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In a time when the failures of healthcare are under growing scrutiny, “Complicated” brings to light the harrowing reality faced by children with complex illnesses—kids who exist on the margins of mainstream medicine and whose parents risk everything to help them. This powerful documentary, directed by Andrew Abrahams, exposes a hidden crisis where medical uncertainty, inadequate research, and child protection laws collide in unexpected and heartbreaking ways.
In this interview, Andrew Abrahams, known for thought-provoking films like “Under Our Skin” and the Academy Award-shortlisted American Justice on Trial, discusses the inspiration behind “Complicated,” the challenges of telling such a deeply personal yet urgent story, and the broader implications for pediatric care.
VENTS: So what initially drew you to the subject of EDS syndrome and the broader issues of medical gaslighting?
Andrew Abrahams: Well, okay. The broader issue of medical gaslighting was something that I was familiar with.
I made a film that came out in 2008 called “Under Our Skin,” which is about the Lyme disease epidemic and the Lyme Disease controversy, the controversy around it. And that deals with a lot of medical gaslighting of physicians sort of rolling their eyes when they hear when they hear the term Lyme Disease. So that’s why because of that film, someone came to me with this idea.
And they told me about this is a mother of three kids with Ehlers-Danlos Syndrome and has been heavily involved in the issue and in patient care. And so I didn’t know anything about this. I didn’t know anything about Ehlers-Danlos Syndrome.
And it wasn’t just the issue of Ehlers-Danlos Syndrome, which is a condition that is little understood. And because it’s a complex and invisible illness, there’s no genetic test for the most common form, which is hypermobile EDS. A lot of people fall through the cracks in the medical system, and especially kids, because that’s when it begins to show itself, usually after puberty.
So she brought this, she told me about this illness where kids are getting dismissed, gaslit, accused of psychological problems. And then their parents who are desperately trying to help them, bringing them to doctor after doctor, because they’re not getting treated well, they’re not getting better. And because it’s a multi-system and multi-symptom issue, it’s connected tissue, which it’s a deficit, it’s a problem in the connective tissue, and that affects all the parts of the body and all the different systems.
So at a certain point, the parent, and it’s usually the mother who gets targeted for, whether it’s over-medicalization, or medical child abuse is what they’re calling it now, and sometimes Munchausen By Proxy, which means that the mother is actually harming their kid purposefully for her own psychological benefit. So that’s kind of the trajectory of what happens in these cases. And I was like enthralled.
I was like, I’ve never heard of this. It’s crazy. How can this be happening? And that’s what drew me to it.
And I kind of feel like if it’s something that moves me so much, and it’s something I want to know so much about, that I’m kind of a proxy for the hopefully other people will be interested as well.
VENTS: So oddly enough, there’s a bit of sexism thrown into it as well.
Andrew Abrahams: Oh, yeah.
“Complicated” and Sexism in Medicine
VENTS: In this day and age, in this political climate, it’s getting harder to even throw around the word sexism and have anybody take it seriously, because there are some people who just roll their eyes anytime we call something sexist or racist or anything like that. So do you have any thoughts on that?
Andrew Abrahams: I don’t know. I mean, look, I mean, on one hand, I think those words are overused.
And partly because of that, we don’t look at things that truly are problematic, really are problematic. There is an issue of sexism in medicine. Girls and women are not taken as seriously and not taken as seriously as men in the milieu of the medical system, by doctors or in hospitals.
That’s a fact. It’s also true that black people have a harder time accessing care and have certain assumptions thrown in. And we look at both of these issues in the film.
We talk about the different treatment for girls and women. We also have one subject who is Black and has EDS. And one of the symptoms for her is that she gets bruising on her body easily.
And so she goes to the doctor and they immediately think that it’s her husband who’s abusing her. And she also talks about how there’s very few, there’s much less people of color who are diagnosed with Ehlers-Danlos Syndrome, not because they don’t have it, but because they don’t have the same access of care. So these issues are real.
They’re definitely real. And we touch upon these issues and many, many more in the film. That’s one of the things that draws me to this issue, is that within this one film, there’s a lot of issues that we’re actually looking at.
And that’s the complicated nature of it.
VENTS: You mentioned Lyme disease. Well, I have an aunt who has Lyme disease. So… how did your background shape the way that you told this story? You got into that a little bit, but is there anything else?
Andrew Abrahams: Well, my background is in visual anthropology, actually. And that is, I have a master’s degree from USC and visual anthropology is kind of a hybrid of film and cultural anthropology.
And one of the hallmarks of anthropology, of cultural anthropology, is an idea of participant observation. So you go into the cultural world almost as a participant. You’re observing, but you’re also participating.
So that to me is really important, like going in deep, getting as familiar as possible, becoming as intimate as possible with your subjects and their stories, creating a sort of reciprocity so that you’re not just getting something from them and they’re not just getting something from you. There’s a give and take. I’m witnessing their story, which is at their most vulnerable.
And so they’re getting that kind of witnessing and validation. And I’m getting the honor and the privilege of being able to witness that, because it really is, to be able to be with somebody in communion with them at their most difficult is really quite an honor and responsibility. So that’s really, I think, the background.
That’s the background both for my work in general and specifically around this film. That is something that’s so challenging and heartbreaking, really.
Gaining Trust
VENTS: Speaking of which, did you face any challenges in gaining trust of the families or any medical professionals you spoke to?
Andrew Abrahams: Absolutely.
Yeah. You’re asking all the right questions because all those things are there. Yes.
I just spoke about the importance of creating a trusting relationship and a sort of give and take. And yet it wasn’t easy. I was a little surprised because with my Lyme Disease film, people were sort of like throwing themselves at me, wanting to tell their story.
And this was different. I wasn’t expecting it. I was expecting that same kind of thing.
But I quickly came to understand that the kids that we were working with have been traumatized by the system, by the medical system that didn’t believe them. So they’re very leery, especially of adults in terms of it’s hard for them to trust. And for parents, it’s difficult for them too because they’re so scared that anything they say might come back to hurt them because a lot of them have been embroiled in child protective system cases where they’re being either scrutinized or accused, outright accused, of medical child abuse.
So they’re scared too. So trust was a big issue here. And it’s only because I spent so much time with these kids and their families that I was able to establish that trust.
It takes time. Even outside of the medical concerns, there have long been concerns about families, like if a child falls and gets a bruise, will they be taken away or something because of suspected child abuse? So this is another example of those sort of fears, which are legitimate. Yeah.
I don’t know if you remember the sort of like Shaken Baby Syndrome a while back. That was a big thing. Many of those kids who had many of those shaken baby kids had Ehlers-Danlos Syndrome.
And so this is a it’s a real issue. It’s a real issue where we just assume things that we don’t understand that there must be some nefarious cause because things like Ehlers-Danlos syndrome can’t easily be diagnosed or explained. We assume that it’s either psychological or that there’s some kind of abuse going on.
That’s a gigantic problem…The film “Complicated” is really just a microcosm of this issue, which is much larger than just Ehlers-Danlos Syndrome.
It’s true for other complicated and invisible illnesses and rare diseases that we don’t have a handle on or that are just too complicated for us to to to accommodate or to to work with.
Glimmers of Hope
VENTS: And the movie looks at heartbreaking realities, but also these glimmers of hope. So was it was it sort of a strange task to balance those out thematically for the movie, or did you just sort of…let things unfold as they will?
Andrew Abrahams: Both.
We let things unfold, but we also had to sort of…create a story out of it. So beginning, middle and end, you know, and unfortunately, in this world, there’s not always a beginning, middle and an end, because this kind of thing, it just goes on and on and on. You know, people with this illness, it’s like it’s a lifelong thing usually, and there’s ups and downs.
And so it was a challenge to to find this sort of like narrative arc. And it was also a challenge to find, like you said, the positive or the, you know, the hope amidst the suffering, because there really is a lot of suffering. And I think besides seeing these young people sort of like trying to thrive, despite their illness, and despite the things that are holding them back, to me, that’s like really powerful, just that in itself.
But there was also a glimmer of hope in terms of like possibilities for finding the gene that’s actually causing hypermobile EDS. Because if you have the diagnostics, then they’re sick, then the fact that they’re sick is validated, and it’s much easier to get diagnosed. It’s easier to be taken seriously.
And then eventually, it’s easier to get treated.
“Complicated” and Awareness
VENTS: So the documentary highlights the systemic failures in the US healthcare, and the child protective systems. So what do you hope “Complicated” will contribute to addressing such issues?
Andrew Abrahams: First of all, like just to create an awareness around this, I think that we don’t have, there’s not a lot of awareness around.
I think, you know, I keep returning to this idea of “Complicated “because it’s, it’s something that like, is systemic. We don’t know how to address complicated things, complicated issues, complicated health problems, complicated legal matters, complicated films, even like, like a film that’s complicated, that like you can’t say easily, this film is about X.
“Complicated” is not just about X, our film is not just about X, it’s about X, Y, and Z. And so we don’t, societally, we just don’t know how to accommodate things that are complicated. So I hope that in showing the reality, a lived reality of complicated experiences, complicated illnesses, and then what happens when you have a complicated illness, and the suffering that comes from it, that that will perk up our ears and pay attention a little more.
And so the conduit is to make a film that’s moving, that’s in some ways entertaining, that grabs you, that you can find empathy with the characters, that you care about the characters, that that will move people, because ultimately it’s about emotion, you know, people, people have to be moved. And that’s really what I would like to do. With this film.
VENTS: …In your, in your opinion, why do you think it’s so hard for some people to believe that these cases are real? Because I understood it..What’s the roadblock for some people?
Andrew Abrahams: Well, you understood it…because of the film, because you spent 90 minutes with the film. But a doctor who has 15 minutes with a patient…and they have diagnostic tests that they depend on, and they’re not getting those. So it’s really about a large part of this has to do with time.
And in our increasingly sped up world of internet and social media, and our, you know, the increasing lack of patients. Sure. And lack of time.
That’s a big part of this, like, our medical system doesn’t have time. And our legal system doesn’t have time for these kinds of complexities. And yet, that’s the nature of reality.
So we’ve got to do something…
