THE VFA PIONEER HISTORIES PROJECT
Adriane Fugh-Berman, M.D.
“It doesn’t take that many people to make a change, whether it’s a good change or a bad change. So it’s really important for people to be activists.”
Interviewed by Judy Waxman, Oral Historian, October 2023
AFB: Hi. I’m Adriane Fugh-Berman, and I was born in 1958 in Washington DC.
JW: Great. Well, tell us a little about your childhood.
AFB: I’m the child of activists. My parents were antiwar activists involved in Vietnam War protests. My brother, who was almost eleven years older than I was, was head of Students for a Democratic Society (SDS) at Rutgers. So, I was an activist from being a kid. I joked that I learned to walk in demonstrations. I brought pictures of napalmed children to show and tell.
I’m half Chinese and half Polish Russian Jewish. My mother’s family is from Beijing, and she came to the U.S. by herself at age 20 to study at Fordham. Her father, my grandfather, was the aide-de-camp to John Leighton Stuart, who was the last American ambassador to China before the Communists took over. I think my grandfather had the first passport out of Communist China. When John Leighton Stuart was thrown out of China, he came to the U.S. with my grandfather. My father’s family is from Bialystok, which was sometimes Poland, sometimes Russia. And so, my father was born in Patterson, New Jersey, of immigrant parents.
JW: Tell us when you first were aware of women’s issues and the women’s movement.
AFB: Well, I think I was always a feminist, with my mother and my grandmother and my aunts as models. All of the women in my family were very strong and quite fearless. I think I’m the most cowardly of the women in my family. I’m not considered that by friends and colleagues, but I am nothing compared to the other women in my family. My Chinese grandfather came from aristocracy, my grandmother’s family was more of peasant extraction; but she took men for vasectomies in her rural Chinese village. My mother was a strong peace activist, and in some ways, a women’s activist as well. She believed very strongly in the right to abortion. She helped some women get abortions before it was legal.
My father died when I was a child, when I was nine, and my mother had to go to work. She went to work in a Chinese restaurant and then in 1971, she opened her own restaurant, which was the first northern Chinese restaurant in Washington D.C. – The Court of the Mandarins. It was the first fancy Chinese restaurant in D.C. I think my mother was the second woman restauranteur in D.C. to run a fancy restaurant. It was very difficult being a minority woman restauranteur in 1971, and I remember that the suppliers used to try and cheat her. She would weigh every shipment herself and if a shipment of produce was a pound underweight, she would send the whole thing back and people really learned not to try and cheat her.
It was also a time when women couldn’t get credit easily and you had to have your husband sign something. I remember at the time, her trying to get credit and sort of yelling into a phone, “My husband is dead. My husband is dead.” And just the difficulties that a woman business owner had in that time was a lot. But she was a successful restauranteur. When Nixon was planning to go to China, we delivered food to the White House. We were tasked with delivering different Chinese dishes to the White House so that he could learn about Chinese food before his trip to China.
JW: So, when did you actually learn about what I’ll call the second wave of feminism?
AFB: I was always very interested in abortion rights and when I was a teenager, I volunteered at Planned Parenthood in the teen clinic there. And then when I was in college, I created a work study position at Preterm Clinic which was an abortion clinic in Washington, D.C., really a model abortion clinic. That’s also where I worked full time after college. At the time, there were a lot of Salvadoran refugees in Washington D.C. and sometimes, not just Salvadorans, but low socioeconomic status women who would be a little further along in their pregnancy than the clinic did abortions.
We did abortions up to twelve weeks, and some of the physicians there would do abortions in their office up to 14 weeks. So, if somebody was a little further along, I would be in the position of begging one of the doctors to please do an abortion for the same price in their office and I would come to help because the abortion counselors assisted at the procedures. At some point, I decided that it would be easier to go to medical school and become a doctor and do abortions. It was not a very well thought out thing at the time.
Somewhere around there, I think around 1981, I joined the collective of off our backs, which really was very much an education in feminism. off our backs was a radical feminist news journal that published every month from 1970 to 2008. I think I started there in 1981 and I was with them for about seven years or so. I mean, at some point I went to medical school. I published a series of articles about how horrible it was to be an older student (I was 27 when I went to medical school, which is considered ancient) and how difficult it was to be a feminist in medical school. I guess I was still on the collective at that point, and I think I probably stopped when I started residency in the Bronx.
JW: Did you write articles for the newsletter?
AFB: Oh, yes, every month.
JW: What did you write? Do you remember any?
AFB: I wrote a lot on women’s health issues. My interest in Right to Life really got me involved with both the off our backs collective in some ways, but also with the National Women’s Health Network, which I was with for a long time. I remember, probably for off our backs, I was covering a Right to Life convention. I used to go to Right to Life conventions and cover them. I remember one that took place in Cherry Hill, New Jersey. I don’t remember what the year was, and after covering the conference, I came out and joined a protest against Right to Life outside of the conference and then hitched a ride back on the National Women’s Health Network bus. That’s how I got to meet Belita Cowan, who is one of the founders of the National Women’s Health Network. I think she’s the one who encouraged me to run for the board, and I did that.
But getting back to off our backs, I wrote a lot about Right to Life. I wrote about menstrual extraction, I wrote about infant formula, I was at off our backs when AIDS started, we did a lot of writing about that. So, different women’s health issues. It was really lessons in feminist journalism, but also in working as part of a collective. off our backs was a traditional collective, meaning all decisions had to be unanimous.
JW: Okay, that’s hard. I know.
AFB: Yes. But it was such an amazing group of women. It had a full-time manager who ran the office and was there all the time. Most of the time that I was there, that was Tracie Dejanikus. The collective would get together on layout weekend every month. So, from Friday to Sunday, a very intense weekend, where some of us were still finishing up articles. We would be laying out other people’s articles and this was way before computers. So, we would be letter-pressing out headlines one letter at a time, and rolling hot wax on the back of cut-out columns of text, and putting them on these large boards that we would then lug to the printer. We were sometimes up all night, especially on Sunday night, but we had amazing conversations and did amazing work. I’m still close to a number of the women that I was on the collective with.
JW: I want to go back to ask you what it was like to be a spy when you would go to these Right to Life conferences.
AFB: Yes, it was very interesting. The thing I was most interested in was the misinformation that was being supplied to people. I mean, there were many wonderful, good people who went to these conferences, some of whom I would have a drink with and talk to them about these issues. I would go to sessions where there would be a physician who would tell them that women were being lied to about abortion. That abortion was very dangerous. And they would flash pictures of New England Journal of Medicine articles, and scientific medical articles to back up their claims that abortion was extremely dangerous. And in fact, those were real medical journal articles, they were just articles that were from before abortion was legal. So, of course abortion was extremely dangerous before it was legal.
These physicians (who were terrible), these physicians also would tell the audience that rape did not result in pregnancy, that if a woman were truly raped, that her fallopian tubes would spit out the rapist sperm. And again, there would be a slide with a reference to a medical journal article. And, “See, these are 200 women who came into the emergency room who had been raped. None of them became pregnant.” Now, that was absolutely true, except that all of those women had received the morning after pill. So, of course they didn’t get pregnant.
JW: Because they used contraception.
AFB: It was terrible. I thought that these healthcare professionals were misinforming people. They had horrible visions of what an abortion clinic was like. It was difficult for me sometimes not to break my spy role and just explain things to the audience, because they thought that abortions could be done up until birth and – just a lot of misinformation. So, I’ve always been interested in that aspect. It’s one thing for people to be opposed to abortion for religious or spiritual or whatever reasons, but they shouldn’t be misinformed about it.
I graduated med school in 1988, and then I did a family medicine internship in the residency program in social medicine at Montefiore Hospital in the Bronx. I was trying to figure out how long I was on the board of the National Women’s Health Network, and I’m a little unclear about this. I know I was on the board in the 1980s, and I was on the executive board from 1994 to 2002. I was chair of the organization for three years during that time, from 1996 to 1999.
And then, even after I left the board, I wrote a column for them called, Prescription for Change that ran in every newsletter for many years, up until a few years ago. The last ten years or so I was doing it with Charlea Massion, who’s a family medicine physician in Santa Cruz, California, who started the American College of Women’s Health Physicians. We were doing a column together for many years, and before that I was doing it myself.
JW: Do you have a memorable experience from those years with the National Women’s Health Network?
AFB: It was so much fun and we accomplished so much. Nowadays I do a lot of work against consumer advocacy groups, which is very strange from somebody who came out of the consumer advocacy movement. But in the old days, consumer advocacy groups were not industry funded, and they really represented their constituencies and they did a lot of good. What was so wonderful about the women’s health movement is that there were so many women who learned about women’s health, whether or not they were actually trained as health providers, and were able to just go toe to toe with doctors and researchers and legislators and regulators, about the evidence, and about what women wanted and what women needed.
Nowadays, most consumer advocacy groups – there’s more than 7000 consumer advocacy groups in the U.S. and there are fewer than 20 of them that we can identify that are not industry funded. Nowadays, advocacy groups are out there saying all manner of bad drugs should be funded. Ineffective drugs, dangerous drugs, extremely expensive, ineffective, dangerous drugs. It’s all about access to questionable therapies now, as opposed to actually having a very critical perspective on drugs and other therapeutics.
I think the most important work that the National Women’s Health Network did was our FDA work. We were at a lot of FDA advisory committee meetings. We worked a lot on the FDA to make sure that drugs and devices were safe. And not just the FDA. We did a lot of work, for example, on menopausal hormone therapy. On the medicalization of being a woman, the medicalization of pregnancy, of menarche, of menopause. And we were out there saying that menopausal hormone therapy was dangerous and untested many years before other people. And it was really the advocacy of the National Women’s Health Network, along with some other groups that got the Women’s Health Initiative funded.
The Women’s Health Initiative was a government funded, long-term trial of the most popular menopausal hormone therapy, that proved that the risks outweighed the benefits. That menopausal hormone therapy caused breast cancer, stroke, increased the risk of cardiovascular disease, gallbladder disease, dementia, ovarian cancer, deaths from lung cancer, et cetera. And it’s really horrifying to see that menopausal hormone therapy is starting to be promoted again. Menopause is being medicalized again. There are articles about how women have suffered from menopause. There’s such a stigma that workplaces have to make accommodations for menopausal women, and things are going in a very dangerous direction. There is definitely promotion of menopausal hormone therapy coming back. A lot of trashing of the Women’s Health Initiative, which was a definitive trial. I didn’t think I would see this day, but I didn’t think we’d live in a post Roe v. Wade world either.
JW: I did not know that it was being promoted again. I’m very sorry to hear that.
AFB: Yes. And even after the Women’s Health Initiative, it was thought that women who went through menopause early, would have to be on hormones.
JW: Were you ever part of any of the testimony? I know there was lots of testimony in Congress.
AFB: Yes. I did a lot of testimony to the FDA and some to Congress on a variety of issues. I think we had a lot of successes; a lot of failures too, as well. But I feel like you always make progress even when you fail in something specific. One of the triumphs that the network had was we did some work against this terbutaline pump. There was a company that was promoting an at home infusion pump with medication called terbutaline that was supposed to prevent preterm labor, or treat preterm labor, and the medication was not approved for this use.
It was being used off-label, but the company was promoting the use of the pump, which we argued was actually promoting the use of the medication, because the medication was the only thing that could be used with that pump for subcutaneous infusion. And this medication, terbutaline, was the only one that could be subcutaneously administered. So we went to the FDA, we got the label changed, because this drug was risky. It had some neurodevelopmental effects, at least in animal studies, and the company ended up suing the National Women’s Health Network. It was a “SLAPP” suit (Strategic Litigation Against Public Participation), and I think that the ACLU got involved.
Eventually the company dropped the suit after the FDA came out and said, “This is a dangerous medication and should not be used for preterm labor at all.” So, we feel that we informed a lot of women, a lot of legislators, a lot of regulators, about the dangers of that drug, and how wonderful for a women’s health organization that had really a minority of healthcare providers. These were very well-educated and self-educated women’s health activists who could talk statistics and talk medicine with anyone.
I completed a family medicine internship at Montefiore in the Bronx, and then I left to come back to D.C. and take care of my ill mother. I ended up becoming medical director of a couple of alternative medicine clinics in D.C. When the Office of Alternative Medicine was inflicted by Congress onto the NIH, I went and worked there, and then later went back to contraception, working in the NIH – National Institute of Child Health and Human Development, in their contraceptive development branch.
JW: What are you currently involved in now?
AFB: I’m at Georgetown University Medical Center. I’m a professor in the department of pharmacology and physiology and also family medicine. And I co-direct a master’s program in health and the public interest, which is our version of a public health program. I also run a project called PharmedOut that does research and education on how the pharmaceutical and medical device industry manipulate the prescribing habits of physicians.
JW: Interesting. So, not the public, but the physicians, in terms of what they try to sell them.
AFB: Yes, because they’re the ones with the prescription pads, they’re the ones doing the surgeries, doing the procedures. We do things for consumers as well, but I learned early on that if you publish articles in the medical literature, they get picked up by reporters and then get disseminated to a lot of different outlets and that’s actually more efficient than just writing for consumers myself. We have some materials aimed towards consumers, but mainly are focusing on healthcare providers. We’re well known among pharmaceutical companies, I’m sure.
Still fighting menopausal hormone therapy. We’re fighting overuse of opioids in the U.S. and elsewhere. We’re fighting the overuse of Alzheimer’s drugs, the overuse of weight loss drugs. We reverse engineer marketing messages from continuing medical education modules and medical publications. We do continuing medical education activities ourselves for physicians. We have a podcast called Pharmanipulation; available on Spotify and Apple and other venues. And we have a monthly newsletter with lots of resources on our site. We do a lot of teaching, and we also publish studies and commentaries in the medical literature and also some for consumers as well.
JW: How would you say your parents’ activism and your early work at Planned Parenthood and Preterm, how did that affect your whole career?
AFB: It’s made me very woman focused in terms of my career and in terms of the topics that I’ve studied. I hope I’m at least half as fearless as my female relatives, as the women in my family. I was raised to always do the right thing and to speak up, even if you’re a minority of one. My mother used to say, “Even if you’re a minority of one, you have to speak up.” That’s caused a lot of trouble in my life, but hopefully it’s good trouble. It’s been really important to me to be able to have interns and staff and students, to be able to train them some, in activism and advocacy. I teach a health advocacy class within the Health and the Public Interest Master’s program, which is really fun. The students have to monitor advocacy groups, and they have to go to advocacy events, and they also have to develop advocacy projects themselves. And that’s been really fun. We need to teach the next generation.
JW: Well, is there any other story you’re dying to tell us? Any other experience we don’t want to leave unsaid?
AFB: There are so many battles that we’ve fought 20 or 30 or 50 years ago that I can’t believe that we have to fight again. Abortion rights, medicalization of women’s health, and for that matter, is democracy in the U.S. at risk? I think it’s really important for people to understand that it doesn’t take that many people to make a change, whether it’s a good change or a bad change, and that it’s really important for people to be activists. And even when we lose a battle, we’re still bearing witness. We’re still educating people. We’re still inspiring people. We’re still keeping corporations in check and keeping the too powerful in check. So, that’s what I want to say.
JW: Fabulous.