← unPAUSED with Dr. Mary Claire Haver
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- [00:00]
Katie Couric
What makes me mad is it's another example of the medical establishment ignoring a very specific issue that happens to women and not really focusing on it, not providing the research dollars because everyone thinks about like Viagra, okay? Men can't get it up, so they poured millions of dollars. They create this drug in a nanosecond and yet women who are suffering, they're being ignored and it really pisses me off.
- [00:38]
Dr. Mary Claire Haver
The views and opinions expressed on Unpaused are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any
- [00:48]
Podcast Advertiser/Host Voice
related materials are intended to be a
- [00:50]
Dr. Mary Claire Haver
substitute for professional medical advice, diagnosis or treatment. Today's guest is someone who has been a part of my life for a very long time, long before I ever imagined sitting across from her with a microphone. Like so many people of my generation, I grew up watching Katie Couric every morning on the Today Show. She was the anchor I trusted to help me understand the world. She was in our living rooms during moments that defined entire decades. Last year, I had the opportunity to meet Katie in person, write for her newsletter, and then join her on stage at one of her live events. Meeting and working with her confirmed what I had always sensed from afar. Katie's not simply an icon, she's a truth teller, a connector, a fierce advocate for cancer and women's health, and someone who cares deeply about using her platform for good. Katie Couric is a journalist, author, producer and now founder of Katie Couric media. She spent 15 years as the co host of the Today show and served as the anchor of the CBS Evening News and and has interviewed nearly every president, world leader, public figure, scientist and cultural voice of the last four decades. Her 2021 memoir, Going There, became an instant New York Times bestseller. She created and co founded Stand up to Cancer, which raised hundreds of millions of dollars for cancer research. She hosts the award winning podcast Next Question with Katie Couric, and she continues to lead national conversations on everything from politics and and media literacy to cancer prevention, women's health, and the well being of our democracy. What I admire most about her, though, is her ability to merge journalism with humanity. She has endured profound loss, she has reinvented herself repeatedly. She has used her grief to fuel advocacy, and she has remained curious and courageous in a media landscape that is more polarized and more punishing than ever. I'm deeply honored to welcome Katie Couric to Unpaused. This is a conversation about women's health, caregiving and the power of reinvention. I'm Dr. Mary Claire Haver, a board certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of Obstetrics and Gynecology at the University of Texas Medical Branch. Welcome to Unpaused, the podcast where we cut through the silence and talk about what it really takes for for women to thrive in the second half of life
- [03:18]
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- [04:43]
Dr. Mary Claire Haver
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- [05:31]
Dr. Mary Claire Haver
so Katie Couric I still can't believe I'm saying that word like Katie Couric is on unpaused. It's such a big deal for me. Such an honor. So thank you for being here.
- [05:38]
Katie Couric
Well, I'm a huge fan, Mary Claire, so I'm very excited to be here and looking forward to talking about everything and anything.
- [05:45]
Dr. Mary Claire Haver
First, let's, like, give me some backstory, because I don't know all this, really. Where did you grow up, really?
- [05:49]
Katie Couric
I grew up in Arlington, Virginia, a pretty Leave it to Beaver household and neighborhood. You know, at night, we'd play Red Light, Green Light and capture the flag and ride our bikes from dawn till dusk.
- [06:05]
Dr. Mary Claire Haver
Don't come home if the sun's out.
- [06:06]
Katie Couric
No. And, you know, I'm the youngest of four kids, went to public school my whole life. Had a decidedly middle class background, although my parents really focused on education. My dad was a newspaper reporter and then went into public relations. My mom, they met when she was a cartographer for Rand McNally living in Chicago, and he was in the Navy. But my mom, like so many women of her generation, cartographers.
- [06:36]
Dr. Mary Claire Haver
She drew maps.
- [06:37]
Katie Couric
Yes.
- [06:38]
Dr. Mary Claire Haver
Yeah, yeah. So I was a geologist, undergrad.
- [06:40]
Katie Couric
Oh, okay.
- [06:41]
Dr. Mary Claire Haver
So I have a fair share of cartography skills.
- [06:43]
Katie Couric
And she did layout for a magazine called Coronet, which I think was a precursor to Esquire magazine. My mom was very artistic and very clever, and my dad was extremely. My mom was smart, too. But my dad was deeply intellectual, I think, and very, very well read. And while he never made a lot of money and, you know, we couldn't join a country club and all the things that more affluent families in my neighborhood did, although my neighborhood didn't have that many affluent families, I never wanted for anything. You know, I feel like I had such an incredible childhood, Mary Claire. And I feel it's because my parents, I never for one moment. And now as an adult, I realize that not everyone is this fortunate. But I never for a nanosecond doubted my parents unconditional love.
- [07:45]
Dr. Mary Claire Haver
That's amazing.
- [07:46]
Katie Couric
And support. And my mom used to say, everybody needs a cheerleader, and I'm yours. Aw. So I think that has helped me so much. You know, you think about the foundation of your childhood and the things your parents equip you to handle just by giving you that solid sort of reservoir of love that I think it's helped me so much through both my successes, failures, my triumphs and disappointments, my heartache, and my, you know, finding love again and all the ups and downs that I've experienced in my life. I really credit my parents giving me this solid foundation that has helped me navigate so many different things. And I always feel so bad when I hear of people who don't have access to good educations or solid sort of family bonds, but who have acrimonious or really difficult relationships with their parents.
- [08:52]
Dr. Mary Claire Haver
A lot of estrangement.
- [08:53]
Katie Couric
And I thank, Gosh, that is a tough way to go through life. And I think people obviously deal with it and compensate for it, but it's just much harder, I think. And now when I watch my daughter race her son and my grandson, and I think, gosh, you just really have to love children and obviously give them boundaries, too. But just how much is imprinted psychologically on us by our parents and what an awesome responsibility that is.
- [09:35]
Dr. Mary Claire Haver
You went to university College?
- [09:38]
Katie Couric
I went to uva.
- [09:39]
Dr. Mary Claire Haver
Uva. And were you a journalism.
- [09:41]
Katie Couric
Well, they didn't really have a journalism department, so my dad had me talk to a number of people before I went to college because my father really kind of encouraged me to go into journalism because I was actually a pretty good writer all through junior high school and high school. I was a master procrastinator. So I think he thought I would work well under deadline. Always extremely outgoing, always very curious. So my dad kind of encouraged me to work at different radio stations during the summers while I was at UVA and before I went to college, I did talk to some people in journalism and they all told me, most of them said, you know, go somewhere, you get a very broad liberal arts education.
- [10:26]
Dr. Mary Claire Haver
My parents, like, my mom went to college to meet a husband. She did secretarial science for two years to get her.
- [10:32]
Katie Couric
Mrs.
- [10:32]
Dr. Mary Claire Haver
Yes, and she did. And, you know, that worked out for 60 something years and it was all fine. And it's fascinating to hear you talk about this. Cause I love my parents, but, you know, I think they, my, my dad was like, well, she's pretty, she'll marry well. Like, they weren't worried about me. I had good grades, I was a good student. But like, my dad never, like, sat me down and talked about my career future. He's just like, marry well, choose well.
- [10:53]
Katie Couric
Yeah, well, I think that was very typical of that generation. My father maybe, perhaps was a bit of an anomaly in terms, you know, there were. I was the fourth kid and I two older sisters and an older brother and my dad really, I think it was both my parents really wanting us to get good educations. That was like, every time we got $5 from my grandmother, we put it in our college fund. You know, every time we did anything, you know, if we worked in the summer, it all went into our college fund. So we were very oriented toward getting a good education. And my sisters Both went to Smith College, which at the time was a sevent Sisters, one of the seven sisters. You know, Smith, Wellesley, Radcliffe, blah blah, blah. And this was before women were admitted to Ivy League school. So to go to a seven sister school was sort of the pinnacle for a young woman in my sister's era. And then they started letting in women to schools like Princeton, Harvard and Yale. But my grades weren't good enough to go to a school like that. And in fact, one of the. But the earliest traumas for me was I got rejected from Smith and Smith apparently loved sisters. My sister Emily was 5 beta kappa at Smith. You know, both my sisters had done well there and I didn't even get wait listed. You're like fatal rejected. Well, it was really, it was really hard. And I think part of it was I were kind of hard in high school, but not that hard my junior year when I knew it was gonna really count. I got all A's and was really focused. But I wasn't that academic in high school. And I ended up going to uva. I was in state. It was a little easier for in state people to get in than out of state people. Today I don't think I'd even get into uva. Cause it is so, so, so competitive. But I ended up going to school. Honest with you, that was, was much better suited for, for me and my personality. But I, I am just getting back to, to your earlier comment. I think, I think my parents really understood the importance of being financially independent as a woman and not necessarily, you know, just relying on your husband.
- [13:24]
Dr. Mary Claire Haver
The lesson didn't come from mom and dad, but it was secondary because I was.
- [13:28]
Katie Couric
Where did you get that lesson?
- [13:29]
Dr. Mary Claire Haver
My aunt's who went through some horrific divorces and were basically left destitute. And I watched them move into public housing and like really scary situations. My cousins having to switch schools and live in these like scary apartments. And I was, I was like, uh, you know, like that, that was what was like, you must make your own money. You can't rely on this. It was not coming from mom and dad, but it's just watching the experiences
- [13:55]
Katie Couric
of my aunts that's so interesting and thinking I do not want that to happen to me. In fact, there was a very good book that I read when I was a younger. Well, actually not that young. I think I was on the Today show and I interviewed a woman, a writer named Leslie Bennetts. And she wrote a book called the Feminist's Mistake. Kind of a play on the feminist mystique. And it was all about women who had sex, sublimated all their ambition, who had stopped working or never worked at all. And after a period of time, their husbands divorced them or left them or sadly tragically passed away. And it was sort of about the importance of creating your own sense of purpose, your own financial independence. And that really, really stuck with me. I mean, it reinforced what I think my parents had ingrained in us, in their daughters anyway. And I feel bad because it's not to say raising a family and taking care of kids isn't a worthy thing to do, but it is.
- [15:09]
Dr. Mary Claire Haver
It puts you in a vulnerable position.
- [15:11]
Katie Couric
Yes, exactly.
- [15:11]
Dr. Mary Claire Haver
That you may not. And that's the lesson I taught my daughters. And you know, 20 years of OBGYN practice, I would take care of these women through multiple life changes, right? You know, having kids, da, da. And inevitably some of them divorce. And watching them tell stories of I haven't worked in 15 years and you know, and I would go home and tell my girls these stories, right, of you know, this could happen. There's no guarantees. Your husband could get sick, lose his job, get a divorce, whatever. And like what are you going to do?
- [15:39]
Katie Couric
You know, right.
- [15:40]
Dr. Mary Claire Haver
You've got to have a way to support yourself even if you choose to stay home, be a mom, you know, and that's amazing. But I'm just so driven by that, that fear of, you know, and I lived through my parents bankruptcy, you know, so I saw the, you know, what, what at the time seemed like the worst thing that could happen and I just didn't want that for my kids.
- [15:59]
Katie Couric
And I also think it's just, you know, even if you do take time to raise children, it's, it's something that I think women need to think about. You know, I know so many of my friends and you hear stories of when it's not just empty nest syndrome, it's just that what now? And I think the secret to a happy life really is to find to have purpose. And some of that purpose can be your children. But I also think that there has to be. It's helpful to have more than just kind of wanting to raise good, successful kids. I think to kind of feel passionate about something, to care about something, to love what you do, to feel that you can have an impact, small or large, is so important just to your self esteem and to your identity.
- [17:01]
Dr. Mary Claire Haver
For a long time I was practicing and in a great institution, but I felt like I was on a treadmill and I felt trapped and that I had a great job, great money, great influence, But I always felt like I have to put on this costume every day and show up. And it's a machine that I've joined to have the financial security. And at this point in my life, I sit up in the morning with my cup of coffee and I look out and I live on the water, so I'm so blessed. And I look at the Gulf of Mexico and I'm like, I have choices. I have options. This is. A lot of women don't have this. Like, I can decide what I want to do with my day. And I feel like I'm the luckiest woman in the world.
- [17:43]
Katie Couric
Yeah.
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Dr. Mary Claire Haver
You know, and so much of what I do is impacting the world and women, and that's great. But I, like, sit there and I'm like, if I just wanted to stay home a couple days, you know, like, that's okay. A lot of people don't have that.
- [17:55]
Katie Couric
No.
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Dr. Mary Claire Haver
You know, and I didn't have that for a long time. And that was hard, you know, not having choice.
- [18:01]
Katie Couric
Right.
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Dr. Mary Claire Haver
Like, when that alarm went off at 3:30 every morning. When you were, you know, doing the Today show, did you ever feel like you were on that treadmill and you had to get up and perform? Every day.
- [18:10]
Katie Couric
I loved it. I also felt like, you know, I was helping people understand the world. You know, I mean, I think I had this big audience and this big sort of community that, that I was a part of that I could say, hey, I really think we need to do a story on X, Y or Z, I think, you know, so I had a lot of input editorially. Like I controlled my own destiny. I would say, can I go do an interview on this? Can we do a fun series called Changing Places? I'll fill in for Jay Leno and he can fill in for me. And, you know, everybody can kind of pick something that they've always wanted to do and do it. So I had a lot of input. But I think what's interesting for you, as you were talking, I was thinking, you know, you as a physician can have such an impact on your patients, but it is a limited stage. And to be able to use your expertise and your knowledge and for as much as people shit on social media, and I think it is really. There are a lot of negative aspects to it.
- [19:20]
Dr. Mary Claire Haver
Absolutely.
- [19:20]
Katie Couric
The fact that it provides this entree of and this, you know, really national, if not international stage where you can share important information that people are really hungry for. I think it's a really phenomenal thing. And that is why you have been able to build your company and serve people in a much more, you know, a much broader, more expansive way.
- [19:54]
Dr. Mary Claire Haver
I mean, I'm doing the same thing I was doing across instead of sitting across from Katie in an exam room with a time limit, you know, it's the exact same conversation I'm having with my phone. You know, because when you're recording on social, you're talking to your phone, there's no one there.
- [20:08]
Katie Couric
Right.
- [20:08]
Dr. Mary Claire Haver
Usually now it goes out to millions of people, but I'm just repeating the exact same behavior, not in the exact same.
- [20:15]
Katie Couric
Which must be so incredibly gratifying to know that. And you think, you know, you mentioned time limits and you, you know, a lot of women don't have access to the best doctors or they live in rural communities or underserved communities or they don't have insurance. And you know, so to be able to use someone like you as a resource is such a gift for so many people. And so that must make you feel like a public servant, really.
- [20:45]
Podcast Advertiser/Host Voice
It does.
- [20:46]
Dr. Mary Claire Haver
It really does.
- [20:49]
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- [21:45]
Dr. Mary Claire Haver
What would your dream private practice look like?
- [21:48]
Podcast Advertiser/Host Voice
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- [21:50]
Dr. Mary Claire Haver
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- [22:22]
Katie Couric
Yeah, I majored in American studies, so American literature and history. And I, I learned how to write. I wrote for my school paper during the summers I was working at radio in Washington D.C. cause I grew up right outside of D.C. in Arlington and you know, it seemed to be tailor Made for my personality and for the things I like to do and for my sort of insatiable curiosity. And so I just applied for a job at ABC News when I graduated from uva and I really pursued it aggressively. I got my mom, I write about this in my book, to drive her cream colored Buick station wagon down to the Washington bureau of ABC News. I said, mom, just wait for me here. You know, she's parked on Desal Street, I think it was. And I go into the building and I said, hi, may I talk to Davey Newman? Because I knew Davey Newman was the producer of World News Tonight. And Davey Newman's brothers, twin brothers, Steve and Eddie Newman had gone to high school with my sister Kiki. And so they said, we can't just let you upstairs to the newsroom. So I saw a house phone and I called Davey. They said, you can use the phone if you want. I said, great. I said, hi, Davey, this is Katie Couric. You don't know me, but your brother Steven, Eddie went to high school with my sister Kiki. And I was wondering if I could just come up and say hi. And my dad always said I had moxie, which is really what I wanted to name the book I wrote about my life and career. Moxie. But yes. And then ultimately Davey Newman, I'm sure he wanted to get rid of me. Introduced me to the deputy bureau chief, Kevin Delaney, who hired entry level people called desk assistants, where basically you were a gopher making coffee, xeroxine. That's how you started, you know, fetching, you know, ham sandwiches for just like I imagine. Yeah, that's how I started. And I just worked really hard and tried to learn and then went to cnn. When that started, my friend Wendy Walker, who's still one of my closest friends in the world, was going over to CNN and she brought me with her. And at cnn it was like a startup so you could do all sorts of different things. And it was a non union shop, so I could even go out and do interviews and try my hand at on air reporting. And I was so bad, the president of CNN called and said he never wanted to see me on the air again.
- [24:53]
Dr. Mary Claire Haver
Oh my God, you're not.
- [24:54]
Katie Couric
Yeah. So I had to kind of fight and be scrappy every step of the way.
- [24:58]
Dr. Mary Claire Haver
But how did you overcome that?
- [25:00]
Katie Couric
Like I was like. Cause it was like my first big break. I was reporting from the White House and learning how to save Zippignu Brzezinski and practicing all night and talking to my hairbrush like it was A microphone. You know, I just thought, okay, well, I sucked. And how do you get better? You know, I believe Malcolm Gladwell's right. You know, 10,000 hours. And, you know, I just looked around and I thought, these people are good. They're talented and smart, or they can write and be in front of a camera, but are they that much better than I am? No, they just have more experience. So I said, I'm just gonna try harder, do more. And then I worked in local news in Miami after cnn, and then worked in local news in Washington. And that's where Tim Russert, who was the Washington bureau chief of NBC, saw me, because we were in the same building as the network, the local news people. And he saw me, you know, chasing Marion Barry, the mayor of Washington, D.C. who had a lot of problems around. And he asked me to come down to his office and said, we have an opening as a deputy Pentagon correspondent. Do you think you could do that job? And I said, you know, of course I didn't think I could do that job.
- [26:29]
Dr. Mary Claire Haver
But you said inside.
- [26:30]
Katie Couric
I was like, holy shit. I know nothing about the military, that this is gonna be a disaster. But I said, you know, I don't have a military background, but I think I could do it. And he said, okay, well, let's give it a try. And that got my foot in the door at NBC, got me a job on a national flat network on air.
- [26:56]
Dr. Mary Claire Haver
How old were you at that point?
- [26:57]
Katie Couric
I had just gotten married to Jay. It was right before we got married, because I remember I couldn't start until after our honeymoon. And I took all these kind of gone manuals with me on my honeymoon. Our honeymoon was studying, like, the difference between an F16 and an F17 and an A1A tank and, you know, all the different scrambled eggs that people wear on what they call the ribbons and stu on their uniforms. So I got married in 1989, and I was born in 1957. So I had just turned, like, 32. But I had spent my 20s really focused on work and really wanting to get to a position where if I did have children and, you know, women have to kind of navigate all this, at least I'd be in a position where I wasn't just starting. I thought, first of all, I hadn't met anyone, so, I mean, I dated, but nobody who was really marriage material. And I really just wanted to have the flexibility to move. I didn't wanna have to work with a partner and say, I don't know, is this gonna be good for you professionally? I Was just free as a bird to really pursue my own personal ambitions. And then, you know, by the time I had a baby and was pregnant with Ellie, I had gotten the job at the Today show. So I had a very serendipitous journey professionally. But it was also backed up by the fact that I had worked really hard. But I was also, I think there was for me, I probably less so in medicine. There was an element of luck because I think TV journalism, there's a subjective nature to it. And I was just kind of, at the time, just what the doctor ordered. At the Today show, they had had a transition from Jane Pauley to Deborah Norville. The audience didn't really respond to Deborah Norville. And they kind of wanted to go back to someone who honestly was not as beautiful and perhaps threatening to a morning audience. So there I come along and I ended up being put in that position. And then it was kind of off to the races for me.
- [29:25]
Dr. Mary Claire Haver
So you did that for 15 years?
- [29:28]
Katie Couric
Well, I did the Today show for 15 years and then I became Les Moonves, who was head of cbs, brought me over to the CBS Evening News and I did that for five years.
- [29:40]
Dr. Mary Claire Haver
Were you the first few?
- [29:41]
Katie Couric
I was the first solo. Barbara Walters and Harry Reasoner. I'm really dating myself. Had done it at ABC News and then Connie Chung had did it. Connie Chung did it for a nanosecond with Dan Rather at cbs. But I was the first person, woman to be the solo anchor. In other words, there was no man, no man involved. And it was a big deal at the time. And that was really one of the things that motivated me. I thought I wanted little girls and little boys to see a female could handle that job with confidence and competence. And that's real. And plus, you know, 15 years. As much as I loved my job at the Today show, like any job, 15 years is a long time. And it started to feel a little repetitive. And I think I just wanted a new challenge. So that's why I went to cbs. It ended up being a very challenging experience for me because CBS was quite old school, I think patriarchal. And I think the audi between the internal kind of sexism and the external sexism of an audience not necessarily being ready for a female anchor in an evening news format, the most traditional audience. And then we, on top of that, tried to rejigger the format a bit, tried to make it a little more accessible and viewer friendly. It just was. It was a lot too much too soon for an audience. And while I was very proud, Mary Claire of the journalism I did on the Today show. I did so many hard hitting, important interviews. I think because of the nature of the Today show, people remembered me or identified me more with the fun, kind of softer, fluffier content. And so I think it felt a little bit incongruous for people to see me in a role that was 100% serious. That really didn't allow me to show my personality at all, which only kind of can be conveyed. When you're interacting with a co anchor, you're doing something fun. And I think it just, it just I think, felt to a lot of viewers, what happened to her? Did she have a lobotomy? Like, she used to be fun and funny and friendly and I think it was just kind of like a hard adjustment for people to make me in this role. Looking back on it, I'm glad I did it, but I think for a lot of reasons, it was probably not the right decision.
- [32:33]
Dr. Mary Claire Haver
So here's what I remember about when I think about Katie Courier. Like, before I got to know you and you know, I didn't watch the morning I was in med school, I was in residency, I was delivering a baby at 8 in the morning when, you know, I remember, of course, you know, who you were, that you were cute and fun and stuff. But I remember having a colon as a doctor, you know, having a colonoscopy on national tv. I remember when you got breast cancer and talked about it. I remember when your husband died. And I remember you had two kids, two girls. Cause I had two girls.
- [33:05]
Katie Couric
Yeah.
- [33:05]
Dr. Mary Claire Haver
And then Katie Courage Media.
- [33:07]
Katie Couric
Yeah.
- [33:08]
Dr. Mary Claire Haver
So what made you say, I'm gonna do this, I'm gonna start my own company?
- [33:13]
Katie Couric
Well, you know, I had done really most of the big jobs in network news still, to my surprise, honestly, that I was able to kind of reach the pinnacle of the industry after CBS and after that really didn't go that well. I stuck with it for five years. I knew that I wanted to keep working. And at one point I think I was asked if I wanted to go back to the Today show. But by then I had sort of already committed to doing a syndicated talk show and an afternoon talk show, it turns out. I mean, they're great and there's so many people who are good at it. Obviously, Oprah was the queen, but for me, it didn't allow me to really dig into important issues. I think afternoon talk shows are a little more infotainment. And you know, it's funny, I'm such a dichotomy actually, because I do have this Very bubbly, outgoing personality. I mean, I think I've gotten less bubbly as I've gotten older.
- [34:32]
Dr. Mary Claire Haver
But Katie Couric Media is hard hitting.
- [34:34]
Katie Couric
Yeah, I'm actually a serious.
- [34:35]
Dr. Mary Claire Haver
Yeah.
- [34:36]
Katie Couric
Person underneath kind of my effusive, bubbly personality. So a talk show wasn't kind of the best fit for me. So then I went to Yahoo because I saw the media landscape shifting from linear to digital. And then after Yahoo. Never really realized fully or never really became the digital behemoth I was hoping it would be in journalism. So here I was. I had done a documentary series for Nat Geo. I had done a couple of other documentaries. And I remember taking a walk with a good friend of mine, Donna Rockwell Smailovitz, who tragically passed away after a hernia operation. She had a pulmonary embolism and it was just crushing. I just loved her so much. And she had worked at CNN with me as a producer, and then she had become a therapist. And we took a walk around the reservoir here in New York City and she said, you know, you should just do your own thing. You know, why do you need a big network infrastructure? And it's true. I mean, it was at that moment that disintermediation, the ability to go direct to consumer, to an audience was within everyone's reach and only growing. And meanwhile, linear television news, legacy media, yeah, was really declining just because of the paradox of choice, if you will. So I thought, I'm gonna do my own thing. I can feel very liberated. I don't have corporate people breathing down my neck. I don't have pressure for ratings. I can really turn my lens on topics that I think are important, like cancer research and cancer screening and cancer, you know, that colonoscopy, you know, after my husband Jay's death really started me on a lifelong journey of advocacy, not only for cancer, but other things. You know, I did a documentary, I executive produced a documentary about als. And I'm very interested in medical and news and science, you know, and I think it's because of my. My learned experience, you know, I had to understand what was going on with Jay when he was diagnosed with colon cancer.
- [37:03]
Dr. Mary Claire Haver
You wrote, I think in your book. I read you were just like anybody else. You were like, researching and trying to call, you know, people in New York and, you know, you just felt callist.
- [37:14]
Katie Couric
I called like pharmaceutical companies in Israel. If I read they had a anti angiogenesis drug or a monoclonal antibody. And I learned everything about, at the time about approaches to cancer therapies and, you know, sadly, the same drug that had been used since the 50s. 5 fu. And Leucovorin was basically the first line treatment. And there hadn't been many advances. And when Jay was diagnosed, it had metastasized so much, it was all over his liver. And a stage 4 colorectal diagnosis back then was the prognosis, as my doctor told me in one of those little corner rooms in New York Hospital. He said, is bleak. And it was. But I wanted to make sure that no stone was left unturned. And anyway, I have found my cancer work so rewarding, and it's really been. Been therapeutic for me, a way to honor my husband. You know, Ellie and Carrie, mary Claire were 6 and 2 when Jay died. Yeah, they were babies, you know, and never got to know their dad. You know, when I took those aptitude tests in high school, they all said I should be a social worker. You know, I've always kind of had a lot of empathy, but I think to be able to really focus on this has given me so much purpose.
- [38:46]
Dr. Mary Claire Haver
I mean, you can tell, and I think you alone, whether you realize it or not, because I'm on the patient end, right. And I'm prescribing colonoscopy. Go get your colonoscopy. It's time. Da, da, da. You took so much of that fear away just by being brave enough to just destigmatize it. And you really normalize to me. The colonoscopy.
- [39:07]
Katie Couric
I don't think people even knew the word colonoscopy. I mean, Ronald Reagan back in the day had polyps. I don't know if you remember this. You're too young. But that put colon cancer and sort of colons, if you will, kind of front and center. I think Regis Philbin had one. I didn't share much about my husband's illness because that wasn't mine to share. And it was really important for me to preserve our privacy. It was so traumatic going through that, as you can imagine. Current diagnosis, nine months.
- [39:40]
Dr. Mary Claire Haver
Okay.
- [39:40]
Katie Couric
And, you know, the tabloids were writing about it, and your brother.
- [39:44]
Dr. Mary Claire Haver
My brother was like two years esophageal but widely metastatic at diagnosis.
- [39:48]
Katie Couric
I remember you telling me that.
- [39:50]
Dr. Mary Claire Haver
Yeah. And he did all the treatments, and, you know, it was never gonna be good for him. And he held on for a couple years, but. Yeah, you're just so. And it was Covid so, you know, trying to get over there to see him and. Cause he lived out of state and.
- [40:07]
Katie Couric
And esophageal is one of the fastest growing cancers.
- [40:10]
Dr. Mary Claire Haver
Yeah.
- [40:10]
Katie Couric
And they think it might be because of Barrett's. Barrett's syndrome.
- [40:14]
Dr. Mary Claire Haver
He was a smoker. He quit. But he had been a longtime smoker, and he had had reflux his whole life.
- [40:20]
Katie Couric
Yes. Don't they think, Mary Claire, that some of the reflux medications might mask some of the signs of esophageal cancer? What are they called?
- [40:31]
Dr. Mary Claire Haver
They're called the proton pump inhibitors.
- [40:33]
Katie Couric
Thank you.
- [40:34]
Dr. Mary Claire Haver
So I won't even take them anymore.
- [40:36]
Katie Couric
Right.
- [40:36]
Dr. Mary Claire Haver
So. And I went for my yearly colon colonoscopy, and I. I had arranged to have an upper GI at the same time because my brother had died of esophageal cancer. And I'd had lifelong. Like, my whole family, we all have reflux, and. And I remember, like, getting there that day, and I'd done the colon prep and everything, and they're like, hey, you're. We're covering your colonoscopy, but the upper GI is going to be like three or $4,000. And I just threw my credit card down, you know, because I needed peace of mind.
- [41:04]
Katie Couric
Right.
- [41:05]
Dr. Mary Claire Haver
And I thought, what do normal people do?
- [41:07]
Katie Couric
I thought that so much when I was being treated for breast cancer the day of.
- [41:12]
Dr. Mary Claire Haver
I've gone through the emotions of the prep and, you know, his death, and, okay, we're gonna go do this, and what if they find something? And da, da, da. And I just thought, my God, and thank God. And they ended up getting most of it covered on the back end, but it was a lot.
- [41:26]
Katie Couric
I have a question, though, since we brought up the subject, and I imagine some of your listeners and viewers might have acid reflux. So now, is it. Do people. What do they do for acid reflux? Now, if those things seem to be associated with esophageal cancer, more aggressive scopes,
- [41:47]
Dr. Mary Claire Haver
you have to look and see. There's no. We don't have a good screening test, like a blood test for esophageal cancer,
- [41:53]
Katie Couric
but what do they do for the symptoms of acid reflux?
- [41:55]
Dr. Mary Claire Haver
So they are less aggressive with certain medications. They're trying to do lifestyle and diet and nutrition. And if they're obese, we get them on a GLP1. Because sometimes the pressure of being heavier, I mean, instead of just throwing everyone immediately on these medications, they're.
- [42:11]
Katie Couric
What are they called? I'm trying to remember. What was the name of the drug, though?
- [42:15]
Dr. Mary Claire Haver
There's two Nexium.
- [42:16]
Katie Couric
Yeah. And there's another one.
- [42:18]
Dr. Mary Claire Haver
Yeah. Omeprazole and pantoprazole are the two main PPI. And then there's H2 blockers, which block the acid production and then there's one that turns off the pump that makes the acid. So but instead of addressing like for me, I had H. Pylori and so once we got that managed, I never, I rarely, rarely have reflux anymore and my whole family had H. Pylori. So I think we're getting better at
- [42:43]
Katie Couric
the root cause because of the rise in esophageal cancer, I think has, I mean, correct me if I'm wrong, prompted physicians to rethink how they treat acid reflux. Right? Yeah, so I see. I love medicine. I'm so interested. I wish I'd gone to medical school.
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- [46:44]
Dr. Mary Claire Haver
so media, the media landscape. I saw some clips from Rich Roll and so I'm starting to ask you about but you talked about, you know, in medicine it's polarizing. Social media is polarizing. Was it that polarizing? Like you've watched the evolution of what the hell is happening? You know, why is I used to go and watch the news to learn things and now I like watch the conservative media. And then I'll watch both because I want to know, are we somewhere in the middle? But like everyone loves Katie Couric, but no, no, no.
- [47:17]
Katie Couric
I think, you know, journalism is a really tough industry right now. Really tough business. But it's never been more important, honestly. And I think that we have parallel versions of truth. I think that, you know, we have media organizations that primarily serve as propaganda arms of the current administration. And then we have other media organizations who are labeled as liberal, who I think actually are doing more fact based journalism. Now you could say, oh, they're not giving this administration credit for anything. They're attacking it all the time. But I think this is, we're living in such unprecedented times where institutions are being, you know, done away with. Journalism is being dismissed and disrespected and distrusted. And it's just a very crazy time because you have information coming to you from every direction. You know, when I got into journalism, it was very, there were very few outlets. And now everyone's a journalist. Everyone can give their version of the truth, everyone can give their opinion. And it's just very confusing for the average news consumer.
- [48:58]
Dr. Mary Claire Haver
So my parents, my father passed away, but mama and mom has dementia. But you know, while she was still watching things and definitely my in laws, my father in law just died this year. My mother in law's still doing it. Only watch certain news channels. They're only getting news from one source.
- [49:14]
Katie Couric
Right.
- [49:15]
Dr. Mary Claire Haver
That's all they know. And they are convinced that this is true. But never occur to them that maybe this is biased media because they watch the news to get the news. And they don't think of it as liberal or Democrat, you know, or as conservative or anything. They just think it's the news. But they only watch Fox. Yes.
- [49:35]
Katie Couric
Yeah.
- [49:35]
Dr. Mary Claire Haver
All day, every day. I had to have a special TV put in our house so my father in law so it wouldn't be in the room with me because it just would go on all day. And these are good people who went to college who, you know, in their 70s and 80s are just non stop, you know, while they're awake, this is on and they're being fed these messages over and over again and they don't see anything wrong with it.
- [49:59]
Katie Couric
Right. And I think that's such an important point because I think sometimes each side demonizes the other.
- [50:06]
Dr. Mary Claire Haver
Yes.
- [50:07]
Katie Couric
And I think a lot of it is the content that they are consuming and that's shaping their worldview inevitably. And to your point, in many homes it's kept in. Kept on 24 7. And they're not necessarily getting a different perspective. I believe that the New York Times and the Washington Post and the Wall Street Journal, which has quite a conservative op ed page that I am a big fan of legacy media. NPR, PBS NewsHour, network newscasts. You know, I know MSNBC has a particular bent. I know Fox News has the opposite bent. You know, you really have to learn to be an educated news consumer and you have to consider the source of everything you read and get it from multiple outlets. I think it's one of the quintessential problems of our time. And how do we come together when we see things so differently. And the information we're getting, as my friend Nicole says, people are getting affirmation, not information. We're looking at sources that basically confirm our beliefs, our pre existing biases.
- [51:30]
Dr. Mary Claire Haver
This is sounding a lot like the Women's Health Initiative. I mean, the exact same thing in a much smaller scale happened with that.
- [51:41]
Katie Couric
Right.
- [51:42]
Dr. Mary Claire Haver
You know, let's talk about that. You know, when that broke.
- [51:45]
Katie Couric
So I was doing the Today show and in fact, an article in the New York Times Magazine written by Susan Dominus, who's a great reporter at the New York Times, talked about how not only the study, and I'd love, you know much more about this than I do, Mary Claire, but not only was the study flawed in terms of the subjects that were being evaluated for hrt. Right, right. But then the reason the study was stopped got misinterpreted and misreported. So I think it was kind of those two things coming together that stopped research into hormone replacement therapy.
- [52:29]
Dr. Mary Claire Haver
The downstream effects of this have affected an entire generation of women's health outside of reproduction and probably including reproduction. But like, you were on the ground, you're being fed reports, you know, like, you gotta read this, whatever. But like, do you remember, like it was the number one medical news story of 2002.
- [52:48]
Katie Couric
Yeah.
- [52:48]
Dr. Mary Claire Haver
This estrogen causes breast cancer mess. And I've had a few experts on the podcast, they're queued up, you know, for the next few weeks who were there like on the research and talking about like the fights behind and like this alternative view of the results. And, you know, and it just played out behind closed doors and it just feels so much the polarization and, you know, the paternalism and the, you know, we know what's best and not allowing women to have a voice in their own care.
- [53:18]
Katie Couric
Right. Can you like, give me a synopsis of what you've learned happened?
- [53:26]
Dr. Mary Claire Haver
It was a billion dollar study which.
- [53:28]
Katie Couric
But weren't the women mostly postmenopausal?
- [53:31]
Dr. Mary Claire Haver
The outcome of the study was heart disease. Is she gonna have a heart attack or not?
- [53:36]
Katie Couric
Right.
- [53:36]
Dr. Mary Claire Haver
You know, is giving her hormone therapy at whatever age going to decrease her risk of a heart attack? And that was. The observational data said that. But, you know, in medicine we have to have control randomized. So they went with an older study group because it takes a while to have a. But the women were obese, had multiple risk factors, probably already had existing cardiovascular disease. They weren't getting caths or any evaluation of their coronary arteries before they were giving them HRT. And the average age was 63, right. Not 50, 51, which is when we started hormone therapy, you know, back in the day, and which is an usual time. So they reported it. Not only does it not help heart disease, but it will increase your risk of breast cancer. And that risk never reached statistical significance. And it was only in the arm that took estrogen plus progestogen plus, they excluded women with hot flashes because they know they were in placebo. Like, there were so many little things that really skewed the results. We use this data all the time now that we can say, if you start young, there seems to be. There is a protective effect. If you don't have existing cardiovascular disease to protect you, you know, you will have a heart disease later in life, you know, if you. If you were on hrt. But that was like doing and looking at certain ages. If you start before 60 or within 10 years of your menopause, there is cardiovascular protection. But if you start older, there is not. So, like all that new, there was zero nuance when they reported it, but it was a hell of a news story, right?
- [55:03]
Katie Couric
But I think the big panic was this breast cancer risk, right? And it was a very, very small percent. So the nuance was relative risk, which
- [55:13]
Dr. Mary Claire Haver
is hard for me to understand. I do this work every day versus individual risk. So the absolute number of women who had breast cancer from taking the combined therapy of a very old medication we don't use anymore was like one case out of a thousand per year, but it was 25% higher than the baseline rate. And so they reported 25% increased risk of breast cancer, you know, and scared the hell out of women. It scared the hell out of me as a young, you know, resident. And we were terrified, and we were waiting. You know, we weren't even allowed to see the study when the headlines came out. And once that genie got out of
- [55:49]
Katie Couric
the bottle, it just stopped all the research in its tracks, didn't it? And I still get confused about the estrogen progesterone combo, because if you have your reproductive organs, you need something to
- [56:02]
Dr. Mary Claire Haver
protect the lining of the uterus.
- [56:03]
Katie Couric
So you need progesterone.
- [56:05]
Podcast Advertiser/Host Voice
Yeah.
- [56:06]
Dr. Mary Claire Haver
So because the endometrium, the lining of the uterus, the inside, like where the babies grow, where your periods are made, is highly sensitive to estrogen. It builds this tissue out, right? And progesterone makes you shed it at the end of the cycle. And if you just have estrogen going on and on and on, that tissue will just continue to grow and divide. And for some women, it becomes hyperplastic. And then maybe malignant. So we can give you a progestogen and negate that risk.
- [56:31]
Katie Couric
You know, I was going through menopause kind of right around the time I became the anchor of the CBS Evening News. So I didn't want to be like Arthur Brooks in broadcasting news, you know.
- [56:43]
Dr. Mary Claire Haver
Did you have hot flashes?
- [56:44]
Katie Couric
I didn't really have hot flashes. I had night sweats. But I also wanted to stay mentally sharp, you know, I didn't want to have a brain fart in the middle of the evening news. So I started, I went on the patch and then I took bioidentical progesterone at night. I sometimes forgot, honestly. And I loved it. And I would have stayed on it forever. I don't know if I'm allowed to do that. I would have talked to my doctor, obviously. But then I was diagnosed out of the blue with breast cancer and it was hormone receptor positive breast cancer. Now quick question while I have you, doctor, Was that caused by my HRT and progesterone?
- [57:29]
Dr. Mary Claire Haver
No. When we look at the data. So there were other trials, there's like a Keeps trial and a Cronos trial and other things in Europe because in Europe they actually didn't use the primpro that we used in the U.S. so the estrogen only arm which was premarin equine estrogen, you know, of course you had decreased 30% decrease, you know, relative risk of breast cancer. So the estrogen only arm estrogen was very protective we think because it's an anti inflammatory and lowered their risk. And though the women who were on HRT at the time of their diagnosis had lower stage and better survival rates. So a certain amount of women are going to get breast cancer. And we're working on why that happens.
- [58:08]
Katie Couric
Yeah, because I have not.
- [58:09]
Dr. Mary Claire Haver
But women on hrt, especially modern HRT form and most women do not have a family history. Most breast cancer is a one off.
- [58:17]
Katie Couric
Right. So it's like 82% or something. Right.
- [58:20]
Dr. Mary Claire Haver
So you being on HRT at the time of your diagnosis probably led to an earlier stage diagnosis for multiple reasons. One, we think it plumps up the cells so that they're easier to find. Right. Did you feel a note or you just went in for a routine?
- [58:34]
Katie Couric
I just went in for a routine
- [58:35]
Dr. Mary Claire Haver
mammogram and that you are usually getting regular screening because you're going to your doctor to get your refills and they're getting your mammograms.
- [58:42]
Katie Couric
Right. And also I'm kind of hyper about my health because I'm A single mom. Yeah.
- [58:47]
Dr. Mary Claire Haver
So, yeah, your HRT did not cause your breast cancer. It was probably feeding those cells that had had a malignant transformation from healthy cell to a malignant cell. And so they. Because you had estrogen receptor positive. So we all have estrogen receptors on the breast cells. And then if they. When they go through the malignant transformation, they might retain those receptors. So we can use those receptors to attack the cancer cell and put you on blockers and things. So I don't know if you were on AIs or any of the aromatase inhibitors or tamoxifen.
- [59:16]
Katie Couric
I am now. You are not. I'm on anastrozole. What upsets me, though, of getting back to the Women's Health Initiative, is that for 30 years, this research really dominated. Like, it was never really done. And I feel like if this study had not been stopped, and I remember interviewing Bernadine Healy, who was the female head of nih, which was great. I thought, well, if that study had not been halted, they probably now would have some kind of therapy that would bypass any kind of estrogen in my breasts or.
- [59:55]
Dr. Mary Claire Haver
So they do.
- [59:55]
Katie Couric
You know. They do, yeah.
- [59:56]
Dr. Mary Claire Haver
Let me tell you about it.
- [59:57]
Katie Couric
But I know there's vaginal estrogen.
- [59:59]
Dr. Mary Claire Haver
You can use vaginal estrogen today. There is a medication called basodoxifene, which is a cirm, a selective estrogen modulator. Basically, it binds preferentially to different estrogen receptors. We have alpha and beta. It's very high tech. So cirms are things like. Tamoxifen is a sermon. Okay. It preferentially binds. So what Basodoxifene is.
- [60:19]
Katie Couric
When you say serum, I think people think of, like, the thing.
- [60:21]
Dr. Mary Claire Haver
Oh, the ceremony. I mean, in your blood.
- [60:23]
Katie Couric
In your blood. So it's a pill, though. So.
- [60:26]
Dr. Mary Claire Haver
Yeah. So basodoxifene is a pill. They've combined it with Premarin and it's called Duave or duavy. And duavy allows that estrogen to get to your brain, your bones, your joints, my skin.
- [60:39]
Katie Couric
Your skin, thank God.
- [60:41]
Dr. Mary Claire Haver
But it binds and blocks the estrogen receptor and downregulates in the breast.
- [60:47]
Katie Couric
Well, why hasn't my. I love my doctor.
- [60:49]
Dr. Mary Claire Haver
Hang on. So they're doing studies right now in high risk patients who had stage zero cancers. And so far, the early data is showing that on this Duo V, they are not seeing. They're seeing decreased recurrence.
- [61:03]
Katie Couric
Wow.
- [61:04]
Dr. Mary Claire Haver
So we're getting there, but there is hope. So my patients who are high risk, we're talking to them or anyone who has like bleeding or severe breast tenderness. Like Duavi. Like my best. Best friend growing up, Carolyn. Mom. Horrific. Died, you know, and she's so terrified, but her. Her symptoms were so bad. So I came to a compromise with her on this medication, and it's changed her life. She sleeps at night knowing it's probably lowering her risk of breast cancer because the way the estrogen receptor reacts in her and in her breast and in her uterus, but she's getting the symptomatic treatment she needs.
- [61:41]
Katie Couric
Yeah, I would love to look into that because estrogen is like a wonder hormone.
- [61:46]
Dr. Mary Claire Haver
We tend, as humans, function better when it's in our system. But, you know, it's a balance of recurrence, risk versus. No, of course, everything else in your life. And what's missing in the post cancer conversation for most women, they're great at giving you nausea medicine for your chemo, and they're great about, you know, warning you about all these side effects. Except for your sexual health, your bones, your joints, your, you know, the things that when we remove this estrogen, no one's like, preparing you or like.
- [62:13]
Katie Couric
Right.
- [62:14]
Dr. Mary Claire Haver
Help guiding you through this.
- [62:15]
Katie Couric
That's true. That's fascinating. And I'm so glad I know more about that now because I'm doing a document on hormonal.
- [62:26]
Dr. Mary Claire Haver
Do you have a name yet? Can I say it?
- [62:27]
Katie Couric
Yeah, yeah. I mean, we had our first meeting this morning, actually, with the directors and the producers and the researchers. And, you know, I've been interested in the disparities between. In medical research between men and women for some time. I think when I first learned that it wasn't. Women were not required to be included in clinical trials until 1993, and the fact that, you know, the statistics are just staggering that an average of four years longer to be diagnosed with the disease. Women's pain has suffered so long. Right. Not been acknowledged. Right. And so many things. I couldn't believe, Mary Claire, that I just read that they finally have female crash test dummies that have breasts. And they did realize they had to make them smaller, but they didn't consider sort of the physiology of a woman's body. And now they have in crash test dummies and who cares? Right.
- [63:33]
Dr. Mary Claire Haver
Except way more likely to die in a car crash.
- [63:36]
Katie Couric
Yes, exactly.
- [63:37]
Dr. Mary Claire Haver
Than a man. Because the dummies that they do all the safety testing on and make the seat belts for and the airbags were tested on male dummies, never on females.
- [63:47]
Katie Couric
And the statistics, there's so many that are so shocking. And so this issue has really I think bubbled to the surface, but I feel like it's kind of in bits and pieces. So we want to kind of try to give people connected, connect the dots and give them the big picture of why women have been so dismissed and ignored.
- [64:12]
Dr. Mary Claire Haver
The system was built, you know, by men, for men, basically for men and actually Caucasian men. And throughout history and anything that went what didn't fit that model was considered abnormal, atypical. You know, despite females are 41, 51% of the population, our chest pain and a heart attack is atypical. But I think the first step is recognizing it. And that's what we're so good at, communicating. And then it's like, okay, we recognize it and now we have to legislate it, we have to teach it, we have to make this mandatory part of the curriculum. I really see, I really like my prayer is at the end of my life. So my daughter's in medical school that she will understand the sex based differences in health, you know, and at a level that was never taught to me. Isn't that crazy that we have a women's health specialty, that it doesn't include having babies? OBGYN is great and I'm an obstetrician, gynecologist, that's the breast and pelvis, you know, and having babies, but like that should be one part and then everything else. Women's cardiovascular disease, women's autoimmune disease, women's musculoskeletal disease. Women's health should be a specialty outside of obstetrics. So there are a couple of fellowships. So my friends, Lisa Larkin, who was president of the Menopause Society, and Heather Hirsch, who's very active on social media right now, they both did women's health fellowships out of internal medicine. So but we need more of that.
- [65:36]
Katie Couric
You know what I thought was so interesting that. And I don't know if it's changed, but I remember when I first started really digging into this topic that so many medical schools don't have a women's health rotation or curriculum. And that there was a group of, I guess, doctors at Stanford. I'm sure they were mostly women who took it upon themselves to develop their own curriculum focusing on women's health. Today. Do medical schools have this kind of specialty for that is insane to me. Or just fellowships?
- [66:09]
Dr. Mary Claire Haver
It's just really fellowships. And it is difficult. You know, the curriculums are so massive. And you know, even in ob gyn, when I think about, we are expected to be social workers, psychiatrists, you know, surgeons, midwives, you know, all the things. And for me to, like, track all this stuff down and know the differences in male and female cardiovascular disease and male and female urology, and it's a lot. And I think it needs its own specialty curriculum, and we just have to. To demand it.
- [66:42]
Katie Couric
Well, getting back to estrogen, I thought it was so interesting that the reason that women weren't studied more closely in clinical trials was because of their hormones and hormonal fluctuations.
- [66:55]
Dr. Mary Claire Haver
That's considered hard.
- [66:56]
Katie Couric
Right.
- [66:57]
Dr. Mary Claire Haver
Even the animal models, they take out the estrus. They don't have periods. It's a little bit different, you know,
- [67:03]
Katie Couric
if you have a dog, male mice, for the longest times. Right?
- [67:08]
Dr. Mary Claire Haver
Yeah.
- [67:08]
Katie Couric
Yeah. So I think it's like we were too difficult to study.
- [67:14]
Dr. Mary Claire Haver
And is it really difficult? It's just us. But compared to men, you know, it's more expensive to factor in hormonal changes throughout the cycle or not having hormones as a post menopausal person, you know, it just more expensive. It's harder. And, you know, the cardiovascular drugs we use today were, you know, not really tested in women, so.
- [67:35]
Katie Couric
Exactly. And that's why we're calling this film that we're developing and getting ready to shoot Hormonal. Because so much of women's health is predicated on hormones. And even as we get older, I think it's so fascinating. I don't know how much you know about this, and I'm gonna dig into it. You know, dementia and Alzheimer's and how our hormones are affecting our brain health. Right. And also the microbiome. So interesting. But. But I think that I read that even though two out of three Alzheimer's patients are female, only 12% of the funding in Alzheimer's research is focused on women.
- [68:15]
Dr. Mary Claire Haver
Exactly.
- [68:15]
Katie Couric
And why women are getting this disease or the role hormones play. So I think it's gonna be so revelatory, and I think there are a lot of things that are still. I mean, there are many areas, Mary Claire, you know better than I do, of women suffering in silence, but I think about sort of this stigma around postpartum depression and even psychosis. And I covered stories about that. Andrea Yates in Texas.
- [68:41]
Dr. Mary Claire Haver
She was 20 miles. I was in residence.
- [68:43]
Katie Couric
Oh, my God. That story stuck with me, has stuck with me for decades. And for your listeners who don't remember, Andrea Yates was from Texas, From Houston. Right.
- [68:55]
Dr. Mary Claire Haver
Just outside of Houston.
- [68:56]
Katie Couric
Houston.
- [68:56]
Dr. Mary Claire Haver
Between Houston and Galveston, where I was practicing.
- [68:58]
Katie Couric
She had five children, all very young, homeschooling them. Her husband, Rusty, worked at NASA.
- [69:06]
Dr. Mary Claire Haver
So she had postpartum psychosis. So the most extreme version of postpartum depression, she had a hypoestrogenic state that. Absolutely. She was hearing voices.
- [69:18]
Katie Couric
Kill five of them, clearly, that told
- [69:20]
Dr. Mary Claire Haver
her she had to save her children. By drowning them. By killing them.
- [69:23]
Katie Couric
Right. She killed them. She drowned her oldest son. In a very scary story. I went down with a producer from the Today show, Sarah Clagett. We flew to Houston, and I met Rusty, her husband. And he invited me in the house, and he showed me where the little boys had kept their Legos and the, you know, they had a very young infant daughter. And then he said, would you like to see the bathroom? I think her oldest son's name was Noah, if I remember correctly. It was the worst story, Mary Claire. And she chased her oldest son and drowned him in the bathtub. And I said to Rusty Yates, I don't think I can do that, but I remember doing a lot of research, and you might remember this, too. She had both postpartum depression and psychosis. And they ended up like she just got very shitty care. And part of it is they don't know how to treat this right. But they took her off her postpartum psychosis meds, kept her on her postpartum depression meds, which made her feel well enough to act out her scary, intrusive thoughts. The intrusive thoughts, you know. But anyway, the reason I bring that up, it was so heartbreaking. But that's a topic that I think mothers, new mothers, are ashamed to talk about. Postpartum depression, I think it affects so many. And again, that's because of your hormonal changes, right, Mary Claire, that happen after you give birth?
- [71:11]
Dr. Mary Claire Haver
Yeah. So you have this massive drop in estrogen postpartum, especially if you're nursing, because the prolactin will suppress the function of the ovary, which is meant to keep you from getting pregnant again so you can take care of your infant. And as you're nursing, the ability to reproduce goes down. And that's an evolutionary advantage, but it will, in some women, will absolutely unlock, you know, intrusive thoughts. I had intrusive thoughts when Catherine was born. I remember being in the tub with her and, like, giving her a little bath. And I would have thoughts of her drowning. I had no impulse to act, but it was the scary thing.
- [71:48]
Katie Couric
I had that, too. I was always afraid that I would leave Ellie on the side of the road, like, what if that happened? And I think it's like. It's both chemical and then this overwhelming sense of responsibility you have that you're responsible for this little thing, you know, so it is really scary. But what makes me mad is I think it's another example of the medical establishment ignoring a very specific issue that happens to women and not really focusing on it, not providing the research dollars, because I am sure everyone thinks about, like Viagra, okay? Men can't get it up, so they pour millions of dollars, 40 options for a Viagra, and they create this drug in a nanosecond. And yet women who are suffering, they're being ignored. And it really pisses me off.
- [72:44]
Dr. Mary Claire Haver
One good thing that came out of the eights by the time I finished or early. So within three or four years, we had mandatory screening for postpartum depression and psychosis. That had never happened before. And I don't know if that was just a Texas thing, because I've only practiced in Texas until recently, but every single postpartum patient we were screening at every visit with a, you know, standardized screening test for depression. And that came directly out of what happened to Andrea Yates.
- [73:11]
Katie Couric
Well, thank goodness. And I hope that's done all across the country. But, you know, even Ellie said I, she, she struggled with postpartum depression and she didn't really even talk to me about it. And we're extremely close. And I just think anything we can do, I guess there are more support groups, people are talking about it more openly.
- [73:29]
Dr. Mary Claire Haver
I think it's her social media, because they're sharing stories.
- [73:32]
Katie Couric
I still don't think the support that there's enough focus on it and enough science that's really interrogating how we can mitigate the symptoms.
- [73:43]
Dr. Mary Claire Haver
So why do you keep working? I'm assuming if you quit tomorrow, you'd be fine. Like the house wouldn't fall down. You would financially be okay?
- [73:50]
Katie Couric
Oh, I, I would definitely be okay financially. I've been, I've been overpaid for years. But what keeps you.
- [73:57]
Dr. Mary Claire Haver
I mean, you're, you're, you work. You are constantly working.
- [74:00]
Katie Couric
I know, and I love that about that. I feel like I have this reservoir of trust that among some people now in the current political environment, you know, some people don't like what I'm doing, but I feel that I'm doing a public service, honestly. I feel like if I can help give information to people that will either prevent them from getting colon cancer or help them understand an issue or clarify something and that people appreciate that. My goal is to provide fact based, scientifically backed at a time where science is being so sadly demeaned and, you know, just so upsetting to me because scientists are heroes in my book, and so are doctors. But I feel like I have an obligation to use whatever reservoir of trust I've built up and also the platform I have to try to give important information. And I love it because I am learning things all the time. You know, I was thinking the other day I went to some place and. Or I had a conversation. Oh, it was with Ellie Hoenig, the lawyer. All about, like, how the immigration courts are different than the regular courts and how due process is different for illegal immigrants and they, you know, or immigrants. Anyway, I just feel like there's so much I still don't know and still don't understand that in a way, I'm being selfish because I'm learning these things in real time. And through my experience of learning and understanding, I hopefully am illuminating things for other people. And so I just like it. I don't know what I would do. I mean, I think I would find a cause I cared about or, you know, a charity or a nonprofit. And really. But, you know, sometimes I think, what's wrong with me? Am I worried of what will happen if I actually stand still for a moment? Maybe I'm afraid of that on some level, but that's between me and my therapist, I guess, which I don't have right now. Maybe I need to get one. But anyway, I just like being busy. I like being active. I like feeling like I'm having some kind of impact, even if it's for, like, five people and not 7 million or whatever the Today show viewership was, that I'm being of service as weird
- [76:51]
Dr. Mary Claire Haver
and cheesy because so many of my followers get to this point, you know, I'm 57. You're 60.
- [76:58]
Katie Couric
68.
- [76:59]
Dr. Mary Claire Haver
68. And, you know, menopause happens this midlife shift, this inflection point, and they feel invisible and that their words don't matter and that their actions can't change the world. But I just love that you're like, no.
- [77:13]
Katie Couric
Yeah, I've always been a bit of a nonconformist and not one to necessarily follow societal rules. And I just think it's so important. And getting back to sort of longevity and health span, I think. I think it's so sad that women live longer but don't live well. And I think, obviously we're talking about our physical selves, but I think to live well, that means rich and important friendships and hobbies and things that you're passionate about, you know? And so I want to keep doing this in some capacity, maybe not at the ridiculous level. I'M doing now, you know, working on documentaries and doing this and, you know, then I'm kind of like a cancer clearinghouse for so many people too, because people reach out to me, but I wanna stay engaged in the world, you know, and I'm sure you feel that way too. And how do you do that? You do it by doing, right?
- [78:23]
Dr. Mary Claire Haver
Yeah, you do it by doing and just leaning into where you feel like you're doing the most good.
- [78:28]
Katie Couric
Yeah.
- [78:29]
Dr. Mary Claire Haver
Well, thank you so much for that.
- [78:30]
Katie Couric
This was so fun. I really appreciate what you're doing and you are performing such a public service for so many women and so many men who need to care about the health of their partners.
- [78:45]
Dr. Mary Claire Haver
You can hear more from Katie by listening to her podcast Next Question with Katie Couric. Wherever you get your podcast or subscribe to her newsletter, Wake Up Call at Katie Katie courrec.com you can find full episodes of Unpaused on YouTube at Dr.
- [78:59]
Podcast Advertiser/Host Voice
Mary Claire, I'd love to hear from
- [79:01]
Dr. Mary Claire Haver
you about this topic and anything else that's on your mind. You can find me on Instagram @Doctor MaryClaire and get honest and accurate information on health, fitness and navigating midlife@thepauselife.com My upcoming book, the New Perimenopause is available for pre order on Amazon. If you're loving this podcast, I have an important request. Please take a moment to follow Unpaused on your favorite podcast app. Following and listening is what pushes this information to more women who need it. So if this podcast has helped you feel seen, understood or supported, hit follow right now so you never miss an episode. Thank you for being here with me. Let's keep going. Unpaused. Unpaused is presented by Odyssey in conjunction with Pod People People. I'm your host, Dr. Mary Claire Haver. The views and opinions expressed on Unpaused are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis or treatment.
- [80:10]
Andrew Huberman
By order of the Peaky Blinders Academy Award winner Cillian Murphy returns alongside an all star cast including Rebecca Ferguson, Tim Roth, Sophie Rundle, with Academy Award nominee Barry Keoghan and Emmy Award winner Stephen Graham. In Netflix's upcoming film Peaky Blinders, the Immortal Man Tommy Shelby must face his own demons and choose whether to confront his legacy or burn it to the ground. Peaky Blinders the Immortal man is in select theaters March 6th and on Netflix March 20th. Rated River.