Making the World a Better Place: A Miss America Contestant Fulfills her Dream

Tuition for college and medical school can be daunting. As a senior facing her last term at Penn State and hoping to go to medical school, Charmaine (nee Kowalski) Rapaport, ’83, had literally 10 cents in her bank account. So when she saw a billboard touting a free term of tuition as the prize for the Miss Penn State pageant, she decided to try out.

“I didn’t want to wear a bathing suit, but I worked as a lifeguard and figured it wasn’t much different,” she said. Perhaps the outcome was inevitable: Charmaine grew up in State College, home of University Park, attended State College Area High School and chose Penn State for college, spending those years as a cheerleader. “You don’t get more Penn State than me,” she laughed.

She also was extremely focused on her life’s goal: as a Liberal Arts major who took calculus, physics, and organic chemistry as “interesting” electives, she realized as a junior that she “wanted to become a psychoneuropharmacotherapist.” Realizing she needed to go to medical school to become a psychiatrist as it appeared to be the career which most closely fit the bill, she actually took her MCATs the same day that she competed in the Miss Penn State pageant.

She won the contest and paid her tuition, then learned she had to compete in the Miss Pennsylvania pageant several weeks later.

She won again – playing a Rachmaninoff piano concerto for her talent (she’s played since age nine). Yet she was surprised that her overall scores placed her above twenty-six other contestants. In a competition two years prior, she had competed with Sharon Stone, “a beautiful, wide-eyed 18-year-old” who was scouted and later became a famous actress, Charmaine won a state talent award for her piano performance.

To attend the pageant, Dr. Rapaport recalls crossing a picket line of feminist protestors and feeling demoralized. “I believe in equal rights and equal pay for equal work,” she said. When interviewed by the University’s newspaper, she tried to explain that the pageant was merely a way to earn money. “There were very few ways back then for women to augment their income through scholarships. This was my answer in addition to numerous part-time jobs, since no one was looking at my athletic abilities,” she explained. “I basically said: I need money for school, and I hope to serve humanity in the end. At least there is an organization that rewards people for that.”

She was extremely touched when another student wrote a letter to the editor defending her actions, stating, “Why don’t you question the contestants’ motivations or assess their academic records? I challenge you to discuss quantum physics with the winner and am not sure you could do it!”

Dr. Rapaport spent a year as Miss Pennsylvania earning money for medical school, making $125 for every session spent cutting ribbons, attending ceremonies and signing autographs. She also conducted research (microtoming rat brains) and applied to several medical schools, but never revealed her status as Miss Pennsylvania. She didn’t even put it on her resume

“I wanted to be taken seriously, and I thought, ‘Who would select someone who wore a banner and a crown?’ I had a car with a huge ‘Miss Pennsylvania’ sign on it, so I would park way in the back when I went for interviews,” she said. “I didn’t want people to think that I got into medical school because I knew the governor.”

She did compete in the Miss America contest in Atlantic City, and although she did not win, she was later told she had the top scores in the interview category. She remembers questions like: Would you ever marry someone without a college education? She recalls saying something like, “one’s level of education does not necessarily correlate with one’s intellect or integrity, if that’s what you are looking for.”

More importantly, Dr. Rapaport won a key scholarship: the David B. Allman Award for Medical Education.

As the only one of fifty Miss America contestants entering medical school, she not only received the scholarship that year but the next, as well. In total, her pageant earnings – all scholarship money – paid for nearly half her medical education.

Even so, she tried keeping her pageant experience a “secret” in medical school. She recalls sitting in the back row, wearing pants and glasses, with her hair in a ponytail, overhearing male colleagues speculate on who was the likely Miss Pennsylvania candidate (word had leaked out). “They saw a pretty girl in the second row and instantly said, ‘Oh, it’s gotta be her,’” she laughed. “The Miss America Pageant, at least in those days, was not a beauty pageant, as is the Miss USA Pageant, so I had no trouble blending in.”

Why was she so reluctant to admit this publicly? “Medicine is a serious career guided by ethical principles. It’s not like going into show business and being center-stage,” she said. “We’re taking care of patients and taking the Hippocratic Oath. It’s not about me; it’s about the patient. Pageants were simply a means to an end.”

Looking back, she’s more comfortable now sharing this piece of her history, even with fellow alumni, primarily because “It’s just one among many narratives of medical students which evolves where strong motivation is present.”

After graduating with Honors in Psychiatry and AOA, Dr. Rapaport completed her psychiatry residency (and served as chief resident) at Harvard, Beth Israel, then spent time in Boston, Australia, and Florida. She has been working in New York City for more than a decade.

She’s also been married twenty-three years to a surgeon and has four sons (the oldest graduating from M.I.T., the second attending Johns Hopkins University, with a 17- and 14-year old still at home).

She is a clinical assistant professor of psychiatry and currently works as a psychiatrist at the Manhattan Veterans Administration (part of the VA New York Harbor Health System) specializing in post-traumatic stress disorder (PTSD) and teaching medical students and residents at New York University. She is also a trustee of the American Academy of Psychoanalysis and Dynamic Psychiatry, serving terms on the education and election committees.

Dr. Rapaport has accomplished the vow she made as a Miss America contestant: to help make the world a better place. Each day, she seeks to help veterans address assorted anguishes – from PTSD and chronic pain, to dealing with traumatic brain injuries.

At work, she is the lead psychiatrist for a new VA initiative that integrates psychiatry in the primary care clinic, ensuring that patients do not feel singled out or labeled when referred to help for mental illness.

She serves veterans from ages twenty-two to ninety-three – from those recently returning from Iraq to Vietnam, Korean and WWII veterans. “These are a very deserving group of people who have served our country, and so many are traumatized both physically and mentally,” she said. “The psychiatry is very challenging, as these are some of the most difficult cases one can treat. A patient who is post-traumatic can have depression, psychosis, violent tempers, nightmares, flashbacks, suicidal thoughts, severe medical issues, and substance abuse issues all in one. So much needs to be done and quickly, and the optimal approach happens through careful coordination of a variety of services.”

“We have learned that much of mental illness is biologically based, and we often treat it with medication,” she said. “However, with or without medication, psychotherapy is generally crucial in the equation leading to better outcomes along with family, social, and interpersonal issues being addressed.”

Dr. Rapaport has particular empathy for the plight of veterans, particularly those who have engaged in combat or who have been prisoners of war. “Patients with post-traumatic stress disorder can be quite irritable and can go from ‘zero to 100 in two seconds’. And they’re living with spouses and children and trying to hold down jobs and go back to school in many cases. With all of these stressors, they often need to learn new coping skills to integrate back into society including dealing with depression, anxiety, poor sleep, and tendency to isolate, use substances of abuse to self-medicate, and deal with survival guilt.”

“It’s a very challenging type of patient, but I feel gratified when I’m able to help them,” she added.

While she credits her mom for providing “the empathy gene,” Dr. Rapaport said that Penn State College of Medicine helped prepare her for this work by providing both a supportive learning environment and a comprehensive education.

She added, “Today, many psychiatrists prescribe medication and send patients elsewhere for therapy. I’m old school. I am fortunate that my training has prepared me for a full spectrum of psychiatric skills ranging from psychopharmacologic interventions to group and individual psychodynamically-oriented treatment.”

Dr. Rapaport chose Penn State College of Medicine (even though Stanford offered her a full scholarship) because “this was my home, these are my people. And it’s a great school.” It also boasted a sleep study center that she was keenly interested in with two key figures: Anthony Kales, M.D., then Chair of the Department of Psychiatry, and his wife Joyce Kales, M.D., a psychiatrist and lecturer who provided a strong female role model.

The Kales became nurturing mentors to Dr. Rapaport: teaching her, encouraging her, inviting her to their home, and even providing her with a job (running the sleep study lab at night) to help pay for school.

Remembering her own role models, Dr. Rapaport urges her fellow alumni not to downplay the importance of teaching medical students and residents. “We need to give the message: Whatever field one practices, attempt to look at all aspects of the patient. Do they have a place to live and food on the table? And find the good in each of them–it’s there and it will help you to do your best work.”

She added. “Just as we were taught at Penn State, patient-centered care is where it’s at.”

Click here to read additional stories on the Penn State College of Medicine Alumni Update.