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The Fullness of Midlife

“Be an advocate for yourself and others.”

by Dr. Barb DePree MD

Marta Hill Gray with Dr. Barb

Marta Hill GrayPrincipal of Gray Matter Group, Marta Hill Gray has experience in marketing, branding, sponsorships, media, and promotion for companies like Boeing, Sesame Workshop, and Campbell’s Soup. Changes in the media landscape allowed her to choose her next chapter, which she decided to focus on women’s health, gender equity, and leadership initiatives. From her home base near Washington, DC, she tracks research and industry developments and makes connections, advocates, and strategizes. 

Listen here.


Dr. Barb: Today we’ll be chatting with Marta Hill Gray, a business strategist who has worked with companies like Boeing, Bank of America, and Campbell's Soup before becoming an advocate for women and women’s health. She now has her own business, Gray Matter Group. She helps locate partners, make new connections and unique solutions for puzzles and predicaments.

Marta, welcome!

Marta: Thank you Barb.

Dr. Barb: Thanks for joining me today. It's always fun to catch up with you and hear what you’ve been busy doing, because you network amongst many interesting people with what you do. But before we talk about what’s exciting about what’s happening today, based on Campbell's Soup, Bank of America, and your previous career, you’re finding yourself in a very different place.

If you would, share how you came from where you once were to where you are now.

The recurring theme for me is reinvention.Marta: Well, I think the recurring theme for me is reinvention, unlike someone like yourself who has practiced medicine for many years and has had a pretty straight path with your career. In the industry I was in earlier, I had a career in television a little bit, and was a fashion model. Then I moved into marketing and advertising and sponsorship--those kinds of things and the media…. When newspapers and magazines started to fall out of favor, and the internet came on, and media changed so tremendously, I had to reinvent myself because the work I had done had pretty much faded away or changed shape at least.

I really wanted to find something that I was passionate about, and women's health and women’s issues, I find, are without a question the things that excite me and interest me. So I moved into women’s health, with a focus on women’s health, but I work in women’s issues as well. And it's been really rewarding.

Dr. Barb: So, specifically, what areas of women’s health are you engaging with?  Give us some conversations you’ve had recently about women’s health and what’s happening in the world of women’s health and how are you intersecting?

Marta: Well, I think what I’m finding especially interesting lately is new treatment options for women and women’s health. As you well know, and a lot of people know, many of the clinical trials that are held for new treatments and new drugs don’t include the ratio--a balanced ratio--of women. So, when they treat any kind of fashion that both males and females deal with, which  could be  heart disease, could be chemotherapy, different things like that, often times they don’t have a balanced ration of men to women. So the impact on women can be difficult, if not catastrophic, because our bodies are very different from men’s. And so I find particularly interesting. I’m working with organizations around heart disease. Women manifest heart disease differently than men. It's tricky--the symptoms are different. Many women go to the emergency room and aren’t treated for heart disease and they’re having a heart attack, but the symptoms don’t line up with men’s. So that to me is interesting, gotta get the word out.

I’m sort of an evangelist on these things. That, reproductive health, menopause, those are also very important. And then recently I’ve started working with a cancer group that deals with a rare neuroendocrine cancer that affects both men and women. But it's a very complicated thing, and it’s interesting and it's fascinating how it impacts people and families and lives. The intersection--my real focus is women’s health and the discrepancies in the care and information that exist between men and women.

Dr. Barb: In the time you’ve have engaging in these conversations would you say you witnessed a perceptible change in what is happening… as far as bringing along women in clinical trials or recognizing and addressing the differences that may exist in the disease and their further treatment options?

Marta: I think the needle is moving, yes. There’s a lot of people working for this. There’s an office of women’s health at the FDA, and they are lively and working hard. And I think there are a lot of conversations now with a lot of the different groups--pharmaceutical companies, advocacy groups--and they are working hard to champion women’s health and the needs for women’s health. So especially in the current climate, it's a challenge. But I think that it makes the people who are engaged in women’s health even more committed to making sure that we have good information and good care and good treatment options.

Dr. Barb: So as we recognize important health conditions like heart disease in women, what do you think are some of the best ways to disseminate that information?  How do women receive information to have them act and have it impact their lives? When we talked about heart disease, it is any age; but again as you mention, magazines, they aren’t really where women go for information these days, where previously that would be the way to communicate. So, how is it we should try to engage women to have further conversation?

Marta: Well, I think it's so critical. One in three women is going to get heart disease in her lifetime. It's the number one killer--more than all the cancers--so it's really really important that women pay attention to this. And I think that because it's not as visible, the information isn’t out there, women think it isn’t going to happen to them and so, the Internet is really the place to get good information.

There are multiple organizations that focus on heart disease, and they do a good job of disseminating information. I think women have to be proactive about it. I don’t think it’s as visible as Susan G. Komen and breast cancer, which they’ve done a wonderful job in educating women--talking about it, making it part of the conversation and raising so much money and awareness. I think heart disease has a ways to go. But, women really have to be proactive.

Certainly you know more about this Barb. But, this does run in families; it can be it is a genetic... huh [laughs]... it can be it is a genetic gift; that if your mother had heart disease, you need to be aware. Just like ovarian or breast cancer, I think. Maybe you can speak a bit about how you’re learning more and more about genetics and how they impact disease in generations.

Dr. Barb: It is interesting, because I do think we have unearthed a vast array of more information to explore by recognizing that family history matters, and now the whole world of genetics. My slice of that is around breast cancer and trying to help women understand what women should be tested for the possibility of a gene that causes breast cancer, for instance.

In that particular case, more women see themselves at high risk than actually are at high risk.

There are very few women who probably have a gene who puts them at an increased risk for breast cancer. But I think we’re just starting to understand that more broadly; maybe even around Alzheimer’s, and I know that’s another area you’ve had some conversations and interests in.

Do you feel some optimism about addressing that as a growing health concern?

Marta: Wow, good point on Alzheimer's. Yes, I didn’t mention that there are many groups that are really advocating for Alzheimer's in terms of caregiving; that’s the thing that I think is so tragic: how many families are impacted by caregiving…

Women get Alzheimer's two-to-one to men. I was at a briefing where a doctor shared his theory--and it's strictly a theory--that part of the impact of estrogen on women, especially, especially as they get older and go through menopause, there is the loss of estrogen. So here again, we see hormones in a conversation around something that we perhaps never thought of before. And the conversation was around the fact that men have estrogen in their brains, even more than women do at a certain age. So when you test for this, you can actually see that men have more estrogen than women do. And, as a person who is not a doctor and not a medical professional, that would never occur to me.

It's weird science for sure, Barb [laughs]. But I do think more organizations are fighting to get more treatment options, have more clinical trials. As you well know, pharma has not had a lot of success around treatments for Alzheimer's in clinical trials. It is hugely expensive to create clinical trials and new drugs. It’s complicated, and it's just such a rotten disease. It’s just tragic.

Dr. Barb: It is, it is. It impacts so many people. Something you said made me recall the media impact about hormones as you talked about hormones. I think 15 years later, post-WHI, in talking about the concerns around hormone therapy for women. We are still feeling the negative impact of that message. I think that could be another discussion in and of itself, but the Women’s Health Initiative was not a particularly well-designed study to look at some of the things they actually came out to make statements upon.

But I think to me, it underlines the importance of the message and how it's messaged. I was being interviewed not long ago by an online healthcare site and they pointed out that about 70 percent of the information on the internet regarding healthcare is incorrect. And when I think about how the media has had a huge impact in certain pockets….

Marta: Ohhh….

Dr. Barb: Why is it that can’t we have more broad-media impact in other areas that might really matter and where it might change lives? I don’t know if you could speak into that or if you’re willing to share, or if you know of websites that you feel are credible and are a good place for women to go to find information or to share experiences.

Marta: Well, I agree with you, and I think it's really complicated. A few of the healthcare providers I know laugh because when patients come in, they are what the healthcare providers call “Google Docs.” So they come in and they have all this health information and they are so proud of themselves that they’ve accessed via Google. But, so much is inaccurate and  incorrect. It becomes problematic because people begin to self-diagnose, and it's a slippery slope.

I personally think the National Institute of Health, the CDC, FDA Women’s Health site... I think there are some regulated sites that are well worth looking at, as well as other sites that are vetted and managed by healthcare professionals. That would be a site such as HealthyWomen. If you can go to specific conditions, oftentimes there are sites that are specific to certain kinds of cancers and certain kinds of disease. It can be enormously helpful.

Even WebMD, even though it is sort of medicine-lite, can guide you to some better information. That’s just been my experience. But all in all, when you click onto people who are having conversations, that’s when I think that a lot of information is incorrectly disseminated. It’s where patients are talking to patients without any medical corroboration. So, they are giving their personal opinions, which isn’t credible medical advice.

Dr. Barb: It is a difficult situation, and I’m hopeful there will be avenues to improve upon that. I don’t know whether I can be optimistic about that or not. It is a frustrating area as a clinician. When you only have 15 minutes with a patient. Instead of instructing them, you’re trying to argue, so to speak--that’s not quite exactly the word--but, maybe give them reason why what they came in knowing isn’t exactly the truth of the matter. It is a lot of what we do, or try to do, to talk about what they have learned, on their own, that isn’t exactly accurate.

Marta: Right, and the other thing, too, is the inequity of information. So, a lot of people who have good healthcare, and they can get in to see a doctor and talk about these things--that’s a very different situation from someone who may not have the resources; who may not have health insurance; may not have a doctor that they have a relationship with to actually inquire as to different symptoms or thoughts. So they use the internet as a resource, and it can be a slippery slope with that. I think... and it concerns me a lot because… I think that people are looking for information that they might not have the financial resources or the health insurance to get what they need: to see a proper professional.

Dr. Barb: How can people be more involved?

You have to be your own health advocate.Marta: I really think you have to be your own health advocate. I’m sure you see that with your own patients. I think you have to be… when you see your physician, you have to have a list. I always make a list, because I’ll inevitably forget something. I make a big fat list, and come in and just check the boxes. “What about this?” “Do I need to know about that?” “What about vitamin D?” “What do you think about taking supplements?” “How or what can I do to be healthier?” And I think everybody has to be their own champion.

It's the same old thing isn't it? It’s diet, it’s exercise, it’s lifestyle--some of it genetic. Some of it you can’t control, but I think for the things you can control, you must. And the rest you need rely and find yourself a good doctor, a good nurse practitioner, a good clinician that will care for you and help you--help you! I think that’s the thing now. That’s why I would go see you, Dr. Barb, to say, “help me, guide me” because you are the expert, and that’s what we need. It's not something on the Internet. You’ve got to be your own champion though, you’ve got to ask the questions. If you don’t ask, you won’t find out.

Dr. Barb: I think that’s a good point, and I think sometimes personalities don’t mesh. So it's hard to get the message across. I think I’ve heard you say before, “You can fire your doctor.”

Marta: Darn right! And I learned that from Michelle Robson with EmpowHer. She said that all the time. “You can fire your doctor.” I think people see the white jackets and think: well, they know everything, and they’re all powerful. But they’re not. And if you don’t believe them or you don’t like them, if they don’t make you feel comfortable in that environment talking about your personal health issues, find someone else.

Dr. Barb: I would agree. And I think as a physician, I would agree. Because it is...we call it “shared medical decision.” I had a patient in this week who had a diagnosis of breast cancer, and she’s about two years out from her breast cancer diagnosis, but she opted out of the recommendation that she take Tamoxifen following that. And it’s recommended she be on it for five years. But for a variety of reasons, she and her husband made the decision with her oncologist that she wasn’t; that it was not something that she was comfortable with. Well, she shared with me that she was no longer welcome at her oncologist’s practice as a result of that. We were talking about survivorship, her survivorship plan, and her imaging, and how things were transpiring. She said, “Well I don’t really have anyone navigating that for me.” Then she told me why. And I was dismayed to think that we can’t have an individual make an intelligent decision for their own health. We may feel like we know the best and what they should do, but in the end, we still have to allow individuals to make the decision that is right in their place. I think that it is a two-way street. I that case, that patient made the right choice to quote, “fire her doctor.”

But, it's left her feeling pretty alone in navigating a somewhat difficult situation. So I think physicians could do a better job as well.

Marta: It's a real challenge, it’s a real challenge. And I think that the patient has more command of their situation, but also, you have to be responsible. I think a lot of us were raised to respect doctors because they were the professionals and the experts. But it’s a new dawn and a new day. You can certainly respect them and appreciate them, but you have to find one in your camp and relatable. So, good for us!

Dr. Barb: Exactly. So as we wrap up our time today, do you have any other parting thoughts or encouragements or words to pass on to our listeners?

It's our job to find places to connect.

Marta: I just think that as we get older, we have to become more engaged. That’s what I’ve found. And kind of back to the start of our conversation about reinvention. I think a lot of us, as we get older, start to feel like our best years are behind us; but, the onus is on us that our best years are ahead of us, and that we stay edgy and fun and engaged… enjoy our good health and manage it; be an advocate for yourself and for others.

I think that part of being older is having more experience, being wiser. There’s a place for us, and I read a lot about women who get to a certain age and feel disconnected. But, I think it's our job to be connected and to find places to connect. That will keep us young and healthy.

So, there’s my wisdom for today. [laughs]

Dr. Barb: Those are great words, and thanks for your time today, Marta.

Marta: Thanks Barb.


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