Pharmed Out: an Interview With Adriane Fugh-Berman (Part 2)

Adriane Fugh-Berman

Last week I posted the first half of my interview with Dr. Adriane Fugh-Berman, the director of the Pharmed Out project at Georgetown University Medical Center, which will be holding its 3rd annual conference on June 14-15.  At the end of Part 1, we were discussing the need for informed consent in medical school when attending physicians remove the souls of medical students.  We’ll pick up the conversation from there.

Can you think of any particularly bad moments that seem emblematic to you? 

The interns discussing how we envied patients because they were lying in bed and eating and watching TV.  It’s terrible looking back on how distorted our thinking was. One of my internship mates ended up in a mental institution; another intern attempted suicide. Standing in a supply cabinet looking for a kit to cath someone who hadn’t peed in 18 hours and realizing, “Hey, I haven’t peed in 18 hours either.” On a psych rotation, handing out an account of a patient permanently damaged by electroconvulsive treatment to fellow students and having them hand it back, saying, “I don’t want to hear the other side if it involves more reading.”  Being criticized for putting my arm around a pregnant teen on the way to the exam room.  Realizing that preference in IV fluids or antibiotics varied by medical specialty as opposed to patient or disease characteristics. The utter exhaustion — falling asleep on a bus to my clinic for four hours, as the bus crisscrossed the Bronx.  The guy I lived with didn’t make it home one night because he fell asleep on a dumpster at a subway station.

What about your writing?  When did that start, and how?

I always wrote.  I come from a family of writers and activists. Words were important. My father was a professor working on his fourth book on American government when he died at age 39.  My mother wrote as well — a column for a small newspaper, letters to the editor.  She would have written more had she not been left widowed and penniless with a nine-year-old and a 19-year-old. She never finished a cookbook she started, but my brother, a chef, later wrote one. I was made to write letters as a child, and my family wrote letters to each other.  I remember coming home once to an eight page screed from my mother unfurling from a kitchen cabinet.

Anyway, my mother went into the restaurant business, which she ran like a social-service agency. She hired a busboy too damaged to speak, poor single mothers, a prostitute from Chinatown. She brought in chefs from China. Our restaurant launched many others in DC. She was so generous to everyone. We never had money, but we had lots of fun and ate like kings. Food, in my family, was the most important thing. My grandmother believed you should be able to recreate any dish you taste. Not that she deigned to make much non-Chinese food. She did make a great apple pie, from sour, quarter-size apples from a tree in her backyard. I didn’t realize that she had learned to make apple pie in some YWCA American acculturation course she took after coming to the U.S.. As a child I thought apple pie was a Chinese dish. The day my grandmother made a bad dish was the day we knew she was dying.

How have you managed to keep Pharmed Out going?

Those of us who started the project came out of nonprofit groups so we knew how to work crazy hours, convince volunteers to work harder for free than they ever worked for pay, and stretch a penny until it screams.  We have an incredibly smart, savvy, responsive, creative team.

Our strength has always been the industry insiders who have provided us invaluable information on marketing practice, and the utter dedication of the doctors, scientists, students, artists and all the individual donors — who have kept the project going despite our having no external funding support since 2008. Every single person whom I paid off the initial grant continued to volunteer for the project after the money ran out. Our Web master supported the site for years; every academic stayed on. Even our work-study student continued to work for free after our funds ran out. Our fabulous anonymous team is what makes this project great. Because so many team members — not just industry — must remain anonymous, we made a decision not to name those team members who could be named. Our staff has been phenomenal. Alicia Bell, now a med student at the Medical College of Virginia, was the founding staff-person who became an amazing colleague over our first four years; without her we would not have achieved the impact we did.  Beth Johnson and Nicole Dubowitz have also been great.  But every one of our projects is a team effort.  As director, I get way too much credit.  I have a brilliant, efficient team that reminds me often of one of my mother’s favorite quotes: “The difficult with ease, the impossible with time.”

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