April 14, 2025 • 53 mins
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.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Today on the Ever Onward podcast, we have Dr Riana
Menon.
She's an unbelievable breastcancer surgeon here in the
Treasure Valley.
She's got an incredibletraining pedigree, most recently
at MD Anderson before cominghere, has now just started her
private practice.
It's going to be exciting totalk to her about what motivates
her and all the great workshe's doing, and then finally
(00:21):
we'll get to what she's doinginternationally.
She's a board member of TIBAand then she started Boda Girls,
which is an unbelievableorganization in Kenya doing so
much good.
I know you will enjoy this, drRihanna Menon.
Prior to Rihanna, we will hearfrom the guys Mark Cleverley and
Holt Haga, who will be talkingabout our incredible downtown
project.
Speaker 2 (00:42):
Good morning everyone .
We're here with anotherAllQuist update.
I'm Mark Cleverley withAllquist Holt, Haga, VP of
leasing Allquist Development.
So we haven't talked about itfor a while and there's been a
lot of changes and things goingon and thought we'd talk about
4th and Idaho, the ICCU towerthat's going up downtown right
(01:02):
now.
It's been a project obviouslywe've been working on for a
while.
Steel's going up.
We're actually having a toppingoff ceremony here in May with
steel, so exciting stuff coming.
So I wanted to hit on that.
And, just to start us, we justgot a lease signed with Kiln,
(01:24):
their second location in theValley Amazing group.
I know a lot of people knowabout Kiln out here at Eagle
View Landing but they're taking30,000 square feet of the
building.
Yeah, huge win, Huge win for us.
So really, we're down to threefloors in a seven-story building
.
We're down to 60,000 squarefeet out of 140.
(01:45):
And so walk us through kind ofwhat our thought process has
been on these last three floorsover the last few months.
Speaker 3 (01:53):
Well, you know it's a huge win and I think initially
when we, you know, developed theproject and sort of you know,
planned the project, it's all itwas office, right, that whole
13 story tower, 140,000 squarefeet, the top seven floors, all
office, class A office.
And I think we've, we've donethat, obviously with the top,
you know four floors.
(02:13):
You know kiln taking, takingdown 30,000, you know square
feet was was incredible.
They took all of 11 and half of10.
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 thenthe remaining three floors to to
(02:34):
your point, is you know what,what do we?
What's the highest and best usefor those three floors?
And we could, we, you know it'seither office, was kind of what
we had planned, yep, but as welook at it we've sort of pivoted
, right, yeah, and I think youknow what we're going to deliver
is, you know, class A medicaloffice space.
(02:54):
So this is sort of the firstannouncement that we're making
on this project, really, as weroll out our marketing and sort
of pivot a little bit.
But it's become clear and themore that we talk with with
groups in the market and kind ofget a pulse on the market for
the delivery.
Medical is is just it's it'sunderserved in that area
especially.
You know two, two main factors.
(03:16):
Number one is the productthat's there right now.
It's it's old, it's a lot ofit's historic kind of old, it's
old residential homes convertedinto commercial spaces.
Yeah, Right, and so and so ifyou're an independent medical
group looking for, you know,space, and in the downtown
market and the downtown corridornear the St Luke's expansion,
(03:36):
you know your options are reallythese tired, old, uh, you know
homes that are you're verylimited 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 buythis, this new office building
and convert it to to my medicaloffice, you know office, it's
(03:57):
just, it's, it's that cost plus,you know, sometimes double.
So it's it's very, very costprohibitive to do that.
So one of the key drivers isthe existing product.
The second, of course, is StLuke's expansion, which is over
a billion dollars now, you know,set to deliver in, you know,
2029.
So the last three floors thatwe're going to do are going to
(04:19):
be premium medical space andwe're doing a few things to sort
of tailor to that.
You know one of the thingsobviously we've got a ton of
parking, so access is as good asyou can get, which, for medical
, is critical.
Yeah, we're also rolling out avalet parking program which
looks like it's going to beactually in the garage, in the
(04:41):
nested garage that we've got atthe project.
So a variety of things thatjust make it just an incredible,
you know, medical office playor medical office product, and
so I think we're definitelyexcited about it when we first
planned Fortson, idaho, youremember this, we had two towers
.
Speaker 2 (04:59):
One of them was a medical tower and one of them
was an office tower, and goingthrough design review with the
city and what they wanted, Imean we switched.
Uh, basically had to switch anddo one tower of just commercial
and one tower residential,which was fine, but we always
knew that medical was a was likea key component for this area,
right, I mean?
(05:19):
you're a block away from thelargest hospital in the Valley,
right I mean, from next to StLuke's and for years you go
downtown and users, medicalusers, they can't find space
down there.
We fought it with a user whenwe were a gardener company.
We were working with a clinicthat we could not find space for
(05:44):
down there, right I mean, andit took us.
It actually took us a coupleyears to figure out where to put
them Because there was just no,there was no options.
Speaker 3 (05:52):
Yeah, it had to be a separate, standalone ground-up
development, new constructionAbsolutely.
Speaker 2 (05:57):
Project.
Yeah, so this, like you said,because of the outreach to us
and people saying, hey, whatabout, like I'm a medical user,
do you guys have space for medown there?
We have.
Yeah, we shifted to those lastthree floors so we'll still have
the office up on the top four.
Iccu will take the top two andthen we'll, you know, kiln and a
(06:19):
couple others.
But, yeah, medical and it'sgoing to be, it'll be great.
We're excited right to get themedical going.
We've already got groups thatare submitting LOIs on the
floors that we have there.
So it's going to be it's goingto be awesome.
Speaker 3 (06:36):
We're super excited.
Yeah, I think to that point.
If you're, you know, anindependent medical group, for
example, looking for anywherefrom you know 2,500 to you know
even 30, 40,000 square feet, um,this is a trophy project.
Uh, that is, you know, adjacentto downtown and St Luke's.
(06:56):
That that you know is is goingto be a great option.
Yep, yeah, love it, came in.
Speaker 2 (07:00):
Good job good job.
Speaker 1 (07:10):
Dr Menon, thank you for coming on.
These are always so interesting.
We met in the hall coming inhere, but sometimes I have
people on here that I've justknown 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 gotto talk to her, you've got to
(07:31):
hear her story, you got to.
So I'm really excited.
I feel like I know you alreadyjust because of so many friends
or people that we've had on havebrought your name up.
So thank you for coming ontoday.
Speaker 4 (07:40):
Thank you for having me.
I was going through your listof podcasts and listening to so
many amazing guests that you'vehad on and I am honored to be on
this list.
Speaker 1 (07:48):
We're honored to have you here.
It's fun for me to have peoplein healthcare because then I
immediately want to talk alittle bit about some of the
healthcare stuff.
But with your background it'sthis going to be a fascinating
trip.
But are you okay just maybetelling a little bit about your
story, sure, and kind of just alittle bit about you, your bio,
for people to get to know you alittle bit better before you
(08:09):
started?
Speaker 4 (08:11):
So I grew up in Southern California and my
father is an immigrant fromIndia, and so he told us our
whole lives, the way you guyslive is not the way the rest of
the world lives, and so I kindof always had this perspective
about how lucky we were to livein this country where we had so
(08:32):
many opportunities, and so Ihave gravitated towards health
care my whole life, and one ofthe things that really really
brought me into health care wasthe idea that I could use skills
that are portable and workinternationally, and I traveled
to India to meet my family whenI was young Maybe my first time
was very young and then I spenta prolonged amount of time, kind
(08:53):
of as an 11 or 12 year old,where you're just about to be
this American teenager andseeing how the world is not like
Orange County, california orBoise, idaho is transformational
at a young age.
And so I kind of always knew Iwanted to be in medicine.
(09:14):
I always knew I wanted to be asurgeon, and so as I went
through medical school, I wentto medical school.
Speaker 1 (09:19):
What was your inspiration for that?
Speaker 4 (09:20):
I don't really.
Speaker 1 (09:23):
I just knew that.
Was there family members oranyone that did, I'm the first
one, okay.
Speaker 4 (09:26):
But I like to fix a problem.
You can probably relate to thisas an ER doctor, but surgery in
particular is you have aproblem and you fix it.
And I'm pretty cool underpressure, and so I really liked
being the one who you knowthings are falling apart and you
kind of pick up pieces and staycalm and are a voice of reason
(09:46):
in the room, and so I kind ofnaturally gravitated towards
kind of those more emergencysituations.
Speaker 1 (09:57):
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 guysthat take no.
I mean it's a very dominantkind of thing, very much so.
(10:18):
Very much so.
So it is interesting for methat you chose it and knew it
early and then just plowedthrough it, because there's
probably a lot of barriers andhurdles you had to overcome.
Speaker 4 (10:28):
Very much so.
I was blessed to be in a familythat was just.
My grandmother was my mostardent supporter.
I never once thought there wassomething I couldn't do.
That's awesome do.
And so you know why not go forthe hardest thing, why not be
(10:49):
the the the loudest voice, orwhy not?
Why not do anything you couldwant to do?
Um, because that's what she hadalways done, and I have this
amazing network of really strongwomen in my family.
But, um, but that was.
I never felt that internalbarrier.
She just passed away.
It's two weeks ago.
this sorry, two years ago thisweek and she was my, just my
(11:10):
most important person my wholelife, and so I feel her with me
all the time.
Speaker 1 (11:15):
What made her?
Because I've got my own kind oflike.
I had a grandpa that I alwaystalk about but what for you?
What made it so special andwhat?
What were the qualities ofsomeone like that as a mentor
that that were so important toyou?
Because I think I think, as wehave those experiences,
(11:35):
especially as leaders now liketalking to people I think
sometimes we don't realize theimpact you can have on someone.
But but what were her?
What were her qualities?
What are the things you thinkback that are her kind of legacy
, things that inspired you?
Speaker 4 (11:49):
Thank you for asking this because you know you lose a
grandparent and everybody losesa grandparent.
You know it's just supposed tobe part of life, but she was so
important to me and so I justlove talking about her.
She was one of the most quietlystrong people and sometimes not
so quietly strong, but just aforce, like it was never an
(12:09):
excuse that you're too busy ortoo tired or too.
You just do it, and she wouldeven say to me you're the
strongest one, so you have to doit all the time.
You have to pick up the and youbelieved her.
I believed her to my core and Istill believe her right.
If you have the ability, if youhave the energy, if you have
(12:30):
the know-how, that's your job todo it.
You pick up where other peoplecan't and you don't.
Actually, she was so kind andloving to everyone around her.
She was just so accepting, likefaults and all of anyone,
because she felt like she hadthe bandwidth to pick up where
they left off and I think shewas the most all-encompassing,
(12:52):
just.
She was beautiful, she washilarious, she was I mean, she
died at almost 90 and stillowned her own business and went
to work every day and she justwas one of those people.
That was you, couldn't I?
Speaker 1 (13:06):
couldn't imagine what was her story.
Did she, what was her lifeexperience?
Speaker 4 (13:11):
So she grew up in Portland Maine.
She was the child of twoimmigrants, a Syrian immigrant
and an Irish immigrant.
Her father died very when shewas very young, at eight in a um
.
He was a train foreman and diedin a train accident.
And then I think she kind ofhad to pick up and be the strong
person in her family.
She had a younger brother who'sstill alive and her mother kind
(13:35):
of worked as a cleaner inhouses.
She would say she worked forrich people so she knew all the
beautiful things that she wanted.
So I remember as a little girlI would polish the silver with
her and iron napkins and foldthem and even if you didn't have
a lot of money you hadbeautiful things around you and
(13:58):
it was important to her and sojust to kind of be put together.
And then she wanted to leavePortland Maine.
She became a flight attendantin um the fifties and met my
grandfather, actually on aflight from Chicago to
California and the rest washistory Wow.
Speaker 1 (14:15):
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 youbut, like, I think back to my
cause.
I I think back to my, becauseI've actually thought about this
a lot.
I'm like, why was mygrandfather so impactful on me
and am I being impactful on mykids and my grandkids?
(14:36):
And I do think it's busier now.
There's more noise now and Ithink about the times that I was
with him.
It was quiet and I always saythis and I don't know if it
makes sense to you, but I havevivid memories of him talking to
me because when he talked to meI could feel it.
It just wasn't like words andI'm wondering if it was because
it was quieter.
(14:56):
So I'm trying to be intentionalabout like with my grandkids
now creating times and it maysound artificial a little bit,
but I want to get those boysaway where we're quiet and I can
talk to them and tell themthey're wonderful and they hear
it and I'm not.
They're not distracted, I don'tknow.
I just worry about it's busynow.
(15:17):
It's just like I don't know.
You feel that way ever.
Speaker 4 (15:20):
I feel like that all the time, and I think you're
exactly right about thatquietness, because when, when I
was with my grandmother and Iwas the first grandchild of 13
grandkids and so I was a lotolder than everybody else, so I
had this beautiful time of justus, 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 fabricstore and we'd go to the paint
(15:43):
store and we'd go to, and itdidn't matter what we were doing
, it was just the two of us.
And that you're right it thatquiet time, that that if when
you're with her, you're the onlything that matters.
Speaker 1 (15:54):
Yeah.
Speaker 4 (15:55):
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, evenamongst the noise, to have that
human connection.
Speaker 1 (16:07):
I think there's a lot to learn from that.
Sorry, I interrupted you, soyou're the oldest, so she had to
be tremendously proud of you,like over the moon.
Speaker 4 (16:15):
I know that, because now you go through this.
Speaker 1 (16:17):
You're like I'm going to become a surgeon and then
tell us about your education.
Speaker 4 (16:23):
So I did my medical school in San Diego.
That wasn't too far from home.
I have a little sister who's 14years younger than me, and I
had gone to the East Coast forcollege 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
(16:44):
this place.
So he found me in San Diego andbrought me back here.
I did my residency in SanFrancisco and did two years of
bench cancer research too.
So that was, you know, sevenyears of surgical training.
And then through that wholetime I met another really
important mentor when I was inresidency, who Dr Das, who just
(17:06):
passed away last year but wasone of those people that I
really tried to model the restof my career off of.
He did international work threeor four times a year.
He's originally from India, soI traveled with him to India.
He did clinics in Mexico.
He set up girls' schools inNepal, in India, in South
America as many as you canimagine.
(17:28):
Just one of those people whotruly believed in the
transformation, of empoweringyoung girls and women and what
that does to a society Wow, andhis foundations have continued
to persist.
He was actually a urologist andone of the most ardent
humanitarians that I have evercome in contact with, and so it
(17:48):
really inspired me to show mehow I could do that work and
still be a busy practicingsurgeon.
And then, when I finishedresidency, I did a fellowship at
MD Anderson in Houston, texas,for breast oncology and it was
one of those things where I gotto kind of the pinnacle of
(18:08):
academic cancer medicine and Iwas offered a faculty position
there and I went.
I don't think I want to do thishere, because in Houston and I
feel very passionately aboutaccess to medicine for everyone
I want everyone to be able tohave this high, high quality
care, and we know that that'snot always possible.
(18:29):
And so in Houston there were ahundred amazing breast surgeons
In Idaho, there was just one inthe whole state and she's still
here and she's fantastic, butshe can't do it all her own by
herself.
And so we had decided you knowwe had two little boys at that
time, we had been through a lotof training, my husband's family
was here, we needed the support, so we moved back here and I
(18:51):
thought you know I was thesecond breast surgeon in the
whole state and I thought I wantto be bringing MD Anderson
quality care to Idaho, not wherethere's 100 people who can you
know go anywhere Idaho, notwhere there's a hundred people
who can you know go anywhere.
Speaker 1 (19:04):
Well, thank heavens, a boy from Boise married you
because I mean, when I looked atyour, I mean I'm not.
I looked at your resume and I'mlike I can't wait to hear how,
because the pathway could haveshould have bench, bench
research.
You look at your pedigree oftraining and you're at MD
Anderson.
I'm sure it would have beenvery easy, um and and
(19:27):
prestigious to stay there and beat 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 (19:38):
I can't believe how time has really flown and I'm
really proud of the work thatI've done here.
I think that I did a lot of whatI came to do because when I
first got here there was, like Isaid, one breast surgeon in one
whole hospital system.
I was the first one in my wholehospital system that had the
(19:58):
catchment area of all of Idahoplus Eastern Oregon, eastern
Washington, northern Nevada, wewould get Wyoming, we would get
Wyoming, we would get Alaska.
I mean really a huge catchmentarea and there was no
comprehensive breast program,there were no employed plastic
surgeons.
So when I first got here, youknow, I said, well, why aren't
(20:19):
we doing immediatereconstruction for women who've
had a mastectomy?
Why don't they go home withtheir implants?
Why aren't we doing a morecomprehensive cancer care?
And so by the time I left,which was just about 18 months
ago, we had the biggest breastprogram in the whole state, five
or six plastic surgeons, fiveor six surgeons, um, so really
(20:41):
had elevated what breast cancercare looked like for the entire
state.
So really proud of the work wedid there and really shined a
light on how important this is,but had a lot of barriers too.
Speaker 1 (20:56):
Well, your reputation .
It's been incredible and theimpact you've had.
I mean, you're talked abouteverywhere, so it's cool to have
you on Talk about.
Uh, there's so many things I'mgoing to get into with you,
cause I'm sitting here listeningand thinking of questions.
But, um, you go into, you gointo into surgery.
(21:16):
Then you choose, um, cancersurgery, you go get trained and
and that I mean you're kind ofpicking the very most technical
right.
And then also anythingassociated with cancer and
treatment and surgery is justhard, um, and and you get to, I
think, the best part of medicine.
So, as you know, I kind ofstopped practicing.
(21:37):
I loved it.
I loved it.
I mean, business is greatbecause I tell people all the
time they're like, why would youleave?
And I'm like, well, Ireluctantly left because I
didn't want to leave.
But when you get in businessthe professional satisfaction of
working with otherprofessionals people are happy.
And I will tell you this inhealth care it's hard because a
(22:01):
lot of people aren't happy, andI know that.
That I don't want to, thatdoesn't sound.
It's just.
People are tired, they're youknow with with all the changes
that have come in documentationand the way people are paid and
the way the system works and theclunkiness of it, it there, it
lead, it tends to lead, tofatigue that has nothing to do
with patient care, and unlessyou're in it you don't really
(22:22):
realize that this isn't aboutpatient care.
So I'm getting this is a long,rambling statement to get to a
couple of questions.
For me, though, when I think ofmy memories, it is the patients
, and I trained in Arizona andthen came here.
But the patients in Idaho arewonderful this area.
And I trained in Arizona andthen came here.
But the patients in Idaho arewonderful this area they're just
(22:44):
kind and wonderful Talk aboutand like I'm the Neanderthal ER
guy right, is it bone broken, isit bleeding, whatever?
But you have the ability tomake this connection with people
over a period of time whenthey're dealing with the
scariest thing that you everhear in your life is you have
(23:04):
cancer your hardest day.
Talk about how wonderful it isto be part of that with patients
.
Speaker 4 (23:09):
I think you did the perfect intro because we hear so
much about burnout, we hear somuch about these other factors
and it is hard to be just adoctor 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 careeror your life, it is those
personal connections, it's thatquiet moment and I think you
(23:31):
alluded to it earlier.
How do we have human connection?
It's in these quiet moments.
So kind of the best and mostgratifying part about my job is
to meet people on their firstday where they are terrified.
They think 100% of the timethey think they're going to die
and then, even if I know, I lookat it and I go we're going to
do great.
Or wow, we've got a big journeyahead, but you're still going
(23:54):
to do great.
And that's what I like aboutbreast cancer in particular is
because it's such a hopefulfield.
I kind of always say the besttime to get breast cancer is now
.
Better time would be in fiveyears or 10 years because it
changes so quickly.
But to be able to sit down in avery logical way, whether
you're an engineer or a farmer.
(24:14):
I can explain it to you in away 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 toyour career, get you back to
your life.
It won't ever be totally thesame.
I don't mean to minimize it,but this is how I can sit with
(24:35):
you.
I can look you in the eye.
Speaker 1 (24:44):
I can sit here with your family and just know that
we can connect and get you to aplace where you leave much more
relieved, much happier, and Ithink for you.
I'm sitting here thinkingbecause for us, when I was in
the ER for all those years, youwould have certainly I mean
that's where people die is inthe ER.
So you would have very sadthings.
That happen all the time.
But you have a regularoccurrence where you have people
that have been told they havecancer many times young people
that for the first time areprobably like questioning their
(25:06):
mortality, which, becauseusually you go through life and
we take you know, we take forgranted much of where we live,
what we have.
You brought that up with withyour experience internationally,
and then you take for grantedyour health.
I mean, it's just, you can'thelp.
Most of the time you're healthyand it's easy, and all of a
sudden someone says you havecancer.
You're like your mind andthat's the first time they're
(25:29):
coming to you hopeless, right ofwhat's going to happen.
And that happens over and overand over again.
Speaker 4 (25:38):
And it can be very overwhelming.
And so one of the reasons Iwent into private practice about
18 months ago and one of thebiggest reasons was because that
period of waiting was gettingreally out of control.
So it was from biopsy that youknow someone gives you a call
and says you have cancer.
(25:59):
To see me for the first timeand I'm the first practitioner
you see was 46 days.
Biopsy to surgery was 80 days.
Speaker 1 (26:07):
That's tough.
Speaker 4 (26:07):
And it was so stressful Because the first
thing you have to do is spendabout 15 minutes de-escalating
the frank trauma that you've hadfor thinking that you're going
to die, and not only that, youhave a cancer that's growing and
changing inside you and Ialways say this is my, it's my
biggest, best piece of advicewhen you have cancer.
The internet is only for catvideos.
That's it Do not look atanything else, because about 99%
(26:32):
of things don't apply to youbut they will scare you.
And so our biggest change andmy biggest stress was I just
need to get more and more andmore and more and more people in
, and then you lose thatconnection because you're so
overwhelmed.
I was coming in, we wereputting in one patient before
our template, going over lunchand seeing a patient staying one
(26:53):
day later and my amazing nurseand I were just drowning and we
couldn't bring our best selvesevery time because and then
every day off, I would justoperate 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.
You just can't, you can't go onthat way, and I'm I'm I would
(27:13):
say it's, like you know 10 yearsinto my career, but I'm not old
enough that I can do that formuch longer.
And so I made a big change andit was terrifying, but we
routinely um, I work with one ofyour tenants here, lyra Total
Breast Health, and we we getpatients in.
She calls me and says there's acancer coming and I say, okay,
(27:35):
we saved a spot for next week.
And so that time of anxiety hashas been broken down to a week,
10 days, two weeks into surgerywithin 30 days, and that gives
me I can breathe easy.
Speaker 1 (27:49):
Talk about the autonomy and control a little
bit, because I I mean, I'm wayolder than you, so you know you
go back to when I started inthis thing and and then the
evolution, like literally duringmy time and and listen, there
were some wonderful things aboutthe affordable care act and and
then there was the bureaucraticlayers of stuff that have
(28:11):
happened with.
You can pick anything inhealthcare, like between like
you had patient and doctor atsome point but you can pick
pharmacy and PBMs.
You can pick insurancecompanies and interbattle.
You can pick.
You pick regulations that likeI'm sure some of them made sense
, but just piles of regulationsand and and you know the legal
(28:33):
side of things it gets.
That's the part that gets justfatiguing.
I think, no matter you pick,you pick the specialty across
medicine and people are justlike 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 takecontrol, because at some point,
like you think of the trainingand time and effort that it
(28:55):
takes you to get to there, andthen I think one of the things
you said that really hit homewith me is like you're human.
Speaker 4 (29:03):
We're just people.
Speaker 1 (29:05):
People.
You have your kids and you haveyour life and you have your
family and you have so muchenergy and love and compassion,
and then you take care of people.
You need all that, and thenthere's this thing, which is
like the administrative side oflife, 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.
(29:25):
You can limit your sleep asmuch as you can, and I we tried
that for years.
I used to say sleep's overrated.
I said that till I startedhaving all my heart problems.
I'm like ah, I was wrong, don'tlisten to me anymore.
But but you at some point.
So I'm glad.
So it's settling out reallywell for you.
Speaker 4 (29:40):
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 thatI'm so proud of.
And I know, and I have my cutelittle clinic.
It has flowers and chandeliersand and art and you call and
someone answers a real personanswers and you can get to us.
Speaker 1 (30:03):
Hey, while we're doing this, because there's a
lot of people on YouTube, howcan people reach you while we're
yeah?
Speaker 4 (30:09):
I'm Mountain State Breast and General Surgery.
Google my name and you can getin to see me.
Speaker 1 (30:16):
We're going to pull it up Mountain.
Speaker 4 (30:17):
State Breast and General Surgery Breast and
general surgery Breast andgeneral surgery.
Speaker 1 (30:20):
It's been a year and a half.
Speaker 4 (30:21):
It's been a year and a half.
I have a wonderful partner, drKerry Newton, who came from
Seltzer, and we just have youknow.
You can tell by our website.
We are interested in who youare.
We talk a lot about lifestyle.
We talk about cancer prevention.
Speaker 1 (30:35):
I love that tagline right from the beginning.
Back up a little bit, Maddie.
Our priority is personalizedwhole person care.
Speaker 4 (30:42):
Yeah, so when you walk in and we do general
surgery and we do a lot oflifestyle counseling and you
know, maybe you have a herniaand maybe you're not ready for
repair right now because we haveto work on a few things, but
we'll work with you and get youthere, and so these are the
things that are so gratifying.
As a doctor, I get all the timeI want with you.
(31:03):
I can say you know, you havethis tumor.
We're going to talk just aboutthis.
We're going to talk about theperson who's you know around
this tumor as well, and talkabout how my favorite analogy is
when you're talking about atumor, it's like saying or
cancer, it's like saying youhave a pet.
It could be a pet goldfish, itcould be a pet dragon.
That's how different they are.
(31:23):
Obviously, if you have a dragon, we're not going to use
goldfish medicine, but we willslay your dragon.
If you have a goldfish, don'teven worry.
We don't have to do any of thatdragon stuff.
And so just breaking down in avery expert way gives people
this confidence that it's notjust oh, oh, nobody knows what
to do.
This is unknowable.
(31:44):
No, I can get you through this,that's awesome.
Speaker 1 (31:48):
I want to shift to your international work, but
before we do, I think it wouldbe, I think, for people
listening because our storieswere said.
I'm so glad I listened to yourpodcast because what is the
advice you would give tofamilies listening to this
podcast?
Out there, with breast cancerdetection, early diagnosis, what
are some things that everyoneshould know?
Speaker 4 (32:09):
So everyone should know that mammograms are safe
and they are the way that wecatch breast cancer early.
So unfortunately in Idaho we'rekind of 50th in screening 50th
50th Holy.
Speaker 1 (32:19):
Why do we always have to be 50th in everything?
Speaker 4 (32:22):
And that means that one in three new breast cancer
diagnosis is advanced stage, andso we can catch this early.
And I know there's so much feararound cancer.
But what I promise is I don'tcare what we find, I have a good
plan for it, and the earlier wecatch it, the better.
We have a chance to catch it.
We're really 50th 50th darn itand Dr White of Lyra and
(32:47):
Representative Brooke Green andmyself just were able to help
pass a bill that the governorsigned just two weeks ago that
pays for coverage for allhigh-risk breast cancer
screening.
Pays for coverage for allhigh-risk breast cancer
screening, and so, whereas womenwere paying like $4,000 out of
pocket, that this went to yourdeductible, but it wasn't just a
covered service.
Now, if you're considered athigh risk for breast cancer, if
(33:11):
you have high-density breasts,we have a lot of other great
options for you.
Speaker 1 (33:17):
Let me ask you some questions on that.
Like, you're high-risk, youhave high density, you know.
You know that.
Um what?
What should a mammogram cost?
What's the true cost of amammogram?
Speaker 4 (33:27):
Oh well, so it's most most people are charged covers
right Most coverage, If you haveinsurance, 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 ofpocket if you have nothing.
But high-risk screening can bepretty darn expensive.
It can be $500 to $3,000 for anMRI.
(33:50):
And those are out of pocket.
It can be for a diagnosticmammogram $800.
But we're working with moreaffordable and more indifferent
options in the community.
Dr White has opened imagingcenters that make it really
accessible and because she hasthese new other modalities,
everyone else has followed suit.
Speaker 1 (34:11):
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 (34:15):
It's easier, there's more options, there's more
affordability and it's nowcovered.
So there's really what I wouldsay to people is don't be afraid
, get out there.
Mammograms are very safe andthey are the way that we are
detecting breast cancer, andthat, I think, segues nicely to
this international work that I'mdoing because the programs I've
set up in Idaho.
(34:35):
I'm trying to do the same thingin Kenya.
Speaker 1 (34:38):
All right, let's go there now, because I think what
I mean like you're superappreciated, famous here for the
work you've done traditionalhealth care.
You've really I mean, you'vereally revolutionized breast
care in Idaho in a short periodof time and it's an honor to
have you on and talk about that.
(34:59):
Now let's talk about yourinternational work.
So you were inspired by thismentor of yours.
Very much so Dr Das, so Dr Dasand 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 gotso much going on.
I really want to understand howyou're like hey, not only am I
going to do this, I've got afamily, I've got my career, I've
(35:19):
got my practice, but youprioritized this international
care.
That's not easy.
Speaker 4 (35:25):
It's not, and I think when you're, when you're young.
So I did you know, four yearsof college four years of medical
school, seven years ofresidency and a one-year
fellowship.
So you're at the end of this andyou're like I got to get a job.
So, as I was moving to Idaho in2016, one of my mentors reached
out who had been going to theSerian Kenya through the Teba
(35:46):
Foundation for a long time andhe said do you want to come with
me?
I said, yes, I want.
This is perfect.
I have a three, three monthsoff for the first time in my
life.
This is perfect.
I'll go with you to Kenya.
And the Teva Foundation is a USfundraising arm for some of
these projects in Kenya thatpartners and this is what's
really unique, is it partnerswith the Kenyan organizations,
(36:08):
and so it's never just us flyingin 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 aweek of operating and just kind
of, whatever walks in, you doanything, you get really
creative.
And so I always laugh when I'mhere 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.
(36:29):
And so I really got the bugbecause talk about it's like the
antidote to there's.
There's no EMR.
You're not calling an insurancecompany.
You're not, um, waiting in line, you're, you're.
You are in a room with a personand takes it back to the basics
right.
So gratifying.
And so I did that once and Igot the bug.
And every year since 2016, Ihave gone to Kenya for about a
(36:53):
year with the Teba Foundation.
I then joined their board andthen last year I became their
vice president.
So I'm in all in and that kindof it's like cleaning your
filter.
Every year.
It reminds me of the joy ofmedicine and, you know, our
society puts a big investmentinto making a surgeon.
(37:14):
You know, you saw all thoseyears.
You know I got, I got grants togo to school, I got loans to
get into medical school.
I uh, you know Medicare paysfor residency, so there's a it's
.
And then, of course, my familyand people around me my husband,
my kids, everybody has put alot of time into allowing me to
become a very specializedsurgeon, and I have this
portable skill and it'swonderful.
(37:35):
So, you know, having a fatherthat grew up in India, I feel
strongly that I have skills thatneed to be shared, and so I go
to Kenya and for an area ofabout 5 million people, there
are zero of the specialists forme, and so I love being able to
show up and say you know, tellme what you need the other best
part about doing that andpartnering with the same
(37:57):
hospital all the time is you'renever I know where those
patients went, so when I leave Ileave them with my family
medicine colleagues and thenurses there.
Speaker 1 (38:07):
And so they get full handoff.
Speaker 4 (38:08):
They're there all the time.
They WhatsApp me all year longand say, oh, I got this scan.
Is this good for your next trip?
Is this good?
What do you think about thisfollow-up?
So it's kind of the opposite ofjust flying in and doing
something.
It's really a partnership thatis long-term.
And then I have to mention in2019, we went and a friend of
(38:31):
mine gave me, donated a bunch ofDays for Girls, sustainable
menstrual hygiene kits and Iknow you had the founder of Salt
on.
And so you know about thisperiod, poverty and how, really
across the world, girls don'tstay in school because they
don't have access to menstrualhygiene, and so, within the
Treasure Valley, we have thisreally strong relationship with
(38:52):
this company called Days forGirls as a nonprofit, and there
are hundreds of women just inthe Treasure Valley who sew
these menstrual hygiene kitsthat are sustainable, reusable
lasts about five years.
So my friend donated 200 ofthese kits, which is a huge
donation, about $15 a piece.
So she really gave me a big legup and I took these two young
women with me a junior in highschool and a senior at Boise, at
(39:16):
BSU and they went and taughthow to do these and it's it's
paired with sustainablemenstrual hygiene kit, um, and
and paired with just basicbiology.
This is a uterus.
There's no ovary, this is how ababy's made.
And it was so powerful.
And then these girls within fourdays all 200 were gone.
(39:36):
They were busing them to thehospital and then, at the end of
one of these days, two girlsget on the back of a motorcycle
taxi called Potobotas, drove offand the principal was standing
right there and she said, oh mygosh, this is so dangerous.
You know, these girls are sovulnerable.
(39:57):
They're taken to a field theynever may get home.
They're really vulnerable.
And so that really sparkedsomething.
Um, and we became theco-founders of something called
Boda Girls, which are motorcyclewomen, run motorcycle taxi
service.
They drive pink motorcycles,they go to the schools, they
teach menstrual hygiene, theytake girls to and from school.
So it's women driving girls.
They bring women to thehospital.
(40:19):
They do about a hundreddeliveries a year, a month in
the hospital, whereas beforethey weren't, you know, on the
road or really high maternalfetal death rates in this area.
These babies are getting earlychildhood care, they're getting
vaccinated, they do kitchengardens, so they send them home
(40:41):
with nutrition.
Speaker 1 (40:42):
Oh my goodness, it's the biggest wraparound.
Is there a?
Speaker 4 (40:44):
way to look this up, please.
It's called bodagirlsorg,bodagirlsorg, b-o-d-a
bodagirlsorg, and so not onlyare these women, they were
subsistence farmers.
We know about these women.
We started with 12.
And actually one of our hugefunders has been Red Aspen, who
you had on.
Speaker 2 (41:01):
Oh, that's cool.
Speaker 4 (41:02):
And they partnered.
They give us significant moneyand help us buy these pink
motorcycles.
Red Aspen donated money forportable ultrasounds so they
send the ultrasoundtechnologists into the villages
and then they know if they havea high risk pregnancy, they know
if they have twins, they knowwhen they're going to deliver
and say okay, when you're ready,you call this Boda girl and
(41:23):
you'll get delivered at thehospital.
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 onlydo we have these women, okay,
so they were subsistence farmersmaking $1 a day.
It's a dollar, truly a dollar aday, and they're raising
children and their children arehungry.
(41:43):
These Boda Girls now make $10 aday.
They are so it's not justdriving.
They get this wraparound.
They have to do 10 certificates.
They do self-defense,self-esteem mentorship.
They learn about computerliteracy so they can market
themselves.
They have app-basedentrepreneurship, they do the
Days for Girls curriculum, theydo gender-based violence and now
(42:08):
what we're trying to add on isa breast cancer component.
So that's currently what we'reworking on this year and what
we're fundraising for.
There are, for an area of 5million people, there are zero
mammograms zero and so we'reworking on fundraising for a
mobile mammogram unit.
And then we're teaching theBoda girls how to, because
(42:29):
there's a lot of fear andthere's a lot of stigma, and I
will say that a pretty perfectoverlap to the work I've done in
Idaho has been in Kenya, andit's not and here it's not even
because of resources.
It's around trust, it's aroundfear of cancer, it's around you
know awareness, around screening.
(42:50):
I'm basically doing the samework that I did here, there and
it makes it so I'm always socareful not to come in and go.
Well, I'm a US doctor and I'mtelling you this I go.
These are the problems I had inmy own community and I'd love
to teach you and help to shapethese programs, because I just
did this.
Speaker 1 (43:08):
I'm just listen.
I'm kind of blown away becauseI'm sitting here thinking like
the impact of transportation ina safe way with someone that you
trust in a community where thatdoesn't exist.
How impactful and when and howit started, so authentically in
the impact it's making.
Wow.
Speaker 4 (43:28):
It's incredible and and we started with.
And so just those 12 firstwomen had 43 kids between them,
so they went from being inabject poverty.
They weren't able to go toschool, they didn't have shoes
to go to school, they didn'thave books, they didn't have
healthcare, they didn't haveenough to eat.
All 43 of those children, justin the first year and that was
(43:48):
in 2022 are now middle-classovernight.
All of those women are mentorsthe first year and that was in
2022, are now middle classovernight.
All of those women are mentorsin their community.
They are heroes in theircommunity.
And that has now we're up to 40Boda Girls, and now we are
launching in a separate site.
Speaker 1 (44:09):
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 maybe listening to this?
So go to your, go to yourwebsite, obviously, so yeah, so
boatagirlsorg um is it?
Speaker 4 (44:19):
and what I can say is we know.
So the Teba foundation has oneemployee, our executive director
so, and our board covers herentire salary.
So every dollar you donate goesdirectly to these programs.
And so I can say, and when Ihave, you know, I I'm always
hitting up my friends, right,and I say you don't, you're not
(44:39):
sending your money to Africa,quote, unquote.
I know where all these dollarsare 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 theregoes a long way.
Speaker 1 (44:51):
How much?
Just to put it in perspective,like one boda girl, what does
that cost?
Speaker 4 (44:55):
a year About $5,000 for the motorcycle, for her
training, for everything thatgoes into being we're donating.
Speaker 1 (45:03):
Thank you, yes, this is incredible and the impact.
Speaker 4 (45:08):
So not only does that , and then here's the really
exciting part.
So we're working.
We have all this data and we'reworking with banks, because,
within 18 months, every singleone of our 40 Votagirls have
purchased their own photos backand that's based on.
they offer free rides to thehospital and we set aside a
dollar for each one of thoserides, and so part of that
(45:32):
$5,000 subsidizes those ridesand so at the end of that 18
months she owns her ownmotorcycle.
And that is incredibly powerfulbecause most men don't, and the
men in the area are leasing forabout $3 a day and if they don't
pay back that lease they loseit, and so that's a precarious
(45:53):
place for a man to be.
But it's a really precariousplace for a woman to be, because
if she has a sick kid she can'tgo riding.
The peak times that most peopleare needing to get to work are
when she's got to get her kidsto school, when she has to go
get water, when she has to takecare of all of the
responsibilities she has as awoman.
(46:13):
So she's already behind theeight ball, and then it's going
to be really hard for her to payback that loan and they're kind
of predatory loans so they endup paying about three times more
for a motorcycle.
So after 18 months for her toown, her own bike is its own
source of income forever.
Speaker 1 (46:32):
Did your grandma know about all this stuff?
She did right.
Speaker 4 (46:35):
This was just taken off and she was so proud and,
and she was so proud of this.
And every time I would see aboater 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 (46:52):
I was just, I'm just sitting here thinking about what
you're saying, but I'm sureyou've heard the Tara Raya Trent
speak.
Um, and it's been years agosince I heard her first time in
person speak, but I remember hertalking about hunger and I was
in the audience and and she saidyou probably have a definition
of hunger, but you don'tunderstand true hunger.
(47:15):
And it was so impactful on mebecause she talked about these
women, in these situations thatthey're in and with children,
and the hunger to provide andthe hunger to improve the life
their own life and the lives oftheir children and their future
and their posterity.
And she's like that is truehunger.
And and as you're talking aboutthis, I just I'm I'm looking at
(47:39):
some of these pictures thinkinghow impactful this is and it's,
it's super inspiring.
How, how do you?
I mean, I got to ask how do youdo it all?
Speaker 4 (47:48):
It it, um, that's a great question.
It it, um, that's a greatquestion.
And and going, actually goinginto my private practice has
given me so much bandwidth thatI took back to.
Just these are things that fillme up.
I just feel so motivated.
Like gets you going.
The only way to do it is to doit, and then you just keep going
(48:10):
after that, and the amount ofgratitude like I said, if we
stopped at those 12 women, thatwould have been enough for me
right.
It was so impactful.
Those 12 women are incredibleand I see them every year and
they are heroes.
And if you look on our socialmedia on Boater Girls, you see
them.
You see their big smiles.
They went from kind of meek andwe had the data on them they
were.
Most of them had experiencedserious trauma.
(48:32):
Almost all of them were singlewomen.
All of them had children.
And when you talk about thathunger, the amount of grit and
resilience that is in thesewomen as an untapped possibility
that they're using all theirenergy just to survive, and then
you see what these smallinterventions do.
How do you stop?
(48:52):
You can't?
You just keep going?
And then you see the successesand you just keep going.
And so I've that, that presencethat we talked about.
I love being home with my boys.
They're actually coming with meto Kenya this year.
Speaker 2 (49:06):
I'm so excited they're 13 and 14.
Speaker 4 (49:08):
They're going to be watching all those motorcycles.
They're going to be going allthose motorcycles.
They're going to be going intothe fields.
They're going to be reading tochildren.
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
(49:29):
easy to kind of think ofabstractly people in Africa, but
when you see that these areyour friends, they're your
colleagues, they're yourcommunity, they're people just
like you, there's no betterlesson than that to see and
connect with a person in frontof you.
It's very hard to other peopleand I think you know that mostly
(49:51):
from the ER.
It's it's very hard to otherpeople and I think you know that
mostly from the ER like it'svery hard to hate people when
you see them up close and you'rein their most intimate times
and they're most scared orthey're most joyous or whatever
it is.
It's such.
There's such universal humanemotions.
Speaker 1 (50:05):
Yeah, and you think about I don't know.
You just think about the worldwe're in and there's so many
things that divide and tearpeople apart and it's so.
And then I know it's going tosound really weird, but like
yesterday I was going downtownto speak at the BOMA thing and I
stopped right by our buildings,pioneer Crossing, right where
(50:27):
you come off the freeway, wherethe 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 therewas a homeless guy there and,
for whatever reason, I sat for along time because there was a
lot of traffic at that light,just looking at him and I
thought he was young and Ithought that kid, that's
(50:47):
someone's son, and and I gotreally kind of super emotional
and I thought that's someone'skid right there and I thought
I'm late to this thing, but Iwish I don't know.
There's just I think we forget.
It's easy to put barriers upwhere we look at people and we
(51:09):
don't realize that that'ssomeone's kid and he's got a
story and somehow he's there andwhat happened and what happened
.
And you can't help everyone.
But, my gosh, we can getinvolved in good stuff and try
to give back.
I think my takeaway is for fivegrand.
I think of all the other thingswe do with money like $5,000,
(51:32):
the impact that would make on aperson.
It's exponential.
It's generational to them and toeveryone around.
So, oh, my goodness, I didn'texpect this to be this cool.
I didn't, so donate.
So a challenge out there forpeople.
We have some regular listenersI know they're business guys but
(51:53):
botagirlsorg, and it's easythere to donate, and for $5,000,
you can.
Speaker 4 (52:01):
You can impact not just one person, literally
thousands of people in this onedonation.
Speaker 1 (52:08):
Well, this has been amazing.
I don't even know how to endthis.
Like what's next?
Your practice is going well.
People can reach you there ifthey need anything.
Speaker 4 (52:18):
Yes, and that's been transformational, I think, um
figuring out.
You know, once you leave thisbig 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 thataren't lost in this morass of
bureaucracy.
(52:38):
And so we're just trying toconnect our doctors to our
patients.
Just us, it's just us.
Speaker 1 (52:46):
This has been awesome .
Thank you so much for coming on.
Speaker 4 (52:48):
Thank you for having me.
Speaker 1 (52:49):
This is great and just I want to extend our
support, anything we can do tohelp you.
We're all in.
This is changing.
This is great.
Appreciate all you do for thecommunity and for the world at
large, because I was thinkingabout your grandma, man.
She's got to be so dang proudof you.
(53:11):
It's cool.
Well, thanks for coming on.
Speaker 4 (53:15):
Thank you so much.
Speaker 1 (53:16):
Thanks everybody.
Today on the Ever Onward podcast, we have Dr Riana
Menon.
She's an unbelievable breastcancer surgeon here in the
Treasure Valley.
She's got an incredibletraining pedigree, most recently
at MD Anderson before cominghere, has now just started her
private practice.
It's going to be exciting totalk to her about what motivates
her and all the great workshe's doing, and then finally
(00:21):
we'll get to what she's doinginternationally.
She's a board member of TIBAand then she started Boda Girls,
which is an unbelievableorganization in Kenya doing so
much good.
I know you will enjoy this, drRihanna Menon.
Prior to Rihanna, we will hearfrom the guys Mark Cleverley and
Holt Haga, who will be talkingabout our incredible downtown
project.
Speaker 2 (00:42):
Good morning everyone .
We're here with anotherAllQuist update.
I'm Mark Cleverley withAllquist Holt, Haga, VP of
leasing Allquist Development.
So we haven't talked about itfor a while and there's been a
lot of changes and things goingon and thought we'd talk about
4th and Idaho, the ICCU towerthat's going up downtown right
(01:02):
now.
It's been a project obviouslywe've been working on for a
while.
Steel's going up.
We're actually having a toppingoff ceremony here in May with
steel, so exciting stuff coming.
So I wanted to hit on that.
And, just to start us, we justgot a lease signed with Kiln,
(01:24):
their second location in theValley Amazing group.
I know a lot of people knowabout Kiln out here at Eagle
View Landing but they're taking30,000 square feet of the
building.
Yeah, huge win, Huge win for us.
So really, we're down to threefloors in a seven-story building
.
We're down to 60,000 squarefeet out of 140.
(01:45):
And so walk us through kind ofwhat our thought process has
been on these last three floorsover the last few months.
Speaker 3 (01:53):
Well, you know it's a huge win and I think initially
when we, you know, developed theproject and sort of you know,
planned the project, it's all itwas office, right, that whole
13 story tower, 140,000 squarefeet, the top seven floors, all
office, class A office.
And I think we've, we've donethat, obviously with the top,
you know four floors.
(02:13):
You know kiln taking, takingdown 30,000, you know square
feet was was incredible.
They took all of 11 and half of10.
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 thenthe remaining three floors to to
(02:34):
your point, is you know what,what do we?
What's the highest and best usefor those three floors?
And we could, we, you know it'seither office, was kind of what
we had planned, yep, but as welook at it we've sort of pivoted
, right, yeah, and I think youknow what we're going to deliver
is, you know, class A medicaloffice space.
(02:54):
So this is sort of the firstannouncement that we're making
on this project, really, as weroll out our marketing and sort
of pivot a little bit.
But it's become clear and themore that we talk with with
groups in the market and kind ofget a pulse on the market for
the delivery.
Medical is is just it's it'sunderserved in that area
especially.
You know two, two main factors.
(03:16):
Number one is the productthat's there right now.
It's it's old, it's a lot ofit's historic kind of old, it's
old residential homes convertedinto commercial spaces.
Yeah, Right, and so and so ifyou're an independent medical
group looking for, you know,space, and in the downtown
market and the downtown corridornear the St Luke's expansion,
(03:36):
you know your options are reallythese tired, old, uh, you know
homes that are you're verylimited 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 buythis, this new office building
and convert it to to my medicaloffice, you know office, it's
(03:57):
just, it's, it's that cost plus,you know, sometimes double.
So it's it's very, very costprohibitive to do that.
So one of the key drivers isthe existing product.
The second, of course, is StLuke's expansion, which is over
a billion dollars now, you know,set to deliver in, you know,
2029.
So the last three floors thatwe're going to do are going to
(04:19):
be premium medical space andwe're doing a few things to sort
of tailor to that.
You know one of the thingsobviously we've got a ton of
parking, so access is as good asyou can get, which, for medical
, is critical.
Yeah, we're also rolling out avalet parking program which
looks like it's going to beactually in the garage, in the
(04:41):
nested garage that we've got atthe project.
So a variety of things thatjust make it just an incredible,
you know, medical office playor medical office product, and
so I think we're definitelyexcited about it when we first
planned Fortson, idaho, youremember this, we had two towers
.
Speaker 2 (04:59):
One of them was a medical tower and one of them
was an office tower, and goingthrough design review with the
city and what they wanted, Imean we switched.
Uh, basically had to switch anddo one tower of just commercial
and one tower residential,which was fine, but we always
knew that medical was a was likea key component for this area,
right, I mean?
(05:19):
you're a block away from thelargest hospital in the Valley,
right I mean, from next to StLuke's and for years you go
downtown and users, medicalusers, they can't find space
down there.
We fought it with a user whenwe were a gardener company.
We were working with a clinicthat we could not find space for
(05:44):
down there, right I mean, andit took us.
It actually took us a coupleyears to figure out where to put
them Because there was just no,there was no options.
Speaker 3 (05:52):
Yeah, it had to be a separate, standalone ground-up
development, new constructionAbsolutely.
Speaker 2 (05:57):
Project.
Yeah, so this, like you said,because of the outreach to us
and people saying, hey, whatabout, like I'm a medical user,
do you guys have space for medown there?
We have.
Yeah, we shifted to those lastthree floors so we'll still have
the office up on the top four.
Iccu will take the top two andthen we'll, you know, kiln and a
(06:19):
couple others.
But, yeah, medical and it'sgoing to be, it'll be great.
We're excited right to get themedical going.
We've already got groups thatare submitting LOIs on the
floors that we have there.
So it's going to be it's goingto be awesome.
Speaker 3 (06:36):
We're super excited.
Yeah, I think to that point.
If you're, you know, anindependent medical group, for
example, looking for anywherefrom you know 2,500 to you know
even 30, 40,000 square feet, um,this is a trophy project.
Uh, that is, you know, adjacentto downtown and St Luke's.
(06:56):
That that you know is is goingto be a great option.
Yep, yeah, love it, came in.
Speaker 2 (07:00):
Good job good job.
Speaker 1 (07:10):
Dr Menon, thank you for coming on.
These are always so interesting.
We met in the hall coming inhere, but sometimes I have
people on here that I've justknown 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 gotto talk to her, you've got to
(07:31):
hear her story, you got to.
So I'm really excited.
I feel like I know you alreadyjust because of so many friends
or people that we've had on havebrought your name up.
So thank you for coming ontoday.
Speaker 4 (07:40):
Thank you for having me.
I was going through your listof podcasts and listening to so
many amazing guests that you'vehad on and I am honored to be on
this list.
Speaker 1 (07:48):
We're honored to have you here.
It's fun for me to have peoplein healthcare because then I
immediately want to talk alittle bit about some of the
healthcare stuff.
But with your background it'sthis going to be a fascinating
trip.
But are you okay just maybetelling a little bit about your
story, sure, and kind of just alittle bit about you, your bio,
for people to get to know you alittle bit better before you
(08:09):
started?
Speaker 4 (08:11):
So I grew up in Southern California and my
father is an immigrant fromIndia, and so he told us our
whole lives, the way you guyslive is not the way the rest of
the world lives, and so I kindof always had this perspective
about how lucky we were to livein this country where we had so
(08:32):
many opportunities, and so Ihave gravitated towards health
care my whole life, and one ofthe things that really really
brought me into health care wasthe idea that I could use skills
that are portable and workinternationally, and I traveled
to India to meet my family whenI was young Maybe my first time
was very young and then I spenta prolonged amount of time, kind
(08:53):
of as an 11 or 12 year old,where you're just about to be
this American teenager andseeing how the world is not like
Orange County, california orBoise, idaho is transformational
at a young age.
And so I kind of always knew Iwanted to be in medicine.
(09:14):
I always knew I wanted to be asurgeon, and so as I went
through medical school, I wentto medical school.
Speaker 1 (09:19):
What was your inspiration for that?
Speaker 4 (09:20):
I don't really.
Speaker 1 (09:23):
I just knew that.
Was there family members oranyone that did, I'm the first
one, okay.
Speaker 4 (09:26):
But I like to fix a problem.
You can probably relate to thisas an ER doctor, but surgery in
particular is you have aproblem and you fix it.
And I'm pretty cool underpressure, and so I really liked
being the one who you knowthings are falling apart and you
kind of pick up pieces and staycalm and are a voice of reason
(09:46):
in the room, and so I kind ofnaturally gravitated towards
kind of those more emergencysituations.
Speaker 1 (09:57):
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 guysthat take no.
I mean it's a very dominantkind of thing, very much so.
(10:18):
Very much so.
So it is interesting for methat you chose it and knew it
early and then just plowedthrough it, because there's
probably a lot of barriers andhurdles you had to overcome.
Speaker 4 (10:28):
Very much so.
I was blessed to be in a familythat was just.
My grandmother was my mostardent supporter.
I never once thought there wassomething I couldn't do.
That's awesome do.
And so you know why not go forthe hardest thing, why not be
(10:49):
the the the loudest voice, orwhy not?
Why not do anything you couldwant to do?
Um, because that's what she hadalways done, and I have this
amazing network of really strongwomen in my family.
But, um, but that was.
I never felt that internalbarrier.
She just passed away.
It's two weeks ago.
this sorry, two years ago thisweek and she was my, just my
(11:10):
most important person my wholelife, and so I feel her with me
all the time.
Speaker 1 (11:15):
What made her?
Because I've got my own kind oflike.
I had a grandpa that I alwaystalk about but what for you?
What made it so special andwhat?
What were the qualities ofsomeone like that as a mentor
that that were so important toyou?
Because I think I think, as wehave those experiences,
(11:35):
especially as leaders now liketalking to people I think
sometimes we don't realize theimpact you can have on someone.
But but what were her?
What were her qualities?
What are the things you thinkback that are her kind of legacy
, things that inspired you?
Speaker 4 (11:49):
Thank you for asking this because you know you lose a
grandparent and everybody losesa grandparent.
You know it's just supposed tobe part of life, but she was so
important to me and so I justlove talking about her.
She was one of the most quietlystrong people and sometimes not
so quietly strong, but just aforce, like it was never an
(12:09):
excuse that you're too busy ortoo tired or too.
You just do it, and she wouldeven say to me you're the
strongest one, so you have to doit all the time.
You have to pick up the and youbelieved her.
I believed her to my core and Istill believe her right.
If you have the ability, if youhave the energy, if you have
(12:30):
the know-how, that's your job todo it.
You pick up where other peoplecan't and you don't.
Actually, she was so kind andloving to everyone around her.
She was just so accepting, likefaults and all of anyone,
because she felt like she hadthe bandwidth to pick up where
they left off and I think shewas the most all-encompassing,
(12:52):
just.
She was beautiful, she washilarious, she was I mean, she
died at almost 90 and stillowned her own business and went
to work every day and she justwas one of those people.
That was you, couldn't I?
Speaker 1 (13:06):
couldn't imagine what was her story.
Did she, what was her lifeexperience?
Speaker 4 (13:11):
So she grew up in Portland Maine.
She was the child of twoimmigrants, a Syrian immigrant
and an Irish immigrant.
Her father died very when shewas very young, at eight in a um
.
He was a train foreman and diedin a train accident.
And then I think she kind ofhad to pick up and be the strong
person in her family.
She had a younger brother who'sstill alive and her mother kind
(13:35):
of worked as a cleaner inhouses.
She would say she worked forrich people so she knew all the
beautiful things that she wanted.
So I remember as a little girlI would polish the silver with
her and iron napkins and foldthem and even if you didn't have
a lot of money you hadbeautiful things around you and
(13:58):
it was important to her and sojust to kind of be put together.
And then she wanted to leavePortland Maine.
She became a flight attendantin um the fifties and met my
grandfather, actually on aflight from Chicago to
California and the rest washistory Wow.
Speaker 1 (14:15):
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 youbut, like, I think back to my
cause.
I I think back to my, becauseI've actually thought about this
a lot.
I'm like, why was mygrandfather so impactful on me
and am I being impactful on mykids and my grandkids?
(14:36):
And I do think it's busier now.
There's more noise now and Ithink about the times that I was
with him.
It was quiet and I always saythis and I don't know if it
makes sense to you, but I havevivid memories of him talking to
me because when he talked to meI could feel it.
It just wasn't like words andI'm wondering if it was because
it was quieter.
(14:56):
So I'm trying to be intentionalabout like with my grandkids
now creating times and it maysound artificial a little bit,
but I want to get those boysaway where we're quiet and I can
talk to them and tell themthey're wonderful and they hear
it and I'm not.
They're not distracted, I don'tknow.
I just worry about it's busynow.
(15:17):
It's just like I don't know.
You feel that way ever.
Speaker 4 (15:20):
I feel like that all the time, and I think you're
exactly right about thatquietness, because when, when I
was with my grandmother and Iwas the first grandchild of 13
grandkids and so I was a lotolder than everybody else, so I
had this beautiful time of justus, 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 fabricstore and we'd go to the paint
(15:43):
store and we'd go to, and itdidn't matter what we were doing
, it was just the two of us.
And that you're right it thatquiet time, that that if when
you're with her, you're the onlything that matters.
Speaker 1 (15:54):
Yeah.
Speaker 4 (15:55):
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, evenamongst the noise, to have that
human connection.
Speaker 1 (16:07):
I think there's a lot to learn from that.
Sorry, I interrupted you, soyou're the oldest, so she had to
be tremendously proud of you,like over the moon.
Speaker 4 (16:15):
I know that, because now you go through this.
Speaker 1 (16:17):
You're like I'm going to become a surgeon and then
tell us about your education.
Speaker 4 (16:23):
So I did my medical school in San Diego.
That wasn't too far from home.
I have a little sister who's 14years younger than me, and I
had gone to the East Coast forcollege 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
(16:44):
this place.
So he found me in San Diego andbrought me back here.
I did my residency in SanFrancisco and did two years of
bench cancer research too.
So that was, you know, sevenyears of surgical training.
And then through that wholetime I met another really
important mentor when I was inresidency, who Dr Das, who just
(17:06):
passed away last year but wasone of those people that I
really tried to model the restof my career off of.
He did international work threeor four times a year.
He's originally from India, soI traveled with him to India.
He did clinics in Mexico.
He set up girls' schools inNepal, in India, in South
America as many as you canimagine.
(17:28):
Just one of those people whotruly believed in the
transformation, of empoweringyoung girls and women and what
that does to a society Wow, andhis foundations have continued
to persist.
He was actually a urologist andone of the most ardent
humanitarians that I have evercome in contact with, and so it
(17:48):
really inspired me to show mehow I could do that work and
still be a busy practicingsurgeon.
And then, when I finishedresidency, I did a fellowship at
MD Anderson in Houston, texas,for breast oncology and it was
one of those things where I gotto kind of the pinnacle of
(18:08):
academic cancer medicine and Iwas offered a faculty position
there and I went.
I don't think I want to do thishere, because in Houston and I
feel very passionately aboutaccess to medicine for everyone
I want everyone to be able tohave this high, high quality
care, and we know that that'snot always possible.
(18:29):
And so in Houston there were ahundred amazing breast surgeons
In Idaho, there was just one inthe whole state and she's still
here and she's fantastic, butshe can't do it all her own by
herself.
And so we had decided you knowwe had two little boys at that
time, we had been through a lotof training, my husband's family
was here, we needed the support, so we moved back here and I
(18:51):
thought you know I was thesecond breast surgeon in the
whole state and I thought I wantto be bringing MD Anderson
quality care to Idaho, not wherethere's 100 people who can you
know go anywhere Idaho, notwhere there's a hundred people
who can you know go anywhere.
Speaker 1 (19:04):
Well, thank heavens, a boy from Boise married you
because I mean, when I looked atyour, I mean I'm not.
I looked at your resume and I'mlike I can't wait to hear how,
because the pathway could haveshould have bench, bench
research.
You look at your pedigree oftraining and you're at MD
Anderson.
I'm sure it would have beenvery easy, um and and
(19:27):
prestigious to stay there and beat 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 (19:38):
I can't believe how time has really flown and I'm
really proud of the work thatI've done here.
I think that I did a lot of whatI came to do because when I
first got here there was, like Isaid, one breast surgeon in one
whole hospital system.
I was the first one in my wholehospital system that had the
(19:58):
catchment area of all of Idahoplus Eastern Oregon, eastern
Washington, northern Nevada, wewould get Wyoming, we would get
Wyoming, we would get Alaska.
I mean really a huge catchmentarea and there was no
comprehensive breast program,there were no employed plastic
surgeons.
So when I first got here, youknow, I said, well, why aren't
(20:19):
we doing immediatereconstruction for women who've
had a mastectomy?
Why don't they go home withtheir implants?
Why aren't we doing a morecomprehensive cancer care?
And so by the time I left,which was just about 18 months
ago, we had the biggest breastprogram in the whole state, five
or six plastic surgeons, fiveor six surgeons, um, so really
(20:41):
had elevated what breast cancercare looked like for the entire
state.
So really proud of the work wedid there and really shined a
light on how important this is,but had a lot of barriers too.
Speaker 1 (20:56):
Well, your reputation .
It's been incredible and theimpact you've had.
I mean, you're talked abouteverywhere, so it's cool to have
you on Talk about.
Uh, there's so many things I'mgoing to get into with you,
cause I'm sitting here listeningand thinking of questions.
But, um, you go into, you gointo into surgery.
(21:16):
Then you choose, um, cancersurgery, you go get trained and
and that I mean you're kind ofpicking the very most technical
right.
And then also anythingassociated with cancer and
treatment and surgery is justhard, um, and and you get to, I
think, the best part of medicine.
So, as you know, I kind ofstopped practicing.
(21:37):
I loved it.
I loved it.
I mean, business is greatbecause I tell people all the
time they're like, why would youleave?
And I'm like, well, Ireluctantly left because I
didn't want to leave.
But when you get in businessthe professional satisfaction of
working with otherprofessionals people are happy.
And I will tell you this inhealth care it's hard because a
(22:01):
lot of people aren't happy, andI know that.
That I don't want to, thatdoesn't sound.
It's just.
People are tired, they're youknow with with all the changes
that have come in documentationand the way people are paid and
the way the system works and theclunkiness of it, it there, it
lead, it tends to lead, tofatigue that has nothing to do
with patient care, and unlessyou're in it you don't really
(22:22):
realize that this isn't aboutpatient care.
So I'm getting this is a long,rambling statement to get to a
couple of questions.
For me, though, when I think ofmy memories, it is the patients
, and I trained in Arizona andthen came here.
But the patients in Idaho arewonderful this area.
And I trained in Arizona andthen came here.
But the patients in Idaho arewonderful this area they're just
(22:44):
kind and wonderful Talk aboutand like I'm the Neanderthal ER
guy right, is it bone broken, isit bleeding, whatever?
But you have the ability tomake this connection with people
over a period of time whenthey're dealing with the
scariest thing that you everhear in your life is you have
(23:04):
cancer your hardest day.
Talk about how wonderful it isto be part of that with patients
.
Speaker 4 (23:09):
I think you did the perfect intro because we hear so
much about burnout, we hear somuch about these other factors
and it is hard to be just adoctor 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 careeror your life, it is those
personal connections, it's thatquiet moment and I think you
(23:31):
alluded to it earlier.
How do we have human connection?
It's in these quiet moments.
So kind of the best and mostgratifying part about my job is
to meet people on their firstday where they are terrified.
They think 100% of the timethey think they're going to die
and then, even if I know, I lookat it and I go we're going to
do great.
Or wow, we've got a big journeyahead, but you're still going
(23:54):
to do great.
And that's what I like aboutbreast cancer in particular is
because it's such a hopefulfield.
I kind of always say the besttime to get breast cancer is now
.
Better time would be in fiveyears or 10 years because it
changes so quickly.
But to be able to sit down in avery logical way, whether
you're an engineer or a farmer.
(24:14):
I can explain it to you in away 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 toyour career, get you back to
your life.
It won't ever be totally thesame.
I don't mean to minimize it,but this is how I can sit with
(24:35):
you.
I can look you in the eye.
Speaker 1 (24:44):
I can sit here with your family and just know that
we can connect and get you to aplace where you leave much more
relieved, much happier, and Ithink for you.
I'm sitting here thinkingbecause for us, when I was in
the ER for all those years, youwould have certainly I mean
that's where people die is inthe ER.
So you would have very sadthings.
That happen all the time.
But you have a regularoccurrence where you have people
that have been told they havecancer many times young people
that for the first time areprobably like questioning their
(25:06):
mortality, which, becauseusually you go through life and
we take you know, we take forgranted much of where we live,
what we have.
You brought that up with withyour experience internationally,
and then you take for grantedyour health.
I mean, it's just, you can'thelp.
Most of the time you're healthyand it's easy, and all of a
sudden someone says you havecancer.
You're like your mind andthat's the first time they're
(25:29):
coming to you hopeless, right ofwhat's going to happen.
And that happens over and overand over again.
Speaker 4 (25:38):
And it can be very overwhelming.
And so one of the reasons Iwent into private practice about
18 months ago and one of thebiggest reasons was because that
period of waiting was gettingreally out of control.
So it was from biopsy that youknow someone gives you a call
and says you have cancer.
(25:59):
To see me for the first timeand I'm the first practitioner
you see was 46 days.
Biopsy to surgery was 80 days.
Speaker 1 (26:07):
That's tough.
Speaker 4 (26:07):
And it was so stressful Because the first
thing you have to do is spendabout 15 minutes de-escalating
the frank trauma that you've hadfor thinking that you're going
to die, and not only that, youhave a cancer that's growing and
changing inside you and Ialways say this is my, it's my
biggest, best piece of advicewhen you have cancer.
The internet is only for catvideos.
That's it Do not look atanything else, because about 99%
(26:32):
of things don't apply to youbut they will scare you.
And so our biggest change andmy biggest stress was I just
need to get more and more andmore and more and more people in
, and then you lose thatconnection because you're so
overwhelmed.
I was coming in, we wereputting in one patient before
our template, going over lunchand seeing a patient staying one
(26:53):
day later and my amazing nurseand I were just drowning and we
couldn't bring our best selvesevery time because and then
every day off, I would justoperate 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.
You just can't, you can't go onthat way, and I'm I'm I would
(27:13):
say it's, like you know 10 yearsinto my career, but I'm not old
enough that I can do that formuch longer.
And so I made a big change andit was terrifying, but we
routinely um, I work with one ofyour tenants here, lyra Total
Breast Health, and we we getpatients in.
She calls me and says there's acancer coming and I say, okay,
(27:35):
we saved a spot for next week.
And so that time of anxiety hashas been broken down to a week,
10 days, two weeks into surgerywithin 30 days, and that gives
me I can breathe easy.
Speaker 1 (27:49):
Talk about the autonomy and control a little
bit, because I I mean, I'm wayolder than you, so you know you
go back to when I started inthis thing and and then the
evolution, like literally duringmy time and and listen, there
were some wonderful things aboutthe affordable care act and and
then there was the bureaucraticlayers of stuff that have
(28:11):
happened with.
You can pick anything inhealthcare, like between like
you had patient and doctor atsome point but you can pick
pharmacy and PBMs.
You can pick insurancecompanies and interbattle.
You can pick.
You pick regulations that likeI'm sure some of them made sense
, but just piles of regulationsand and and you know the legal
(28:33):
side of things it gets.
That's the part that gets justfatiguing.
I think, no matter you pick,you pick the specialty across
medicine and people are justlike 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 takecontrol, because at some point,
like you think of the trainingand time and effort that it
(28:55):
takes you to get to there, andthen I think one of the things
you said that really hit homewith me is like you're human.
Speaker 4 (29:03):
We're just people.
Speaker 1 (29:05):
People.
You have your kids and you haveyour life and you have your
family and you have so muchenergy and love and compassion,
and then you take care of people.
You need all that, and thenthere's this thing, which is
like the administrative side oflife, 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.
(29:25):
You can limit your sleep asmuch as you can, and I we tried
that for years.
I used to say sleep's overrated.
I said that till I startedhaving all my heart problems.
I'm like ah, I was wrong, don'tlisten to me anymore.
But but you at some point.
So I'm glad.
So it's settling out reallywell for you.
Speaker 4 (29:40):
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 thatI'm so proud of.
And I know, and I have my cutelittle clinic.
It has flowers and chandeliersand and art and you call and
someone answers a real personanswers and you can get to us.
Speaker 1 (30:03):
Hey, while we're doing this, because there's a
lot of people on YouTube, howcan people reach you while we're
yeah?
Speaker 4 (30:09):
I'm Mountain State Breast and General Surgery.
Google my name and you can getin to see me.
Speaker 1 (30:16):
We're going to pull it up Mountain.
Speaker 4 (30:17):
State Breast and General Surgery Breast and
general surgery Breast andgeneral surgery.
Speaker 1 (30:20):
It's been a year and a half.
Speaker 4 (30:21):
It's been a year and a half.
I have a wonderful partner, drKerry Newton, who came from
Seltzer, and we just have youknow.
You can tell by our website.
We are interested in who youare.
We talk a lot about lifestyle.
We talk about cancer prevention.
Speaker 1 (30:35):
I love that tagline right from the beginning.
Back up a little bit, Maddie.
Our priority is personalizedwhole person care.
Speaker 4 (30:42):
Yeah, so when you walk in and we do general
surgery and we do a lot oflifestyle counseling and you
know, maybe you have a herniaand maybe you're not ready for
repair right now because we haveto work on a few things, but
we'll work with you and get youthere, and so these are the
things that are so gratifying.
As a doctor, I get all the timeI want with you.
(31:03):
I can say you know, you havethis tumor.
We're going to talk just aboutthis.
We're going to talk about theperson who's you know around
this tumor as well, and talkabout how my favorite analogy is
when you're talking about atumor, it's like saying or
cancer, it's like saying youhave a pet.
It could be a pet goldfish, itcould be a pet dragon.
That's how different they are.
(31:23):
Obviously, if you have a dragon, we're not going to use
goldfish medicine, but we willslay your dragon.
If you have a goldfish, don'teven worry.
We don't have to do any of thatdragon stuff.
And so just breaking down in avery expert way gives people
this confidence that it's notjust oh, oh, nobody knows what
to do.
This is unknowable.
(31:44):
No, I can get you through this,that's awesome.
Speaker 1 (31:48):
I want to shift to your international work, but
before we do, I think it wouldbe, I think, for people
listening because our storieswere said.
I'm so glad I listened to yourpodcast because what is the
advice you would give tofamilies listening to this
podcast?
Out there, with breast cancerdetection, early diagnosis, what
are some things that everyoneshould know?
Speaker 4 (32:09):
So everyone should know that mammograms are safe
and they are the way that wecatch breast cancer early.
So unfortunately in Idaho we'rekind of 50th in screening 50th
50th Holy.
Speaker 1 (32:19):
Why do we always have to be 50th in everything?
Speaker 4 (32:22):
And that means that one in three new breast cancer
diagnosis is advanced stage, andso we can catch this early.
And I know there's so much feararound cancer.
But what I promise is I don'tcare what we find, I have a good
plan for it, and the earlier wecatch it, the better.
We have a chance to catch it.
We're really 50th 50th darn itand Dr White of Lyra and
(32:47):
Representative Brooke Green andmyself just were able to help
pass a bill that the governorsigned just two weeks ago that
pays for coverage for allhigh-risk breast cancer
screening.
Pays for coverage for allhigh-risk breast cancer
screening, and so, whereas womenwere paying like $4,000 out of
pocket, that this went to yourdeductible, but it wasn't just a
covered service.
Now, if you're considered athigh risk for breast cancer, if
(33:11):
you have high-density breasts,we have a lot of other great
options for you.
Speaker 1 (33:17):
Let me ask you some questions on that.
Like, you're high-risk, youhave high density, you know.
You know that.
Um what?
What should a mammogram cost?
What's the true cost of amammogram?
Speaker 4 (33:27):
Oh well, so it's most most people are charged covers
right Most coverage, If you haveinsurance, 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 ofpocket if you have nothing.
But high-risk screening can bepretty darn expensive.
It can be $500 to $3,000 for anMRI.
(33:50):
And those are out of pocket.
It can be for a diagnosticmammogram $800.
But we're working with moreaffordable and more indifferent
options in the community.
Dr White has opened imagingcenters that make it really
accessible and because she hasthese new other modalities,
everyone else has followed suit.
Speaker 1 (34:11):
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 (34:15):
It's easier, there's more options, there's more
affordability and it's nowcovered.
So there's really what I wouldsay to people is don't be afraid
, get out there.
Mammograms are very safe andthey are the way that we are
detecting breast cancer, andthat, I think, segues nicely to
this international work that I'mdoing because the programs I've
set up in Idaho.
(34:35):
I'm trying to do the same thingin Kenya.
Speaker 1 (34:38):
All right, let's go there now, because I think what
I mean like you're superappreciated, famous here for the
work you've done traditionalhealth care.
You've really I mean, you'vereally revolutionized breast
care in Idaho in a short periodof time and it's an honor to
have you on and talk about that.
(34:59):
Now let's talk about yourinternational work.
So you were inspired by thismentor of yours.
Very much so Dr Das, so Dr Dasand 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 gotso much going on.
I really want to understand howyou're like hey, not only am I
going to do this, I've got afamily, I've got my career, I've
(35:19):
got my practice, but youprioritized this international
care.
That's not easy.
Speaker 4 (35:25):
It's not, and I think when you're, when you're young.
So I did you know, four yearsof college four years of medical
school, seven years ofresidency and a one-year
fellowship.
So you're at the end of this andyou're like I got to get a job.
So, as I was moving to Idaho in2016, one of my mentors reached
out who had been going to theSerian Kenya through the Teba
(35:46):
Foundation for a long time andhe said do you want to come with
me?
I said, yes, I want.
This is perfect.
I have a three, three monthsoff for the first time in my
life.
This is perfect.
I'll go with you to Kenya.
And the Teva Foundation is a USfundraising arm for some of
these projects in Kenya thatpartners and this is what's
really unique, is it partnerswith the Kenyan organizations,
(36:08):
and so it's never just us flyingin 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 aweek of operating and just kind
of, whatever walks in, you doanything, you get really
creative.
And so I always laugh when I'mhere 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.
(36:29):
And so I really got the bugbecause talk about it's like the
antidote to there's.
There's no EMR.
You're not calling an insurancecompany.
You're not, um, waiting in line, you're, you're.
You are in a room with a personand takes it back to the basics
right.
So gratifying.
And so I did that once and Igot the bug.
And every year since 2016, Ihave gone to Kenya for about a
(36:53):
year with the Teba Foundation.
I then joined their board andthen last year I became their
vice president.
So I'm in all in and that kindof it's like cleaning your
filter.
Every year.
It reminds me of the joy ofmedicine and, you know, our
society puts a big investmentinto making a surgeon.
(37:14):
You know, you saw all thoseyears.
You know I got, I got grants togo to school, I got loans to
get into medical school.
I uh, you know Medicare paysfor residency, so there's a it's
.
And then, of course, my familyand people around me my husband,
my kids, everybody has put alot of time into allowing me to
become a very specializedsurgeon, and I have this
portable skill and it'swonderful.
(37:35):
So, you know, having a fatherthat grew up in India, I feel
strongly that I have skills thatneed to be shared, and so I go
to Kenya and for an area ofabout 5 million people, there
are zero of the specialists forme, and so I love being able to
show up and say you know, tellme what you need the other best
part about doing that andpartnering with the same
(37:57):
hospital all the time is you'renever I know where those
patients went, so when I leave Ileave them with my family
medicine colleagues and thenurses there.
Speaker 1 (38:07):
And so they get full handoff.
Speaker 4 (38:08):
They're there all the time.
They WhatsApp me all year longand say, oh, I got this scan.
Is this good for your next trip?
Is this good?
What do you think about thisfollow-up?
So it's kind of the opposite ofjust flying in and doing
something.
It's really a partnership thatis long-term.
And then I have to mention in2019, we went and a friend of
(38:31):
mine gave me, donated a bunch ofDays for Girls, sustainable
menstrual hygiene kits and Iknow you had the founder of Salt
on.
And so you know about thisperiod, poverty and how, really
across the world, girls don'tstay in school because they
don't have access to menstrualhygiene, and so, within the
Treasure Valley, we have thisreally strong relationship with
(38:52):
this company called Days forGirls as a nonprofit, and there
are hundreds of women just inthe Treasure Valley who sew
these menstrual hygiene kitsthat are sustainable, reusable
lasts about five years.
So my friend donated 200 ofthese kits, which is a huge
donation, about $15 a piece.
So she really gave me a big legup and I took these two young
women with me a junior in highschool and a senior at Boise, at
(39:16):
BSU and they went and taughthow to do these and it's it's
paired with sustainablemenstrual hygiene kit, um, and
and paired with just basicbiology.
This is a uterus.
There's no ovary, this is how ababy's made.
And it was so powerful.
And then these girls within fourdays all 200 were gone.
(39:36):
They were busing them to thehospital and then, at the end of
one of these days, two girlsget on the back of a motorcycle
taxi called Potobotas, drove offand the principal was standing
right there and she said, oh mygosh, this is so dangerous.
You know, these girls are sovulnerable.
(39:57):
They're taken to a field theynever may get home.
They're really vulnerable.
And so that really sparkedsomething.
Um, and we became theco-founders of something called
Boda Girls, which are motorcyclewomen, run motorcycle taxi
service.
They drive pink motorcycles,they go to the schools, they
teach menstrual hygiene, theytake girls to and from school.
So it's women driving girls.
They bring women to thehospital.
(40:19):
They do about a hundreddeliveries a year, a month in
the hospital, whereas beforethey weren't, you know, on the
road or really high maternalfetal death rates in this area.
These babies are getting earlychildhood care, they're getting
vaccinated, they do kitchengardens, so they send them home
(40:41):
with nutrition.
Speaker 1 (40:42):
Oh my goodness, it's the biggest wraparound.
Is there a?
Speaker 4 (40:44):
way to look this up, please.
It's called bodagirlsorg,bodagirlsorg, b-o-d-a
bodagirlsorg, and so not onlyare these women, they were
subsistence farmers.
We know about these women.
We started with 12.
And actually one of our hugefunders has been Red Aspen, who
you had on.
Speaker 2 (41:01):
Oh, that's cool.
Speaker 4 (41:02):
And they partnered.
They give us significant moneyand help us buy these pink
motorcycles.
Red Aspen donated money forportable ultrasounds so they
send the ultrasoundtechnologists into the villages
and then they know if they havea high risk pregnancy, they know
if they have twins, they knowwhen they're going to deliver
and say okay, when you're ready,you call this Boda girl and
(41:23):
you'll get delivered at thehospital.
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 onlydo we have these women, okay,
so they were subsistence farmersmaking $1 a day.
It's a dollar, truly a dollar aday, and they're raising
children and their children arehungry.
(41:43):
These Boda Girls now make $10 aday.
They are so it's not justdriving.
They get this wraparound.
They have to do 10 certificates.
They do self-defense,self-esteem mentorship.
They learn about computerliteracy so they can market
themselves.
They have app-basedentrepreneurship, they do the
Days for Girls curriculum, theydo gender-based violence and now
(42:08):
what we're trying to add on isa breast cancer component.
So that's currently what we'reworking on this year and what
we're fundraising for.
There are, for an area of 5million people, there are zero
mammograms zero and so we'reworking on fundraising for a
mobile mammogram unit.
And then we're teaching theBoda girls how to, because
(42:29):
there's a lot of fear andthere's a lot of stigma, and I
will say that a pretty perfectoverlap to the work I've done in
Idaho has been in Kenya, andit's not and here it's not even
because of resources.
It's around trust, it's aroundfear of cancer, it's around you
know awareness, around screening.
(42:50):
I'm basically doing the samework that I did here, there and
it makes it so I'm always socareful not to come in and go.
Well, I'm a US doctor and I'mtelling you this I go.
These are the problems I had inmy own community and I'd love
to teach you and help to shapethese programs, because I just
did this.
Speaker 1 (43:08):
I'm just listen.
I'm kind of blown away becauseI'm sitting here thinking like
the impact of transportation ina safe way with someone that you
trust in a community where thatdoesn't exist.
How impactful and when and howit started, so authentically in
the impact it's making.
Wow.
Speaker 4 (43:28):
It's incredible and and we started with.
And so just those 12 firstwomen had 43 kids between them,
so they went from being inabject poverty.
They weren't able to go toschool, they didn't have shoes
to go to school, they didn'thave books, they didn't have
healthcare, they didn't haveenough to eat.
All 43 of those children, justin the first year and that was
(43:48):
in 2022 are now middle-classovernight.
All of those women are mentorsthe first year and that was in
2022, are now middle classovernight.
All of those women are mentorsin their community.
They are heroes in theircommunity.
And that has now we're up to 40Boda Girls, and now we are
launching in a separate site.
Speaker 1 (44:09):
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 maybe listening to this?
So go to your, go to yourwebsite, obviously, so yeah, so
boatagirlsorg um is it?
Speaker 4 (44:19):
and what I can say is we know.
So the Teba foundation has oneemployee, our executive director
so, and our board covers herentire salary.
So every dollar you donate goesdirectly to these programs.
And so I can say, and when Ihave, you know, I I'm always
hitting up my friends, right,and I say you don't, you're not
(44:39):
sending your money to Africa,quote, unquote.
I know where all these dollarsare 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 theregoes a long way.
Speaker 1 (44:51):
How much?
Just to put it in perspective,like one boda girl, what does
that cost?
Speaker 4 (44:55):
a year About $5,000 for the motorcycle, for her
training, for everything thatgoes into being we're donating.
Speaker 1 (45:03):
Thank you, yes, this is incredible and the impact.
Speaker 4 (45:08):
So not only does that , and then here's the really
exciting part.
So we're working.
We have all this data and we'reworking with banks, because,
within 18 months, every singleone of our 40 Votagirls have
purchased their own photos backand that's based on.
they offer free rides to thehospital and we set aside a
dollar for each one of thoserides, and so part of that
(45:32):
$5,000 subsidizes those ridesand so at the end of that 18
months she owns her ownmotorcycle.
And that is incredibly powerfulbecause most men don't, and the
men in the area are leasing forabout $3 a day and if they don't
pay back that lease they loseit, and so that's a precarious
(45:53):
place for a man to be.
But it's a really precariousplace for a woman to be, because
if she has a sick kid she can'tgo riding.
The peak times that most peopleare needing to get to work are
when she's got to get her kidsto school, when she has to go
get water, when she has to takecare of all of the
responsibilities she has as awoman.
(46:13):
So she's already behind theeight ball, and then it's going
to be really hard for her to payback that loan and they're kind
of predatory loans so they endup paying about three times more
for a motorcycle.
So after 18 months for her toown, her own bike is its own
source of income forever.
Speaker 1 (46:32):
Did your grandma know about all this stuff?
She did right.
Speaker 4 (46:35):
This was just taken off and she was so proud and,
and she was so proud of this.
And every time I would see aboater 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 (46:52):
I was just, I'm just sitting here thinking about what
you're saying, but I'm sureyou've heard the Tara Raya Trent
speak.
Um, and it's been years agosince I heard her first time in
person speak, but I remember hertalking about hunger and I was
in the audience and and she saidyou probably have a definition
of hunger, but you don'tunderstand true hunger.
(47:15):
And it was so impactful on mebecause she talked about these
women, in these situations thatthey're in and with children,
and the hunger to provide andthe hunger to improve the life
their own life and the lives oftheir children and their future
and their posterity.
And she's like that is truehunger.
And and as you're talking aboutthis, I just I'm I'm looking at
(47:39):
some of these pictures thinkinghow impactful this is and it's,
it's super inspiring.
How, how do you?
I mean, I got to ask how do youdo it all?
Speaker 4 (47:48):
It it, um, that's a great question.
It it, um, that's a greatquestion.
And and going, actually goinginto my private practice has
given me so much bandwidth thatI took back to.
Just these are things that fillme up.
I just feel so motivated.
Like gets you going.
The only way to do it is to doit, and then you just keep going
(48:10):
after that, and the amount ofgratitude like I said, if we
stopped at those 12 women, thatwould have been enough for me
right.
It was so impactful.
Those 12 women are incredibleand I see them every year and
they are heroes.
And if you look on our socialmedia on Boater Girls, you see
them.
You see their big smiles.
They went from kind of meek andwe had the data on them they
were.
Most of them had experiencedserious trauma.
(48:32):
Almost all of them were singlewomen.
All of them had children.
And when you talk about thathunger, the amount of grit and
resilience that is in thesewomen as an untapped possibility
that they're using all theirenergy just to survive, and then
you see what these smallinterventions do.
How do you stop?
(48:52):
You can't?
You just keep going?
And then you see the successesand you just keep going.
And so I've that, that presencethat we talked about.
I love being home with my boys.
They're actually coming with meto Kenya this year.
Speaker 2 (49:06):
I'm so excited they're 13 and 14.
Speaker 4 (49:08):
They're going to be watching all those motorcycles.
They're going to be going allthose motorcycles.
They're going to be going intothe fields.
They're going to be reading tochildren.
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
(49:29):
easy to kind of think ofabstractly people in Africa, but
when you see that these areyour friends, they're your
colleagues, they're yourcommunity, they're people just
like you, there's no betterlesson than that to see and
connect with a person in frontof you.
It's very hard to other peopleand I think you know that mostly
(49:51):
from the ER.
It's it's very hard to otherpeople and I think you know that
mostly from the ER like it'svery hard to hate people when
you see them up close and you'rein their most intimate times
and they're most scared orthey're most joyous or whatever
it is.
It's such.
There's such universal humanemotions.
Speaker 1 (50:05):
Yeah, and you think about I don't know.
You just think about the worldwe're in and there's so many
things that divide and tearpeople apart and it's so.
And then I know it's going tosound really weird, but like
yesterday I was going downtownto speak at the BOMA thing and I
stopped right by our buildings,pioneer Crossing, right where
(50:27):
you come off the freeway, wherethe 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 therewas a homeless guy there and,
for whatever reason, I sat for along time because there was a
lot of traffic at that light,just looking at him and I
thought he was young and Ithought that kid, that's
(50:47):
someone's son, and and I gotreally kind of super emotional
and I thought that's someone'skid right there and I thought
I'm late to this thing, but Iwish I don't know.
There's just I think we forget.
It's easy to put barriers upwhere we look at people and we
(51:09):
don't realize that that'ssomeone's kid and he's got a
story and somehow he's there andwhat happened and what happened
.
And you can't help everyone.
But, my gosh, we can getinvolved in good stuff and try
to give back.
I think my takeaway is for fivegrand.
I think of all the other thingswe do with money like $5,000,
(51:32):
the impact that would make on aperson.
It's exponential.
It's generational to them and toeveryone around.
So, oh, my goodness, I didn'texpect this to be this cool.
I didn't, so donate.
So a challenge out there forpeople.
We have some regular listenersI know they're business guys but
(51:53):
botagirlsorg, and it's easythere to donate, and for $5,000,
you can.
Speaker 4 (52:01):
You can impact not just one person, literally
thousands of people in this onedonation.
Speaker 1 (52:08):
Well, this has been amazing.
I don't even know how to endthis.
Like what's next?
Your practice is going well.
People can reach you there ifthey need anything.
Speaker 4 (52:18):
Yes, and that's been transformational, I think, um
figuring out.
You know, once you leave thisbig 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 thataren't lost in this morass of
bureaucracy.
(52:38):
And so we're just trying toconnect our doctors to our
patients.
Just us, it's just us.
Speaker 1 (52:46):
This has been awesome .
Thank you so much for coming on.
Speaker 4 (52:48):
Thank you for having me.
Speaker 1 (52:49):
This is great and just I want to extend our
support, anything we can do tohelp you.
We're all in.
This is changing.
This is great.
Appreciate all you do for thecommunity and for the world at
large, because I was thinkingabout your grandma, man.
She's got to be so dang proudof you.
(53:11):
It's cool.
Well, thanks for coming on.
Speaker 4 (53:15):
Thank you so much.
Speaker 1 (53:16):
Thanks everybody.
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