Ever Onward Podcast

Saving Lives from Boise to Kenya - Dr. Rhiana Menen | Ever Onward - Ep. 69

• Ahlquist. • Season 1 • Episode 69

Share episode

What happens when a top-tier breast cancer surgeon refuses to accept the status quo? Dr. Rhiana Menen is rewriting the rules of patient care—both in Idaho and around the world.

Trained at MD Anderson and other elite institutions, Dr. Menen arrived in Boise in 2016 and quickly realized something had to change. Patients were waiting over a month for consultations—and even longer for surgery. So she built something new. As the physician-owner of Mountain State Breast and General Surgery, she’s reduced wait times to just days, offering whole-person, personalized care in a system that desperately needed it.

But her mission doesn’t stop in the States. Through the Tiba Foundation, Dr. Menen travels annually to Kenya, providing life-saving surgical care and community health education. She also co-founded Boda Girls, an organization training women to become motorcycle taxi drivers and mobile healthcare workers. What started with menstrual kits has become a full-blown movement—empowering women with jobs, dignity, and the tools to change their communities.

In this episode, we explore how Dr. Menen blends cutting-edge medicine with global compassion, and why she believes real impact starts with seeing people—truly seeing them.

💡 A $5,000 donation can fund a pink motorcycle and transform a woman’s life.

Learn more at bodagirls.org.

Follow Ahlquist on Social Media:

LinkedIn: ⁠⁠⁠https://www.linkedin.com/company/ahlquist/⁠⁠⁠

Instagram: ⁠⁠⁠https://www.instagram.com/ahlquistdev/

TikTok: ⁠⁠⁠https://www.tiktok.com/@ahlquistdev

X (Twitter): ⁠⁠⁠https://x.com/ahlquistdev

Meta (Facebook): ⁠⁠⁠https://www.facebook.com/ahlquistdev/

Youtube: https://youtube.com/@ahlquistdev?si=ejOXPKRqQjtsdVFE


Speaker 1:

Today on the Ever Onward podcast, we have Dr Riana Menon. She's an unbelievable breast cancer surgeon here in the Treasure Valley. She's got an incredible training pedigree, most recently at MD Anderson before coming here, has now just started her private practice. It's going to be exciting to talk to her about what motivates her and all the great work she's doing, and then finally we'll get to what she's doing internationally. She's a board member of TIBA and then she started Boda Girls, which is an unbelievable organization in Kenya doing so much good. I know you will enjoy this, dr Rihanna Menon. Prior to Rihanna, we will hear from the guys Mark Cleverley and Holt Haga, who will be talking about our incredible downtown project.

Speaker 2:

Good morning everyone. We're here with another AllQuist update. I'm Mark Cleverley with Allquist Holt, Haga, VP of leasing Allquist Development. So we haven't talked about it for a while and there's been a lot of changes and things going on and thought we'd talk about 4th and Idaho, the ICCU tower that's going up downtown right now. It's been a project obviously we've been working on for a while. Steel's going up. We're actually having a topping off ceremony here in May with steel, so exciting stuff coming. So I wanted to hit on that. And, just to start us, we just got a lease signed with Kiln, their second location in the Valley Amazing group. I know a lot of people know about Kiln out here at Eagle View Landing but they're taking 30,000 square feet of the building. Yeah, huge win, Huge win for us. So really, we're down to three floors in a seven-story building. We're down to 60,000 square feet out of 140. And so walk us through kind of what our thought process has been on these last three floors over the last few months.

Speaker 3:

Well, you know it's a huge win and I think initially when we, you know, developed the project and sort of you know, planned the project, it's all it was office, right, that whole 13 story tower, 140,000 square feet, the top seven floors, all office, class A office. And I think we've, we've done that, obviously with the top, you know four floors. You know kiln taking, taking down 30,000, you know square feet was was incredible. They took all of 11 and half of 10. Yep, the other half of 10, we've got a handful of letters of intent for traditional office, you know, companies, law firms, financial services, and then the remaining three floors to to your point, is you know what, what do we? What's the highest and best use for those three floors?

Speaker 3:

And we could, we, you know it's either office, was kind of what we had planned, yep, but as we look at it we've sort of pivoted, right, yeah, and I think you know what we're going to deliver is, you know, class A medical office space. So this is sort of the first announcement that we're making on this project, really, as we roll out our marketing and sort of pivot a little bit. But it's become clear and the more that we talk with with groups in the market and kind of get a pulse on the market for the delivery. Medical is is just it's it's underserved in that area especially. You know two, two main factors. Number one is the product that's there right now. It's it's old, it's a lot of it's historic kind of old, it's old residential homes converted into commercial spaces.

Speaker 3:

Yeah, Right, and so and so if you're an independent medical group looking for, you know, space, and in the downtown market and the downtown corridor near the St Luke's expansion, you know your options are really these tired, old, uh, you know homes that are you're very limited in what you can do and it's it's incredibly expensive, yeah, so it's not just the face value price of, hey, I can buy this, this new office building and convert it to to my medical office, you know office, it's just, it's, it's that cost plus, you know, sometimes double. So it's it's very, very cost prohibitive to do that. So one of the key drivers is the existing product. The second, of course, is St Luke's expansion, which is over a billion dollars now, you know, set to deliver in, you know, 2029.

Speaker 3:

So the last three floors that we're going to do are going to be premium medical space and we're doing a few things to sort of tailor to that. You know one of the things obviously we've got a ton of parking, so access is as good as you can get, which, for medical, is critical. Yeah, we're also rolling out a valet parking program which looks like it's going to be actually in the garage, in the nested garage that we've got at the project. So a variety of things that just make it just an incredible, you know, medical office play or medical office product, and so I think we're definitely excited about it when we first planned Fortson, idaho, you remember this, we had two towers.

Speaker 2:

One of them was a medical tower and one of them was an office tower, and going through design review with the city and what they wanted, I mean we switched. Uh, basically had to switch and do one tower of just commercial and one tower residential, which was fine, but we always knew that medical was a was like a key component for this area, right, I mean?

Speaker 2:

you're a block away from the largest hospital in the Valley, right I mean, from next to St Luke's and for years you go downtown and users, medical users, they can't find space down there. We fought it with a user when we were a gardener company. We were working with a clinic that we could not find space for down there, right I mean, and it took us. It actually took us a couple years to figure out where to put them Because there was just no, there was no options.

Speaker 3:

Yeah, it had to be a separate, standalone ground-up development, new construction Absolutely.

Speaker 2:

Project. Yeah, so this, like you said, because of the outreach to us and people saying, hey, what about, like I'm a medical user, do you guys have space for me down there? We have. Yeah, we shifted to those last three floors so we'll still have the office up on the top four. Iccu will take the top two and then we'll, you know, kiln and a couple others. But, yeah, medical and it's going to be, it'll be great. We're excited right to get the medical going. We've already got groups that are submitting LOIs on the floors that we have there. So it's going to be it's going to be awesome.

Speaker 3:

We're super excited. Yeah, I think to that point. If you're, you know, an independent medical group, for example, looking for anywhere from you know 2,500 to you know even 30, 40,000 square feet, um, this is a trophy project. Uh, that is, you know, adjacent to downtown and St Luke's. That that you know is is going to be a great option. Yep, yeah, love it, came in.

Speaker 2:

Good job good job.

Speaker 1:

Dr Menon, thank you for coming on. These are always so interesting. We met in the hall coming in here, but sometimes I have people on here that I've just known forever and then sometimes it's like a first meeting. It was our first meeting today, but I have had literally. It's not a first meeting. It was our first meeting day, but I have had literally it's not an exaggeration. Dozens of people say you've got to talk to her, you've got to hear her story, you got to. So I'm really excited. I feel like I know you already just because of so many friends or people that we've had on have brought your name up. So thank you for coming on today.

Speaker 4:

Thank you for having me. I was going through your list of podcasts and listening to so many amazing guests that you've had on and I am honored to be on this list.

Speaker 1:

We're honored to have you here. It's fun for me to have people in healthcare because then I immediately want to talk a little bit about some of the healthcare stuff. But with your background it's this going to be a fascinating trip. But are you okay just maybe telling a little bit about your story, sure, and kind of just a little bit about you, your bio, for people to get to know you a little bit better before you started?

Speaker 4:

So I grew up in Southern California and my father is an immigrant from India, and so he told us our whole lives, the way you guys live is not the way the rest of the world lives, and so I kind of always had this perspective about how lucky we were to live in this country where we had so many opportunities, and so I have gravitated towards health care my whole life, and one of the things that really really brought me into health care was the idea that I could use skills that are portable and work internationally, and I traveled to India to meet my family when I was young Maybe my first time was very young and then I spent a prolonged amount of time, kind of as an 11 or 12 year old, where you're just about to be this American teenager and seeing how the world is not like Orange County, california or Boise, idaho is transformational at a young age.

Speaker 4:

And so I kind of always knew I wanted to be in medicine. I always knew I wanted to be a surgeon, and so as I went through medical school, I went to medical school.

Speaker 1:

What was your inspiration for that?

Speaker 4:

I don't really.

Speaker 1:

I just knew that. Was there family members or anyone that did, I'm the first one, okay.

Speaker 4:

But I like to fix a problem. You can probably relate to this as an ER doctor, but surgery in particular is you have a problem and you fix it. And I'm pretty cool under pressure, and so I really liked being the one who you know things are falling apart and you kind of pick up pieces and stay calm and are a voice of reason in the room, and so I kind of naturally gravitated towards kind of those more emergency situations.

Speaker 1:

I want to understand this a little more because it's a pretty daunting thing. As a young person and a woman. I'm going to go be a surgeon. I went through this. I mean it's kind of the guys that take no. I mean it's a very dominant kind of thing, very much so. Very much so. So it is interesting for me that you chose it and knew it early and then just plowed through it, because there's probably a lot of barriers and hurdles you had to overcome.

Speaker 4:

Very much so. I was blessed to be in a family that was just. My grandmother was my most ardent supporter. I never once thought there was something I couldn't do. That's awesome do. And so you know why not go for the hardest thing, why not be the the the loudest voice, or why not? Why not do anything you could want to do? Um, because that's what she had always done, and I have this amazing network of really strong women in my family. But, um, but that was. I never felt that internal barrier. She just passed away. It's two weeks ago.

Speaker 4:

this sorry, two years ago this week and she was my, just my most important person my whole life, and so I feel her with me all the time.

Speaker 1:

What made her? Because I've got my own kind of like. I had a grandpa that I always talk about but what for you? What made it so special and what? What were the qualities of someone like that as a mentor that that were so important to you? Because I think I think, as we have those experiences, especially as leaders now like talking to people I think sometimes we don't realize the impact you can have on someone. But but what were her? What were her qualities? What are the things you think back that are her kind of legacy, things that inspired you?

Speaker 4:

Thank you for asking this because you know you lose a grandparent and everybody loses a grandparent. You know it's just supposed to be part of life, but she was so important to me and so I just love talking about her. She was one of the most quietly strong people and sometimes not so quietly strong, but just a force, like it was never an excuse that you're too busy or too tired or too. You just do it, and she would even say to me you're the strongest one, so you have to do it all the time. You have to pick up the and you believed her.

Speaker 4:

I believed her to my core and I still believe her right. If you have the ability, if you have the energy, if you have the know-how, that's your job to do it. You pick up where other people can't and you don't. Actually, she was so kind and loving to everyone around her. She was just so accepting, like faults and all of anyone, because she felt like she had the bandwidth to pick up where they left off and I think she was the most all-encompassing, just.

Speaker 4:

She was beautiful, she was hilarious, she was I mean, she died at almost 90 and still owned her own business and went to work every day and she just was one of those people. That was you, couldn't I?

Speaker 1:

couldn't imagine what was her story. Did she, what was her life experience?

Speaker 4:

So she grew up in Portland Maine. She was the child of two immigrants, a Syrian immigrant and an Irish immigrant. Her father died very when she was very young, at eight in a um. He was a train foreman and died in a train accident. And then I think she kind of had to pick up and be the strong person in her family. She had a younger brother who's still alive and her mother kind of worked as a cleaner in houses. She would say she worked for rich people so she knew all the beautiful things that she wanted. So I remember as a little girl I would polish the silver with her and iron napkins and fold them and even if you didn't have a lot of money you had beautiful things around you and it was important to her and so just to kind of be put together. And then she wanted to leave Portland Maine. She became a flight attendant in um the fifties and met my grandfather, actually on a flight from Chicago to California and the rest was history Wow.

Speaker 1:

You know, I I think about, um, I think about the world we live in now and it's so, it's so busy. Um, I'm a lot older than you but, like, I think back to my cause. I I think back to my, because I've actually thought about this a lot. I'm like, why was my grandfather so impactful on me and am I being impactful on my kids and my grandkids? And I do think it's busier now.

Speaker 1:

There's more noise now and I think about the times that I was with him. It was quiet and I always say this and I don't know if it makes sense to you, but I have vivid memories of him talking to me because when he talked to me I could feel it. It just wasn't like words and I'm wondering if it was because it was quieter. So I'm trying to be intentional about like with my grandkids now creating times and it may sound artificial a little bit, but I want to get those boys away where we're quiet and I can talk to them and tell them they're wonderful and they hear it and I'm not. They're not distracted, I don't know. I just worry about it's busy now. It's just like I don't know. You feel that way ever.

Speaker 4:

I feel like that all the time, and I think you're exactly right about that quietness, because when, when I was with my grandmother and I was the first grandchild of 13 grandkids and so I was a lot older than everybody else, so I had this beautiful time of just us, and it didn't matter what we were doing. She was an interior decorator, so I would drive around in her van and we'd go to the fabric store and we'd go to the paint store and we'd go to, and it didn't matter what we were doing, it was just the two of us.

Speaker 4:

And that you're right it that quiet time, that that if when you're with her, you're the only thing that matters.

Speaker 1:

Yeah.

Speaker 4:

Even if you're doing five other things, you're still the only person that matters, and I think that that is the connection that we need, even amongst the noise, to have that human connection.

Speaker 1:

I think there's a lot to learn from that. Sorry, I interrupted you, so you're the oldest, so she had to be tremendously proud of you, like over the moon.

Speaker 4:

I know that, because now you go through this.

Speaker 1:

You're like I'm going to become a surgeon and then tell us about your education.

Speaker 4:

So I did my medical school in San Diego. That wasn't too far from home. I have a little sister who's 14 years younger than me, and I had gone to the East Coast for college and then really wanted to be home and close to her. After that I met my husband, who's from Boise, in San Diego, and so when people say, oh, everyone's from California, I say, well, you keep marrying us, we wouldn't even know about this place. So he found me in San Diego and brought me back here. I did my residency in San Francisco and did two years of bench cancer research too. So that was, you know, seven years of surgical training. And then through that whole time I met another really important mentor when I was in residency, who Dr Das, who just passed away last year but was one of those people that I really tried to model the rest of my career off of.

Speaker 4:

He did international work three or four times a year. He's originally from India, so I traveled with him to India. He did clinics in Mexico. He set up girls' schools in Nepal, in India, in South America as many as you can imagine. Just one of those people who truly believed in the transformation, of empowering young girls and women and what that does to a society Wow, and his foundations have continued to persist.

Speaker 4:

He was actually a urologist and one of the most ardent humanitarians that I have ever come in contact with, and so it really inspired me to show me how I could do that work and still be a busy practicing surgeon. And then, when I finished residency, I did a fellowship at MD Anderson in Houston, texas, for breast oncology and it was one of those things where I got to kind of the pinnacle of academic cancer medicine and I was offered a faculty position there and I went. I don't think I want to do this here, because in Houston and I feel very passionately about access to medicine for everyone I want everyone to be able to have this high, high quality care, and we know that that's not always possible.

Speaker 4:

And so in Houston there were a hundred amazing breast surgeons In Idaho, there was just one in the whole state and she's still here and she's fantastic, but she can't do it all her own by herself. And so we had decided you know we had two little boys at that time, we had been through a lot of training, my husband's family was here, we needed the support, so we moved back here and I thought you know I was the second breast surgeon in the whole state and I thought I want to be bringing MD Anderson quality care to Idaho, not where there's 100 people who can you know go anywhere Idaho, not where there's a hundred people who can you know go anywhere.

Speaker 1:

Well, thank heavens, a boy from Boise married you because I mean, when I looked at your, I mean I'm not. I looked at your resume and I'm like I can't wait to hear how, because the pathway could have should have bench, bench research. You look at your pedigree of training and you're at MD Anderson. I'm sure it would have been very easy, um and and prestigious to stay there and be at a big referral Institute like that. And you're here in Boise, idaho, How's it been so you've been. You've been here for, uh, almost nine years.

Speaker 4:

I can't believe how time has really flown and I'm really proud of the work that I've done here.

Speaker 4:

I think that I did a lot of what I came to do because when I first got here there was, like I said, one breast surgeon in one whole hospital system.

Speaker 4:

I was the first one in my whole hospital system that had the catchment area of all of Idaho plus Eastern Oregon, eastern Washington, northern Nevada, we would get Wyoming, we would get Wyoming, we would get Alaska. I mean really a huge catchment area and there was no comprehensive breast program, there were no employed plastic surgeons. So when I first got here, you know, I said, well, why aren't we doing immediate reconstruction for women who've had a mastectomy? Why don't they go home with their implants? Why aren't we doing a more comprehensive cancer care? And so by the time I left, which was just about 18 months ago, we had the biggest breast program in the whole state, five or six plastic surgeons, five or six surgeons, um, so really had elevated what breast cancer care looked like for the entire state. So really proud of the work we did there and really shined a light on how important this is, but had a lot of barriers too.

Speaker 1:

Well, your reputation. It's been incredible and the impact you've had. I mean, you're talked about everywhere, so it's cool to have you on Talk about. Uh, there's so many things I'm going to get into with you, cause I'm sitting here listening and thinking of questions. But, um, you go into, you go into into surgery. Then you choose, um, cancer surgery, you go get trained and and that I mean you're kind of picking the very most technical right. And then also anything associated with cancer and treatment and surgery is just hard, um, and and you get to, I think, the best part of medicine. So, as you know, I kind of stopped practicing. I loved it.

Speaker 1:

I loved it. I mean, business is great because I tell people all the time they're like, why would you leave? And I'm like, well, I reluctantly left because I didn't want to leave. But when you get in business the professional satisfaction of working with other professionals people are happy. And I will tell you this in health care it's hard because a lot of people aren't happy, and I know that. That I don't want to, that doesn't sound. It's just.

Speaker 1:

People are tired, they're you know with with all the changes that have come in documentation and the way people are paid and the way the system works and the clunkiness of it, it there, it lead, it tends to lead, to fatigue that has nothing to do with patient care, and unless you're in it you don't really realize that this isn't about patient care. So I'm getting this is a long, rambling statement to get to a couple of questions. For me, though, when I think of my memories, it is the patients, and I trained in Arizona and then came here. But the patients in Idaho are wonderful this area. And I trained in Arizona and then came here. But the patients in Idaho are wonderful this area they're just kind and wonderful Talk about and like I'm the Neanderthal ER guy right, is it bone broken, is it bleeding, whatever? But you have the ability to make this connection with people over a period of time when they're dealing with the scariest thing that you ever hear in your life is you have cancer your hardest day.

Speaker 1:

Talk about how wonderful it is to be part of that with patients.

Speaker 4:

I think you did the perfect intro because we hear so much about burnout, we hear so much about these other factors and it is hard to be just a doctor now because you have to deal with so many other things. But when you distill it down, when you look at the end of your day or your week or your career or your life, it is those personal connections, it's that quiet moment and I think you alluded to it earlier. How do we have human connection? It's in these quiet moments. So kind of the best and most gratifying part about my job is to meet people on their first day where they are terrified. They think 100% of the time they think they're going to die and then, even if I know, I look at it and I go we're going to do great. Or wow, we've got a big journey ahead, but you're still going to do great.

Speaker 4:

And that's what I like about breast cancer in particular is because it's such a hopeful field. I kind of always say the best time to get breast cancer is now. Better time would be in five years or 10 years because it changes so quickly. But to be able to sit down in a very logical way, whether you're an engineer or a farmer. I can explain it to you in a way that I go this is how I know that we're going to do well, this is how I know we're going to get through this together, and I'm going to get you back to your family, get you back to your career, get you back to your life. It won't ever be totally the same. I don't mean to minimize it, but this is how I can sit with you. I can look you in the eye.

Speaker 1:

I can sit here with your family and just know that we can connect and get you to a place where you leave much more relieved, much happier, and I think for you. I'm sitting here thinking because for us, when I was in the ER for all those years, you would have certainly I mean that's where people die is in the ER. So you would have very sad things. That happen all the time.

Speaker 1:

But you have a regular occurrence where you have people that have been told they have cancer many times young people that for the first time are probably like questioning their mortality, which, because usually you go through life and we take you know, we take for granted much of where we live, what we have. You brought that up with with your experience internationally, and then you take for granted your health. I mean, it's just, you can't help. Most of the time you're healthy and it's easy, and all of a sudden someone says you have cancer. You're like your mind and that's the first time they're coming to you hopeless, right of what's going to happen. And that happens over and over and over again.

Speaker 4:

And it can be very overwhelming. And so one of the reasons I went into private practice about 18 months ago and one of the biggest reasons was because that period of waiting was getting really out of control. So it was from biopsy that you know someone gives you a call and says you have cancer. To see me for the first time and I'm the first practitioner you see was 46 days. Biopsy to surgery was 80 days.

Speaker 1:

That's tough.

Speaker 4:

And it was so stressful Because the first thing you have to do is spend about 15 minutes de-escalating the frank trauma that you've had for thinking that you're going to die, and not only that, you have a cancer that's growing and changing inside you and I always say this is my, it's my biggest, best piece of advice when you have cancer. The internet is only for cat videos.

Speaker 4:

That's it Do not look at anything else, because about 99% of things don't apply to you but they will scare you. And so our biggest change and my biggest stress was I just need to get more and more and more and more and more people in, and then you lose that connection because you're so overwhelmed. I was coming in, we were putting in one patient before our template, going over lunch and seeing a patient staying one day later and my amazing nurse and I were just drowning and we couldn't bring our best selves every time because and then every day off, I would just operate all day, and so I wasn't seeing my kids, I wasn't. I was home at eight o'clock. I had a million charts to do.

Speaker 4:

You just can't, you can't go on that way, and I'm I'm I would say it's, like you know 10 years into my career, but I'm not old enough that I can do that for much longer. And so I made a big change and it was terrifying, but we routinely um, I work with one of your tenants here, lyra Total Breast Health, and we we get patients in. She calls me and says there's a cancer coming and I say, okay, we saved a spot for next week.

Speaker 4:

And so that time of anxiety has has been broken down to a week, 10 days, two weeks into surgery within 30 days, and that gives me I can breathe easy.

Speaker 1:

Talk about the autonomy and control a little bit, because I I mean, I'm way older than you, so you know you go back to when I started in this thing and and then the evolution, like literally during my time and and listen, there were some wonderful things about the affordable care act and and then there was the bureaucratic layers of stuff that have happened with.

Speaker 1:

You can pick anything in healthcare, like between like you had patient and doctor at some point but you can pick pharmacy and PBMs. You can pick insurance companies and interbattle. You can pick. You pick regulations that like I'm sure some of them made sense, but just piles of regulations and and and you know the legal side of things it gets. That's the part that gets just fatiguing. I think, no matter you pick, you pick the specialty across medicine and people are just like I, just it's, it doesn't feel like it used to anymore, and so I'm really happy that you were able to say I want to take control, because at some point, like you think of the training and time and effort that it takes you to get to there, and then I think one of the things you said that really hit home with me is like you're human.

Speaker 4:

We're just people.

Speaker 1:

People. You have your kids and you have your life and you have your family and you have so much energy and love and compassion, and then you take care of people. You need all that, and then there's this thing, which is like the administrative side of life, that you have to do, and at some point it's math. You have no more hours. There's no more hours. Um, cause you can. You can limit your sleep as much as you can, and I we tried that for years.

Speaker 1:

I used to say sleep's overrated. I said that till I started having all my heart problems. I'm like ah, I was wrong, don't listen to me anymore. But but you at some point. So I'm glad. So it's settling out really well for you.

Speaker 4:

It is, it's this I I get to every basketball game, I get to every concert. I'm home for dinner most nights, you know it's just it's, and I'm doing the kind of care that I'm so proud of. And I know, and I have my cute little clinic. It has flowers and chandeliers and and art and you call and someone answers a real person answers and you can get to us.

Speaker 1:

Hey, while we're doing this, because there's a lot of people on YouTube, how can people reach you while we're yeah?

Speaker 4:

I'm Mountain State Breast and General Surgery. Google my name and you can get in to see me.

Speaker 1:

We're going to pull it up Mountain.

Speaker 4:

State Breast and General Surgery Breast and general surgery Breast and general surgery.

Speaker 1:

It's been a year and a half.

Speaker 4:

It's been a year and a half. I have a wonderful partner, dr Kerry Newton, who came from Seltzer, and we just have you know. You can tell by our website. We are interested in who you are. We talk a lot about lifestyle. We talk about cancer prevention.

Speaker 1:

I love that tagline right from the beginning. Back up a little bit, Maddie. Our priority is personalized whole person care.

Speaker 4:

Yeah, so when you walk in and we do general surgery and we do a lot of lifestyle counseling and you know, maybe you have a hernia and maybe you're not ready for repair right now because we have to work on a few things, but we'll work with you and get you there, and so these are the things that are so gratifying. As a doctor, I get all the time I want with you. I can say you know, you have this tumor. We're going to talk just about this.

Speaker 4:

We're going to talk about the person who's you know around this tumor as well, and talk about how my favorite analogy is when you're talking about a tumor, it's like saying or cancer, it's like saying you have a pet. It could be a pet goldfish, it could be a pet dragon. That's how different they are. Obviously, if you have a dragon, we're not going to use goldfish medicine, but we will slay your dragon. If you have a goldfish, don't even worry. We don't have to do any of that dragon stuff. And so just breaking down in a very expert way gives people this confidence that it's not just oh, oh, nobody knows what to do. This is unknowable. No, I can get you through this, that's awesome.

Speaker 1:

I want to shift to your international work, but before we do, I think it would be, I think, for people listening because our stories were said. I'm so glad I listened to your podcast because what is the advice you would give to families listening to this podcast? Out there, with breast cancer detection, early diagnosis, what are some things that everyone should know?

Speaker 4:

So everyone should know that mammograms are safe and they are the way that we catch breast cancer early. So unfortunately in Idaho we're kind of 50th in screening 50th 50th Holy.

Speaker 1:

Why do we always have to be 50th in everything?

Speaker 4:

And that means that one in three new breast cancer diagnosis is advanced stage, and so we can catch this early. And I know there's so much fear around cancer. But what I promise is I don't care what we find, I have a good plan for it, and the earlier we catch it, the better. We have a chance to catch it.

Speaker 4:

We're really 50th 50th darn it and Dr White of Lyra and Representative Brooke Green and myself just were able to help pass a bill that the governor signed just two weeks ago that pays for coverage for all high-risk breast cancer screening. Pays for coverage for all high-risk breast cancer screening, and so, whereas women were paying like $4,000 out of pocket, that this went to your deductible, but it wasn't just a covered service. Now, if you're considered at high risk for breast cancer, if you have high-density breasts, we have a lot of other great options for you.

Speaker 1:

Let me ask you some questions on that. Like, you're high-risk, you have high density, you know. You know that. Um what? What should a mammogram cost? What's the true cost of a mammogram?

Speaker 4:

Oh well, so it's most most people are charged covers right Most coverage, If you have insurance, even if you have Medicaid, if you have anything, if you show up for a screener, it shouldn't cost you anything. It's probably about $200 out of pocket if you have nothing. But high-risk screening can be pretty darn expensive. It can be $500 to $3,000 for an MRI.

Speaker 4:

And those are out of pocket. It can be for a diagnostic mammogram $800. But we're working with more affordable and more indifferent options in the community. Dr White has opened imaging centers that make it really accessible and because she has these new other modalities, everyone else has followed suit.

Speaker 1:

So all the big hospitals have it now too, because she was first presented, so it's easier than it's ever been.

Speaker 4:

It's easier, there's more options, there's more affordability and it's now covered. So there's really what I would say to people is don't be afraid, get out there. Mammograms are very safe and they are the way that we are detecting breast cancer, and that, I think, segues nicely to this international work that I'm doing because the programs I've set up in Idaho. I'm trying to do the same thing in Kenya.

Speaker 1:

All right, let's go there now, because I think what I mean like you're super appreciated, famous here for the work you've done traditional health care. You've really I mean, you've really revolutionized breast care in Idaho in a short period of time and it's an honor to have you on and talk about that. Now let's talk about your international work. So you were inspired by this mentor of yours.

Speaker 1:

Very much so Dr Das, so Dr Das and you're like, oh, this is possible, but it's hard because, listen, I think a lot of times you get in life and you've got so much going on. I really want to understand how you're like hey, not only am I going to do this, I've got a family, I've got my career, I've got my practice, but you prioritized this international care. That's not easy.

Speaker 4:

It's not, and I think when you're, when you're young. So I did you know, four years of college four years of medical school, seven years of residency and a one-year fellowship.

Speaker 4:

So you're at the end of this and you're like I got to get a job. So, as I was moving to Idaho in 2016, one of my mentors reached out who had been going to the Serian Kenya through the Teba Foundation for a long time and he said do you want to come with me? I said, yes, I want. This is perfect. I have a three, three months off for the first time in my life. This is perfect. I'll go with you to Kenya.

Speaker 4:

And the Teva Foundation is a US fundraising arm for some of these projects in Kenya that partners and this is what's really unique, is it partners with the Kenyan organizations, and so it's never just us flying in and telling them what to do. It's hey, what do you need? And here I am. And so in 2016, I went, I did a week of operating and just kind of, whatever walks in, you do anything, you get really creative. And so I always laugh when I'm here and I say, oh, I need this and I need this and I need this. And I go there and I'm like, whatever you got, I'll take it, we'll make it work. And so I really got the bug because talk about it's like the antidote to there's. There's no EMR. You're not calling an insurance company. You're not, um, waiting in line, you're, you're. You are in a room with a person and takes it back to the basics right.

Speaker 4:

So gratifying. And so I did that once and I got the bug. And every year since 2016, I have gone to Kenya for about a year with the Teba Foundation. I then joined their board and then last year I became their vice president. So I'm in all in and that kind of it's like cleaning your filter. Every year.

Speaker 4:

It reminds me of the joy of medicine and, you know, our society puts a big investment into making a surgeon.

Speaker 4:

You know, you saw all those years. You know I got, I got grants to go to school, I got loans to get into medical school. I uh, you know Medicare pays for residency, so there's a it's. And then, of course, my family and people around me my husband, my kids, everybody has put a lot of time into allowing me to become a very specialized surgeon, and I have this portable skill and it's wonderful. So, you know, having a father that grew up in India, I feel strongly that I have skills that need to be shared, and so I go to Kenya and for an area of about 5 million people, there are zero of the specialists for me, and so I love being able to show up and say you know, tell me what you need the other best part about doing that and partnering with the same hospital all the time is you're never I know where those patients went, so when I leave I leave them with my family medicine colleagues and the nurses there.

Speaker 1:

And so they get full handoff.

Speaker 4:

They're there all the time. They WhatsApp me all year long and say, oh, I got this scan. Is this good for your next trip? Is this good? What do you think about this follow-up? So it's kind of the opposite of just flying in and doing something. It's really a partnership that is long-term. And then I have to mention in 2019, we went and a friend of mine gave me, donated a bunch of Days for Girls, sustainable menstrual hygiene kits and I know you had the founder of Salt on.

Speaker 4:

And so you know about this period, poverty and how, really across the world, girls don't stay in school because they don't have access to menstrual hygiene, and so, within the Treasure Valley, we have this really strong relationship with this company called Days for Girls as a nonprofit, and there are hundreds of women just in the Treasure Valley who sew these menstrual hygiene kits that are sustainable, reusable lasts about five years.

Speaker 4:

So my friend donated 200 of these kits, which is a huge donation, about $15 a piece. So she really gave me a big leg up and I took these two young women with me a junior in high school and a senior at Boise, at BSU and they went and taught how to do these and it's it's paired with sustainable menstrual hygiene kit, um, and and paired with just basic biology. This is a uterus. There's no ovary, this is how a baby's made. And it was so powerful.

Speaker 4:

And then these girls within four days all 200 were gone. They were busing them to the hospital and then, at the end of one of these days, two girls get on the back of a motorcycle taxi called Potobotas, drove off and the principal was standing right there and she said, oh my gosh, this is so dangerous. You know, these girls are so vulnerable. They're taken to a field they never may get home. They're really vulnerable. And so that really sparked something. Um, and we became the co-founders of something called Boda Girls, which are motorcycle women, run motorcycle taxi service. They drive pink motorcycles, they go to the schools, they teach menstrual hygiene, they take girls to and from school. So it's women driving girls. They bring women to the hospital. They do about a hundred deliveries a year, a month in the hospital, whereas before they weren't, you know, on the road or really high maternal fetal death rates in this area. These babies are getting early childhood care, they're getting vaccinated, they do kitchen gardens, so they send them home with nutrition.

Speaker 1:

Oh my goodness, it's the biggest wraparound. Is there a?

Speaker 4:

way to look this up, please. It's called bodagirlsorg, bodagirlsorg, b-o-d-a bodagirlsorg, and so not only are these women, they were subsistence farmers. We know about these women. We started with 12. And actually one of our huge funders has been Red Aspen, who you had on.

Speaker 2:

Oh, that's cool.

Speaker 4:

And they partnered. They give us significant money and help us buy these pink motorcycles. Red Aspen donated money for portable ultrasounds so they send the ultrasound technologists into the villages and then they know if they have a high risk pregnancy, they know if they have twins, they know when they're going to deliver and say okay, when you're ready, you call this Boda girl and you'll get delivered at the hospital. You have access to a C-section. So this is. It's incredible. It's incredible. And so now, boda Girls, this is. My five-year dream was not only do we have these women, okay, so they were subsistence farmers making $1 a day. It's a dollar, truly a dollar a day, and they're raising children and their children are hungry. These Boda Girls now make $10 a day.

Speaker 4:

They are so it's not just driving. They get this wraparound. They have to do 10 certificates. They do self-defense, self-esteem mentorship. They learn about computer literacy so they can market themselves. They have app-based entrepreneurship, they do the Days for Girls curriculum, they do gender-based violence and now what we're trying to add on is a breast cancer component. So that's currently what we're working on this year and what we're fundraising for. There are, for an area of 5 million people, there are zero mammograms zero and so we're working on fundraising for a mobile mammogram unit. And then we're teaching the Boda girls how to, because there's a lot of fear and there's a lot of stigma, and I will say that a pretty perfect overlap to the work I've done in Idaho has been in Kenya, and it's not and here it's not even because of resources. It's around trust, it's around fear of cancer, it's around you know awareness, around screening.

Speaker 4:

I'm basically doing the same work that I did here, there and it makes it so I'm always so careful not to come in and go. Well, I'm a US doctor and I'm telling you this I go. These are the problems I had in my own community and I'd love to teach you and help to shape these programs, because I just did this.

Speaker 1:

I'm just listen. I'm kind of blown away because I'm sitting here thinking like the impact of transportation in a safe way with someone that you trust in a community where that doesn't exist. How impactful and when and how it started, so authentically in the impact it's making. Wow.

Speaker 4:

It's incredible and and we started with. And so just those 12 first women had 43 kids between them, so they went from being in abject poverty. They weren't able to go to school, they didn't have shoes to go to school, they didn't have books, they didn't have healthcare, they didn't have enough to eat. All 43 of those children, just in the first year and that was in 2022 are now middle-class overnight. All of those women are mentors the first year and that was in 2022, are now middle class overnight. All of those women are mentors in their community. They are heroes in their community. And that has now we're up to 40 Boda Girls, and now we are launching in a separate site.

Speaker 1:

And so we think this is a model that can really be replicated all over the world. This is big stuff. How do? How do people donate that may be listening to this? So go to your, go to your website, obviously, so yeah, so boatagirlsorg um is it?

Speaker 4:

and what I can say is we know. So the Teba foundation has one employee, our executive director so, and our board covers her entire salary. So every dollar you donate goes directly to these programs. And so I can say, and when I have, you know, I I'm always hitting up my friends, right, and I say you don't, you're not sending your money to Africa, quote, unquote. I know where all these dollars are going and I can tell you, and the way salt said it was, you know, a hundred dollars here doesn't go very far, $100 there goes a long way.

Speaker 1:

How much? Just to put it in perspective, like one boda girl, what does that cost?

Speaker 4:

a year About $5,000 for the motorcycle, for her training, for everything that goes into being we're donating.

Speaker 1:

Thank you, yes, this is incredible and the impact.

Speaker 4:

So not only does that, and then here's the really exciting part. So we're working. We have all this data and we're working with banks, because, within 18 months, every single one of our 40 Votagirls have purchased their own photos back and that's based on.

Speaker 4:

they offer free rides to the hospital and we set aside a dollar for each one of those rides, and so part of that $5,000 subsidizes those rides and so at the end of that 18 months she owns her own motorcycle.

Speaker 4:

And that is incredibly powerful because most men don't, and the men in the area are leasing for about $3 a day and if they don't pay back that lease they lose it, and so that's a precarious place for a man to be. But it's a really precarious place for a woman to be, because if she has a sick kid she can't go riding. The peak times that most people are needing to get to work are when she's got to get her kids to school, when she has to go get water, when she has to take care of all of the responsibilities she has as a woman. So she's already behind the eight ball, and then it's going to be really hard for her to pay back that loan and they're kind of predatory loans so they end up paying about three times more for a motorcycle. So after 18 months for her to own, her own bike is its own source of income forever.

Speaker 1:

Did your grandma know about all this stuff? She did right.

Speaker 4:

This was just taken off and she was so proud and, and she was so proud of this. And every time I would see a boater girl, I could just see the spirit of Arlene in them, because she's just tenacious as these women are. They are, they're heroes.

Speaker 1:

I was just, I'm just sitting here thinking about what you're saying, but I'm sure you've heard the Tara Raya Trent speak. Um, and it's been years ago since I heard her first time in person speak, but I remember her talking about hunger and I was in the audience and and she said you probably have a definition of hunger, but you don't understand true hunger. And it was so impactful on me because she talked about these women, in these situations that they're in and with children, and the hunger to provide and the hunger to improve the life their own life and the lives of their children and their future and their posterity. And she's like that is true hunger. And and as you're talking about this, I just I'm I'm looking at some of these pictures thinking how impactful this is and it's, it's super inspiring. How, how do you? I mean, I got to ask how do you do it all?

Speaker 4:

It it, um, that's a great question. It it, um, that's a great question. And and going, actually going into my private practice has given me so much bandwidth that I took back to. Just these are things that fill me up. I just feel so motivated. Like gets you going. The only way to do it is to do it, and then you just keep going after that, and the amount of gratitude like I said, if we stopped at those 12 women, that would have been enough for me right.

Speaker 4:

It was so impactful. Those 12 women are incredible and I see them every year and they are heroes. And if you look on our social media on Boater Girls, you see them. You see their big smiles. They went from kind of meek and we had the data on them they were. Most of them had experienced serious trauma. Almost all of them were single women. All of them had children. And when you talk about that hunger, the amount of grit and resilience that is in these women as an untapped possibility that they're using all their energy just to survive, and then you see what these small interventions do. How do you stop? You can't? You just keep going? And then you see the successes and you just keep going. And so I've that, that presence that we talked about. I love being home with my boys. They're actually coming with me to Kenya this year.

Speaker 2:

I'm so excited they're 13 and 14.

Speaker 4:

They're going to be watching all those motorcycles. They're going to be going all those motorcycles. They're going to be going into the fields. They're going to be reading to children. They're going to be, I hope, having that transformational experience that I had as a young, as a preteen and teenager and just seeing that. You know, our lives are so, we're so fortunate, and it's easy to kind of think of abstractly people in Africa, but when you see that these are your friends, they're your colleagues, they're your community, they're people just like you, there's no better lesson than that to see and connect with a person in front of you. It's very hard to other people and I think you know that mostly from the ER. It's it's very hard to other people and I think you know that mostly from the ER like it's very hard to hate people when you see them up close and you're in their most intimate times and they're most scared or they're most joyous or whatever it is. It's such. There's such universal human emotions.

Speaker 1:

Yeah, and you think about I don't know. You just think about the world we're in and there's so many things that divide and tear people apart and it's so. And then I know it's going to sound really weird, but like yesterday I was going downtown to speak at the BOMA thing and I stopped right by our buildings, pioneer Crossing, right where you come off the freeway, where the Pivot Health is and the Hilton Garden Inn. That's our project. So I was looking at our project, looking at our landscaping, and then I looked over and there was a homeless guy there and, for whatever reason, I sat for a long time because there was a lot of traffic at that light, just looking at him and I thought he was young and I thought that kid, that's someone's son, and and I got really kind of super emotional and I thought that's someone's kid right there and I thought I'm late to this thing, but I wish I don't know.

Speaker 1:

There's just I think we forget. It's easy to put barriers up where we look at people and we don't realize that that's someone's kid and he's got a story and somehow he's there and what happened and what happened. And you can't help everyone. But, my gosh, we can get involved in good stuff and try to give back. I think my takeaway is for five grand. I think of all the other things we do with money like $5,000, the impact that would make on a person. It's exponential.

Speaker 1:

It's generational to them and to everyone around. So, oh, my goodness, I didn't expect this to be this cool. I didn't, so donate. So a challenge out there for people. We have some regular listeners I know they're business guys but botagirlsorg, and it's easy there to donate, and for $5,000, you can.

Speaker 4:

You can impact not just one person, literally thousands of people in this one donation.

Speaker 1:

Well, this has been amazing. I don't even know how to end this. Like what's next? Your practice is going well. People can reach you there if they need anything.

Speaker 4:

Yes, and that's been transformational, I think, um figuring out. You know, once you leave this big medicine machine, how to be creative, how to be innovative, how to be efficient, and that's how you do efficient care, that's how you get people one-on-one in front of you that aren't lost in this morass of bureaucracy. And so we're just trying to connect our doctors to our patients. Just us, it's just us.

Speaker 1:

This has been awesome. Thank you so much for coming on.

Speaker 4:

Thank you for having me.

Speaker 1:

This is great and just I want to extend our support, anything we can do to help you. We're all in. This is changing. This is great. Appreciate all you do for the community and for the world at large, because I was thinking about your grandma, man. She's got to be so dang proud of you. It's cool. Well, thanks for coming on.

Speaker 4:

Thank you so much.

Speaker 1:

Thanks everybody.