Dorothy: [00:00:00] In this episode, we are featuring Ginger Clark. Now, she’s known around this community as a volunteer and she’s a great supporter, but some of the things she talks about today have to do with access to care and why we need to be sure that our health care dollars are going where they need to. She’s very well versed in the world of breast cancer, has a Family history of it and has been through it herself, but what she has to say about access to care is one of the most profound and important messages I have heard in a long time.
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Ginger, thank you so much for being with us here today on Let’s Talk About Your Breast.
Ginger: I’m happy to be here and make whatever contribution I can.
Dorothy: Oh, we’re so delighted to have you. Now tell us a little bit about Ginger Clark. I mean, I know of you and half the world it seems like knows of you, but tell us about your community work and, and the different things that you’ve done.
Ginger: I’ve been involved with any number of non profit organizations. I went, after I retired from Exxon, I got a Master of Liberal Studies at Rice Continuing, Glasscock Continuing School, because I had studied math and science pretty much all the way through a Ph. D.
Dorothy: Mm hmm.
Ginger: And, after doing that, I [00:02:00] became much more involved in the rice community. I had been a member of the Baker Roundtable because I’d always been interested in, in those, those issues. So I, from there I was on the Graduate Liberal Studies Alumni and I ended up being president one year.
Dorothy: Oh my.
Ginger: And then I’ve been on the board of Friends of Fondren. My sister Janet, whom you know, recruited me to the board of the Houston Symphony. I’m not the, I’m not the most musically talented member of the family. My two sisters Barbara and Vivian were excellent pianists. I was lazy. I didn’t practice. So it doesn’t happen naturally. Then, I’ve been involved in my neighborhood garden club, which I joined really to meet the other women in the neighborhood.
And then somehow, eight years later, I [00:03:00] end up being elected president, not because I know so much about gardening, I really don’t, but because nobody else wanted to do it.
Dorothy: Oh, goodness.
Ginger: So then, um, so I’ve participated a lot with the symphony activities.
Dorothy: Mm hmm.
Ginger: The different, uh, What my favorite of theirs is their annual wine dinner.
Dorothy: Oh, well, of course. Yes. Yes.
Ginger: Yeah. And then there’s another group that I’ve been involved with more as a supporter is Emerge, which, uh, was started by, I think some Teach for America alums and what they do. is they work with, uh, high achieving students in, in, uh, public schools. They’re with HISD, Spring Branch, I think, Alief, all of the local public schools. And they identify these kids in 10th grade [00:04:00] and then work with them to enable them to apply to colleges, get into colleges, because it’s quite, you know, It’s quite a marathon.
Dorothy: Oh, yes.
Ginger: And if your parents have never been to college or in many cases, these are first generation kids, they don’t have a clue. So what Emerge does in many ways is provide a lot of the things that your sort of middle class professional parents provide for their kids to try and help these kids to be able to achieve at the level they’re capable of to eliminate some of the obstacles.
Dorothy: And that is so needed now, so very needed. So, you’ve supported many different organizations, been involved, as you’re telling us, in so many. Your original position, though, as a geophysicist, you, you were around a lot of men in a very different environment.
Ginger: Uh, [00:05:00] yes. When I started, there were very few women. Now, by the time I retired, they had quite a few more. Things have definitely been changing. They may not be perfect, but they’re a whole lot better.
Dorothy: Oh, yes. And it’s because women like you stepped out and were able to do that. So, I first met you at a function, um, for Planned Parenthood.
Ginger: Yeah. Oh, I forgot to mention that.
Dorothy: Yeah, and I know that that’s been a, uh, a real special charity work that you’ve done. Why is access to health so important to you, especially for women?
Ginger: Well, access to health is important for everybody. Women at a younger age have more health needs than men. I remember this was quite a few years ago, a young woman who was the, uh, my French teacher, the Alliance Francaise, her husband had his own little company.
And so she was absolutely shocked at [00:06:00] what it would cost to cover her for insurance because she was a female of reproductive age, a male of reproductive, of that age is pretty inexpensive to cover, so women do have special needs. Uh, then obviously being a woman, I’m inclined to identify with that and, uh, it does seem like our system, where we spend tremendous amounts of money, but we don’t exactly achieve optimal results.
Dorothy: Oh, no.
Ginger: Because too much is spent in some areas. Like my parents last years, uh, one or two of the surgeries my father had, in retrospect, wouldn’t do it, do it again, because the payoff just wasn’t there to, to, uh, Compensate for all this, I mean medical, medical treatment, you’re going to be [00:07:00] worse off before you’re better off. So.
Dorothy: Well, that, that is no saying in there, yes.
Ginger: That, that has to be, there has to be enough of a, of a payout on the end, otherwise you’re more comfortable just living with that and going on. Uh, so that was kind of an eye opening experience.
Dorothy: Oh yes.
Ginger: Because I only knew one grandparent. My parents had never been around elderly people. My one grandmother who I did know, she lived, my mother’s family’s from New Orleans and she lived with her children. My mother was the only one of five who got married. New Orleans is a different place, to say the least. And so my aunt, who is my mother’s younger sister, took care of her, basically. So, you know, we’ve never really seen what the end of life is like.
And actually, as a [00:08:00] result of doing that, as the eldest daughter and having just returned retired, although Barbara and I were doing it before I retired, taking mother and dad to her, their appointments and so on. I was the one who basically took over as the point person on things. And, as a result of that, when I had to write a capstone for my Master of Liberal Studies, I thought, well, what have I been doing? The title was Aging in a High Tech Society.
Dorothy: Oh, I bet that was fascinating.
Ginger: Well, I learned a lot that is actually useful for me because I figure, uh, you know what? After your parents, you’re next.
Dorothy: You’re next. That’s, that’s so true.
Ginger: That, uh, and forewarned is forewarned. You can make plans and one of the things I’ve done as a result of that is I had gone to a doctor who I really liked for years, but she [00:09:00] was a single, single practitioner. And when you get older, you’re going to need more doctors and more of this, and one of the things I learned from doing that is , having all the records in one place
Dorothy: is so helpful.
Ginger: Is essential.
Dorothy: Yes.
Ginger: So I then switched to, uh, Baylor, their, uh, uh, Stratus clinic there. They may have changed the name. I can’t keep track of all change.
Dorothy: Yes, yes.
Ginger: So that was, that was one thing I learned. The other thing I learned is the most dangerous thing for the elderly is falling.
Dorothy: Mm-Hmm. Absolutely.
Ginger: And, uh, other, you know, I’m sure there are other things that,
Dorothy: Oh, no, that, that leads the list.
Ginger: Yeah. Yes. So, so it was a worthwhile. Worthwhile experience. And then I’d given money to Planned Parenthood for
Dorothy: Uh huh.
Ginger: For years. [00:10:00] Because it just the other thing that was interesting that I learned when I did my research was I read about different health systems and Medicare, the name actually comes from the Canadian system, and the original idea, because I always kind of wondered, you know, I am elderly now, I am covered by Medicare, but from an economic perspective, don’t you want to cover your working age population first? And then maybe the kids, because kids are inexpensive to cover. But the reason was, this was back in 65 or something, the idea was, well, there aren’t that many old people, everybody likes grandma, let’s get it in through grandma, and then we’ll be able to expand it.
Dorothy: Oh, how interesting.
Ginger: But of course that never happened.
Dorothy: It never got expanded, right.
Ginger: And the reason it didn’t was because a large fraction of the population already had employer provided insurance, so you didn’t, you didn’t get the drive, the political [00:11:00] drive, to make it happen.
Dorothy: And how much that has changed over these last 30, 40 years?
Ginger: Well, I know when I was working for Exxon, this was sometime in the 80s, they had a big meeting with everybody and saying, we’re changing the, insurance system. You can have a PPO or an HMO and the price will correspond, uh, because the cost had just skyrocketed.
Dorothy: Right.
Ginger: And so it’s been a game ever since.
Dorothy: Yes.
Ginger: For trying to squeeze here and you squeeze here. It’s kind of like controlling the drug and just The illegal drug industry. You, you shut down this route. Oh, it comes in that route.
Dorothy: Right?
Ginger: You change these rules and they figure out another way. Well, there’s a whole, ah, I think a whole degree in coding.
Dorothy: Mm-Hmm.
Ginger: And there are ways to code so that you get more money packed.
Dorothy: Right, right.
Ginger: So,
Dorothy: my goodness.
Ginger: It looks to me [00:12:00] like. It’s a hopeless system.
Dorothy: No, well listen, there’s always hope now, but still, you’ve got it nailed. Healthcare is very complex. Any healthcare provider is feeling that kind of squeeze.
Ginger: Mm hmm.
Dorothy: And it is very, very difficult to cover. Uh, you, with today’s insurance prices, any, any employee, employer situation is always hassling with that. Now you had your own health, uh, I don’t want to say crisis because I don’t think it, knowing you it wouldn’t have been like that, but you went through your own situation with breast cancer.
Ginger: Yes. Um, that was in, uh, 1970, actually I was diagnosed, I went in December for the mammogram. I mean, I’d been doing it for years. And then I got called back and I really didn’t think too much because I’d [00:13:00] had that happen before. But after the radiologist had looked at the pictures, he called me back and showed them to me.
And there were two little spots, these little white starbursts patterns. And he said, uh, can’t be sure, but I think these, I think this is cancer. Well, I had looked at a lot of seismic data, so he’s, he’s done a lot of interpretation. And it was like 90%. Oh, well, this is it. But then I had to have the biopsy. And they said, well, you’ll have a, uh, anesthetic. I have never had anything so bad.
Dorothy: Oh my goodness.
Ginger: When they took those, those little samples.
Dorothy: Uh huh.
Ginger: And then it turned out I was walking over to my sister’s, we were going to go together, three of us, to the Planned Parenthood, uh, luncheon in, it was January, I think, of 2020, and I received a call from my gynecologist, [00:14:00] telling me that she had gotten the report from the lab and the biopsy had shown cancer.
Dorothy: Oh my goodness.
Ginger: So, I was thinking, well, I went to the luncheon, I was thinking, well, at least I don’t have to worry about who’s going to pay for it.
Dorothy: Right.
Ginger: Or any of those things, because I’ve always had insurance. At that point I was on Medicare, but even before, I had the employer provided insurance. So, I had one less, one less worry than a lot of other women have.
Dorothy: That is what our uninsured women worry the most about. It’s not if they’re going to survive, it is how they’re going to pay for everything.
Ginger: Well, and the other thing too, like in my case, because I had been going for these mammograms, they caught it relatively early. It was DCIS.
Dorothy: Mm hmm.
Ginger: Uh, so. That’s kind of like [00:15:00] the first stage. Now, my sister who, three of us live in Houston. We grew up here in Houston. And my fourth sister, who actually is now retired and OBGYN, lives in North Carolina. Well, she had had breast cancer about two years before I did. It was the same thing, the DCI, DCIS.
And it was also in the left breast, for what it’s worth. Now, when I went to see the oncologist, uh, At Baylor, my sister Janet went with me and she was a little concerned, you know, there could be a, is there a genetic link here when you have two? And they went, the nurse went down and asked the geneticist and they said, no, at their ages. No, that’s just, I guess, random errors, old age, et cetera. And what the, um, radiologist had explained to me, I always kind of wondered, well, how with x rays, how is a cancer cell that [00:16:00] much different from a regular cell? It’s density, because that’s what x rays pick up. And the, uh, radiologist explained to me that what you’re seeing are calcium deposits left after the cell dies? And then last, the last exam I went for, uh, the radiologist said, well, what happened. Uh, because I think the oncologist, Dr. Osborne, had said that, oh, you may have had that for 10 years. It’s just been growing. And this radiologist said, well, what happens is it grows, it fills the tube. And it runs out of room, so they start dying, and I guess that’s when they might start thinking about looking for another home.
Dorothy: That is absolutely right.
Ginger: And that’s the dangerous, dangerous part.
Dorothy: That is a great way of explaining it.
Ginger: So the thing is, if women can get these, and then, my sister had told me, Vivian, the OBGYN, you know, like one in eight women [00:17:00] will get breast cancer. It’s just that common. Because the DNA keeps the cells keep replicating and there are more chances for error as you, as you age. So it’s quite common, but it’s one if you catch it early.
Dorothy: Makes all the difference.
Ginger: Yeah, there, there are, I know, some really nasty versions of it that there’s not much you can do about, but the garden variety like what I had, you catch it early and you had the, they gave me a choice of treatments. I could have a lumpectomy, but I had two bad lumps.
So that was, and then you’d have either radiation or chemo afterwards. Well, a number of years ago with some other friends, we helped a friend who was going through that at MD Anderson. She had had the lumpectomy and then was having chemo. Well, after seeing what she went through, [00:18:00] but you know what? At my age, just not worth it.
And so I opted for the mastectomy plus having, I mean, didn’t know a lot about oncology. But, I did know a lot about imaging, just image different things, and there’s uh, okay, there’s these two you can see, how many others are in there that you can’t see? So I opted for the mastectomy. Now the surgeon suggested that I go talk to a plastic surgeon first to see if I wanted to have the reconstructive surgery afterwards.
And I had this vague idea, well, you know, you slit it open, you scoop out the bad stuff, and then stick in a silicon bag. I couldn’t have been further from the truth.
Dorothy: No, it’s not quite right.
Ginger: Not at all. So Janet and I went over. She was sitting behind me, so I couldn’t see her, and the [00:19:00] surgeon, a very nice young man, he was from Brazil, which probably isn’t too surprising. That’s the cosmetic surgery capital of the world. But he, he was doing reconstructive surgery. He was explaining that, uh, what they would do is first you have to stretch the skin back out and it would go through multiple, you know, it didn’t take long for me to decide. It’s age 70. I’m not going to be wearing any low cut, low cut ball gowns any time soon. In fact, if I go to buy something, show me the ones with sleeves. So, you know, it would be different for a much younger woman.
Dorothy: Certainly.
Ginger: The concerns.
Dorothy: And the choice was yours.
Ginger: Yeah.
Dorothy: I mean, that is, that is one of the things that, that for many of our uninsured women, they don’t have as many choices.
Ginger: No.
Dorothy: Mainly because they come later.
Ginger: Yeah. And that’s the, that’s the tragic thing.
Dorothy: Yeah. And their treatment is just so, so, [00:20:00] um, much more intense and has to go on longer. But even to have reconstruction for some of them is just not an option because they can’t take that time off work. You know, they can’t, they don’t have anyone take care of them or during that time. So, yeah, that’s a very personal decision for.
Ginger: Yeah, and it’s going to be different for different women at different stages of their lives.
Dorothy: Absolutely. Absolutely.
Ginger: Because what’s important to a younger woman and what’s important to an older woman are frequently two different things. That was, and I had read years ago the book, it was quite well written by an oncologist, uh, Indian guy, so I can’t remember his name, but it was Cancer, the Emperor of All Maladies.
Dorothy: Oh, yes. Yes.
Ginger: It was very well written and it gave me quite a respect for oncologists, what they were up against. And the reality that [00:21:00] these methods that you’re using, whether it’s radiation, of course they can get it much more focused now, radiation or chemo. You’re, you’re killing cells, but because the cancer cells grow faster, you’re, it’s a, it’s a differential thing. You’re knocking more of them, but it’s bad for the body as well.
Dorothy: It’s very hard on the body.
Ginger: So it’s something that if it was, aside from seeing what my friend Janet Beck went through with the, that was, that was enough to say, no.
Dorothy: No.
Ginger: I’ll opt for this.
Dorothy: So you did all that during the pandemic?
Ginger: Well, I was very lucky. I had my surgery on March 6th.
Dorothy: Oh, you’re kidding.
Ginger: Right before everything shut down. So, I was at home recuperating, isolated anyways, when that, now because obviously, if it had been scheduled for two weeks later, it would [00:22:00] have been canceled because it wasn’t, You know, they didn’t have to get it right now, but then I would be living with that.
Dorothy: Oh, that would have been, yeah.
Ginger: And even though you know, oh well, it doesn’t matter, it’s still unnerving.
Dorothy: Right.
Ginger: So, so I was just very, very lucky with that.
Dorothy: Yes, so during that time, now you have a sister who’s already been through this, and many of your friends, like you were saying, but what was the most valuable thing anyone said to you? Did you, or special thing that anyone did during your recovery, during your time?
Ginger: Well, I had several neighbors who would come over with some little flowers or presents. Lunch or whatever. I, I live in a very nice neighborhood with really wonderful neighbors.
Dorothy: Oh, that is so important.
Ginger: And then of course I have my sisters and we live in the same neighborhood, a little triangle, and it just [00:23:00] makes it, well even during COVID we had our own little pod. Oh, yeah. We just go over to each other’s house.
Dorothy: Well, you know, one of the things I hear often from our, our, uh, guest is those little things meant so much. And, you know, when people say, well, what can I do? You never can think of anything, but when they just do it, then it means so much. And, you know, there’s just a lot of them in your mind, no matter how
Ginger: Oh, yeah. It’s, it’s not a;
Dorothy: it’s a lot of them in your mind. Right.
Ginger: It’s I sound rather matter of fact now, but when I received the diagnosis, for sure it was like, oh, this is, you just don’t think it’s going to happen to you.
Dorothy: That’s it.
Ginger: But it does.
Dorothy: It does. Yes, no one does.
Ginger: It does.
Dorothy: And, and why is it important now for you? And, and I know you’ve been very open about your diagnosis and about that time. Why is it important for you to share?
Ginger: Well, if it could help [00:24:00] someone else, that would be, you know, this is, this is how I approached it. Somebody else might approach it a different way, but that might, you know, Help someone else who’s trying to make these decisions.
Dorothy: Right. Was there, was there any time during all this that you thought, well, maybe this was the end of your life, or?
Ginger: No. I’m, I mean, I am obviously not a medical doctor, but I was trained as a scientist, so I think probabilistically.
Dorothy: Ah.
Ginger: So, yeah, it’s a bummer. I’d rather not had it.
Dorothy: Right.
Ginger: To be perfectly honest. But, it’s not the worst thing that could have happened. And I had last year, this summer, two of my former colleagues passed away from cancer. One I knew he’d had brain cancer for about two years, and the other I didn’t know about until he died, pancreatic cancer. And my sister Barbara has a really good [00:25:00] friend who died about two years ago of pancreatic cancer. So, you know, you get to a certain stage of life and you don’t know what’s gonna happen. So if that’s my one bout with cancer,
Dorothy: so be it.
Ginger: I’m grateful, thank goodness.
Dorothy: Yes. Well, you’re almost to that five year mark, aren’t you?
Ginger: Um, one more year.
Dorothy: One more year. Yeah.
Ginger: Yeah. And I’ve taken the Tamoxifen
Dorothy: Mm-Hmm.
Ginger: uh, and. Dr. Osborne, well, you know, it’s up to you. It’ll reduce the risk a little bit, but some women have side effects. I had no side effects, and he’s, and I think he said it helps with bone density, so all right.
Dorothy: Oh, yes.
Ginger: Sign me up.
Dorothy: Because we’re back to that falling.
Ginger: Oh, yes.
Dorothy: How important it can be to, to have that good bone health. Yes.
Ginger: So the thing, the thing that, It is such a shame is that so many women don’t get the screening so that they could catch it early. And then I [00:26:00] know you’ve got these coaches that go out into the rural areas, which is phenomenal because from what I, you know, I know what I read in the Chronicle, but in other, the rural hospitals nationwide have just been closing in droves.
Dorothy: Yes.
Ginger: The population is shrinking. Then of course in Texas, you have those choose the expletive of your choice in Austin. Oh, we don’t want to expand Medicaid even though the feds are gonna subsidize it and you know what the Daniel Kahneman, I read his book. He says you can’t take things away from people Loss aversion is the Technical term. Once it’s in there, they aren’t going to take it away. Oh, but the feds might not pay for it anymore. Meanwhile, if you take a good look at your property taxes in [00:27:00] Harris County, which are pretty steep, there’s a line for the Harris County Hospital District. Now, I think you have to take care of people. You don’t want people drying in the street.
It’s a necessity, but it’s not, it’s like we’re turning down free money. It’s not truly free money, but it’s money that’s there, and it’s going elsewhere. It’s not gonna stop.
Dorothy: No.
Ginger: They’re not gonna stop the program because we don’t participate. No, and gradually other states have kind of inched in to join it. It just, it makes no economic sense whatsoever. Ever.
Dorothy: The jobs have been brewing and everything else.
Ginger: And then you think the people, well, and the rural hospitals need the support.
Dorothy: Yes.
Ginger: And um, you think of the people who end up suffering needlessly because of that, and yeah, they end up at Ben Taub. Great.
Dorothy: But in the rural areas, we don’t have Ben tops. No, we don’t have public health.
Ginger: Well, there was this one, I think it was in the New Yorker. An article, I forget which [00:28:00] various thing I read in, it was about a young woman, I think in Flatonia or one of those small Texas towns, who should have had, a preemptive abortion as soon as she got pregnant because she suffered from so many, uh, comorbidities. Well, they’re not COVID, but diabetes, high blood pressure, overweight, that the probability of her caring to term was somewhere between zero and none, but oh no, they couldn’t do it. And she did go to the hospital and, or in the bigger city And, well, they sent her back, and then by the time she was in the ambulance to go back to the hospital, she died.
That’s another result. I’m pretty sure it was in the New Yorker. Uh, that’s another result of, of the insane interference with medical practice by people who know [00:29:00] as much about medical practice as I do, and I know enough to know. I’ll let the doctor decide.
Dorothy: Right. Well, that’s such a good point, Ginger. Because we really have stripped the physicians of their ability to practice medicine. They just can’t do it.
Ginger: I don’t blame them for being cautious. Oh, well, the doctors, they made the wrong choice. Well, if you threaten somebody with prison, taking their license away, a huge fine.
Dorothy: Yes.
Ginger: You expect, it’s just human nature. They’re going to have to think of themselves first. And you can’t blame them.
Dorothy: Well, I can certainly see why you’re so passionate about access to healthcare.
Ginger: Well, it just makes no sense. It makes no sense.
Dorothy: It doesn’t. There’s so much within the healthcare arena that doesn’t make sense.
And
Ginger: there are things that if you can do, and of course, then they end up spending huge sums of money trying to keep someone alive [00:30:00] when
Dorothy: the time is done,
Ginger: the time is done. And then, but there is one of the books I read. Oh yeah, but there’s always a nephew from Peoria who comes in and says, we want every, in fact, one of my neighbors went through this, her truly beloved sister had brain cancer. And my neighbor had been a nurse, so she knew. And yet the daughter kept insisting on every possible treatment. So it was dragged out for months. And it was a hardship on everyone in the family. It was a hardship on her mother, my friend’s sister. For It’s one thing to take a chance when, you know, they’ve got some of these immunotherapy things that really do [00:31:00] work, or maybe it won’t work, but it has a chance of working.
Dorothy: Right.
Ginger: But when there’s zero chance, and then you have people for things, if they got in early, that
Dorothy: You wouldn’t need all
Ginger: that. It wouldn’t, you wouldn’t It just, it just is, it’s irrational.
Dorothy: Those are great messages and things that we’ve really got to come to grips with. These are the hard lessons of, of our lifetime right now. And so if you have one message to send to people, what is it going to be?
Ginger: Well, I, I think for those of us who have the good fortune to have access to medical care. Get those mammograms.
Dorothy: Great message.
Ginger: I mean, I was kind of thinking, Oh, do I really need to do this again? Well, it turned out the answer was yes.
Dorothy: Yes. Yes. And straight message. Get that mammogram and we can catch it early. Thank you so much for [00:32:00] being with us today. It’s just been a delight to have you.
Ginger: Well, thank you very much. I enjoyed speaking with you.
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