting a hospital—a word derived from the term ‘hospitality’—patients are greeted by physicians and hospital staff. Hospital lobbies are often large, open, and welcoming; certain hospitals, like Grady Memorial Hospital in Atlanta, embellish their lobbies with ornate decorations or historical remnants. Behind the scenes, medical students undergo rigorous training so that they can learn to treat and address patients in a proper manner. Individuals today, however, often neglect to consider the origins of hospitals and medicine.
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This past summer, I had the opportunity explore medicine, hospitality, and compassion as I traveled to over 50 sites and more than 47 towns and cities in Italy with the Italian Studies Summer Program, an interdisciplinary venture that focused on bioethics, humanities, medicine, and compassion. This study abroad experience involved faculty from the Emory Center for Ethics and School of Medicine in collaboration with the Italian Studies program. Different hospitals and universities observed on this study abroad provided insight into the history of health and medicine and illuminated the integration of medicine with art. Snapshots of just a few of the places that I visited in Italy are described below. 
Ospedale degli Innocenti
Located in Florence, Italy, the ‘Hospital of the Innocents’ initially served as an orphanage for young children. Parents unable to care for their babies could anonymously leave them in a rotating wheel that would then carry them into building. Sometimes parents would leave half a locket or trinket with the child and keep the other half, as a way to maintain a connection with their loved ones. The image of a baby comfortably swaddled in fabric became a prominent sign for the Innocenti, which inspired the symbol of the American Academy of Pediatrics today. Filippo Brunelleschi designed this building in the 1400s; by constructing certain open spaces that actively filtered in light, he helped facilitate an environment conducive to healing for orphaned children.
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Sculptures of swaddled babies.
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Drawers labeled by child's name containing half a locket.
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Half a locket inside one of the drawers.
Ospedale Santa Maria Nuova
Founded in 1288, the ‘Hospital of Santa Maria Nuova’ is the oldest hospital currently operating in Florence and offers services such as dermatology, radiology, neurology, psychiatry, and more. This hospital also hosts an elaborate piece of architecture called The Cloister of Bones, a temple built in the nineteenth century that acted as a burial site. 
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Exterior of the Hospital of Santa Maria Nuova in Florence.
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The Cloister of Bones.
Santa Maria della Scala
Located in Siena, this hospital—now a museum—once cared for children and the sick. Abandoned babies were provided with wet nurses, and girls were even given dowries. Because it was positioned among common traveling routes, this hospital also provided welcome lodgings for pilgrims, as indicated by the presence of a Pilgrim’s Hall. Frescoes in the hospital provide insight into early medical treatment and the fusion of care and compassion. For instance, Caring for the Sick by Domenico di Bartolo seemingly depicts an extremely ill man being comforted and supported through his illness; it also portrays another man whose injuries are being examined.
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Partial image of 'Caring for the Sick' by Domenico di Bartolo.
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The Pilgrim's Hall.
Teatro Anatomico: The Anatomical Theatre
Universities once employed the use of anatomical theatres in order to perform dissections and teach anatomy to curious observers, including medical students and physicians. The first anatomical theatre was built at the University of Padua—the fifth-oldest currently operating university in the world—in the late 1500s. A small operating table is positioned in the middle of the theatre, on a bottom level; seating capable of serving more than one hundred individuals is elevated and looks down on the table. Demonstrations would sometimes be accompanied by live music. Additionally, the University of Bologna, the world’s oldest surviving university, holds a smaller anatomical theatre that depicts images of prominent historical figures, such as Hippocrates and Galen. 
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The entrance to "Teatro Anatomico" in Bologna.
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Old medical books on display at the University of Bologna.
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Carvings of Galen (left) and Hippocrates (right) at the University of Bologna.
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Wider view of the University of Bologna's anatomical theatre.
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The dissection table at the University of Bologna.
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The anatomical theatre at the University of Padua. Source: Kalibos via Wikimedia Commons
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"When I Walk": A Review

5/13/2015

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By: Safurah Bharwani

To most people, waking up, walking to the bathroom, brushing your teeth, and getting dressed seems like a normal, mundane morning routine. However, to Jason DaSilva, these everyday tasks became increasingly more difficult.

On April 16th, 2015, the Center for Human Health’s film series, Health Screenings, the Disability Studies Initiative and the Center for Ethics screened the documentary, When I Walk. This film focused on the story of filmmaker Jason DaSilva and his journey with multiple sclerosis. Jason was 25 years old, a rising independent filmmaker exploring the world and its magnificence through the lens of his camera, when his life suddenly changed. He had been diagnosed with primary progressive multiple sclerosis. Primary progressive multiple sclerosis, or PPMS, is a disease of the central nervous system, commonly characterized by the progressive slowing and worsening of neurologic functions, such as numbness, weakness, difficulty walking, etc. [1] Jason’s chronicle of his mental state at the time of his diagnosis mimics that of hope in the face of fear and a strong willpower to learn to live in harmony with his MS. He experienced an unfortunate fall on a family vacation at the beach at the early stages of his PPMS, after which he gradually but progressively worsened in terms of physical stability. He mentioned to his mother, during the time after his diagnosis, that he always thought about being sick. His condition had taken over his mind, over his entire life.

Since his childhood, Jason found solace in artistic expression, whether it was through music and performance, sketching and painting, or through photography and film making. He decided to make a documentary based on the candid chronicle of his journey through life since his diagnosis, not only for personal therapeutic purposes, but also to share and enlighten the world around him to be educated about his personal experiences with MS.
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As time progressed, viewers visibly saw the increasing impact of Jason’s condition. He went from walking straight to needing to grab onto a handle for support, then onto using a cane, a walker, a wheelchair, and eventually, a motorized scooter for mobility. As his MS began to progress, he found himself retracting from activities he used to previously engage in, such as going out with friends over the weekends. As his condition became more serious, and as he began to lose mobility over the period of time, PPMS seemed to be taking more and more from Jason. So many things were unusual for Jason: he couldn’t walk down the street without stares, he couldn’t eat without spilling a little food on the table, and even putting on a pair of jeans for him was incredibly taxing. Though he showed us times of triumph and joy with his condition, everything was different. PPMS had changed his life.

The documentary made me feel as if I was walking with Jason throughout different stages of his life and disease. We saw his diagnosis and the progression of his MS, to arrive at the point where he established a relationship with the delightful Alice Cook. Jason and Alice met at an MS support group, which Jason attended after his mother’s recommendation. MS personally affected them both, though in different ways. Alice’s mother has MS. Thus, the showed different experiences with the condition and the way in which it affects everything in a diagnosed person and caregiver’s life. Their relationship grew as Jason’s condition progressed aggressively.  Alice became his primary caretaker, assisting him in all aspects of his life: dressing, bathing, eating, and getting around the city. They built a beautiful life together, celebrating their love and happiness in matrimony, surrounded by family and friends.

Through their new lives together, Jason and Alice became a team. They both understood the reality of the disease, and fought together to overcome any difficulties and barriers they faced. They searched for ways to find more disability accessible taxi services, restaurants, and businesses. But through the day-to-day life, Alice felt tightly bound to Jason because of his PPMS. She found herself sacrificing her own priorities and passions for the sake of taking care of him because she didn’t want to leave him alone – or rather, because she felt that she couldn’t, or shouldn’t, leave him alone. The couple wanted to have a family, but given Jason’s condition, they were unsure if they would be able. After medical consultation, they were thrilled to know that Jason was still viable and that he could be the father to her. Alice got pregnant, but unfortunately had a miscarriage. This was particularly hard for Jason as his mobility impairments and lack of accessibility of the city’s transportation system prevented him from going to the hospital with Alice. He felt stranded and partially to blame, but there was nothing he could do. The couple recovered from this loss, and celebrated the new pregnancy, thus ending the movie on a positive cliffhanger.
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Jason and Alice at their wedding ceremony. Screen shot from film.
This film is an incredible representation of the stages of discovering and coping with acquired disability. Jason DaSilva’s story shed light on many important issues in the realm of disability and human health studies. Jason understandably experienced a great deal of emotional growth and anguish throughout the process of the progression of his condition. Though he didn’t want to burden anyone, he grew dependent on other people for his daily function and survival. This introduced an important contrast between the concepts of autonomy and dependence in regards to disability. [2] Overall, Jason’s story followed the path of sociologist Arthur Frank’s quest narrative, in which he journeyed through the call, road of trials, and the return. According to Frank (1994), the call “consists of recognizing a symptom not just as the sign of a disease but as the beginning of a journey[,] […] accepting the illness as affecting [his] life” (p. 7). [3] Jason’s fall at the beach at the very beginning of his film marked the start of his journey with multiple sclerosis. With the diagnosis of multiple sclerosis as the call of Jason’s quest, he moved to the road of trials, in which he underwent the medical visits, experienced the stigma of disability, and struggled with his condition as he began to become physically weaker. As Frank explains, the road of trials is by no means “minimized” by the acceptance Jason has for his condition, but rather it is “progressively understood […] thus […] gain[ing] meaning” (p. 8). [3] The third and final stage of Jason’s quest narrative is the return, which is characterized by the granting of a “boon,” or rather an “enhanced subjectivity, extending towards others […] and toward life generally” (p. 8). [3] Though Jason continues to live with his condition of PPMS, his return is characterized by his acceptance of his condition, and his willingness to find meaning and make the most out of his art, passions, love, and the rest of his life. [3]

Jason DaSilva’s story truly was unique; it was uplifting, inspiring, and the chronicle of a brave soul, whose vulnerability and pursuit of happiness continue to fuel his willpower to fight multiple sclerosis.

 

1: Primary-progressive MS (PPMS). (n.d.). Retrieved April 23, 2015, from http://www.nationalmssociety.org/What-is-MS/Types-of-MS/Primary-progressive-MS

2: Braswell, H. (2011). Can there be a Disability Studies Theory of" End-of-Life Autonomy?". Disability Studies Quarterly, 31(4).

3: Frank, A. W. (1994). Reclaiming an orphan genre: the first-person narrative of illness. Literature and Medicine, 13(1), 1-21.

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A Visit to the National Center for Civil and Human Rights

4/15/2015

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By: Jennifer Sarrett, Ph.D.

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Article 25 of the United Nations Declaration of Human Rights states:

   (1) Everyone has the right to a standard of living adequate    for the health and well-being of himself and of his family,      including food, clothing, housing and medical care and          necessary social services, and the right to security in the      event of unemployment, sickness, disability, widowhood,      old age or other lack of livelihood in circumstances beyond    his control.

   (2) Motherhood and childhood are entitled to special care      and assistance. All children, whether born in or out of          wedlock, shall enjoy the same social protection.

Although this is the only direct declaration of health as a human right within the declaration, many of the other rights are directly or indirectly related to human health. Enjoying a “right to life, liberty and security of person” (Article 3) is mediated by good health and challenged in poor health. Enjoying your “right to work” (Article 23) and “right to education” (Article 26) is difficult without access to proper nutrition or health care. Being subject to “cruel, inhuman or degrading treatment or punishment” (Article 5) has direct implications on an individual’s health. Political, social, legal, and familial participation and recognition (Articles 10, 11, 13, 14, 16, 17, 18, 19, 20, 21, 24, 27) rely upon the individual to obtain and sustain good health. In other words, health and human rights are deeply connected.

On June 23, 2014, the National Center for Civil and Human Rights opened its doors to the public. The Center is located in Pemberton Place® adjacent to the World of Coca-Cola and the Georgia Aquarium, on land donated by the Coca-Cola Company. This 43,000-square-foot facility host three exhibits and a wall featuring rotating murals that highlight various human rights concerns. Currently, this wall displays a mural by Baltimore street artists, Gaia, based on the hashtag #IfTheyGunnedMeDown, which exposes media portrayals of black victims of violence. Next to the wall, The Voice to the Voiceless exhibit displays selections from The Morehouse College Martin Luther King, Jr. collection while the Rolls Down Like Water exhibit directly upstairs tells the story of the American Civil Rights Movement. This exhibit houses the award-winning interactive lunch counter experience, which aims to provide visitors a simulation of the experience of participating in the lunch counter sit-ins of the Civil Rights Movement. Finally, the third floor houses an interactive exhibit dedicated to The Global Human Rights Movement. This exhibit, titled Spark of Conviction, includes a description and definition of human rights, features profiles of major human rights activists, and describes ways our everyday activities and choices relate to certain human rights abuses.

The Destination HealthEU news team recently visited the museum with the aim of highlighting the explicit and implicit ways in which the human rights issues included in these exhibits relate to issues of human health. In the coming weeks, we will present our findings and interpretations of the ways human rights and human health intersect using our museum experiences as the foundation. We will discuss physiological reactions to participating in civil rights movements , the health-related issues major activists are addressing in the current human rights work, and the ways our daily activities can lead to diminishing the health and human rights of individuals around the world.

We would like to thank David Mandel, the Director of Exhibitions and Design, for meeting with us and guiding us though the museum.

Keep an eye out for these posts and consider making a visit to the National Center for Civil and Human Rights yourself!

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Human Nature, Human Health: An Interview with Dr. Neill

3/24/2015

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By: Hannah Heitz

I walked into Dr. Neill’s office and immediately noticed his collection of rat beanie babies and the abundant variety of books filling the shelves, his desk, and organized in stacks across the floor. We sat down by his desk and he prompted me, “So what do you write for?”

Dr. Neill is famous across campus for his course titled “Drugs and Behavior” which analyzes addiction and how various drugs affect the brain. He passionately discusses how social inequality contributes to chronic stress, increasing the risk of developing addiction to cocaine, cigarettes, and alcohol. As a Human Health student currently taking this course, I thought he would be perfect to profile for Destination HealthEU.

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He grew up during the Cold War—a time full of anxiety. What about human nature made such self-destructive behavior possible? How should we live? How are we built? These questions were not answered through his studies of anthropology or psychology. Perhaps this was because, at the time, the field of anthropology said there is no universal human nature and psychology similarly, through the Behaviorist outlook, denied human nature. During Winter Term at his college, a month devoted to research, he designed his own self-taught course on neuroanatomy. He had a passion for a field that was only just beginning: neuroscience.

Dr. Neill took the MCAT and, to this day, does not know his score. He ultimately decided against attending medical school. His inquisitive academic nature had dreams of asking questions bigger and far different than those that comprise the typical medical training.

He soon began learning behavioral neuroscience in graduate school at the University of Chicago. Upon graduation, he came straight to Emory (1971), where he has conducted research and taught many graduate and undergraduate courses in the areas of behavioral neuroscience and psychopharmacology. He now focuses on the intersection of neuroscience, philosophy, and religion. He animatedly pointed out the sections of his library devoted to each subject; each area had its own shelf and more.

In his Drugs and Behavior course he discusses the effects of chronic stress, I asked what this could mean for Emory students who seem to live in a constant state of anxiety, whether over a test, an internship, or a personal issue. He told me that most students are here in part because of that exact anxiety. It helped us all make it to Emory. In high school, we were likely anxious about our grades, activities, and choices, which helped us make it through the competitive admissions process. Yet, at some point, all of this anxiety has the potential to backfire. Dr. Neill questions what kind of society can have individuals both achieve their goals and not live in a state of constant stress. He paused, and followed up describing the incredible resilience he sees in Emory students as well. They may struggle, as they often do in his Drugs and Behavior course, but they often work hard and bounce back.  

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Dr. Neill’s passion for understanding human nature is an all-encompassing field that delves into the greater themes that govern our life. His drive to pursue his intellectual curiosity is a testament to following your dreams. As he told me, his profession fits his interests; he gets to study the biological bases of human nature and get paid to tell students about it.

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"Turning Discovery into Health" at Emory

1/26/2015

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By: Jill Welkley, PhD

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A series of six videos that will be featured here on Destination HealthEU in the coming weeks is comprised of student work from a new undergraduate course in Human Health (405R) offered last Fall semester. The class, titled "Translational Projects in Human Health", was taught by Dr. Jill Welkley, an Associate Professor in the Center for the Study of Human Health. The course fulfills one of two translational requirement courses within the new undergraduate BA in Human Health, a new program within  Emory College of Arts and Science directed by Dr.Michelle Lampl.. The Center also houses a Global Health, Culture, and Society minor and Predictive Health minor at the undergraduate level.

The final project for HLTH 405R was to produce a 2-3 minute video that showcased the work of an Emory researcher of their choice. These researchers aim to educate, engage, and empower a targeted population in a human health research area. These videos aimed to promote the NIH slogan- “Turning Discovery into Health” – Translating Laboratory-basic Science discoveries into better treatments, therapies, and interventions to improve the nation’s health. Our specific target area was "Pillars of Health". Students were asked to research and submit topics that interested them  and present their ideas to the class. The class chose six of the project proposals and students worked in pairs on their topic area. Students conducted interviews with Emory researchers in their field, collecting 60 minutes or more of film, which they then edited to the required 2-3 minute length, adding b-roll shots, graphics and music to enhance engagement. Keep an eye out for these incredible videos!

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Emory study abroad class to visit ethnobotanical field research site in southern Italy

6/11/2013

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On June 15, 2013, Emory students enrolled in the interdisciplinary program in Italian and Medical Humanities will visit the village of Ginestra to learn about Arbëreshë history and medical traditions of the region. Ginestra is an Arbëreshë community founded in the second half of the fifteenth century. Located in the northern area of ​​Basilicata in the Vulture area, it is home to about 750 inhabitants in the municipality.

The visiting students and professors will be guests of Dr. Cassandra Quave of the Emory Center for the Study of Human Health, the local administration of the municipality of Ginestra, the local language institute and cultural organization. Students will begin their day with a visit to a local vineyard and the Ethnobotanical Garden of Ginestra, where they will learn about local wild food and medicinal plants. After the lesson on local plants, students will be treated to a presentation on Arbëreshë history and experience a tasting of traditional foods. For the full announcement on this event, please visit the following news link (in Italian).

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Emory Global Health Institute photography contest

5/22/2013

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The Emory Global Health Institute sponsors a photography contest each fall. The purpose of this contest is to foster cultural sensitivity by encouraging Emory students conducting global health projects to examine the culture and people with whom they are working.
Emory students may submit photographs that they personally take during a global health field experience in a low- or middle-income country. These global health field experiences can be Emory programs or non-Emory projects (e.g., Peace Corps experiences, study abroad programs, personal travel, etc.). All photographs submitted must be taken by the student submitting them.
 
Five winning photographs are announced each fall and each winning photographer receives a $500 prize.  The deadline for the 2013 contest is Monday, September 23, 2013. For more information about the contest, check out the EGHI website:
 
http://www.globalhealth.emory.edu/fundingOpportunities/Photog.php
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Photo: Brian Chu, RSPH Alumnus and 2008 Photography Contest Winner
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Center for the Study of Human Health sponsors the 2013 Annual AAHM conference this weekend

5/15/2013

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This weekend the American Association for the History of Medicine (AAHM) is holding its 86th annual meeting in Atlanta, Georgia.  The Center for the Study of Human Health is proud to be a sponsor, and encourages students to register and attend the conference from May 16th to May 19th.  More details are available on our Events page.  Registration is available through the School of Medicine.
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Nadine Kaslow, PhD blends psychology and dance

5/13/2013

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Many of our graduating seniors can likely relate to the difficulties of choosing a career path, let along having to make difficult decisions between pursuing a research passion versus one of a more personal nature. This choice was once faced by the new president-elect of the American Psychological Association, Nadine Kaslow, an Emory professor and chief psychologist of Grady Health System who is also the psychologist for the Atlanta Ballet. Dr. Kaslow has been able to incorporate her two passions through these joint appointments. To learn more about the motivations underlying her career and lifestyle paths, please visit http://www.cnn.com/2013/05/10/health/lifeswork-nadine-kaslow/.
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Emory Mosaic Tells the History of Medicine

1/30/2012

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Emory students should visit the Woodruff Health Sciences Center Administration Building during business hours to get a glimpse at our campus’ massive mosaic depicting the history of medicine.  Stretching 66 feet long and three stories tall, the mosaic uses approximately 2.5 million small tiles to document more than 30 historical events and key medical figures.  The mosaic was commissioned in part by John Skandalakis (1920-2009), directer of the Centers for Surgical Anatomy and Technique, and brought to life by Sirio Tonelli in 1996.
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