Dorothy: [00:00:00] Did you know that being a caretaker could be bad for your health? This physician is convinced that the caretaker needs special attention and that that’s the one who is the most forgotten person in the breast cancer journey. Hear what you can do to make sure that you taking care of another, especially at this critical time in their life, could be bad for your own health.
Let’s Talk About Your Breast. A different kind of podcast presented to you by The Rose. The Breast Center of Excellence and a Texas treasure. You’re going to hear frank discussions about tough topics. And you’re going to learn why knowing about your breast could save your life. Join us as we hear another story and we answer those tough questions that you may have.
Hi, I’m Dorothy Gibbons and I’m the CEO and co founder of The Rose, and we are here to [00:01:00] talk about your breast. Today we have with us Claudia Cotes, Dr. Cotes has a stellar career, but she always has had this heart for Spanish speaking patients, and I can’t stress that enough. Claudia is a radiologist. She was our lead interpreting physician, and she has now become the assistant professor, chief of UT Breast Center at UT Houston, right?
Claudia: Correct.
Dorothy: Okay, thank you for being with us.
Claudia: Thank you so much for having me here, Dorothy. It’s a pleasure to be back.
Dorothy: And it’s great to see you. You were with us for about six years, and got us through so many unusual times and, and just kept pushing us forward and it was, it was really great. And you weren’t shy to talk to our patients at all.
And I think a lot of that was because you do come from Colombia. And tell us just a little something about how in the world you ever became a physician.
Claudia: [00:02:00] Well, it’s a long story, but very obvious to me now that I look back. I come from a family of doctors. My dad is a radiologist back in Colombia. His dad was a doctor back in the day. And I always grew surrounded by radiologists. My dad has his own private practice right there. And I would see what he did every single day. My mom worked with him in his private practice. So our family basically grew with this business. I think the company is almost my age, maybe a little younger than I am. Um, so it’s like a The little brother or the little sister that we all have in the family. Uh, it’s my mom’s favorite kid for sure and um I just knew the environment. Uh, why did I became a radiologist and a doctor? I don’t know, you know. When I had to decide in Colombia is a little bit different when you want to decide to be a doctor Right after high school, you have to make a decision of what career you’re going to go into.
It’s not like you can [00:03:00] go to college and then take some undergrad courses and then decide what you’re going to do Afterwards, but you just make the decision and you go for it. And at that point I was considering options. One of the options was to go into the arts. I like the arts. I like music. I liked um acting but I also liked Medicine in general, uh, biology, science, chemistry, and that, those were the areas that I was best in school.
So it was very simple. I had only one option and it was to do medical school. So it was a very simple decision and I knew if I was going to do medical school, I was going to be a radiologist. So basically I, I put all my life in there at 17. I was 17 at the time and I said, you know, this is what I’m going to do. I’m going to be a radiologist.
Dorothy: Wow. Wow. So young to make that decision.
Claudia: Yes. And sometimes I wonder Maybe I made the wrong decision, you know when you’re so young and you make [00:04:00] decisions Uh, but I think I actually made the right one. Thankfully. Uh, and my life took me through it. Um in so many different ways that just kept telling me this is what you were supposed to be doing. So i’m glad of that decision that I made.
Dorothy: So when you came to The Rose, You had worked— where before you came here?
Claudia: So, uh, I came to the United States after I finished medical school. I decided to come to the United States for many reasons. Uh, one of them is that I knew radiology here in the United States was going to give me a better training, uh, than if I had stayed in Colombia.
I don’t want to say it’s bad in Colombia. It’s actually very, very good. Uh, but in terms of equipment, of opportunity, um, in radiology, you have to be very up to date. You know, the equipment and technology has a very important role in radiology. So I knew if I wanted to Be the best trained I could I would have to come here [00:05:00] So I went through all the tests and you know, it took me maybe a year or two to get all my documents and Tests ready to be able to apply.
So I applied to a position and I got my position at utmb for radiology and that’s where everything started. So basically after medical school in Colombia, I came straight here To do my residency training. So I did that I did my fellowship at UTMB as well, and then, fresh out of my fellowship, my opportunity to join The Rose came.
Dorothy: Right, right.
Claudia: So, it was basically training, and then The Rose.
Dorothy: So, I so remember when you first came to us. You were very pregnant, and, and I, I have so admired the way you, just went ahead with your life. Even though you had this very demanding job that was going to take a lot of time. And really to be lead interpreting means there’s a lot of extra [00:06:00] responsibilities and I don’t know that everybody really realizes that but but there are there’s just a lot with it.
Claudia: There are. Especially if you’re putting your heart into those things, you know. Because if if you were just doing the job and coming in and leaving and and not putting all your effort to it then it might be more simple. But when you’re really care about the cost and you’re really trying to to make the place better than when you got in it. Um, that’s when things become more not difficult, but you get more involved, uh, not only physically, but emotionally. And yes, I was super pregnant, uh, at the time. And, uh, when I finally joined, I was first time mom, uh, with a little kid at home. Um, she’s now seven. So, yeah, she’s now seven. Um, And yeah, I remember, I don’t know if I told you this story, Dorothy, but I remember I was maybe still in residency and [00:07:00] I was driving one day, uh, and 6th and I saw the little ribbon in the highway.
Dorothy: Of The Rose—
Claudia: You know, when it used to be right there in 610 and, uh, and Westbrook. And I was like, huh, there’s a breast facility there. And I, one day I thought in my mind, you know, it would be nice to be working in a place right there. Just like that. And I was still a resident. I didn’t know that The Rose existed at the time. And then, it was so funny, because when I came to interview here, I was at Featherwood. I wasn’t at this location. I wasn’t at the Galleria location. And then when I noticed it was the exact same place I had seen before on that highway right there I was like, oh my gosh.
Dorothy: Oh my gosh, so it was like such a sign.
Claudia: Yes, and I was like this this was meant to be. Uh, so even though I was young even though I knew was going to be a great challenge for me Um, I felt like it was the place I needed to be at that time.
Dorothy: Absolutely. [00:08:00] Absolutely. So tell me Did you find any difference, uh, working with the mixed populations? And when I say mixed, insured, uninsured, I know that our physicians don’t even know who is and who isn’t once they get back into the rooms. But did you ever see any difference, notice any difference, all the same, same concerns?
Claudia: Well, it’s different when you have patients who are uninsured and underserved. Basically for a few reasons. One, Hispanic women, a lot of Hispanic women that we see here, you notice that they’re not well aware in many things about their health, especially breast health. Maybe it’s the language, maybe it’s the social situation that they’re living in, maybe it’s the cultural, uh, differences they have. Um, you know, being shy about their breasts, or not telling anyone about it. Um, all of those things are different for this type of population. [00:09:00] Uh, but also you see the needs that this population has. Um, Not only Hispanics, but every race that is underserved or uninsured. Um, it gives you some perspective of the reality that these women are living.
Um, and I feel like it makes our job a little bit more empathic. You know, you have to have that empathy with the patient and understand where they’re coming from. Um, So in that sense, I think it’s different. Sometimes when you see patients who are insured and you’re right, we treat them the same. I, I didn’t even check if they had insurance or not insured or whatever.
Um, but you do see the difference when somebody has access to care and they’re insured, how their diseases are usually diagnosed earlier. and usually have a better, uh, ending in some ways. They get treated, uh, quicker, [00:10:00] earlier, and have better prognosis with early seizes. So, um, it, it’s different in that sense.
Dorothy: Right. And I, I really wish you’d speak more to the language barrier. You know, we, we often think, and I, I can remember our naivety way back when, when we thought, Oh, well, we’re just going to print something in Spanish. Long before we realized how many different dialects how many different terms mean different things. And so as you’re talking to the patients, what was the number did they did you have a number one question?
Did you have a Number one concern that they expressed and when they realized you spoke spanish, Did you see a turn and how open they would be?
Claudia: Yeah, absolutely like I would notice a difference between Me— Which i’m a spanish spanish speaking person With other doctors that didn’t speak spanish I would go in the room and it wouldn’t take me five [00:11:00] minutes. I would be there for longer because one thing I realized a lot for this patients is that It’s probably the first time they have seen a doctor And they have the chance to talk to this person in their language and tell them everything that’s going on. So um, of course we have to be— Knowing that we have a certain time amount of time to talk to these patients, but I would get so invested in talking to these women that maybe was their only chance to to have a doctor speaking to them. So they will talk about other diseases they were going through they will talk about all this emotional problems they were going through difficulties in their lives in general and I could see how patients would really open up to me, um, and tell me exactly what their situation was besides of their breast health.
Uh, so I took every single opportunity I had for these patients, not only to advise them about their breast health and give them my recommendations for their concern at the time, but also to tell them, [00:12:00] you know what, you have to tell this to your mom or your sister or your friends. Uh, Or sometimes they would even talk about their family, you know, well, you know, my mom had had a lump uh for the past five years and it’s getting bigger and I would be like, you know, maybe she hasn’t seen a doctor tell her to come here. Tell her there’s a place for them to come. Um, so that’s that’s one of the things that I enjoyed the most at The Rose that I could tell all these patients you have somewhere to go. Somewhere where somebody would speak to you in the same language that you need and a lot of our techs and our front desk personnel spoke Spanish.
So I told them you come here And you’re going to have somebody that will see you and will understand you and will help you with whatever your diagnosis is. Um, so yeah, definitely they would open up and and tell me more things.
Dorothy: And that’s so important You have to trust who you’re going to in the medical field. We always say you know, a lot of recovery from breast cancer when you’re going through treatment is how much you [00:13:00] trust the physician treating you, how much you trust what you’re hearing, and it’s the same when you’re having your mammogram half the time, and, and who would know what it means and what it’s about, and we, we forget as medical professionals, we’re using the jargon that others don’t understand, and, uh, it’s especially difficult for, for the uninsured, and when there’s a language barrier.
Claudia: Absolutely, yeah, so that was my opportunity to to just explain this patient what’s going on, what you need to know about your breast health and spread the word about it in your community. Uh, because that was the only way for me at that time, to be able to help more women is by that single patient that came into the reading room, into the room for me to expand that word.
So. So I took every opportunity I could.
Dorothy: And that’s, you know, when we, when we have word of mouth it is even more impactful than anything you could ever [00:14:00] advertise or put out there.
Claudia: Especially in this, uh, community. You know, they would spread the word. And I think it’s the most important thing. You know, you have to, and that trust you were talking about. Uh, that’s something that you only do one by one. You know, you, you talk to the patient, you’ll say, this doctor really listened to me. Uh, she was able to explain to me, even if I had pain and nothing else was going on, she took the time to tell me, your pain is probably because of this reason. Look at your images. It looks clean. I would explain to them. Everybody understands when you take the time to explain it in a way that is simple for them. So, just put the effort and do that. It creates trust.
Dorothy: You, you quickly said, I’d show them their images. Now that, that was kind of unique. I mean, when you started doing that, that was just really important to our, our patients. It, it, it didn’t just increase that trust, but it also said, you are, you are a smart woman. You can, you can help, you can understand this.
Claudia: Absolutely. And I think that’s a [00:15:00] way of, of increasing patient literacy, you know, and in health literacy is to show them it’s not just this image that you don’t understand. Yes, it takes a whole career to understand images.
Dorothy: Right.
Claudia: But you can pinpoint how to lump looks or how to mass looks to a patient and they can definitely say I see what you’re talking about. I I see that spot that you’re telling me. So it’s not just based on well, the doctor just told me this and that no, these are smart women, and you can tell them you see how different the difference between this tissue and that one. That’s what I’m going to go after. So they understand what we’re doing and they’re part of the decision making. They know what they’re expecting to, to get from the treatment and from the diagnosis. Um, and it’s important to include them. I would always tell them, do you agree with this plan? Do you like how this sounds because I want them to know that they have the not only the responsibility, but also they need to, to know what’s going on with their [00:16:00] bodies. Not just listen to what the doctor is telling them and just trust away. So I, I took the time, especially when patients were curious, to show them. And most of them understand exactly what I’m telling them. Maybe not in the medical terms or the jargon that we use, but it makes sense to them.
Dorothy: And I’m always amazed with how curious women are and don’t know the right questions to ask. Um, now was that partially behind your inspiration for Hola Bloom?
Claudia: Yes. Uh, This Hola Bloom non profit that we created was inspired in many things. Um, as you know, it started with my dear friend Heather, uh, getting diagnosed with breast cancer. Her first mammogram. She’s an anesthesiologist.
Dorothy: Ah, yes.
Claudia: Um, and it was her first mammogram ever. You know, 40, doing everything she was supposed to do. And she just went and got her mammogram and things were not right in that mammogram. [00:17:00] Um, So, talking to her and her, uh, diagnosis and how things were, uh, it was difficult for her. Even being, um, from here, from the United States, uh, she’s married to a, um, person from Venezuela. So, she kind of has some, uh, links to the Hispanic community as well. And we were talking and we were thinking how hard could it be then for somebody that doesn’t speak the language. You know, if it was hard for me as a physician.
And, as somebody that speaks Spanish, she’s bilingual too, how hard would it be for someone that has no idea in this country, uh, about the language, about what to do, or even so to someone that has no insurance or has never had access to healthcare. So, um, we decided to create this, uh, with the goal of explaining to patients what breast imaging is, why they need to get their mammograms done. [00:18:00] Um, and also in the standpoint from a patient, you know, from Heather’s point of view, uh, how to navigate the emotional, um, all the emotional situation that can happen with a diagnosis like breast cancer, and also to know how to make decisions on why she decided to make the decisions she make during her treatment, uh, in a way our Hispanic community could understand.
Um, so yeah, it helped. In many ways and uh, it was inspired by many things Uh from my end uh, it was inspired of the need that I saw in the hispanic community here in houston. I wanted to be able to inform these patients a little bit better of their breast health.
Dorothy: And you have some big plans for Hola Bloom.
Claudia: Yes, uh, we wanted to keep, uh, growing. We want to keep involving the Hispanic community. We want to create more talks in which we can find more women. Uh, together, uh, we’ve done some events, uh, where [00:19:00] we go to the Colombian consulate and give talks to women there and also tell them where they can go to find care, uh, because if we don’t tell them what the next step would be, where would they go?
Dorothy: Right.
Claudia: So I tell them, go to The Rose. Of course, you know, it’s important to inform them not only what to find in their breasts, but also how to find care, uh, for their needs. Uh, so that’s an important thing that we’re doing. Um, I’m also now. You know, as you know, social media is a really good, um, way of getting access to people, no matter if they’re insured, uninsured, I mean, everybody has a phone, almost everybody does.
Um, so I, I have understood very quickly and I have to thank you a lot for that because you show me the importance of the media, you know, how, how much more women you can reach instead of just being in the reading room or patient by patient. But if you start to communicate and put that voice out there through larger outlets, [00:20:00] so that’s something i’m trying to do.
I opened my social media as well so that patients can find me and my goal is to share from something they can watch on their phone every night and just scroll through and then oh, this is Dr. Cotes talking about whatever, you know. They can they can learn every day of new things and get reminded that well maybe you haven’t done your mammogram this year. Maybe this is the time so just keeping that going it’s a lot of work, you know to create a social media presence But I this year I was like, you know I have to start, and the sooner I start, the more women I’m going to be reaching, so, so I started that as well.
Dorothy: Well, I know when you were with us, and we do any kind of, uh, community outreach or PSA, you always insisted we had to also do it in Spanish.
And, you know, you took the time to do it, to, to give us that resource, and it was always very uh, I don’t want to use the word popular, but, [00:21:00] you know, it was so embraced. And when we started moving more Spanish speaking material to our website, you know, it just made all the difference in the world. And I really thank you for getting us on that path, because you were willing to, you know, just be out there and talk about it.
Claudia: Well, I have to thank you too for letting me go back to this Um, you know, I i’ve always liked the media. I always like that and although i’m an introvert too Uh, just like you I find it fascinating, you know and and I I used to do little things for tv when I was younger when I was a kid and you know, I had the option of doing something related to the arts when I was younger or medicine. And I feel like now, when I started with The Rose and doing interviews and talking to, to patients and just putting myself out there, it kind of also feed that need that I have or that interest I had in the media as well. Uh, and and it was something that I experienced [00:22:00] with The Rose. I hadn’t done that for a long time. So yeah, so I I enjoy doing this too, and I think i’m doing it for the best cause it could be you know, which is letting our hispanic population be aware of their health.
Dorothy: But now you are also Insistent that you take this story to physicians. I mean you’ve spoken at several different conferences And you’ve spoken about a subject that isn’t often on the agenda. You know, handling the uninsured, serving the uninsured, how to make medical services more accessible. And I always thought that was actually pretty brave. Because that’s not a topic that many want to even talk about.
Claudia: Well, if you don’t talk about it, it’s like it doesn’t exist. So you have to let other doctors know, even if they’re not dealing with the uninsured and underserved population, they need to know about this problem. Because if they don’t. There’s not going to be change done [00:23:00] from the medical field or and we’re trying but people have to really experience what it is to see patients that they as much as you want them to get access to care they don’t have it.
I mean i’ve seen patients that just because they they don’t have transportation to get to a place they can’t see their doctors or get their treatments or get their chemotherapy. And you wonder sometimes you say well, there have been so bad patients, you know they’re not coming in and they don’t show up to their appointments— It’s not because they don’t want to, of course they want to, but they don’t have somebody to stay at home with their kids or, or they don’t, they miss the bus.
You know, it’s just, we take a lot of things for granted. And I think when you are a physician that are not dealing, who are, who’s not dealing with all this patient population, you really don’t understand the difficulties that they go through. So, It is important to show doctors who are not exposed, what these patients are, who these patients are. Uh, not just to classify them like this [00:24:00] population that nobody talks about and it’s just somebody’s taking care of them, so we’re not going to mess with it. No, I think we have to get together as a group and know that it’s a problem and it’s a problem that is growing in the United States to be able to help them to a major extent like involving legislature, you know. Looking into laws and talking to our representatives to see how we’re going to be able to help this population in need, you know, it’s our responsibility as physicians um to be able to help everybody equally so, yes, i’ve spoken to to other doctors in conferences. I’m actually presenting some papers about that because I think it’s important For other physicians to be aware as well and know how to help, you know, because they might be like, okay, I know I’m aware, but what can I do? So there are many ways, um, radiologists can use their voices, can, can use [00:25:00] their expertise to help this, this population.
Dorothy: And I know you once spoke about how physicians that you were speaking to at one of the conferences really didn’t know. But once you had talked, They were coming up to you and saying, Oh my gosh, I had no idea. Oh my gosh, what, what else can we do? And, and that’s, that’s, you know, I truly believe physicians do, like you said, want to take care of everyone.
But we don’t have a system for them to do that. And there’s too much emphasis on less time with the patients these days than more time are just, you know, it’s just different. And, and I think you were a breath, you know, breath of fresh air coming in and going, Hey, we’ve got, we’ve got a problem here. Let’s see what we can do.
Claudia: No, especially if you, if you see the population in the United States, I mean, the Hispanic population is growing. Um, so that also brings up the importance of having a very diverse, um, staff.
Dorothy: Yes.
Claudia: No, you need to have staffing that is diverse. You need [00:26:00] to have doctors that look like their patients. You need to have this patients know that they have someone like them taking care of them. Um, because that’s how you’re going to build that trust. That’s how you’re going to help these patients. Um, so I think starting with diversity in the workforce is important and we are trying in radiology to, to make places diverse. And, uh, UT Houston, I think it’s a very diverse place. I mean, I, I’ve seen doctors almost from every nationality, um, but especially for breast imaging in, in Houston, um, I think it’s important for us to be diverse and, and speak the same language.
Dorothy: Absolutely. And, you know, when you said, uh, the medical community is, is embracing more diversity, there was a time when women were not embraced. And so that, um, speak to that a little bit. I mean, is this something you would encourage a woman, a young woman, to consider and go into?
Claudia: Absolutely. Absolutely. We need women, [00:27:00] um, leading in radiology and in medicine. Um, of course, if you’re doing breast imaging, being a woman gives you, uh, a little bit of, um, yeah, like a, It helps you a little advantage because patients, sometimes they can be shy. Sometimes they prefer a woman to look at their breasts. They feel like the woman is understanding them a little better because they have breasts too.
Uh, of course there are great male breast imagers, for sure. Um, but if you notice, it’s interesting to me to see a lot of the textbooks in breast imaging are by male patients and a lot of the doctors that speak in conferences are male patients. Even though breast imaging is mostly women, I think we have more women than men in breast imaging, uh, a lot of the higher levels in breast imaging are still men.
Um, so. I think it’s slowly [00:28:00] getting there where we’re going to be equal, uh, in the amount of leadership and, and, and, you know, um, higher—
Dorothy: yeah, the folks that make the rules.
Claudia: Yeah.
Dorothy: Yeah.
Claudia: We’re going to end up being more equal. Um, I think there’s still room to grow. Uh, but I definitely feel like there has also been a change in how men think about women and they’re being inclusive to, so I’ve seen a lot of male doctors that are now promoting having women, uh, leading as well. And that’s something that I, that I found in my job and something that I learned from The Rose to, uh, you know, The roles were, were mainly women.
Dorothy: Yes.
Claudia: Do we have a man in The Rose?
Dorothy: We have, we had one man at that, still have one male employee, but our radiologist, we’ve had men.
Claudia: Yes, but, but usually, you know, uh, in the leadership is mostly women and, and you see how this runs very well. And now that I joined [00:29:00] UT Houston, the, the chair is a, is a woman also. Um, so. So. It’s been good to see that example of women leading in medicine and in business. To me, it has been really fascinating.
Dorothy: So go back to your day to day work as a radiologist. You know, many times when we would diagnose people, you were the person telling that woman you have cancer. So tell us a little bit about that. How, how do you communicate that to a woman and how difficult or not difficult, or it is on you.
Claudia: I’m going to be honest with you, it was very difficult. In my training, we were used to giving results by phone. So we would call the patient. I remember when I was a fellow, I was like, this is really hard to do. You know, how to tell someone these bad news. Um, so I basically created a script going back to my acting and all that stuff and I created a script, you know I I have to know exactly what I need to tell this patient. I have [00:30:00] to make some silence and listen to how this patient is feeling to see how i’m going to respond to whatever their reaction is. Sometimes you would have patients that are very sad.
Sometimes you’ll have patients that are mad uh, sometimes patients would be, you know, they can react in so many different ways when you get news like that. So I created my script and over the phone, it was a little bit easier. You know, I’m not seeing this patient. I’m not looking at this patient’s eyes.
I don’t see their surroundings. So I had a pretty much good, I can do this. And I was doing it. When I came to The Rose and they told me, well, we give the results in person. I was like, okay. We’ll do that. And the script didn’t really work that well, uh, for me, uh, because when you have somebody in front of you who’s, and I’m, I’m an emotional person, I mean, I can, I can really feel how other people feel.[00:31:00]
Um, I started doing that and very quickly I realized I have to do something about this because I, I can’t do it. I would do it. You know, I would tell the patient I would have a straight face, I would be empathetic and I would lay with them, but then. I would leave that room in tears. Every single time. So Jeannie and the techs were like, Are you okay?
And I’m like, Give me five minutes. And I would just close the door and cry and cry and cry. Sometimes it would be because I would see the face of the person by them, you know. And it brought me back to when my mom had breast cancer.
Dorothy: Now you haven’t talked about that much. I thought maybe you would. What was that like?
You were young.
Claudia: Yeah.
Dorothy: So how old were you at that time?
Claudia: I was like maybe 24, [00:32:00] 22. She’s fine. It’s just emotional.
Dorothy: So it wasn’t just you seeing that patient’s journey that’s ahead from the physician’s point of view, you were seeing it as a daughter.
Claudia: And I was seen as a caregiver, you know, because I took care of my mom during that time. And I noticed quickly that a lot of the patients that would trigger me you know, that feeling of, Oh, I know how you’re feeling, you know, I can totally relate to this, is when I saw the caregiver besides them.
And, um, very often we forget, we forget about this person that is helping the cancer patient through their diagnosis. And it’s hard, it’s a, it’s a high, um, it’s a very emotional toll. Uh, because you have to be there strong. Uh, you have to be there, uh, positive. [00:33:00] You don’t want this person to see you thinking that oh my god, this is really bad. You have to give them always a positive vibe and tell them, Hey, you’re gonna be okay um. And sometimes you don’t know you don’t know if they’re gonna be okay. You you hope they are and you will do everything to make sure they are but we don’t have that answer.
Dorothy: No, we don’t and and when it’s you taking care of your mother talk about roles being reversed and it’s so—
Claudia: Totally so—
Dorothy: You didn’t you didn’t have that comfort from her. You were having to be the comforter.
Claudia: And it happens a lot, you know, you’ll see a daughter taking care of their mothers, um, their grandmothers, husbands taking care of their wives. And it’s usually, um, a person that is not taking care of, you know, nobody’s taking care of the caregiver and you’re expecting this person to be there all the time.
Um, but it can be difficult, especially if it’s someone that you [00:34:00] love. Going through all these things. So, that was hard for me. Um, and, I actually went through therapy. You know, I’ve always been going through therapy. I love going to therapy. I think it’s important for everybody to go.
Dorothy: I’m so glad you said that.
Claudia: Yes. It is.
Dorothy: It’s important.
Claudia: It is important. I mean, it’s like when you go to the gym and take care of your body, you have to go through, you know, therapy and take care of your mind and your feelings, you know. So I’ve always been there. But then when I started giving this news to patients in person, that’s when I realized There’s something in me that I haven’t really let go you know, so I talked about it with the therapist and I realized it had a lot to do with the type of patient that I would see.
So, a patient that had a younger daughter or a mother who her daughter is taking care of her, you know, those were the cases that triggered me the most. So, I [00:35:00] went through therapy and I worked it up and after, you know, a few months of full therapy with that. I was able to do it much better. I was not doing it bad.
You know, I was doing my job as a physician and it’s like the role I take. This is my role today. I’m doctor. I’m going to walk into that room and I’m going to just deliver. Um, but then emotionally, Claudia, the real woman in person behind this role, uh, I had to work on that. So I did. And then I didn’t cry anymore until now.
Dorothy: No, but Claudia, I think when you you describe yourself as putting on that role. Those patients always knew that you understood. And they always felt like you had a special knowing. It wasn’t just that you could speak the language. You had something extra that, that was gonna ensure them that there’s, there’s hope here.
Yeah, cause, and, and as you know, The Rose was able to [00:36:00] find treatment for all of our uninsured people. But still, there’s many, many barriers ahead and challenges ahead that they’re just going to have to get through and somehow you being there and encouraging them meant a lot.
Claudia: You know, I think I was in the perfect scenario to be able to give this type of bad news to patients here at The Rose because I would tell these patients, wait, there’s hope. It’s not like you’re because they would be I’d have nowhere to go. I have no money I have what am I gonna do? Like I literally they had no idea what to do. But I always make sure they had a plan and they knew what the next step was gonna be. So, yes, is it an easy year that you’re gonna have ahead of you? No, I mean this is gonna be really hard and, and you’re gonna go through a lot of things and I know what those things are and I can tell you. Um, but they had a place to rely on and, and a service that they would get because somebody like The [00:37:00] Rose is here to provide that service to them. So that was easy for me.
You know, I, I could find like, okay, I’m giving them hope. Thanks to The Rose, I can tell them, you’re not going to be alone. So ending the conversation and those notes, uh, was always positive. And I would see how those patients would go through the route and of care and get treated. So that was, uh, wonderful.
Dorothy: So you have two young daughters now, you know, what are your dreams for them?
Claudia: Wow. You know, it’s it’s hard, you know, because you want to dream the best for them, of course. You want the best lives they can ever have. But one thing that I’ve understood very quickly is, no matter how much I try to be the best mom for them, It’s their own lives you’re gonna they’re gonna have their own experiences their own [00:38:00] difficulties in life and I want to be there to guide them and to help them as much as I can but I know I won’t be able to protect them from every single thing that happens.
So my dream for them is just to grow as human beings constantly learn and become better people as they grow, you know a better person every day and to enjoy life, you know. I mean, what else can, can they do, you know, it’s just life is so short and so many things you can be during your lifetime, you know, you can be a doctor.
Now you don’t know what you’re going to be in the future. Uh, they can be whatever they want to be. And, and we’re in a country where thankfully there’s opportunity. Especially, um, if you’re born with a family that can give you opportunity. Not everybody has the same privileges. I understand that. Um, but there’s opportunities still.
So [00:39:00] my dream for them is just to leave, like live the best lives they can. That’s it. Do whatever they want to do. Be where, whoever they want to be. Um, but just be the best they can.
Dorothy: Yes. Yes. I think that is so so important that our children here they can be and they can be whatever you know, it’s so different these days. I think we’ve Our whole population has grown In maturity and knowing we cannot shape everything that comes along If nothing else kovach told us that we learned a lot through that time.
Claudia: Absolutely.
Dorothy: Yeah. Yeah. So, uh, do you think this is, this is a question I know that I didn’t even think about asking you, but some of our physicians have been noticing that women are more curious now since COVID. Are you seeing that there’s more questions? Are you seeing [00:40:00] there’s more of an interest in knowing? Of course, you always were a great teacher, but—
Claudia: Yeah, I think what’s happening now is that it has to do a lot with social media. You know, we were all hiding in our homes and we just had the phone to look through and social media TV and all that. And because it was a pandemic, but, um, people were interested in health in general, you know, they wanted to know what the treatment would be. They wanted to know what so and so doctor is saying, uh, they wanted to have some science backing up the things they were hearing. So, everybody was just like absorbing more health information in general in these past few years. You know, all that we saw in the news for a very long time was COVID and how are the numbers and how is it growing and how does it transmit and how so it’s, it was like a very scientific time. I feel like, uh, even though it was like a novel virus, people were trying to research about it very quickly and [00:41:00] papers were coming out.
So I feel like. In general, the population had to understand or be more involved with health during this time. So, I think patients are more empowered in some way, uh, because they know where to find information now. They know how to Google information and that’s one of the things I hope for, that people know how to Google information.
Dorothy: That’s so important.
Claudia: Exactly. And don’t end up with information that is not correct or not backed on science. But, I feel like, like patients in general, people in general, now. Feel more empowered to look up and understand what they’ve been told. So I I’ve seen a little bit of a change, uh, in relationship to that, like people want to know more and they want to make sure, you know, and they want to know where you got your information from and they want to know what’s backing up what you’re saying.
So, yeah, I’ve noticed that change and I think it’s great, you know, I mean, it’s funny because I’ve seen it in Colombia back in the day and [00:42:00] I seen in some patients. Now, even probably the older patients, they just take whatever you say, you know, they’re like, don’t, don’t, don’t, whatever you say, doctor, and I’m like, I really want you to understand this.
I mean, this is you, you are making this decisions. We’re here to guide you through and to tell you what we recommend as physicians. And I totally appreciate that you trust me completely. But when I’m consenting a patient, and when, when I’m telling them, What I’m going to be doing, I expect them to really understand what I’m saying and not just say, Well, the doctor told me so many things, I didn’t even understand what she was talking about. No, I, we do want our patients to understand. So I think it’s great that patients are, are doing that. I think they, every patient should.
Dorothy: It’s one of the few positive things that really did come out of this.
Claudia: Yeah, I would call it a positive thing.
Dorothy: So, as we wind up talking today, and I certainly hope we get you back for other things, I want you back to talk a whole lot more about Hola Bloom.
Think [00:43:00] of what would you want to say to our Spanish speaking women about their breasts and let them know what they need to know. What, what is the one message you’d like to send to them?
Claudia: Ah, me gustaría decirle a las pacientes que hablan español, que sientan que tienen un lugar adonde ir. Uh, aqui en los Estados Unidos, si estan en Houston. The Rosiempre va a estar aquí para ustedes. Quiero que sepan que deben tener control de su salud. Um, Siempre estar investigando sobre su salud, ver médicos, asegurarse de que están haciendo los exámenes de screening que necesitan hacer. Screening es importante para descubrir las enfermedades cuando todavía son tratables.
Lo importante para las mujeres hispanas que me están oyendo, es que sepan que el cáncer de seno es muy común, nos pasa mucho a las mujeres hispanas, y muchas mujeres hispanas en comparación con las blancas, mueren de cáncer de seno. Y es precisamente por la razón que no [00:44:00] conocemos a nuestro cuerpo, no estamos siguiendo las guías cómo debemos, y es importante que tengamos las mismas oportunidades. y todo empieza con nosotras mismas. Conociendo las oportunidades que tenemos. Mujeres que sientan una maza en su seno, que sientan una diferencia en su seno, vayan al medico, siempre va a haber un lugar para ustedes. Siempre va a estar The Rose para ustedes si tienen algo en su seno. Y si son mayores de 40 años, hacerse su mamografia todos los años es lo más importante para detectar un cáncer de seno de manera temprana. Eso es lo más importante.
Dorothy: And so to all women, what would you say?
Claudia: To all women? I’m going to, I’m going to try to be short and nice here, but I want to say women should feel empowered about their breast health and health in general. Um, screening is very important. When we do screening, we’re basically checking for disease before you can even feel it.
Um, and although there’s a lot of things said about mammography, and I, I’ve seen those blog posts, and I’ve seen these people [00:45:00] talking about how mammography can, can be harmful. What science demonstrates is that since mammography started, less women are dying from breast cancer. So we know it works, it is effective, and it’s the best test we have out there.
Is it the perfect test? No. But it’s the best test we have right now. If you want to have an early diagnosis, in the case you’re one of that one in eight women that can develop breast cancer in their lifetime, you must get a mammogram every year from age 40. Some patients, depending on their risk, they might need to go earlier.
You know, they might need to start earlier. So, by age 30, go to your doctor and find out if you’re one of these high risk patients that need to get screened before, uh, before 40. But it’s important to take screening into account, not only screening for breast imaging, but for other conditions, colon cancer, cervical cancer, um, screening is there for us to catch our [00:46:00] diseases early.
So take that opportunity and do that every year. And of course, know your body, feel your breast, trust your instinct. If you feel something that doesn’t feel right, go to your doctor. Don’t wait, even if your husband tells you. Not to go even if your friend tell you tells you it’s nothing If you feel something just go get it checked. That’s the most important thing
Dorothy: Great great advice Dr. Cotes. And, and I think the the overall theme we’ve heard today and you’ve been so candid and honest with us Is we have to take care of ourselves. We really have to put ourselves first and whether it’s our spiritual side our mental side our emotional side or our physical side We do have to take care of ourselves.
Claudia: Yes, just be better every day from all the aspects that you can. That’s that’s important.
Dorothy: Well, thank you for being such an inspiration and for sharing so much with our listeners And [00:47:00] we’re so pleased that you’re continuing in this journey you’re on to bring more education to the spanish speaking woman and to really make sure she understands what is going on. So thank you for that. Good luck in everything that you’re doing now, and, um, we just, we just really appreciate the time you were with us.
Claudia: Thank you, Dorothy. It’s always a pleasure to be here. You’re a great inspiration for me too. I learned so much from you and I know this is just the beginning. I’m going to keep helping, uh, this patient population and we’ll see where life takes me.
Dorothy: That’s it. That’s it. So we’re going to wind up today and again, we, we encourage you to take care of yourself. Until the next time when we talk about your breast.
Post-Credits: Thank you for joining us today on Let’s Talk About Your Breasts. This podcast is produced by Freddy Cruz Creative Works, and brought to you by The Rose. Visit TheRose.Org to learn more about our organization. Subscribe to [00:48:00] our podcast. Share episodes with friends and join the conversation on social media using #LetsTalkAboutYourBreasts. We welcome your feedback and suggestions. Consider supporting The Rose. Your gift can make the difference to a person in need. And remember, self care is not selfish, it’s essential.
