Transcript:

Ben Smith:

Welcome to the Retirement Success in Maine Podcast. My name is Ben Smith. Allow me to introduce my co-host, the Rudolph to my Dasher, Curtis Worcester. How you're doing there Curtis?

Curtis Worcester:

All Right. I'm doing well, Ben. I don't know how you timed that one, but we got the first snow of the year today, so that was pretty good with the intro.

Ben Smith:

I know. Yes. I know Rudolph had a rough start, so this is corresponding anything here about all the boys and girls wouldn't play with Rudolph. He eventually become a hero, right?

Curtis Worcester:

Sorry, I persevere, I persevere. I'll get through it. We're good.

Ben Smith:

Well, Curtis, I know we're talking snow and a little bit of the holiday season here, but of course, one of our favorite charitable events that we support each year during the good weather is the Energy 4 Life Golf Scramble-

Curtis Worcester:

That's right.

Ben Smith:

... and that happened on this year, actually it's on October 4th. But we've done that every year. We like to golf, and we can support some charity along the way, kind of a win-win for everybody. But for our longtime listeners to our show, they may recall the episode number three where we interviewed Susan Ware Page about her family heating oil business and transitioning from generation to generation. As part of the show, she discussed how her family, the Ware family, owners of Maritime Energy, started the Energy 4 Life program to help local families dealing with cancer. Energy 4 Life was started by the late Karen Ware, her daughter Susan Page and the Ware family. Susan's quote, which she told us in the episode, was that her mom had zest for life, which is why she had Energy 4 Life, which I was thinking of the heating oil, right?

Curtis Worcester:

I know, I remember that.

Ben Smith:

I was like, "Geez, Energy 4 Life, that makes a lot of sense for a heating oil company." She goes, "No, it was all about how the zest for life from our moms and that she wanted help others and help find cures so hopefully one day other families wouldn't have to experience what she did. It was important for us," as what Susan continues to say, "to show our support for the people who are fighting this horrible disease and in memory of the ones near and dear to our hearts who we have lost."

So each year, hundreds of golfers come together to support the Energy 4 Life charity, Golf Scramble, and this year our next guest was speaking to the group on behalf of the Maine Cancer Foundation. He painted a picture of how cancer is impacting the State of Maine, about how the dollars raised locally are helping our families, friends, neighbors, and communities. We ran up to him after his talk and introduced our podcast and how Maine in particular is impacted by cancer. We wanted to especially hear about how when personally when we're diagnosed with cancer, what are the first steps, what do we do next? So that was our ask of this next guest. We're pretty excited he said yes and agreed to come on our show. So that's what we're going to discuss today.

Curtis Worcester:

That's right. That's right. As you said, Ben, we actually met our next guest back in October. A little background on him, so he actually earned a degree in criminal justice from St. Joseph's College of Maine, began working as a beat cop in Portland in 2005. He was 21 and worked the swing shift in Portland's East End, patrolling Munjoy Hill in the nearby areas from mid-afternoon until the early morning hours. In 2011, he was actually named Officer of the Year, which is incredible, and then in 2012, after much hand wringing, made the leap from the police department to manage the Boys & Girls Clubs of South Portland. He said, "I started spending so much time there, it bled into my personal life. I thought I could make a more positive change day to day doing proactive work than reactive work."

So the relationships he made and the people he worked with made the experience some of the best years of his life he said. In 2016, he moved on from the South Portland Clubhouse and managed the Ronald McDonald House in Portland, which offers housing near hospitals to families whose children need medical care. It was a quieter environment but one that still focused on helping families and children. In 2018, he joined the Maine Cancer Foundation first as the Community Outreach Manager and the Director of Development. And now we're thrilled to announce that he is the Executive Director of the Maine Cancer Foundation. He's just as easily found in Aroostook County as he is in Cumberland. He's an avid outdoorsman studying to become a registered main guide. It's not uncommon for him to forego a hotel room for his tent while on the road for the Maine Cancer Foundation. Our next guest currently lives in Portland with his wife and two daughters. With that, please welcome Ray Ruby to the Retirement Success in Maine Podcast. Ray, thank you so much for coming on our show today.

Ray Ruby:

Thank you, guys, so much. That is quite the introduction. I really appreciate it. It makes you stop and think a little bit. Appreciate that.

Ben Smith:

Well, Ray, again, we want to talk a lot about the Cancer Foundation and what's happening on the scene in cancer in Maine. It's always helpful to hear about you. I know we gave you the read in terms of the bio there, but I'm going to out you because obviously you're not from Maine, right?

Ray Ruby:

Yes.

Ben Smith:

So tell us how a kid from Connecticut goes from being a police officer in Portland to a non-profit helping kids, then another non-profit assisting families impacted by cancer in Maine. There's some twists and turns there. So looking backwards, tell us about that story and what's been your why.

Ray Ruby:

Well, I mean you touched on the outdoorsman piece of it. There's that famous quote, "Not all who wander are lost." And so, as you talk about my career path, I always say it's like a switchback, not really much of a path. And that's okay. It's something I used to tell kids at the Boys & Girls Club, "You don't have to do one thing forever. As life gives you opportunities, you either seize them or you don't."

For me, Maine has always been near and dear to my heart. Every summer we came up to Old Orchard Beach, spent a week there, did my school shopping in Kittery on the way home. But my mom and my family is from Maine. And so, my grandparents, my meme and pepe, are from Northern Maine, first Canada, then Northern Maine, and then they made their way down to Connecticut to open up a tree cutting business. My pepe worked in the woods, and it was an opportunity. There's a lot of connections from Northern Maine to Connecticut, and a lot of it had to do with economic growth at the time.

My thought process when picking a college was, "Well, let me go back to the family roots," even though I'm not from here and never officially will be. But my wife is and both my daughters are and my dog, so I'm the only one in the house who's not an official Mainer. But that's okay because I feel like I treat the state like a tourist in some ways. I'm not afraid to try the local spot that everyone goes to and the ones that nobody goes to in different communities and the people who live there only go there.

So yeah, Maine, it's a place that we will never leave. There's been opportunities, and that is just never going to happen. When we talk about retirement stuff later and people talk about moving to Florida, I'm not that guy. You guys don't have to worry about that advice for me. Again, my career path, just to go back, I wanted to be a police officer. There was no cops in my family, it was just something different. I wanted to be around people and to have an impact on my local community. And then as being a police officer in Portland and really enjoying my time there, I mostly enjoyed the time in between calls when I would sneak into the schools and talk to kids or come in in my days off and read books or coach a team. And so was able to start a lot of youth programs to try to improve relationships between youth and police officers in Portland. And then unfortunately, because the department thought it was such a great idea and saw so much momentum happening, they made me do it full time. And then it backfired because then I fell in love with the organizations I was working with.

And so, that's what started with the Boys & Girls Club. I turned around and said, "Where are all these kids? How come they're all hanging out on the streets these weeks?" I quickly found out, well, these are the weeks the clubs are closed for cleaning and for maintenance. I'm like, "Wait a second, so they're somewhere safe and in a good place when they're open and then there's another place around the corner and then there's this place." And so that's when I started to realize, "Well, these folks are doing this amazing proactive work every day. Most of the time I'm showing up after the fact, not always, but most of the time. Kind of want to do more of that other stuff where I could be more part of the solution instead of just sometimes cleaning up the mess."

And so, made the leap just 10 years ago last August. It's been 10 years, which just crazy. And then the nonprofit world, I've been blessed to work for some great places. The Ronald McDonald House in Portland will always be near and dear to my heart. It honestly taught me how to be a dad and a parent. In so many ways I learned from so many parents from around the state and around the world actually who were here in Portland receiving care. But what it also told me too is that I didn't want my work just to be in the community that happened to reside in because, like we talked about, the whole state means a lot to all of us. If I can mix both worlds and then also now work for an organization that's statewide, sign me up, and that's where I ended up at MCF.

Curtis Worcester:

All right. Obviously, here you are at Maine Cancer Foundation. Can you just talk about in general or specific if you want to go down there, why does the Maine Cancer Foundation exist?

Ray Ruby:

We're all friends here so I'm sure people listen in the same way. Because Maine doesn't always fall on the top of the list for a lot of folks, especially nationally at times. I think you all know fairly well, and I've got relatives in rural parts of the state, sometimes you got to take care of each other, and Mainers are really used to that. Unfortunately they have to be sometimes.

And so, why does MCF exist? Well, originally we wanted to do our part in the research world. Who doesn't? Who doesn't want to look at this big picture problem, which is cancer, and play a role in eliminating it? And so we did for many years, but what we learned over time, and though research is extremely important, it doesn't necessarily help folks right now. That's where some of the greatest needs are, right now. I mean, we're seeing it more than ever. Some of our partners have been saying it. I've never heard this in five years, and just being like, "Hey, can we just focus on what's in front of us at the moment because it's not good."

And so, that's what Maine Cancer Foundation does. We're an independent organization. We do not rely on federal money. We do not rely on state money. We rely on incredible people like Maritime Energy and the other folks across the state who donate to us, who participate in events, who raise money for us, because that gives us the opportunity to be an independent foundation, a real community foundation who looks around the state, talks to our partners who are experts in these fields, and we react to the needs each year. And they change, and so we could be flexible, we could be nimble in that way.

And so, we always say we're an organization that's there to fill the gaps, and each year sometimes they're different. We'll touch on a little bit on transportation and lodging. That gap is just not going anywhere, and so we have to keep going at it each year. But that might not be the same thing for, say, colon cancer depending on money that's coming into the state federally or whatnot for other groups. So we talk to our partners and look at where can we have the most impact. So back in 2015, we shifted our focus from solely research to more a programmatic approach focused on three main areas, cancer prevention, cancer detection, and then access to care, trying to improve patient outcomes. And so, that's where the majority of the money that we invest each year goes. It's not the whole picture, but that's closer to the complete picture each year in those three buckets.

Curtis Worcester:

Gotcha.

Ben Smith:

Ray, I think that does a really great job summarizing, I think, where Maine Cancer Foundation is. Obviously, you have a very new role to you in terms of being the newly-named executive director of the Maine Cancer Foundation. Love to hear in terms of what is your role there. In terms of executive director versus maybe development director and the community outreach part, how is that different from a day-to-day perspective? I know you've talked about, hey, those three areas of the things that you're looking to do. Love to hear maybe a couple of impactful stories of things that Maine Cancer Foundation has done in last five years. Let's bridge that gap to, locally, how are you helping us, Ray.

Ray Ruby:

I think when I was first brought on as a community outreach person, the reason why I was brought on at that time was because a lot of good was happening. A lot of money was being raised, and a lot of money was being invested, but people in the office were so busy doing both things that there was nobody out in the community saying, "Hey, by the way, we're here to help. We're Maine Cancer Foundation, we're not that other organization or this other organization." And if you're not in it and dealing with this day to day, of course you confuse those organizations, and that's fine. My goal was to go out there and to educate people what we're doing, what we're trying to do, and also make sure that they realize that we're not telling people what's good for them in their community. We're also there to listen and also learn what they think is best for their community.

Because we all know that, we all know those people who come into town, doesn't matter where you are, tell you what's good for you, what could be better, and then they leave. That is not us. The goal is to be a partner. If we did show up and listen, what are we going to do afterwards? How are we going to work together? The first year when I showed up at Maine Cancer Foundation, I made it a point to spend time in all 16 counties. I've been to all of them back more than several times. As we joked about at the beginning, what better way to know a community than instead of flying in, flying out is pitch a tent in the local campsite, and I'm going to be honest with you, have a few beers around the campfire, no kids, it's also a night away.

Susan and them got a kick out of it, not this year, but last year when I came up for the golf tournament. She asked me to speak at the local rotary club the next morning. I'm like, "Well, went to Camden Hills, make some dinner, had a few beers." I used my glass from the golf tournament. I sent them a photo with my feet up by the fire. Woke up in the morning, went hiking. The way I look at it is a lot of folks choose to live in these communities for many different reasons. They've been raised there. They're absolutely beautiful. You shouldn't have to sacrifice the best access to care based off of where you decide to live or where you were born. I mean, we all know how pretty Maine is, and it's got a million different faces, and no one is better than the other.

And so, for me, it's always just great to go into these communities and spend time in them. I always think of a funny story in Skowhegan one time I was up there for an event. Our office happens to be here in Falmouth, it's just a home base. And so, the joke started to kick in, "No, you guys are pretty much based in Boston." I got all the teasing. Well, then I was able to turn around and say, "Well, just so you know, we invested about $120,000 in your hospital in the last couple of years. Then also we worked with our local hospice group, and then the transportation, these are the two partners that we've worked... " And all of a sudden everyone stopped joking. Again, it was all lighthearted, it was good stuff. But at the same time, it's important for me to show and actually explain that we are invested in your community, jokes in all, I get it.

And so, it's important to be there in person and come on a regular basis. I know I'm supposed to go up to Bangor in January, and I'm like, "Geez, that's two months away. I should be going up before then again." And so, it's just being more strategic about that. That's that community piece of it. To jump into the impactful side of things, I know you guys are numbers guys and we could do this all day, but we're pretty proud after the last round of grants that we've given out just since 2015, your local Maine Cancer Foundation has now invested over $16 million to the state in the last seven years.

Curtis Worcester:

Nice.

Ray Ruby:

$16 million in all 16 counties. That's 100 different organizations we've worked with, so you talk about community partners. It's close to 300 grand.

Curtis Worcester:

Yeah, it's incredible.

Ray Ruby:

We've changed things. We've shifted things from one-year grants to two-year grants because we heard from our partners that it's a lot to put words on paper sometimes when you're doing good work. This is how we operate. Yesterday, one of our grantees called. We pick up the phone, we talk to them, we answer their questions, and move on to the next so they can deal what they need to deal with. And so, there's real people that work here because there's real people in the communities, and that's the kind of service they should get from their cancer foundation.

Curtis Worcester:

Absolutely. No, I love that. Thank you so much for sharing all of that in detail with us and our listeners. I want to keep going here in our show and specifically talk about really what's happening with cancer in the State of Maine and for the sake of our show, what happens after we've been diagnosed. Can you just help us understand from the start here, what is going on in the State of Maine around cancer statistics? How is our state doing relative to New England or maybe the rest of the country? Are there cancers that are more prevalent in our population, and maybe why or why not? So if you could just give us some foundational info here.

Ray Ruby:

Happy to. Heart disease is bad, and we always hear that, leading cause of death in the country. And it is significant here in Maine, but it's actually not the leading cause of death for Mainers, cancer is. So that's the first red flag. Maine is one of the worst when it comes to New England states. We have the highest rates in New England, and the biggest driver of that is lung cancer. When you talk about that specific cancer that moves that figure to the top, it's lung cancer here in Maine. And then the quickest and easiest way to explain that would be smoking.

Curtis Worcester:

Sure.

Ray Ruby:

I mean, there are other factors, but if we're talking about the top cancers, top cause of death here in Maine and the top reason why, those are boom, boom and boom. Unfortunately, when we've seen good things happen, then a pandemic hits. And so, lately there's been some great numbers that have been floating around out there, but they all stop around 2019. We haven't seen the effects yet of what the pandemic has caused, delays in screenings, did it increase smoking rates, has it increased unhealthy, bad habits? These are all things that we're going to find out statistically here soon that could paint a completely different picture than we thought where we saw some improvements over the last few years. Is it going to send it in a different direction?

We don't know. I don't want to say it's bad or good, but we've heard enough stories now where people have put off screenings and whatnot and treatment because of the pandemic. We just don't know yet what those outcomes are going to be, but unfortunately, they're probably not going to be good. A big part of these investments that we've talked about last year, we've made some major investments around getting people back in and screened, so working with partners to extend hours and services and hire staff to get people back in, backlogs of screenings, get them in. Ben, you and I talked about this in the past that we could sit here and preach all day, "Get in there, get screened," but if you can't get in for an appointment for 12 months, you're trying to do your part, but that's a problem. We'll talk about being an advocate for yourself later on, but that's just something that you need to be aware of.

And so, that's some hard statistics. When I go around the state and give presentations for people, they're surprised. We all know that cancer's affected all of our families in different ways here in the state, but it's alarming to know it's number one compared to other places. It just goes to show again why we have to exist, to take care of our communities across the state.

Ben Smith:

Ray, I think that's really helpful to understand as a backdrop to our conversation, because when you're saying, "Well, hey, cancer," I think people hear about it and it seems like it's pocketed at times as we hear the personal stories from somebody we know, but it's tough to understand, well, zoom out a little bit and where everything is. I think that's a really important piece to understand.

You referenced this a little bit about access to healthcare in the State of Maine. If I live in Madawaska versus Old Orchard versus Belgrade, I'm going to access healthcare very differently based on where I am. And also, as you said, obviously the pandemic has also maybe changed the way that we're accessing healthcare as well. Can you talk about what's happening in the state with healthcare, especially as it relates to cancer and how to access that?

Ray Ruby:

Yeah, I mean, different doctors across the state would probably talk better about people being able to access care these days through telemedicine. We've seen improvements given the pandemic on services like that. But when you're talking about coming in for treatment, yeah, it's different. The state was not created equal in that way, and that's where we try to help. I thought of this on the drive in this morning because I know you guys got snow. We got a little slush, and then it quickly turned a rain. But I remember last year I took a picture of my front lawn, it was towards the end of winter, start of spring thing. We had lost most of our snow in Portland, and you could see green grass with a little patch of snow in front of my house in Portland. And then I had my father-in-law in Madawaska take a picture of his front yard, and it was almost touching the gutters.

I posted both pictures together on LinkedIn and just said, "These are the type of barriers we don't always think of when it comes to access to care in the state." Even take providers out of it, weather. It's the same state. We're just six hours away in one place is a one way to drive down your street because the snow's so high and they have nowhere to put it, and it's almost spring in Portland. So yes, there's all kinds of barriers when it comes to access to care, whether you're trying to receive treatment and you've got to drive four hours for that. But then there's other things like weather. You might be the primary care provider or you might be the primary caregiver to your spouse because of a disability or whatever, and now you need to seek treatment yourself. People, they have pets. I mean, just things that you wouldn't even think that might alter somebody's plan based off of a pet. These are things that I've heard over the years from some of our partners.

So yeah, it's a challenge if you're somebody who's trying to drive from Washington County into the [inaudible 00:24:34] Area for care, but then you throw in some of these other things as well, whether it's rising gas costs. And so, there's a number of different barriers in our state. I always say it's a big and beautiful, but it causes a lot of complications at times for people to get the best care possible. And then when it comes to, again, receiving treatment, is it somebody who's going in for rounds of radiation or chemotherapy? What does that look like for back and forth round trips? Do they have a place to stay? Sarah's House is a great partner of ours in your neck of the woods who does amazing work. Danny, my coworker, was just visiting the other day. And then [inaudible 00:25:13] folks who are at home, they have many challenges, and the Christine B. Foundation delivering food. Matt Dexter has got a wonderful program, again, in your region.

It's not just us, these partners who are doing great work, we just try to get behind them and give them a little bit of a push. But yeah, access to care in rural parts of the state, not having access to a number of certain oncologists, these are all things that... Unfortunately, I asked my coworker who's from Houlton, I said, "We talk about all the improvements in modern medicine and technology and all these things. Is access to care worse now than it was 20 years ago or 30 years ago when you were in Houlton?" And she said, "Yes. I think it's actually harder." It's an interesting way to look at that part of it.

Ben Smith:

Ray, I'll share with you too, because I know you and I talked about this little offline was I have a family history of colon cancer myself, and my immediate family has routinely found polyps in their colons during colonoscopies. I turned 40, so I'm north of 40 right now, and requested a referral for a colonoscopy. I asked for that, and the referrals lost. I check in, "Where is it?" "Well, I sent it, the other one didn't receive it." And then they made another referral to an out-of-network provider, which then I go to the health insurance and it was going to be I think four or five times the cost to me to doing it out-of-network versus in-network. So I then had to change a referral again to get to an in-network colonoscopy. It was nine months from when I requested the procedure to my PCP to when I had the procedure.

It was many months of advocating, people losing things, people referring to the wrong place. Not giving up, and I had to fight to get the procedure, and I'm 10 minutes away, I am literally 10 minutes away from each of the places I need to go. I could see where I'm 10 minutes away and I'm fighting this and I'm trying to find... Again, everybody's very busy and understaffed and all that. I get why access to good healthcare is important. Again, I had a procedure and I did find a polyp and I'm glad I did it. But even if I didn't have that right, I would still be happy that I had some peace of mind because of doing that. But I could see where, hey, I don't do something, I just give up. And maybe something was there that was really bad and I didn't take care of it, and then all of a sudden now it's maybe too late. I guess my question of that story is, that was me here in Brewer Bangor, Maine, is that the way healthcare is around the state, the region, and the country? Is that just the way we all are dealing right now?

Ray Ruby:

I can't speak to other parts of the country. I mean, I can speak to parts of Maine, and that's unfortunately at times... You have to be your own advocate, and that's tough. When we talk about it being a generational thing, I'm also turning 40 here soon. We're better, we're still not great, but we're better pushing that, pushing back a little bit with our generation. Generations above us are not, and especially ones in Maine. I mean, we could all think of our relatives in Maine who doesn't take much for them to say, "Okay, well, forget it then." I don't blame them, but it's also tough because you talked about colon cancer, it's one of the most treatable cancers when caught early. But also, it has some high death rates when not. And so, it's one of those things.

And so, here you are having to push so hard nine months. I could very much see somebody else who hit their first roadblock stop. I get it. Or your family member who you're trying to convince because a family history who won't do it or doesn't want to, and then you finally get them to call and then again something gets lost, "Well, I tried."

Ben Smith:

Yep, that's right.

Ray Ruby:

That's just not right. We'll touch on patient navigation, but sometimes when you could link on with a patient navigator, it's like having a personal trainer. I mean, it doesn't matter who you are, we all could use a personal trainer in life in some way. That's kind of what they are, they're the ones that push things along at times. When you can work within, whether it's a hospital system or a provider that can supply those services, it could only help. That's not just with lining up appointments and whatnot, it might be securing different financial opportunities or looking into different things. And then you nail it too, you got referred to somebody outside of your plan, and that's a nightmare once that happened. And so, again, if you don't contest that, how many people just pay it because they think they have to. Again, I could think of relatives who would just pay that bill. And so-

Ben Smith:

Or Ray, to your point, is you get referred out of network, and you go, "I can't afford that."

Ray Ruby:

Exactly.

Ben Smith:

I'm not going to do it because all of a sudden now I can't afford that much. And then if I'm doing it, then I'm taking money away from my family somehow or I'm making a choice between food on the table and feeding my family or getting this procedure, that's an impossible choice, right?

Ray Ruby:

Yep. No, especially these days, and you guys can speak to this much better than I can, but just the cost of living is higher. And so, people are making tough decisions. To think that you would make a decision that would impact your health in this way is tough. And so, we are not the solution. We are trying to be a part of it, and we want to help. But it doesn't just take us, it takes others as well. As we look out for our family members, for the people who are listening too, it's okay to push them, push them a little bit because we all want to be around for each other. It's important to take care of yourself if you want to be around, if you want to enjoy retirement, gosh, if you actually do want to move to Florida, I don't know why you would want to, but if you want to, have at it. We want for you if that's what you want.

Curtis Worcester:

Exactly. No, that's great. I want to go back a little bit here with that foundation we laid with about healthcare access and Ben's question initially. Can you just talk about why it's important for us to get treatment for cancer as locally as possible?

Ray Ruby:

Yeah, I mean, there's just a lot of information out there that we've received over time is that the best outcomes usually are when folks can be treated closest to home as possible. So think of your support networks. I know I sent over to you guys a financial toxicity study that we invested in years back to get a better idea, and I was shocked looking at that. I figured, yeah, it's bad. I figured it's bad. I know it's bad the impact it has from having a diagnosis, but what I did not take into account was the emotional side of it and how much that plays. And so, we can't discount, that being within reach of your networks, your support systems do play a large role, having a doctors and nurses and people that start to get to know you and get a feel for you.

And so, it doesn't always happen this way, but a lot of times when you can get treatment... I was talking to somebody at the golf tournament we were all at saying how they had an operation outside of their community but then they had their treatment as close as possible. So sometimes it's a mix of both. But yeah, I think that plays a big role. In my time at the Ronald McDonald House, I saw the impact it had on families who were not close to those systems over time and the impact it can have on you and your health and your families. That can't be lost in this mix when it just comes to dollars and cents, it plays a big role.

And then the other piece of it too is your survivorship afterwards. I just talked to somebody on Monday night, breast cancer survivor, and we were just talking about the medication she's on and the impact it has on her health now. Yes, she survived breast cancer, but there's this whole other chapter and the side effects from the medication and then also just the emotional side of it as well. And so, there's a whole other survivorship piece that I've learned about in the last five years that I was quite naive to. I always thought you try to fight this fight and you fight it and you win and then you move on. That is not the case. A lot of times, cancer does come back for folks, is a higher percentage afterwards. When you're going in for your six month scans or whatever it might be, your blood test, these are things that weigh on people emotionally, and as we all know, stress and taking care of ourselves then has an impact on our health, which then our health has impact on disease. So again, it's this trickle down effect type of thing.

Ben Smith:

So Ray, you're getting into the next area where I want to go, is this whole what happens next after I've been diagnosed, right? Again, from a personal level, each one of us, I'm just thinking about that day, because we know there's many of us out there that are getting that heartbreaking news that, "I'm sorry, but you've been diagnosed with cancer." So what is day one? I'm receiving cancer diagnosis, I just got that call, what are the first things that we need to do on that first day? But also then go forward on what does the first week look like and then the first month? I think it's helpful for us to know of, "Hey, I got the call, now what?" I'd love to hear your response to that.

Ray Ruby:

Yeah, I'll say I don't know firsthand, and I hope I never do for myself. I can't imagine that feeling. Talking with other people who have had that conversation, they tend not to hear anything else that's said that day. All they tend to hear is that you have cancer. I can only imagine that everything else is black. You just don't hear anything else. And so, I think the important thing is that once you have an idea of what your provider is going to offer for a plan, it is reaching out to your support system and folks that might have gone through it and that might have dealt with it in the past and just talking about your options, because a lot of times there might be some different options in place.

I think the first thing to do is just take a deep breath and realizing that there is a lot of good that is happening still. There is still a lot of improvements. We talked about colon cancer, one of the most treatable things when caught early. We've seen great improvements around breast cancer. Though incidents are high, outcomes have become better. And so, it's okay to have a little bit of optimism mixed in there. But it's also okay to take a moment and just realize that this might be pretty hard and you might need to lean on people. And so, looking at those stakeholders in your life and sharing that information with them.

But I think the next big thing is that for that next, what I've heard from folks, is that next big appointment. We've talked about this. So you don't go in dizzy and having that same feeling all over again is writing down questions, questions for yourself, your family. There's no bad question. There's also a lot of services sometimes that don't get talked about that you should ask. "Is there opportunities for financial support can I qualify for? Is there transportation if needed? Is there lodging if it's needed? If I'm having to go to New York for something, what are some things for outside of Maine if I'm going to Portland? Or if it's such a bad drive, can I fly? Are there groups?" We work with two of them that... It's air transportation services. And so, I think it's just important to write it down. Because we've all done it, we have a million things on our brain, and we go into these really, really important things and then we're just still in the daze.

I think it's okay to have be in a daze for that first one, I know I would be. But that second time around going back in very prepared, seeking if there is a patient navigation type of program within that health system or that provider. And just seeing what options, what kind of support I have. And then sometimes it's great if you're allowed, I know with the pandemic it was hard having to go into these things alone, but if you are allowed to have somebody come in with you, making sure that they're obviously there to ask some of those questions too and sometimes be an advocate for you. We talked about some of our family members who are not great at it. Well, that might be the time where we need to step in and be that point person.

Curtis Worcester:

I want to keep going here, Ray, with again along the lines of this emotional raw reaction that I can only imagine is certainly natural. Like you're saying, you hear it, you go fuzzy, you blur everything out. Continuing along those lines, I think a big thing here is obviously fear, fear for your health clearly. But then I guess what are things that people are scared of? Is it sharing the news with family? How do I tell my family? Am I going to have the money to pay for these treatments? Again, I think health and your own health is in the forefront there, but there is so much around this diagnosis. Can you just talk about that?

Ray Ruby:

Yeah, I think it's different for everyone because cancer affects everyone, whether you have a lot of money or you're not as well off or if you're in Portland or you're in a rural part of the state. It does not play favorites. And so, I think a lot of people, they fear that they're letting their families down or something they did wrong. I mean, shoot, we talked about lung cancer earlier. I can't tell you how many times somebody said to their family member, "I have lung cancer, but I didn't smoke." It's almost like I was going to judge them. Why is that even something that somebody has to say because it doesn't matter. What we're talking about is how can we make sure that you're around and you're here and you're healthy. It doesn't matter at that moment, at least in my mind, what got you here.

I'm very careful because there's a statistic everyone loves to say is that 50% of cancers can be prevented by healthy lifestyle choices. That's a big number. But also 50% can't. Or we all know that person who was the marathon runner who never smoked a day in their life and had lung cancer. And so, it doesn't take long to come up with those examples pretty quickly. It should be less about that and more about making sure that people feel comforted and knowing that there's going to be good days and there's going to be bad days and allowing yourself that. You're not letting anyone down. I think when you talk to parents, especially with young kids, I think they don't even think at first about their health, they just immediately look at their kids. I understand that, but at the same time, you want to be there for them and the best way to be there for them is to get the best outcome possible.

Yeah, there's an emotional side of it. That's why, honestly, I don't usually talk about my connections to cancer when I talk to people or give presentations because I bet you we could just turn this podcast around and both of you can go into great detail about how cancer has affected your families. So I listen, and I think sometimes that's the best thing we could do for folks is just be there, be a good listener. Know that I'm not a doctor and I'm not going to solve their cancer, but I can listen to what they have going on, provide some possible feedback, be an advocate at times.

That's where Mainers really do step up. We talked earlier about how we do sometimes get a little left down on the bottom of some lists, and that's okay. But where we do step up, and I know you've seen it in your communities, I've seen it mine, I've seen it around the state, the way we rally around each other, the way communities support one another, the way we come out for each other. I mean, these transportation programs, many of them we work with are volunteer drivers. They're not just driving, let's be honest, they're grabbing them a snack or food on the way to this. That's what people from Maine do. It's never just a little, it's a lot. I mean, that's why I fall in love with them every time I go into a different community because these are the stories that I hear, the things that I see.

And honestly, fundraising is hard, but I tell you, I come back so motivated every time I spend time talking with folks because it just means that we get a chance to help them. Yeah, some of these trips sometimes when you're around the state hearing these stories, they're tough. All it does is come back and motivate us to do more, because I always say, "The more we raise, the more we can do here in the state." But unfortunately, you hear these stories and it's not just you think of somebody older, it's the person I was just talking to the other day who's younger than me dealing with breast cancer. And so, it's the things that we're dealing with.

Ben Smith:

Ray, again, we go through the day one, week one, and you made the point about being an advocate. That's a really important thing here, especially around a treatment plan, right? I know from assisting my grandparents and other family members with their healthcare, it's important to go into a doctor's office more prepared. Especially as we age, I think that's even more important. Again, this is a retirement podcast, and if you're 60, you might be able to navigate a lot of things yourself. If you're 90, that might be a lot more difficult to do. Ray, let's fast forward here a little bit. I know you're just covering that emotional reaction that we are getting from that initial diagnosis. Now we're talking to our doctors about a treatment plan. I know from assisting my grandparents and other family members with their healthcare, it's important to go into our doctor's office more prepared.

If I'm 60, I might be able to do something myself, but 90, that might be a lot more difficult to do. But even the person I bring with me might not be the medical expert in our family or know these things, so what are some of the ways that we can get more out of these meetings with our doctors and also figure out what the right questions are to ask because maybe I don't even know what to ask or my family members don't even know what to ask? Maybe it's a blur, we're just along for the ride, and we just don't know what to do. So how would you guide somebody like this here?

Ray Ruby:

I mean, I think one of the things is just stopping and looking around and seeing... Again, one in three of us, I mean, let's look at this call right here, odds are statistically one of us will be diagnosed in our lifetime. Unfortunately, that's what we're looking at. And so, it's also looking at your peers, it's looking at people. There's some great organizations across the state, different cancer resource centers, whether it's Bessie Wright down in Ellsworth that provides a lot of services to the Washington County, Hancock County. I'm talking about the Dempsey Centers here in Southern Maine, but also in Lewiston, Auburn region. You can go on and on, Cancer Center for Western Maine. There's just a number of great centers across the state where you can call and ask a lot of questions and be referred to different folks, whether support groups or people going through things who this isn't their first rodeo.

And so, that's normally where I send folks, is those resource centers. Just fantastic, and they're community based. They've unfortunately been through a lot of this. And then also, again, looking around your own community. I'm not saying that you listen to Uncle Joe that you have who just tells you everything and this is how he did it and this is what you should do, and that's the only way to go. It's just collecting that information and then making the best decisions for you.

But when you talk about age, yeah, I mean, a big part of that is tricky. Especially as we get older, we seem to turn a lot of that trust back to the provider. I think it's okay to maybe not say you disagree or ask for what other options that you have, and it's not rude, and it's not mean. I always say, "Well, this is new for me. What does this mean? I'm sorry, but I don't mean to be rude," and I'm just talking about myself. I think it's okay. Here in Maine, sometimes people receive treatment at multiple different places, so it could be quite tricky. That's why we've invested so much around patient navigation because it just feels like it gives you more of a point person sometimes in your plan. And not everyone provides that, but I think everyone knows the value of it. And so, we're looking at, Maine Cancer Foundation, how do we grow this? I mean, I was on a call about a month ago with an advisory group, and you had major health systems in the state, you had insurance providers, you had all different people from the state of Maine, the Maine CDC and Cancer Registry and all these different folks in the room.

I kept hearing patient navigation over and over and over and over again. So I circled it, I starred, I underlined it, and I was like, "Okay, it's pretty clear that this is working. This is great. What does that mean for us? How do we maybe expand on this to make sure that people have this?" Because if you talk to somebody who's, say, in their 60s or 70s, and I know some that they hear about a patient nav and they say, "Gosh, I wish I had somebody like that during my care." But then that's not always the case. We just had a phone call this week of a woman in her 90s who is dealing with colon cancer but living with her daughter. They have a plan in place, and the doctors feel great about it. She's going to go in for an operation even though she's in her 90s and things look good. And she's doing a wonderful fundraiser for us too, which is just incredible to even think about us in that way while going through all this. But that's where they want to channel their energy.

So yeah, it's tricky. There's no perfect answer to it. I think it's just having conversations. Google gets you only so far, and sometimes it does more damage than good, but sometimes it's also listening to just one person is sometimes just as bad. It's just important to have these conversations with people in your life, specialists, community centers. Just don't be afraid to call. I mean, you can call the Maine Cancer Foundation. If we don't have the answers, normally we can point you in the right direction to a partner who might. It's important that we don't pretend to know everything. And so, I'm not a doctor, and so I just make sure that I can connect them with the right people.

Curtis Worcester:

No, that's incredible. As Mainers ourselves here, and I know we outed you in the beginning for not being from Maine, but I don't want to speak, [inaudible 00:48:45], he spoke for me there. Okay, so I was going to say we'll accept you in. I think the amazing work that you're doing in the State of Maine, I think everyone in the state would welcome you in with open arms. So the three of us now sitting here as Mainers, so we know we're all very good and eager to offer help to our family, our friends, communities in need. We've talked about it throughout this whole show is how much we enjoy... I don't know if we enjoy the cause or enjoy the reason, but we enjoy rallying for those in need. I think we all can also agree that we're pretty bad about asking for help for ourselves or accepting support from those family, friends, or communities ourselves. Do you find that that mentality changes with a cancer diagnosis?

Ray Ruby:

Not much. I've learned this in funny different ways sometimes is that I might be in a community that's 20 minutes from another one, and I mention, "Hey, I was just there yesterday," and people are like, "Don't mention that town here." It's 20 minutes. "Yeah, yeah, don't mention." I'm not going to out anyone, but I'm just like, "Okay, all right."

Curtis Worcester:

Got it.

Ray Ruby:

It's just funny that's how we are. My wife's, again, from Madawaska. She's a Mainer, but now she's downstate. Doesn't matter, she grew up there, and now she's downstate. Which I think is interesting.

But I get it, and so yeah, I think we take care of each other. We always use the analogy of everyone does. You're on the airplane, they tell you put your mask on before you help anyone else. We've beaten that one over and over again. But it is just so true. We want to help other people, but you can't help them if you're not around, if you're not your complete self. I know it's a overused analogy, but it really is. If you can't be there, if you're not going to be around then... That's why you can't push it off. We know our bodies, and sometimes we do get signs, not all the time, when the check engine line is on and we ignore it. And we just can't. You can't.

You got to get in there. It's easier said than done for me who happens to be in Portland, and we talked about I can make an appointment, cancel it three times, and still show up in a week. That might not be the same for other people for sure. But it's also making sure that we're reading the signs. I learned as a young police officer from an older police officer, when the hair is standing up on the back of your neck, nine out of 10 times, something's about to happen, your body's telling you. Once in a while it's not, and so you got to trust yourself, because we don't always get those signs. We don't always get them, but when we do, we got to seize that.

Ben said you got that peace of mind when you went. Even if they didn't find a polyp that time, you did the right thing. You look at your family history, went in, that's peace of mind, and that's a good feeling. And so, I think it's just really, really important for people to... I know, and I've had these conversations too, of being like, "Oh, I want to wait till the next year, my insurance or this or that," but if your body's telling you something, you got to listen. We all heard the stories, a lot of times we don't get those signs. And so, if we're lucky enough, I guess, to get a warning, it's important to take care of ourselves. It's easier said than done.

I just made my first dermatology appointment for the first time in my life about a month ago. So proud of myself. I felt like I just got my oil chains, I'm like, "I'm responsible-

Ben Smith:

You're the man, right?

Ray Ruby:

Here I am telling everyone about we invest so much around sun safety here in the State of Maine, because we do a great job as Mainers to get outside but we do a not so great job, especially in the fall and such, to put sunscreen on. It's like, "Great, we're outside being active better than most states across the country, it's incredible, outdoor recreation rates and whatnot. But then our melanoma rates shoot up as well." I went in and I made an appointment. I knew that there was a backlog at different places, so I checked with my insurance and I found a new place, and that's where I got pretty savvy and was like, "I'm going to squeeze right in here," and I did because I didn't want to wait eight months, nine months from what I was hearing. And so again, sometimes you got to be a little bit of savvy about it, unfortunately, and be your own advocate, but it's just really important we stay on top of these things.

Ben Smith:

Ray, thanks for that answer because I think it's really important to, again, understand where we are with cancer in the State of Maine and how it's impacting us personally. When we chatted a few weeks back, I wrote down this quote, you said, "When bad things happen, our human nature is that we need to channel to something good." I really enjoyed that statement. We had mentioned this about Susan Ware Page and her family doing something good for others in the community in Maine that are impacted by cancer after losing her mom. My question to you is, so what are some good things, could be small, could be big, that our audience can do to help kick cancer in the butt?

Ray Ruby:

Yeah. I took a phone call last year from somebody here in Maine, young woman who was just diagnosed with breast cancer. I think she might have called me after her appointment, so you talk about in the days, and was like, "I need to do something. I need to give back." First thing I told her was, "Well, first you need to take care of yourself. That's the most important thing at this very moment." But that just goes to show you people in Maine, they want to channel that energy. In that mo moment, she needed to save her energy and focus on herself, but afterwards, she ended up being an incredible participant in our event, which is Tri for a Cure, an all-women's triathlon here in Maine that raises a lot of money for our organization and is just significant for our granting.

And so, I think it's just a great thing, it's just human nature. We want to have legacies, we want to give back, we want to have an impact that's bigger than ourselves, and that's a really good thing. I know I'm hoping to teach that to both of my girls as well. And other people react to it. We have a fundraiser in Casco Bay in August that's literally a pontoon. It's a bunch of boats, they call it a flotilla. I'm not big in the boating world, but I did show up to it this year on a pontoon. It's a flotilla, and all the boats line up together. Two lobster boats backed up to each other, and the Don Campbell band played on the back of it for hours to people on Casco Bay, and they raised over $50,000 for our organization.

Why did they do that? Well, Don's mom had been diagnosed with cancer the year before and was dealing with the battle, and he wanted to take music, which we all know could do a lot of good for us, and turn it to even more good. And so, you think of the impact on something like that and you think of whether it's just kids having a lemonade stand who just want to give back to their community. I think what's special, not to just keep tooting the horn of Maine Cancer Foundation is that I've talked with you guys, we don't have favorite places in Maine, we love the whole state. It's like what you're in the mood for. When I go hiking, I was just hiking in Grafton Notch last Friday night and I just happened to be in the mood for the Baldpate area, just because it's so darn beautiful.

And so, what's special about Maine Cancer Foundation is that you might reside in one area of the state, you might have went to school in a different area of the state, you might recreate somewhere else, and you might have family in a different part. So when you look at partners, why not work with one that makes the investments in all those places? But I also want to say, don't be shy with also looking at your own community. Because sometimes people ask us, "Well, what about that local cancer resource center in my community? Should I work with them? Should I donate for them? Should I raise money for them?" Absolutely. And we're going to do the same. But if you also want to extend those dollars, and we talk about investing them, across the state, into multiple communities, that's where we come into play. Please, I hope that message gets across. That does not ever take away working within your own community.

We just look at the bigger picture at times in the whole state. So I'm very careful when I give that message, when I do go into communities to make sure we don't look like we're trying to swoop in any way. We're partners, and the whole point is to elevate us all. Maine Cancer Foundation exists to reduce the impact of cancer in Maine, and the only way we do that is with supporters and partners. And so, it's important that we work with everyone. Yeah, it's really interesting to see what people come up with. I was collecting cans a couple of weeks ago, to being on a flotilla, to an all-women's triathlon. There was a indoor cycling place here recently that just did a 12-hour cycling event.

People come up with creative and fun ways, and I think I want to just end with that, is that cancer is really tough, and it is hard on all of us. So if you are going to channel that energy, if you are going to raise some dollars to make an impact, it's okay to have fun doing it, because this is hard enough. It's okay to smile, it's okay to have a good time. The Maritime Energy event, it's just wonderful to see everyone year after year at that event. And guess what, before you know it, you turn around and it's raised over $150,000 for our organization in just under a dozen years. So you could have fun and have an incredible impact in your community across the state in no time.

Curtis Worcester:

No, that's fantastic. We do have one final question for you, Ray. Obviously, we're here on the Retirement Success in Maine Podcast, so we love to ask all of our guests, how are you going to find your retirement success when you get there?

Ray Ruby:

I thought about that question long and hard. It's probably the least one I was prepared for. Probably much like my career, it's gone in different directions at times. I think that's something I've tried to be as safe with as possible and slow and steady over time. I think for me what I've learned especially in the last couple years is that it's very important to have a rainy day fund, because the world can change in a blink of an eye. You can hear you got cancer one minute or we could all be in our homes for three months. It's important to be prepared but at the same time having a plan and working towards it.

And so, I'm a planner, just like I planned out most of my camping trips for our family already for next year. I think it's important to have a plan in place, and it's important to have these conversations year after year with the folks who know more than you and hear what they have to say. If your dream is to go to Florida, then great. I want people to know that I'm okay with that. But my hope is that retirement would be is that we have a family camp in Allagash.

Curtis Worcester:

Awesome.

Ray Ruby:

The goal is to spend a lot more time up there when I get to that part of my life.

Curtis Worcester:

Awesome.

Ben Smith:

Love it. Well, Ray, thank you so much for coming on our show. Again, really great to get to know you, your new role, but also Maine Cancer Foundation, how you're battling cancer rates in the State of Maine, how you're helping to improve outcomes in the lives that you're touching. Again, I know we covered a lot, and I think we could have probably covered another eight hours of things here, but I think it was a really great entree for our listeners to really dig into this topic, how is it personally impacting us but also in the state, so thank you for coming on. I'd love to maybe at some point in the future have you come on again and just give an update on where things are because it's so great to get your message out there and also where are things happening as times are changing is keep people informed, so appreciate that.

Ray Ruby:

And thank you, guys. I know it's a challenging time for everyone, and the services that you provide a lot of folks and the comforts that you're able to provide is a huge deal. I know you deliver a service in a different way, but it is extremely important. I just thank you for chasing me out of the ballroom to continue this conversation. I hope that I'm welcome to bother you guys the next time I'm in town, which hopefully will be here soon.

Ben Smith:

Love it. Ray, when you're in town, give us a call, we'd love to catch up. But until then, we'll catch you next time.

Ray Ruby:

Thanks, guys.

Ben Smith:

So newly minted Ray Ruby, Executive Director of the Maine Cancer Foundation, really excited to have him on. Again, when we asked him, we didn't obviously know that that was his role going to be developing or even when we had a little pre-chat with him, we didn't know that.

Curtis Worcester:

That's right.

Ben Smith:

Obviously, you could just see it when you meet him is he is very mission-driven and lives a very authentic life in terms of helping families in Maine. So again, I know we like to take a little highlighter to things that we learned or we liked about today's show. Curtis, what was something that you took away from our conversation with Ray today?

Curtis Worcester:

I think this may sound like an easy answer, but I think the whole show, honestly. I think Ray did a great job going through the Maine Cancer Foundation and the incredible work that they do and then honing in on the individual stuff, put yourself first, advocate for ourselves. I know we all know how willing we are to help out others, especially in Maine, but at the end of the day, as Ray said, you can't help if you're not here. So doing the work yourself, checking on yourself, pushing those who may not want to get checked in your family, so really just the whole creating that plan, if you will, and really preparing yourself and doing the work. And then he touched on other resources. I know we talked about the patient navigators a little bit, Ben. It's just incredible the support groups and the help that's available to people. I think he did a great job from start to finish for us.

Ben Smith:

Yeah, I agree. I think one thing that we'll actually put in our show notes, was he mentioned this Maine Cancer Foundation did a financial toxicity study. What are we talking about? So interesting was this whole, hey, when it comes to finances and when it comes to financial burden, that tends to create maybe a little bit of a negative atmosphere for us to go seek help or to talk about things because of fear of cost or what the costs are to even travel, to get a hotel room, to fly somewhere. Or I'm out of work and I got to take care of myself for a period of time, so money's a big deal here. We're financial advisors, so interested to read that. If you're interested as well, we'll share that as part of our show notes today. You can go to blog.guidancepointllc.com/76, because we're episode 76, and you can check out, obviously, our transcript, the links there. Link to the Maine Cancer Foundation will be there as well.

And also want to throw it to you guys too, if you have suggestions for a future topics or things that you'd like to see, let us know, or if you have feedback. If you're getting value from the conversations we're having, love to hear from that too. Feel free to drop us a line and you can go to guidancepointllc.com and you can look at our team and you can reach out and drop us a line there too.

Thanks for tuning in. We really appreciate you guys staying with us through episode 76. Always a pleasure. We got some really great episodes coming up. We're going to talk a little bit about sports gambling and addiction to sports gambling, because I know retirees we get a little more time, a little more money, and it might be something that could be a concern. That's one thing we're talking about. We're also going to talk to is a couple in the southern part of the state, The Maine Foodies. Very popular social media presence, and a couple that goes out, documents their food. So we're going to talk a little bit about best of food here. A few things we're really excited about here coming up. Take a look at it and hit that Subscribe button on your favorite podcast player, and catch you next time.