QQ: Tell me a little bit about yourself, where you’re from, that sort of thing.
CA: Well, I’m Courtney Abrams, and the most defining thing about me right now is that I am a third-year medical school student at MUSC. I grew up in Charleston, we moved here when I was three. I grew up in a really politically active household and from a really early age had instilled in me this really passionate fighting sense of social justice. I grew up canvassing with my Mom for the Mayor’s Council for Affordable Housing, and watching political debates on TV with her trying to explain it to me. That really defined a lot of my childhood, which was great, and both of my parents were so big on social outreach, so we would do Families Helping Families at Christmas and we would go serve at the Crisis Ministries soup kitchen. That was part of my childhood that I don’t think I valued until I got a little older. I went to college at the State University of New York at Geneseo near Rochester, New York, and I studied Political Science and did my thesis on the structure and sustainability of the Canadian single payer health care system, so I got really involved in health policy when I was in college, then did some graduate work at the University of Massachusetts, then dabbled in law school very briefly.
QQ: So how did you become involved in the LGBTQ community?
CA: Well I kind of grew up with it in a way. I have and had a lot of family members who are gay and lesbian, so technically my involvement started when I was three and we went to visit my aunt in San Francisco, and she was marching with her lesbian conga drum and maraca group, Sista Boom, so I marched in the San Francisco Pride parade with her at the age of three. My parents were very conscious of making it—it wasn’t even different it just was. Some aunts and uncles were married to each other, some aunts were with other women, some uncles were with men, it wasn’t even different, it was just part of our family dynamic. My formal involvement probably started in college, with the Women’s Action Coalition.
QQ: When did you come out?
CA: Oh God, I came out really late for some reason, and I still don’t know why, because I had no fear of retribution. There was no question in my mind that it wouldn’t change a thing about the way my family looked at me. Growing up, everyone always assumed that I was gay, and I never understood why, and so I think just to be contrary I was very determined that I was not going to be. Looking back I could kick myself, hindsight is 20/20 and all that. I came out to my parents probably about three or four years ago, I actually don’t really remember. It was a while after I first came out to myself and started exploring dating women and things like that; I think it was just something I wanted to have well researched. I wanted to be able to say, “This is something I have realized, and it’s something I realized a while ago and here’s how I can back it up.” I think because I come from a family of attorneys, that’s how we process things, I know that sounds really weird…
QQ: No, I understand, both of my parents are lawyers, too.
CA: So you get it, you have to have the background before you stake your claim.
QQ: Yeah, you have to be ready to fight to the doom…
CA: Yeah, and even though I knew they wouldn’t care, I knew that the first question would be, “Well that’s wonderful, have you been dating somebody?” And I wanted to be like, “Yes, I’ve dated this person and I’ve met this person and done this and so clearly, I am, in fact, a lesbian.”
QQ: That’s hilarious.
CA: And I have to tell this story cause I love it. When I came out to my Mom, we were walking the dogs, and I told her that I’d been dating someone and that someone was a girl, and she kind of paused and she said, “So, what you’re saying is, you kissed a girl and you liked it.” I was like “Mom! Come on!” And she goes, “Was it the taste of her cherry chap stick?” And then I told my Dad. He was watching the football game or some sporting thing on TV, and I was like Dad can I talk to you for a second, and he didn’t really look away form the TV, but he was like, “Yeah, what’s up?” And I said “I’m dating someone and that someone is a girl,” and he goes “Okay.” I was like, “Do you have anything to say about that?” And he was like, “Well, no republicans.” That was it. It was probably the easiest coming out in the history of gayness. I couldn’t ask for a more supportive family.
QQ: What are your future plans as far as the medical profession goes? Do you plan on melding your career with activism?
CA: Absolutely. I don’t think I could have a career that didn’t have a big foot in social justice. I have another year of rotations to do to figure out what I want, but I really like family medicine. I also really like emergency medicine, and I just did a child and adolescent psychiatry rotation that I loved, so I’m kind of on the fence. I’ll probably wind up in primary care because I can do a little bit of everything with that.
Regardless of what primary field I go into, my major, major goal is that I also want to be an abortion provider a couple days a week at a clinic like Planned Parenthood, because the number of providers is steadily declining, and the physicians who came into practice in a pre-Roe V. Wade world and know what that looks like are retiring, so we now have a very complacent generation of future physicians who take for granted that those rights are there, and that they’re not in danger, when in fact they’re in danger every day. So, in that sense, I think social activism will be a very big part of my work. I’m a big supporter of Planned Parenthood, and Physicians for Reproductive Health and Choice, and I’m the president of Medical Students for Choice at MUSC right now. So that aspect of my political and social views will be part of my work.
In terms of GLBTQAAI activism, I don’t think I can separate that from who I am and my job. One of the things I really liked about child and adolescent psychiatry was the chance to talk to some kids who were wrestling with their sexuality. Just to hear their fears and what about it was confusing and scary, and ways that they thought it could be better or easier, ways that they could feel safe. Just talking to them and hearing their stories has been invaluable. I would love to volunteer at a group like We Are Family, as their physician on call, to be there whenever they need someone to come talk to the kids, and of course my personal life is very wrapped up in that sort of activism.
QQ: What do you think the medical community’s role in the broader community should be, ideally?
CA: I think we are supposed to be the advocates for our patients, no matter who those patients may be, especially when those patients are youth, and may not have their own voice legally. I think our responsibility, as their providers, is to be their voice. We hold a unique position in the sense of confidentiality, in that what a patient tells us, short of some serious legal demands, has to stay confidential. I think it’s up to us to take those things that we hear in confidence, and find a way to incorporate them in our day-to-day practice. So, when a patient comes to us and says “I’m gay and I’m scared,” or “I think I might be a lesbian, and I said this to my Mom, and my Mom hit me.” Or when they come to you and they say, “I’m biologically a boy, but I think I’m a girl, I think I was meant to be a girl,” as a physician, it is your job not to judge these patients but to help them find their voices, to help them come to grips with whatever is concerning them or scaring them, and then to take that message to the community at large. It’s such a privilege to be in the position to become a doctor. To be, I guess, worthy of hearing these peoples stories, you need to do them justice, do not let these stories be told to you in vain. Take them to the community at large and say, “I’m a physician, and I’m here to tell you that homosexuality is not a psychiatric disease, I’m here to tell you that these kids are suffering and here’s how they’re suffering, and here’s how they’re vulnerable, and I can tell you this because these kids talk to me in confidence, and while I’m not going to break that confidence, I’m here to tell you that we do have a problem, and it’s time we address it.” And maybe you come at that from this old world view that the doctor has kind of a special place in professional society. I think you need to use that to your advantage, take that soapbox that they give you and step up on it. Take that authority and use it to help your patients outside of the office.
QQ: So I’m thinking of the pharmaceutical companies and of how so much of America is being privatized. What do you think is necessary to insure that those in the medical profession are able to prioritize the well-being of their patients over the profits?
CA: Very naively, I would hope that you would never compromise a patient’s care for profit, and that is supposed to be one of the tantamount pillars of our profession. Realistically, I know that’s probably not always the case, which is sad. Personally, I’m probably one of the biggest supporters of a national health care system you’ll ever meet. The profession has to be for-profit--I would like to make a living and pay off my student loans--but, I think when it becomes a profit-driven, capitalist profession, you do sort of lose that sense of, you know, well this patient really needs to talk to me for longer than the allotted appointment and I don’t have anything to do later, let me sit and talk with them, versus let me shoo them out the door anyway, and use that twenty minutes that I have free to do all my paperwork. I think part of the biggest problem is that it’s such a red-tape-driven profession, and unfortunately, it’s becoming a cover-your-rear sort of practice because as a country we can be somewhat lawsuit happy, and sometimes it’s completely warranted and sometimes it’s not, but there is such a fear of lawsuit that doctors wind up practicing very defensive medicine. So they are ordering unnecessary tests, they are being done with patients when the appointment is finished and they are then having to sit down and do hours and hours and hours of paperwork at the end of the day. That sort of thing shifts from being more patient-centered to being more bureaucracy-centered, and that’s a chicken-or-egg kind of thing, I don’t know where that started. It’s so refreshing to see physicians who are focused on their patients, and that is still the majority of people in the medical field, but I do think that when you take away the regulation on how much profit you can get from a patient, you stop focusing on the patient. In the countries where they do have a universal healthcare scheme, and doctors are certainly still well-paid, I think you do see a bit more focus on patient well-being. They’re not perfect by any means, but I think they do maintain a bit more focus on patients.
QQ: Okay, all of that being said, if you could pick three things that you would want to see happen in Charleston in the next year, what would you welcome to our community?
CA: One thing I would definitely like to see is more engagement, across all spectrums. I would love to see more political engagement throughout the city and the county. We have a nice arts community--I would love to see more engaged theater, more engaged art and music. I have found those very engaged underground arts communities in other places, and I really enjoyed that. In Massachusetts, I was in this really tiny town called Amherst, and the first weekend I was there, I walked into town and there was a big banner across the main road that said “Happy Untied Nations Appreciation Day!” and I was like, this is the greatest town ever! Little things like that, and honestly, having grown up here, I think Charleston has really made big steps in that. I would just like to see more, I would like to see people taking to the streets and trying to make their voices heard.
I would like to see the GLBTQAAI community unite better. I think that sometimes we can be our own worst enemy; we can be very divisive, amongst ourselves. And we’re a small community but we’re growing, and we have the capacity to be a very loud community, and make ourselves heard, but I don’t think we do that as well as we could, because we are very busy being cliquey, in some ways, and I hope that’s not offensive to anybody, that’s just what I’ve observed. I would love to see us come together better as a community more, not just on Pride weekends but come together in our day-to-day, and work together instead of against each other.
QQ: What do you think about all the stuff that’s going on with DADT, what’s your take on that?
CA: I don’t know why that policy still exists, I don’t know why in this day and age something like that is still acceptable, and why people are still fighting for it. You’re asking people to go to war for their country, to potentially give up their lives, and put their families on hold and their lives on hold to defend their country, which is, I think, one of the most honorable things you can ask of a person. But you’re asking them to defend rights that they don’t have, to defend rights and benefits that their families don’t have. I mean you’re asking people to go out and potentially die for rights that you’re not actually going to afford them, and you’re asking their families back home to not have the same stability that others have, simply because of who they love.
QQ: What is your definition of feminism and why do you think feminism is relevant and important to the LGBTQ community and rights movement?
CA: I always liked that quote, “Feminism is the radical notion that women are people.” I do consider myself a feminist, and feminism, to me, how I believe it and practice it, is the striving for equality. Not special treatment, not more than, not making up for past wrongs, just literally put us on the same playing field. I keep hearing and reading things about how there is no need for feminism because now women have achieved equality, but it’s just not true. I think we still have such a long way to go.
I don’t think that we can separate the two movements, necessarily, I think the two movements could help each other, but the flip side of that is that I go to Barnes and Noble and the feminist section and the GLBT section are the same thing, they throw the feminist books in with the GLBT books, and as someone who identifies in both communities it sort of irritates me because these are separate identities for me, I can be one without being the other. Because both can sometimes have a negative spin, from the public and the media, I do think we need to recognize them as separate movements, and let them help each other, and parallel each other, but not necessarily be lumped together.
QQ: If you had to ask yourself an interview question, what would it be?
CA: What do I think is a big problem in politics today? I see so little cohesiveness, and I’m really sick of party politics, and the idea that if you are a Republican you’re gonna vote this way and if you’re a Democrat you’re gonna vote this way. I think there are issues that don’t need to exist in party lines, things like gay rights and women’s rights, the environment, international aid. Nobody wants there to be starving children, nobody wants people to be bullied to the point that they commit suicide, nobody wants doctors to be gunned down in their homes or churches, nobody wants to see oil spills, nobody wants to see the environment falling apart and trees being chopped down, at least I hope no one wants to see these things. But I think we get so caught up in what’s supposed to define each party that we miss an opportunity to dissolve party lines, to reach across and say this is not a Democrat issue, this is not a Republican issue, this is not a political party issue, it’s not even a political issue, this is a human issue, it’s a human problem and humanity needs to work together.
We assign ourselves to those parties or candidates or ideologies based on factors that are incredibly personally important but that don’t need to be your political motivator. I hear a lot of people say they’re gonna vote for one person because they are a good Christian. Okay, but maybe that person’s policies don’t help you. Maybe you’re one of those people who really needs a strong public school system, because you can’t afford to send your kids to a private school. Maybe you’re one of those people who needs lower taxes on certain products. Maybe you’re one of those people who needs a strong public health system, or more benefits for Welfare recipients or disability recipients. But there’s this bizarre tie between certain political parties and certain religious beliefs and certain ideological beliefs, and certain by-lines, one word scare tactic bylines, and I don’t mean for that to sound like a conspiracy theory, but I think there are ties like that which don’t necessarily have a real basis in truth but they’re easy to glom onto. People cling to that. I think that becomes a massive problem with our voting population. It perpetuates stereotypes, and I would love to see those stereotypes broken. We have these ideas that the Democrats are gonna raise your taxes and the Republicans don’t care about the environment. It’s not that simple.
QQ: What is your definition of the term queer?
CA: I think queer would be the label between traditional labels, if that makes sense, more of an all-inclusive label. If you say you are gay, you are a man who is only sexually attracted to and only sleeps with men; if you say you’re a lesbian, you’re a woman who is only sexually attracted to and only sleeps with women. If you say you’re a girl, that has a specific connotation to it both biologically and socially; if you say you’re a boy, same thing. Queer is the fluidity between all of the set labels.
QQ: As far as healthcare goes, what is a single-payer system versus a multiple-payer system? Tell me a little bit about your thesis, and how Canada and the U.S. differ. Where are we right now and is that enough?
CA: Well, right off the bat, no, it’s not enough, in fact I don’t even think it’s a good bandaid. I went to school about half an hour south of Lake Ontario, so we were right on the Canadian border, and this was when it was a lot easier to go across the border and get your prescriptions filled. I got really interested in health policy while I was in college, and I had a fantastic thesis advisor who sort of helped me as much as he could and then let me loose to tear things apart! So, the Canadian system is what’s known as a single-payer system. In privatized healthcare systems, like in the US, we have multiple payers, and so we have the patient, their private insurance system, the government, and any government-run health insurance (medicare, welfare, medicaid, any child assistance program). It becomes incredibly complicated in terms of who is responsible for paying what, and insurance companies, depending on which one you have, might cover this procedure, might not, might deny you for having a preexisting condition, might not, so there’s no guarantee that you’re going to have insurance, and there’s no guarantee about who is going to be the primary payer. The problem is we have a huge portion of this country that doesn’t make enough to afford private insurance, but doesn’t make little enough to qualify for government-assisted insurance.
I looked at the single-payer system in Canada, and it is single-payer in that there is one person responsible, and that is the government. So if you are a citizen of Canada, it is actually written into their constitution that you are guaranteed healthcare coverage. I looked at the structure of the single-payer system, how it worked federally and provincially, the balance that they had established between the federal and provincial governments, and what the most recent studies were finding as far as overall health and overall satisfaction with the healthcare system. In this piece of legislation called the Canada Health Act, the federal government says that all citizens will have coverage of things that are medically necessary, and it lists a few criteria for what is medically necessary, and then it leaves it up to the provinces to decide if they are going to expound upon that, or leave it at that bare minimum. So there are differences in terms of coverage between the provinces, just like there are in the States. The flip side is that if you are a citizen of Canada, you have health insurance, it’s not a question of can you afford to go to the doctor, are you trying to decide between going to the doctor or putting food on the table, it’s not a question of that. It’s comprehensive coverage for everyone, and it’s made even more comprehensive for people below a certain income level. I was incredibly impressed by it. Also, I found that a lot of what we hear in the States, about there being long waiting lines and everything, is so exponentially exaggerated, for reasons I still don’t understand. It’s a very flawed system but it’s also a very comprehensive system. At the time I was writing my thesis, eighty seven percent of Canadians were satisfied with their health care system. When I was there, doing my research and talking to people in the policy sector about what they thought, as analysts, I found that it’s such a part of their national identity that they think of access to healthcare as a right.
The only thing I see that system doing is improving, whereas for the U.S., we’re just digging ourselves into a bigger and bigger hole. The more complicated we make this health insurance system, the worse it’s going to be for everybody. The beauty of the Canadian single-payer system, the beauty of the NHS in England, the beauty of the healthcare systems in Scandinavian countries, which, not even arguably, have the best healthcare in the world, is that they are so simple, and that healthcare is provided, bottom line, for everybody. There are also private insurance companies, so if you choose to supplement, if you can afford to supplement, that’s fine, but you’re not going to do that at the expense of anyone else.
I think what we have in the U.S. is not even really a band-aid. It was such a double-edged sword, I was glad that it passed because I felt like if it didn’t pass it would be another two or three administrations before we made any headway with healthcare, but the flip-side is that I don’t think we actually did any good, I don’t think it was good legislation by the time it passed. They took out the public health aspect of it, theres no longer any part of government health insurance. So I don’t think we did anything to fix it.
QQ: Do think there’s a way we could do it in the U.S. that would appease the majority of people?
CA: I think what’s very different about the U.S. is the national attitude, our national identity. The U.S. has such a grip, sometimes to its own detriment, on the “pull yourself up by your bootstraps” mentality. I support that, but everybody needs to have boots to begin with. So, if you’re not providing the boots, as a country, what are you expecting people to do?
QQ: Thanks Courtney!
