Building The Noise with Clare Dougherty: EPISODE 021

SPEAKER_03 0:00

Dr. Brown says all the time, you can do everything right. You can be like a vegan, triathlete, and still get breast cancer. So this is not not about shaming women. For me, I try and flip the paradigm and say, we are just trying to empower women to say, like, if you're like me and my mother had breast cancer, I am very high risk. I had my children later. That makes me even higher risk. So I pushed my OBGYN and we went in and I took a genetic test. I didn't test positive for the brocket genes or anything like that. But based on the algorithm, even just on the conversation I had with my OBGYN, she was able to tell me that I was at a 30%, like my risk is 30% to being diagnosed with breast cancer. Average risk, I would say, is about 10%.

SPEAKER_01 0:49

Welcome to the Building the Noise Podcast.

SPEAKER_00 0:52

Ladies and gentlemen, welcome to the Building the Noise Podcast. My name is Matt Teresco, and today we're joined by Claire Docherty, women's health and patient advocate and CEO of the Brem Foundation to defeat breast cancer. Claire brings more than 20 years of experience advising nonprofit organizations and U.S. members of Congress with a career focused on advancing policy, strategy, and impact for women's and children's health. At Brem, her work sits at the intersection of early detection, access, patient advocacy, and coalition building, including efforts around the Early Act and the Find It Early Act. She understands how patient needs, policy decisions, and public engagement all come together to create real change. Claire, welcome to the podcast.

SPEAKER_03 1:37

Matt, thank you so much for having me. It's great to be here.

SPEAKER_00 1:40

So, Claire, obviously we heard that you're the CEO of the Brem Foundation. Tell us a little bit about what you do, but also why do you do it?

SPEAKER_03 1:48

Sure, sure. Well, thank you. Again, thanks for having me. Um I will say, as CEO of Brem Foundation, I oversee a small but rapidly growing team of high-performing professionals. And we are all focused on one thing uh championing early detection of breast cancer for all women, no matter what your age, when no matter what your socioeconomic background, your race, because the earlier that breast cancer is detected, the better the health outcomes. And unfortunately, today there is so much confusion out there around screening and diagnostics and when to start screening that there is a real need in the breast cancer community for a very sort of finely focused organization and message on early detection of breast cancer. Um, and in my role, I'm able to oversee all facets of the foundation, which include access programs in underserved communities, education uh across, again, all different um patient types and backgrounds. Audiences, yes, sorry. Uh tongue-tied. And then third, I oversee our advocacy. And that's really my background, and that's where I believe I've come in and been able to lift up the voice of Bremm Foundation in ways that we can reach um millions of women through policy change. I love the fact that our access programs, we every day are touching individual women's lives every single day. But through our education work and through advocacy, we're touching millions of lives, and I think really able to move the needle on early detection.

SPEAKER_00 3:34

Tell me more about the access programs.

SPEAKER_03 3:36

Sure. We have two access programs. Um, quick background Brem Foundation was started 20 years ago by Dr. Rachel Brem, who was a guest of the show? Uh yes, former guest. Um, and as you know, really an internationally recognized expert in early detection of breast cancer. Not only has she treated, you know, thousands and thousands of women, she also uses her voice, again, to really help drive understanding and uptake so that women can access early detection services. So if we rewind to 2006, she was running JW Healthcare's um breast health intervention center. And some really formidable women from Maryland came together when she told them that she saw women slipping through the cracks in her in her uh practice because they couldn't afford, they couldn't afford the diagnostics that they needed for early detection. So this group of women came together and started what is today Brem Foundation to defeat breast cancer. Um, and it was really a kitchen table organization back then. Um and we have grown um significantly uh to the point where today uh we administer access programs that you asked about. Um we we administer something called the B Fund, which is a cornerstone program which has been with us since the earliest days. And what that is, is a fund where women who cannot afford the tests that they need to diagnose their breast cancer, we we cover the cost of those tests.

SPEAKER_01 5:12

Oh wow.

SPEAKER_03 5:13

As you know, because of the Affordable Care Act, mammograms are largely free in the United States for women starting at age 40 of average risk. But to diagnose a breast cancer, you need more than a mammogram. You often need an ultrasound, you need an MRI, um, you need a biopsy. And these costs can come with, or these tests can come with tremendous out-of-pocket costs. And um truly, Dr. Brem found that unacceptable. What do you mean women can't afford these tests so that they can get an earlier diagnosis?

SPEAKER_00 5:48

So in the United States of all places.

SPEAKER_03 5:50

Exactly. It's crazy. I mean, women for years have been making these really tough choices around do I get my my diagnostic test or my do I get my uh the tests necessary to diagnose my breast cancer, or do I uh put food on the table, right? Like, why is it a financial choice? So the B Fund was created so that we could reach women um in need. Um we work through community partners, trusted community partners who can help us identify the women uh in need of this support. Um, and then we provide funds so that women can access their diagnostic tests.

SPEAKER_01 6:28

Yeah.

SPEAKER_03 6:29

Um, and our other access program, which has become incredibly popular, is called Wheels for Women. Um, it is a rideshare program where we provide free rides to women in need to their breast cancer screening and diagnostic appointments. And there are other rideshare programs out there, but ours is the only one that's focused purely on early detection and screening. Um and we have been partnering with Lyft since 2019. We started with five partners and we're up to 19 partners. And we have reached to date uh, I believe over 6,000 women with rides. And, you know, every day we're growing, every day we're bringing on new partners. Um and it feels it feels great because we know from our partners that in many cases for women who are accessing wheels for women, the ride is the difference between them getting the test or not getting the test.

SPEAKER_02 7:33

Yeah.

SPEAKER_03 7:33

Um, and again, right, it shouldn't, every woman should be able to diagnose her breast cancer as early as possible. And that something as simple as a ride or something as simple as cost could get in the way of that is just um not acceptable. And that is why Brem Foundation runs our access programs.

SPEAKER_00 7:52

That's a it's fantastic work that you guys are doing, and and we hear every single day patients with different issues, they may know what they have to do or what they're recommended uh to do, and we'll talk about guidelines and how they can be part of the problem um or beneficial depending on how they're read and thought thought about by the population. Um so it's amazing to hear that you guys are are really focused on ensuring that you're removing all barriers that women can face um in getting the uh screening that they need. Uh all cancers, earlier the better, that we can catch the. And uh my big question for you is you've been doing this for quite some time. You've been in the in the health policy and advocacy space for you know over 20 years. How did you get into it? I think a lot of people have a passion or desire to find this world and just don't know how. Um take us back to when you were at Hunter uh and what your thoughts were and how you kind of got into this world.

SPEAKER_03 8:52

Yeah, well, it's it's so funny because you we had talked about this um a couple weeks ago, and it it gets you it gets your wheels turning, right? You don't stop very often to think about sort of why and how did I get into this. And I go back to, you know, I graduated with a communications degree in Boston University, and um, I didn't know what I wanted to do, but I knew I wanted to do something um where I could use those skills. Um, short story is I ended up selling Ad Space in New York City and for a medical publishing company, great company, wonderful people, but I just knew that was not what I wanted to do. And I really just had to examine what is it that that motivates me? What is it that I feel really passionate about when I wake up in the morning and I realized it was policy and policy change. Um and uh so I enrolled uh in a master's program at Hunter College in New York City, um, which was um it was a great fit, and I was exposed just to a lot of interesting people, um, whether they were just different stakeholders in the community or policy makers themselves. And through that program, I had to do fieldwork. And I decided, and I really don't even understand what drove me, but I decided I was gonna do that field work in Washington, D.C., even though I was living in New York City. Wow. Um, so I just I ended up, you know, getting uh an unpaid job role in the office of Congresswoman Carolyn Maloney from um Manhattan. And it was truly from there is where it all started for me, where I just felt in that office my passion for women's health was nurtured. In fact, they were they were pretty uh happy to turn over to me the women's health portfolio while I was um even in, you know, I was pretty young at that point. Sure. Um, but that was where my passion, I think, was ignited. Always interested in helping underserved communities and the vulnerable, but even just learning writ large about gaps, right, in women's health research and um uh learning more about um the growing rate of cancers um affecting women. Um so so that was just sort of a great um that summer, I would say was a formative time for me. And um, that was, I think I said this to you, summer of 1996. And I have never looked back. I did not go back to New York. I ended up creating a whole policy career here in Washington, D.C. And that was, I think, also just due to some really great people. I had some fantastic mentors, particularly the chief of staff that I had with Congresswoman Carolyn Maloney, and I went on to work for him in other roles. I was really lucky to work for a fantastic congresswoman, Congresswoman Lois Caps from Santa Barbara, California, who was a school nurse. And I worked for her and staffed her on the House Energy and Commerce Committee back then, just the Commerce Committee doing her health teamwork.

SPEAKER_00 11:49

People don't understand the value and how impactful school nurses really are.

SPEAKER_03 11:53

Oh my gosh. And and she was just a fantastic advocate and somebody who really understood the importance of public health and understood the importance of taking care of the vulnerable in our communities. So um, yeah, so I did that for a while. And then I think I talked to you about I realized it was time to get off Capitol Hill and to get off into the broader world. Um and uh, you know, I was very lucky to get some really um interesting roles at Campaign for Tobacco Free Kids and uh went on to spend 16 years at Elizabeth Glazer Pediatric AIDS Foundation, which will always be near and dear to my heart. And I learned a ton there and also had some fantastic mentors there who really allowed me to grow in the policy and advocacy, in the communications and external affairs world, and also just to learn about leadership. Learn about leadership and how to lead an organization with grace, um, and to get a lot out of the people that you're working with and that are working on your team, but to also give a lot back to them so that you're building community within an organization.

SPEAKER_00 13:00

So that's fantastic.

SPEAKER_03 13:01

Yeah.

SPEAKER_00 13:02

So, you know, what do you feel is most misunderstood? I want to dive into two domains that you've lived in. What do you think is most misunderstood about health policy and the policy shaping that's taking place?

SPEAKER_03 13:15

Yeah. Um, well, a few things. Uh, I would say uh some people think health policy sounds boring, and maybe some parts of it are boring. Medicare coding and things like that might not be the most exciting, but but at the end of the day, they're really important, right? Because they figure they help us understand what gets paid for and what doesn't get paid for, which often has a huge impact on access.

SPEAKER_02 13:39

Yep.

SPEAKER_03 13:39

Um you know, it's things have changed so much since when I worked on Capitol Hill. And I will say it is sad that it is, it is a less, um, it is a more partisan world than it certainly was when I worked on The Hill. That said, I will say something that I think is maybe misunderstood is that a lot of these issues are incredibly bipartisan, right? They do cut across the aisle and breast cancer being one of them. And I think maybe the misconception is that depending on which side of the aisle you're on or which side of the aisle you support, that you know, either folks don't care, members of Congress don't care. And I think it's just not the truth. I think it's just not the truth. And I think there are plenty of members out there on both sides of the aisle that do care. And I do feel like as advocates, it is our responsibility to bring to them the data and the stories from the community to help them understand why they should go out, what they might perceive as going out a limb to support um our work. Uh, you know, we champion something called the Find It Early Act, and that is bipartisan legislation that, as I mentioned early, removes those out-of-pocket costs for the screening and diagnostic tests that women need to diagnose their breast cancer. And, you know, when you go into offices and you can not only talk about breast cancer, which touches almost everybody's life in America, but you can um you can also show the impact that state, similar state um legislative efforts have had in increasing access to screening services, but also that they don't really drive up insurance premiums. If you can go in there and make that case, sure. And I think that's up that's on us as advocates, I think you you do start to see people say, hey, wait a minute, this is an issue that I should really care about and where I should um where I should show leadership. Um even if I didn't wake up this morning thinking that was going to be at the top of my at the top of my list.

SPEAKER_00 15:56

Sure. Yeah. If the need is there and you see it in in in the constituents and you know your heart is pulled in that direction, there's probably others like you. We have to just start the conversation. And one of the things that I really wanted to key in on, and our listeners will catch a theme here, a trend that we've we've been discussing, is the value of state policy, not just federal. What what are your thoughts on on the need to like organizations like yours, really focus in on the states just as much as, if not more, as you're doing on the federal?

SPEAKER_03 16:27

Yeah, and I have to start by saying I am absolutely not a state advocacy expert. Um, I'm learning from those around me, but um, I'm incredibly lucky to lead an organization that's based in Maryland, Silver Spring, Maryland. And we have deep roots across the state of Maryland. Dr. Brem is originally from Owings Mills. Um, and so I've become just much more familiar, not only with the congressional delegation from the state, but with the the state legislature. And um, I have to say it has really opened my eyes to the importance of states, because in states is where you can often just get the ball rolling. You can, because it's a different, perhaps a smaller playing field. I mean, it really depends on the state. No one, no one would call California small, but you know, you can oftentimes with your grassroots go in and talk to your, for example, legislator in Maryland, get them passionate about an issue and get something passed that you can then point to as a success and bring to um to legislators um at the federal level to say that look, this this passed and it's working. Um in fact, we have worked, we've been very lucky to work very closely with um uh speaker Jocelyn Pina Melnick of the Maryland General Assembly, who is, I mean, she's a she is a truly, I mean, Rachel likes to use this word, um, badass woman. She really is. She is a mover and a shaker, this woman. And we've been working with her on this issue that's very interesting around the um the fact that mammograms not only can show if women uh have uh breast cancer, but they can also show if women are at risk for cardiovascular disease through something called breast arterial calcifications.

SPEAKER_02 18:21

Yes.

SPEAKER_03 18:21

And it it is an issue that Brum Foundation jumped on earlier this year, and we were able to work with the speaker of the House and others in the Maryland General Assembly Health Committee to pass legislation that requires that women be notified if their mammogram shows that they have breast arterial calcification, because then that basically opens up a conversation with their provider to say, hey, I noticed on my in this letter I was informed that I have breast arterial calcification, and you can talk about whether you need to then take action based on that information. And the beauty of that bill is it's a notification bill, so it's you know, it's low cost, and it passed without uh and the governor signed it into law in May, um, and it had no opposition. And now we're taking it to around to um federal legislators to get something introduced. So um I I do have to say, I mean, and I don't want to also make it sound like it's easy because No, not at all. Advocacy is it's not always easy, and we we just happen to be lucky on that particular bill that the leadership was really, really excited about it. But I mean, um I think it's very exciting to go in at that grassroots level, right? When you can say, hey, we have a woman here who lives in your district or you know, who lives down the street from you, um, to whom this issue is very important, or to show the data for you know how many women um across Maryland would benefit from this type of legislation, and then um to see how that state level policy making and advocacy can have a ripple effect, I think is very exciting and very meaningful. And I would have to put a plug in for Susan G. Coman. They have really invested in their state efforts and they are out there really doing great work on that. Um, and Brum Foundation is certainly learning from them.

SPEAKER_00 20:16

And I think one thing that's also important just to throw out is that it shows the importance of patients who are willing to share their stories.

SPEAKER_03 20:24

Agreed. Agreed.

SPEAKER_00 20:25

And I think I think so many people get a diagnosis and figure, all right, well, that's it for me, right? Um I'm gonna focus, I have to focus on this. But if you do get the opportunity, if you do have the chance to share your story, you not only have the opportunity to make change for yourself, but make change for your peers um tomorrow, so to speak.

SPEAKER_03 20:49

I mean, you've had Rachel on here before, or Dr. Bram, I should say, but I mean she herself is a breast cancer survivor, and I can't think of a better story um or a better profile of someone who has taken her breast cancer diagnosis at age 37 and then used that to go out into the world and share her experience and how early detection saved her life and how it can save many other lives.

SPEAKER_00 21:12

So 37. Wow.

SPEAKER_03 21:14

Yeah, yeah. She was 37. Her mother had had breast cancer when she was 12 years old. Then Rachel had uh uh Dr. Brem had a breast cancer diagnosis when she was 37, testing out her own equipment, uh her own ultrasound equipment. She she found her own breast cancer. Wow. Which is a pretty wild story. Yes. She really, you know, in starting the Brem Foundation, um, you know, I know her girls, her she has three daughters, and they're very mindful of their risk, their breast cancer risk as well. And I think they they have just taken that out into the community. And really basically, as I said earlier, part of the core work of Brem Foundation is just helping women understand like, know your risk. Knowing your risk then helps you at least. get ahead or try to get ahead of what um uh or or or really helped you be proactive about the steps you need to be taking to to advocate for your breast health. Um but back to what you were saying I'm really privileged to work alongside many women. I'm not a survivor myself. My mother had breast cancer, but to work along so many women who go out and tell their personal story every day, which is incredibly generous and can also be taxing. And I think it's just the power of those stories cannot be underestimated.

SPEAKER_00 22:32

Yeah yep and and you know you bring up a really good point about knowing your risk. And we had talked uh as you referenced earlier um though that the the guidelines have changed so much that so many people don't know what they are or what it means today and why it's different than what it was. And the term average risk I think causes a lot of confusion for people. What is average risk? And from my own um you know firsthand market research that we run most folks hear average risk and if they don't have a family history I think that that's not them.

SPEAKER_03 23:10

Yeah yeah right it's complicated Matt and you're raising a really important question. I do think that understanding your risk profile as I said is really important but it can be hard to even understand necessarily what that is and a shameless plug for Bremfoundation.org we have some great resources um we have a short risk assessment quiz called checkmate where you just answer a few questions it takes three minutes on your phone and it helps you to better understand what your risk profile is so that you can then go talk to your doctor about it.

SPEAKER_00 23:48

That's amazing three minutes from your phone. Yep and it's called checkmate.

SPEAKER_03 23:54

It's called checkmate yes we'll make sure to link to it yes Brumfoundation.org please take our checkmate risk assessment quiz it's it's very it's not it doesn't have medical jargon it's very patient facing and patient friendly and it just gives you that information so the next time you go to your appointment you have the questions to ask your doctor because many of us sit there and don't don't know what to ask. Yeah and as you mentioned so family history of course very important but it's not the only thing do you have dense breast tissue is an incredibly important factor in your breast cancer risk. But there's other things at what age did you um did you have children? Do you smoke? How much do you drink? There's a variety of factors that um again it's hard right because we don't want to scare people Dr. Brown says all the time you can do everything right you can be like a vegan triathlete and still get breast cancer. So this is not not not about shaming women for me I try and flip the paradigm say we are just trying to empower women to say like if you're like me and my mother had breast cancer, I am very high risk. I had my children later that makes me even higher risk. So I pushed my OBGYN and we went in and I took a um genetic test and it helped me not just understand and I can I can say it here I I didn't test positive for the Brock genes or anything like that. But based on the algorithm even just on the conversation I had with my OBGYN she was able to tell me that I was at a 30% like my risk is 30% to getting to to being diagnosed with breast cancer. Average risk I would say is about 10%. So just asking me these questions about not only my family but about my lifestyle and some of the choices oh and exposure to estrogen exposure to estrogen. So again we can talk about that I'm not the right person to talk about Dr. Bram as the medical expert but things like that do play do play into what your breast cancer risk might be. So again I commend you not only to our uh our checkmate risk quiz um but also we have other fantastic resources on Brem Foundation's website to help you better better understand your risk profile um whether it's uh you know the fact that black women are um dying at 40% higher rates than white women even though they're diagnosed at the same rate we have some really compelling information about that. And also information about the fact that breast cancer diagnoses are on the rise in women under 50 and even under 40 um which makes it that much more important for women to be vigilant and to self-advocate.

SPEAKER_00 26:45

Yeah and that's that's truly what I love about advocacy organizations like yours is that folks have so many questions in this day and age. And yes, you know we're seeing a lot of folks turn to AI but you don't need to do that when you have valuable organizations like the Brem Foundation already here. Yeah right already creating trusted resources that have been verified and validated and you don't have to worry about you know did it uh have a hallucination?

SPEAKER_03 27:15

Yes right well and two things I wanted to say first of all there is a lot of misinformation particularly on TikTok. My niece who is in graduate school in New York came to me and said Aunt Claire you're gonna be so bummed there's things going around TikTok saying that mammograms are bad for you, that they expose you to radiation in really dangerous quantities, things that Dr. Brem can debunk in a minute. So we are actually next year going to be rolling out even more robust social media to counter those messages because I think you and I both know it's it's a really particularly for younger people you know TikTok can be great right you can learn a lot there. And also you can get some really bad information that is not evidence based and everything we do here at Brem Foundation is evidence-based um and supported by data. So the second thing I did want to go back to was your comment on guidelines. Guidelines are very frustrating for us at Brem Foundation. You know the United States Preventive Task Force which I think has an important role to play and been changed. Yes yes is changing is sort of like every day changing. But we've been very frustrated because I think they've created a lot of confusion about when women should start screening for breast cancer. For many years they said you should not start if you're at average risk you should not start screening till the age of 50. And that for us was just criminal it was leaving so many women's lives on the table. So I would say I think it was in 2022 they updated those guidelines to say that women at average risk should start screening at age 40, which was a step forward. But they said that they should start screening every other year. At Brem Foundation we believe very strongly that women at average risk should start screening every year at age 40 every year at age 40 you should start getting a mammogram. And if you are at higher risk someone like me, um frankly all black women all Ashkenazi Jewish women other women uh who have family history or dense breasts you should likely start screening or you should possibly start screening earlier than that based on a conversation with your doctor and going back to what I said earlier about the algorithm that the that the doctor used with me if you have a conversation with your doctor and they get a sense of your risk they might send you for for screening earlier. And if you really if you feel like you're not being heard you really need to push because the later you you you know again I'm trying really hard not to to scare women but like zero breast cancer can really you you can go on to lead a very long and healthy life. A stage four breast cancer certainly there are many women living many years right now with metastatic breast cancer and I'm so in awe of them so many fantastic advocates Sally Wolf and others who are out there just doing the hard work every day but it's just a much tougher diagnosis than an earlier diagnosis. So um so yeah I just I really ask people to to think twice because the guidelines are confusing and that's confusing confusing not just for patients but also for providers. So I think Dr. Brem says again don't be a good girl be a badass woman and if you feel like you're not being heard push back on your provider and if you feel like your provider is still not listening maybe go to another provider for a second if I I mean let's let's just pause here.

SPEAKER_00 30:53

You think about it the the Preventative Services Task Force job is to um you know look at things from a public health policy perspective but also a healthcare economic perspective.

SPEAKER_01 31:05

Yeah.

SPEAKER_00 31:05

And it's not what you are going to pay as the patient it's what the government is willing to pay. So every other year makes things half as expensive for the government. But if that doesn't feel right to you and this is one thing that I've learned through my own healthcare journey and being married and having two daughters is there's nothing like a woman's gut. You need to learn to trust it. And I had my first colonoscopy at 32 um we don't have a family history of of colorectal cancer but we do have a family history of a lot of of other disorders like Crohn's and colitis and and you know I had had my own issues that I wanted to have checked and though I did not quote unquote meet guidelines or or the criteria my doctor was able to get that approved because we had the discussion about family history. And if if anyone's worried about well I I want this but I don't know if I can afford it you can get it covered. It doesn't have to be a uh an uncovered expense no you just might have to do the prior authorization.

SPEAKER_03 32:09

Yes exactly and I will say working for someone like Dr. Bram who I mean I've seen her countless times on the phone with insurance companies advocating for patients and you need a doctor like that who will say listen this woman we're not I mean you and I both know this Matt it's so infuriating that those costs come down to those decisions come down to cost. Yeah because I mean just what's the value of my life what's the value of my life and why and and if you get my if you find my cancer earlier if God forbid I have a cancer find it earlier it's gonna save a lot more money than having to go a lot more intense treatment. So I find it um really frustrating but I also um that's why we lean into all these messages about self-advocacy empowerment but also not just messages educational tools so that you can understand so that you go in equipped to have those conversations and not feel that you're at a deficit when you go in to speak to your doctor or if you have to go in and speak to your insurance company.

SPEAKER_00 33:14

Yeah. You should never fear having a conversation with your clinician the way I always like to explain it to patients is it is an economic transaction just like going to a store. Right. And if you're not getting the value for what you think you should get find another one.

SPEAKER_03 33:30

Yes. And in particular I have to say as a woman there are a lot of very well-meaning physicians who like to talk down to women and particularly younger women and that is partially African American women really and African American women 100% that's why we've really leaned into these messages to say no you need to be your own best advocate and it can be hard but maybe you know bring bring a family member or you know talk it through with a good friend or advocate beforehand so that you feel that um prepared and in fact um I'm getting ahead of ourselves but in a few months Brum Foundation will be launching a tool that has some scripts so that you actually have a script. I don't I'm letting the cat out of the bag Matt and I'm gonna be in nice but um but come uh October we will have more resources like that so that you really feel that you have even just some the language that you need so that you can self-advocate.

SPEAKER_00 34:28

Yeah I mean at the end of the day if you don't feel comfortable having that conversation for yourself bring someone with you who can. Yes. And if you don't have someone like that, there are plenty of advocates out there that are willing to do that for you. We just need to make sure that you are integrated in the advocacy community and there's nowhere better to start than the Brem Foundation. Yeah so I could completely completely agree with you. You know you've had the privilege of working with some amazing people as you've said and and I would agree some some badass women what do you feel is the best piece of advice that you've ever received oh boy that I've ever received ooh piece of advice I mean I would have to go back to uh one of my advisors in graduate school when I was trying to figure out what I wanted to do and she just said to me Claire you have to go where your passion takes you and it sounds corny right I'm sort of like oh okay go where your passion takes you like we can't all do that.

SPEAKER_03 35:27

But but when you do have decisions, when you are at right critical crossroads in your life like I was back then, it sort of you know maybe don't go for the thing where you feel like okay well I can keep doing this but I'm you know I'm not really excited about it. But if you have the opportunity and you are at a moment where you can go for something you know when I got to Washington DC it was like I was like a kid in a candy store. It was like I had come and found the place that just I wasn't finding in New York right I had found this place where you found it where you needed to be really cared about this health policy advocacy stuff that was uh important to me. So I think as much as you can and again I know I have to make money I'm not I'm not here to say like just go to pursue your passion but if you can try to really get a sense of what are the things that motivate me? What are the things that make me every day like I am just truly honored to wake up every day and do the job that I do. And it's it's stimulating it's exciting sometimes it's really hard sometimes it's overwhelming but as one of my members said to me not that long ago Claire if it wasn't hard it wouldn't also really be worth doing. So um I just think if you can do that figure out where your passion is and follow it. And and I think also sort of going back to your question, it's having those mentors that can help you right this very this this very passionate woman at Hunter College but then I've also in my careers at every organization I worked at I had people um who who looked out for me and who saw something in me. And I try to pay that forward now in my career with other people because truly without those people I I I don't know where I would be today.

SPEAKER_00 37:18

Sure. Yeah no it that's fantastic and you you're dead on a mentor can help you make sense of of the thoughts in your head that you've never been able to really see the clear picture and really help guide you in this map of life of uh where those passions align with where people have needs. Right. I could couldn't agree more.

SPEAKER_03 37:40

You know um you talked about it can get daunting right um but what would you say inspires you to keep fighting every day I mean I talked earlier uh about I'm I'm part of something called the Breast Cancer Early Detection Coalition which is um a sort of a loose coalition of organizations again all committed um not just to breast cancer but we're really focused sort of on the early part of the the early detection continuum. And I just work aside alongside some really fantastic women several of whom are survivors um but some who aren't survivors some who are um innovators some who like me are just passionate about the advocacy and um truly like one of the greatest moments in the last uh few months for me was going up to Capitol Hill and with two of these women to um see Senator Angela also Brooks staff person to educate them on early detection of breast cancer. And it was just one of those moments right I was with two women who were survivors two women who are fantastic advocates and I was there as the head of Brem Foundation and I remember coming out of there thinking okay that's why we do this because I believe the senator went on to to co-sponsor the bill that we were advocating for. But also it was just the all the voices coming together the different perspectives to to really I think paint a picture of why um it was important for for the senator to step forward. So I I don't know I I'm I'm in awe of Dr. Brem and what she has done to use her voice to raise this up. She really didn't have to do that right she was a successful physician and she she went on to start this whole foundation um and then and then I'm just really inspired by the broader advocacy community in which I sit because I think we just give each other a lot of energy and support regularly and it makes a big difference.

SPEAKER_00 39:43

I tell you there's nothing better than getting to a coalition meeting or any any group of folks in different disease states you feel like you've come home. Yes very much how I would describe it right it's like yes oh we're we're speaking the same language overstands my pain we have the same pains right and even if we don't agree on everything even if we don't agree on everything you still are you're you're you're able to have these dialogues that you might not be able to have in other places. Exactly and and you know what you'll be able to flesh out those ideas that much better. Yeah. Right. Um you know my last question for you as you think about that girl that was selling advertising space in New York City um I'm thinking of a hot summer day and you know running around the city trying to keep yourself from getting dehydrated what would you tell that girl knowing what you know today?

SPEAKER_03 40:34

Yeah it's a good question and you're hitting the nail on the head it was a hot summer and my apartment didn't have air conditioning. I think what I would tell her is again um there are areas that about which you feel passionate and hang on to those right don't let them go. Again I'm not trying to knock what I was doing in New York it was a great job but had I stayed there I think I I would I would have been unhappy. I mean and I was unhappy by the end um and I think I just had to hold on to the passions that I felt and even if it meant right I was a poor starving graduate student for a couple years and when I got to Capitol Hill I mean I'm embarrassed to say how much how little money I made. I bet but those were lean years but I was laying the foundation for where I would be today and years ago one of my mentors asked me what I would want it to be and I I said you know head up a you know a women's health nonprofit and uh that was that seemed like pie in the sky then right and now I'm here and um truly it's really just all those steps I took you know one after the other carefully right having to make decisions that were good for myself and for my family. But I think what I would say is just hang in there, stay true to that the things that are driving you and driving your passion um because eventually um if you follow that things often do do work out.

SPEAKER_00 42:13

That's right. That's right. Well Claire this has been an absolute privilege. I appreciate the work that you do for patients on a daily basis and the work that you're continuing to do on policy to ensure that patients have all the information that they need. We will make sure to link in the in the show notes to the Brem Foundation and to get get folks to the checkmate uh risk evaluation so that they can understand their own risk and and we look forward to the scripts that will be coming down the line to help guide patients on those conversations. But thank you again we really appreciate your time.

SPEAKER_03 42:50

Thank you Matt and thank you for creating this platform and for all of your advocacy it's really meaningful.

SPEAKER_00 42:54

Thank you. You know it's it's funny it's the stories that you shared about identifying that passion, knowing what you wanted to do but not really sure of what that meant that's exactly where I was and I tell any youth individual I can get my hands on it's like figure out what you really like. You know if it's sports great there's plenty of things around sports that you can do. If you like math and sports well now you're getting into the finance world of sports right there's something out there for everyone we've all been given gifts to use those passions are put there on purpose. Don't put them aside those will take you further than you could ever imagine.

SPEAKER_03 43:36

Right and follow them right because as you're saying it can be a career you just have to figure out what the path is to get there and it might not happen overnight.

SPEAKER_00 43:44

That's right.

SPEAKER_03 43:46

That's great.

SPEAKER_00 43:47

Yeah so thank you so much and again we'll be in touch.

SPEAKER_03 43:50

All right thank you Matt I really appreciate the opportunity of course okay bye