Join Lorie Jones in this episode as she introduces Dr. Sarah Menacho, a trailblazing associate professor of neurosurgery who is redefining success in a rapidly evolving male-dominated field.
Discover how her spontaneous decision to explore neurosurgery led to an unyielding career passion—with early inspiration from her psychiatrist mother and a pivotal stint in the Peace Corps that solidified her interest—and the sacrifices and investments she has made along the way, including a recent MBA to better navigate the business side of medicine.
She candidly discusses the intricate balance of managing a demanding occupation alongside motherhood, emphasizing that success is possible on all fronts for professional women who are striving for excellence and personal fulfillment. Tune in to be inspired by her message of resilience and fearless ambition!
Show Highlights:
- Follow Dr. Sarah Menacho’s inspiring journey into medicine. [04:50]
- Why women in all fields should earn MBAs. [08:28]
- Is early rising the ultimate time management hack? [10:50]
- Sail past projections and vague feedback as women in male-dominated fields. [12:59]
- The power of female role models who haven’t sacrificed motherhood. [20:07]
- Advice to overcome early-career doubts. [23:32]
- Bust myths of being a mom vs. a brain surgeon. [33:51]
- How to navigate choosing a medical specialty. [36:08]
00:01.68
Lorie Jones
Good morning, fearless females. So we are here today with Sarah Minacho. She is an associate professor of neurosurgery. And um thank you so much for doing this for us, Sarah.
00:12.77
Lorie Jones
I have been really interested in catching up with you and and hearing what you do and hearing all about your story. So thank you for making the time.
00:20.14
Sarah Menacho
Of course, yeah, thanks for being flexible. I know we've gone through multiple multiple iterations to get here, so.
00:28.29
Lorie Jones
You know, sometimes it takes a while. When you're a fearless female, you're out there fighting the fight every day. It just takes a little while.
00:33.91
Sarah Menacho
True, true story.
00:36.46
Lorie Jones
So my very first question is, that was I'm a reader. I love reading. Anything and everything. Do you have a favorite book?
00:43.77
Sarah Menacho
Yeah, I was laughing when I was looking at this question because so I have a five year old. And so the books that I read are kind of on that five year old kindergarten level.
00:54.34
Lorie Jones
Uh-huh.
00:55.04
Sarah Menacho
And so the admittedly, the last book that I read with him was The Giving Tree.
00:59.62
Lorie Jones
Oh yeah.
00:59.76
Sarah Menacho
I don't know if you're familiar with that. um And, you know, I love that book.
01:01.57
Lorie Jones
I love that one.
01:05.67
Sarah Menacho
And my son loves that book. And I actually think it's a great message, you know, on sort of
01:11.50
Lorie Jones
Yeah.
01:12.62
Sarah Menacho
you know, do we take, take, take, you know, and not give and what happens. So I don't know if you're going to put it on your list, but um that is literally the last book I read. So.
01:24.09
Lorie Jones
I love it. I actually do love the giving tree. And I think on the other side of it, it kind of tells us a little bit about giving, giving, giving until you're, you're totally given out.
01:31.84
Sarah Menacho
Mm hmm.
01:34.61
Lorie Jones
And you have to watch at that side of things too, right?
01:37.05
Sarah Menacho
You do, especially as a parent, you know, um this unconditional love, you know, like, I sort of tend to be like, okay, we can do that, we can do that. But you also want to raise someone that understands, you know, what it's like to be told no, what it's like to lose in certain situations. So I think both sides of the message in that book are are very important.
01:58.63
Lorie Jones
Yeah, valuable. I do. I love that one. And, and that Shel Silverstein, I grew up on him. And so like the, the end of where the sidewalk ends, that's always been like my favorite.
02:04.68
Sarah Menacho
Oh, yeah.
02:08.19
Sarah Menacho
Yes, another good one. Yeah, yeahp I need to read that one to him.
02:12.44
Lorie Jones
Yeah. Yeah. So tell me a little bit about yourself. Um, tell me about your journey, how you, you know, how you started, where you, how you got where you're at and kind of where you're at, what you're doing today.
02:24.37
Sarah Menacho
Sure, yeah. um I think the journey into medicine probably started early. My mom ah was a psychiatrist, now retired. And then in college, I went to college in Chicago and I did all of my pre-med courses.
02:42.44
Sarah Menacho
But by the time I graduated, I still wasn't quite sure. you know And I didn't want to just jump in. you know Medical school was expensive more now than back then. And so after college, um I spent two years in the Peace Corps in rural West Africa in a country called Burkina Faso.
02:59.17
Lorie Jones
Well.
03:01.98
Sarah Menacho
And I worked out at a rural health clinic, um no running water, no electricity. um You know, we had vaccines that we kept cold by solar panels and we did prenatal care, basic wound care, obviously vaccinations. And that experience is really where I was like, okay, you know, I really want to be in medicine.
03:24.98
Sarah Menacho
So came back, went to medical school and sort of fell into neurosurgery by accident. We had some elective time ah during my third year of med school and I chose neurosurgery because I was kind of like, oh, that might be cool.
03:36.78
Sarah Menacho
You know, very sort of very vapid reason for picking this elective.
03:37.43
Lorie Jones
Oh yeah.
03:42.18
Sarah Menacho
um walked in and saw an emergency case and was just instantly hooked. um And I was actually behind the eight ball at that point in terms of getting like letters of recommendation for neurosurgery and doing some other things.
03:55.62
Sarah Menacho
So played catch up a little bit, but, and I've never once looked back, but I, I definitely am not one of those people that, you know, has wanted to be a neurosurgeon since I was 12 years old or or something like that.
04:07.15
Lorie Jones
yeah
04:07.91
Sarah Menacho
I really fell into it by accident, but um have never once regretted it.
04:13.42
Lorie Jones
So did you know you wanted to be a doctor young or you just were kind of targeting the medical profession in general?
04:19.85
Sarah Menacho
Yeah, it was definitely something I was interested in, you know, from my mom. um And then yeah in college again, I took the required courses, but, um you know, sort of the typical pathway is to be like a pre-med slash, you know, biology major or a chemistry major or something like that.
04:38.07
Sarah Menacho
I actually was a religion major in college, um which was ah also pretty cool.
04:38.06
Lorie Jones
Mm-hmm. All fun!
04:43.83
Sarah Menacho
um And so, you know, I was a little bit all over the place in terms of like career, you know, um thinking about what I wanted to do with my career, but really it was that time in the Peace Corps that solidified it, so.
04:59.67
Lorie Jones
And what what made you decide at that point? Was it just seeing the need or did you like you just love the blood and guts? I don't love blood and guts.
05:07.67
Sarah Menacho
Yeah, no, a little bit of both.
05:08.09
Lorie Jones
so
05:10.66
Sarah Menacho
It was sort of the feeling that I got from, you know, being able to do something, you know, for another person, even in that scenario, very limited resources. And you know here I am now at a large academic medical center where I have every resource available to available to me 24 seven. But it was it was seeing what these you know people were doing with such limited resources, which was incredible. And I was like, hey, I wanna develop this skillset and be able to do this as well on a much bigger level. And it's actually something
05:44.76
Sarah Menacho
on my mind to go back at some point you know um there's lots of different organizations that travel around and and you know partner with local physicians and exchange ideas and and things like that you know so once my son gets a little older i think that's something i would love to do.
06:02.86
Lorie Jones
Yeah, that's really neat. I love that. So is there a place or a time during your journey were you um where you made some where you made an investment in yourself that you're like, oh my goodness, I am so glad I did that thing?
06:16.16
Lorie Jones
If I didn't, I definitely wouldn't be where I'm at today.
06:18.82
Sarah Menacho
Yeah, um I would say a ah more kind of recent investment I've made in myself was that I went, I actually went back to school and got my MBA um and just got that in 2024, just a few months ago. um And I did that because it's really important these days to understand the business side of medicine, you know, things change with insurance and reimbursements and you know patients are confused, providers are confused.
06:47.02
Sarah Menacho
you know um And so I went back and got my MBA just purely so I could educate myself on kind of the more administrative side of of medicine.
06:57.57
Lorie Jones
Yeah.
06:57.75
Sarah Menacho
And that's been you know very valuable. you know I can read a budget sheet now. And I'm now in a role of vice chair of our department.
07:09.33
Sarah Menacho
Um, and so, you know, I think it's, it's definitely more recent, but it's something that's really gonna, I feel set me up moving forward.
07:09.67
Lorie Jones
know
07:17.86
Sarah Menacho
I mean, the patient care will be better. You know, it's, it's unfortunate that patients come in with a brain tumor or or whatever and and have to worry about the bill that they're going to get. you know, that should be the last thing on their mind with a life changing diagnosis.
07:30.73
Lorie Jones
yeah
07:32.91
Sarah Menacho
So just being able to help with that aspect of it and bring them some peace of mind has been really valuable.
07:40.50
Lorie Jones
I love that you mentioned peace of mind. It's like my motto. It's like financial peace of mind.
07:43.86
Sarah Menacho
Yeah.
07:45.25
Lorie Jones
And it does really kind of translate through all sorts of industries.
07:46.24
Sarah Menacho
Yeah.
07:49.52
Lorie Jones
But when you're worried about your insurance, you have a really hard time, you know, even, even surgery and recovery, because you just don't have the bandwidth to take care of all of those, those things that are competing for your attention.
08:05.80
Lorie Jones
Right.
08:06.28
Sarah Menacho
Yeah. And often, you know, like a new diagnosis of a brain tumor can come out of the blue, you know, it's not something that you can plan for and the patient might be, you know, the primary income earner for the family.
08:18.19
Sarah Menacho
So they have a lot of financial worry and the last thing, it's really the last thing that they should be stressing about, what you know, when they're about to undergo major brain surgery, be in the intensive care unit, things like that.
08:30.61
Lorie Jones
Yeah.
08:31.34
Sarah Menacho
So being able to help them through that aspect of it as well as is very valuable.
08:36.96
Lorie Jones
So Sarah, you just told me that you have a five year old son.
08:41.39
Sarah Menacho
Sun, yeah, yeah.
08:41.83
Lorie Jones
All right. And you just finished your How in the heck did you do that? And still, like, what did you do not sleep? Like, what did you get out?
08:50.88
Sarah Menacho
Yeah, I actually learned to be, I've always been somewhat of a morning person, but now I'm like an extra morning person. So what I would do is I would get up at, you know, 5am. and do my classwork um before anyone in the house was awake. you know ah And then I would start the day you know when my son woke up or had to go into work or something like that. so you know And if I didn't do that, you're right. Then it would be, you know I feel like I already spend more time than I want to away from my son, because neurosurgery can be unpredictable, right? When you're on call, who knows what could happen.
09:26.53
Sarah Menacho
And it's definitely a specialty where you make and break plans. you know So that is how I did it.
09:30.14
Lorie Jones
here
09:32.71
Sarah Menacho
Definitely challenging though, you know there was an in-person class requirement every other Friday, Saturday. So you know I would be in class and I'd step out, take a phone call oh you know ah regarding patient care, come back in the class.
09:46.99
Sarah Menacho
Or I'd run over here on my lunch hour and round and come back. you know But you basically have to use every minute, you know every minute efficiently
09:55.96
Lorie Jones
ah
09:56.01
Sarah Menacho
Um, otherwise it it doesn't work. So it was 20 months.
09:58.25
Lorie Jones
Yeah, that sounds like it sounds like a lot. How long did it take was it a to your programmer?
10:04.75
Sarah Menacho
Yeah. And it was a combination of the in-person component that I mentioned. And then there was some virtual, um, there was a virtual component as well.
10:13.35
Lorie Jones
ah that was ah That's a lot of work. that's ah That's a really big time commitment to to get that so i'm glad that. I'm glad that that was a good investment. you know that
10:23.72
Sarah Menacho
Absolutely. Yeah. And the ultimate goal is that hopefully, you know, as I get older, you know, obviously I want to keep practicing as long as I'm capable, but, you know, as I get older and I maybe phase out of taking as much call to use that MBA to get into these administrative roles, you know, so um keep myself busy.
10:39.58
Lorie Jones
ah
10:41.96
Lorie Jones
And then help out on that side.
10:44.28
Sarah Menacho
Yeah, exactly. Still stay active, you know, still stay involved, but maybe a little bit more predictability of the schedule, you know, than you know, trauma call, so.
10:54.87
Lorie Jones
Yeah, yeah, I can see that would be difficult. What? Did you get any really bad advice? Did someone just give you some, but like, what's the worst advice you get you've gotten?
11:05.27
Lorie Jones
And did you take it? Did you not take it? Would you learn?
11:07.52
Sarah Menacho
Yeah, you know I've gotten all sorts of ridiculous advice over the years. I'm a woman in a male-dominated specialty, so you know people are always like, oh, you'll never get a husband.
11:18.58
Sarah Menacho
You'll never have kids. You know what I mean? Just ridiculous. But I have to say, the piece of advice that I hate the most, or I shouldn't say hate, that I dislike the most is when somebody says to me, keep doing what you're doing.
11:33.24
Sarah Menacho
Because what does that even mean? you know i
11:36.94
Lorie Jones
Thank you. know
11:37.62
Sarah Menacho
And, you know, I'll ask for feedback, you know, over the years, all through this journey, student to intern to resident, even now. And when somebody says to me, keep doing what you're doing, I don't know how to interpret that. So, you know, does that mean like I'm doing something wrong, but you just don't have the time to, to, you know, tell me, or am I doing so great that I don't need any, you know, feedback? I doubt that. So if there's one piece of advice that I can't stand, it's when somebody says that to me.
12:07.41
Lorie Jones
I guess that's true. I've never really thought of that before, but that's like a non-answer, isn't it?
12:12.01
Sarah Menacho
It's a complete non-answer and I don't know how to interpret it.
12:12.13
Lorie Jones
You're asking... ah
12:16.23
Sarah Menacho
So if somebody says that to me, I i will literally be like, what does that mean? And I'll put a ah' push for more details because I mean, I'd like to think that I'm someone that has insight, but maybe I'm doing something wrong and I don't know it.
12:29.10
Sarah Menacho
So when you tell me to keep doing what I'm doing, I could be doing something better, but you're not giving me a pathway to that, you know?
12:35.90
Lorie Jones
um
12:36.13
Sarah Menacho
so um But yeah, you know, all the ridiculous things that people have said, you know, over the years. I mean, if I had a dollar for everyone said that, you know, I'll never get married and have kids because, you know, I'm going into neurosurgery.
12:49.43
Sarah Menacho
I mean, I could retire now. But, yeah you know, you just brush that off. You know, people, not sure why people project that, honestly.
12:56.95
Lorie Jones
Yeah, yeah it's ah it it sounds like, and I'm not a neurosurgeon, but it sounds like a really hard discipline with a lot of chaos, but but there's a lot of places in the world where you have a really hard discipline with a lot of chaos.
13:10.85
Sarah Menacho
Absolutely. No, absolutely. So, you know, i i I think it maybe bothered me earlier on, you know, in this in this journey, you know, you could make it like death by a thousand cuts, you know what I mean?
13:22.86
Lorie Jones
Yeah.
13:23.20
Sarah Menacho
but
13:23.37
Lorie Jones
yeah
13:24.15
Sarah Menacho
Um, I really have just brushed it off. And even now it continues, you know, people are like, Oh, I bet you don't see your kid, you know, or like, Oh man, what does your husband think about you being a neurosurgeon?
13:35.70
Sarah Menacho
And I'm like, well, actually I make the decision, you know, on my career, not, not my husband, you know, but since you asked very supportive, you know, so.
13:40.69
Lorie Jones
I didn't ask, actually.
13:45.27
Sarah Menacho
I mean, if I, you know, let every one of those comments get me down, I would never be able to get out of bed in the morning, you know? So really just at this point, I just, in one ear and out the other.
13:51.28
Lorie Jones
no
13:56.05
Lorie Jones
Well, and I was talking to ah and someone in the medical profession not too long ago, and she said that the the doctor, the male to female ratio is about 50%, but neurosurgery, what's the ratio?
14:12.58
Sarah Menacho
It's still pretty male dominated. You know, I think it's 80 plus percent male with the remainder female.
14:17.49
Lorie Jones
Mm-hmm.
14:19.41
Sarah Menacho
it That's better than when I started. And there are some other surgical specialties. I believe general surgery is is very close to 50-50 now. So, you know, we're making strides for sure.
14:29.32
Lorie Jones
no
14:32.73
Lorie Jones
here
14:33.25
Sarah Menacho
um But yeah, when it comes to neurosurgery, you do kind of still think of a traditional male specialty.
14:40.77
Lorie Jones
Yeah, did it did it that did that ever deter you or make you work harder um to get I mean, did you did you second guess that even when you started and be like, well, there are not a lot of women here, maybe I should try something else like
14:54.55
Sarah Menacho
Yeah, you know, I liked it enough that I never second guessed it. and There were certainly times where I was down and discouraged, particularly sort of the junior resident years where, you know, you're buried under paperwork but you're not yet kind of Getting in the operating room doing you know the surgeries and the and the cool stuff that made you choose this specialty. so I had some you know down moments with that, but I was also very fortunate. I had great co-residents, again, mostly male, some women.
15:27.00
Sarah Menacho
who were very, very supportive and you become, I mean, you're spending just ridiculous amounts of time with these people. So they really become like your family. I was single at the time.
15:37.62
Lorie Jones
Mm
15:38.01
Sarah Menacho
And so I relied on those guys and women you know ah to get me through it.
15:41.10
Lorie Jones
hmm.
15:43.10
Sarah Menacho
Certainly I've heard horror stories from you know female colleagues around the country who had bad experiences with co-residents and I think if I had had that I don't know that I would have made it through the seven years because like I said I mean you're sometimes eating three meals a day with these people you know so if you don't get along with them I can imagine it's miserable.
16:01.84
Lorie Jones
Yeah.
16:05.63
Lorie Jones
Yeah. Well, I love that that you provide an example for the, for other girls who are looking around and saying, well, what should I be? You know, well, she's a neurosurgeon. Maybe I could be a neurosurgeon.
16:18.91
Sarah Menacho
Yeah, i you know, I hope that I can be in that mentor role. I get a ton of emails from ah female medical students, female undergrads who inquire about the specialty. And I really try to go out of my way to make time to, you know, if they want to come and chat in person, great, or we'll jump on a Zoom or a Teams and chat about it. And certainly, you know, of the you know, people that I chat with probably less than half decide to pursue neurosurgery.
16:45.72
Lorie Jones
you Yeah.
16:46.07
Sarah Menacho
But you know what, that's okay because it is a demanding specialty. So don't go into it if it's not something that you love, whether you're a male or a female, you know, so, uh, but I get, you know, I get these interesting emails, you know, Oh, Dr. Menacho, what was it like to, you know, be a neurosurgeon and be breastfeeding?
17:06.41
Sarah Menacho
You know what I mean? And how did you pump?
17:07.93
Lorie Jones
Yeah.
17:09.22
Sarah Menacho
you know ah So I'll get those. And then I'll i'll yeah i'll get emails from certainly male undergrads who are like, oh, I heard you let students shadow. Can I come watch a case? I'm interested in neurosurgery.
17:20.02
Sarah Menacho
And I'm like, yeah, come on come on through.
17:21.70
Lorie Jones
you
17:22.12
Sarah Menacho
you know So really runs a gamut of what people ask. ah you know I think that's important when you're going into you know such a demanding specialty. And there's other demanding specialties too, of course, that make sure you turn over every stone you know before you start on such a long journey.
17:37.24
Lorie Jones
yeah Yeah, that's really good advice. You have to want it.
17:42.76
Sarah Menacho
and
17:43.12
Lorie Jones
um Because yeah, because it's gonna take everything from what you
17:43.16
Sarah Menacho
isn
17:48.26
Sarah Menacho
It is. And and you know it sounds cliche, but there will be sacrifice. you know You'll probably miss some family events. you know and You're going to watch your friends and other specialties who have shorter residencies graduate by houses. You don't get married, have kids, not that you can't do that as a resident too, but you know, you're going to sort of watch them have these life events.
18:09.76
Sarah Menacho
And yeah, you're going to have those life events too, but they might just be, you know, a little bit farther down the road, you know, and you have to realize that you have to really want this.
18:20.88
Sarah Menacho
And to me, I wouldn't want to do anything else, you know, but I want students, whether they're men or women, to just really understand that before starting on this journey.
18:23.29
Lorie Jones
yeah
18:29.67
Sarah Menacho
Certainly you can start residency and then you can switch, you know, and and you're not bound to anything. But as much as possible, you want to make the right decision up front, just easier.
18:37.30
Lorie Jones
Yeah. Yeah. That makes sense. So do you have a situation um during your professional journey that you look back on and you're like, oh my goodness, I wish I had known at that point what I know now because I would have handled that so much differently.
18:53.11
Sarah Menacho
Yeah, I think I wish that I had had um maybe more female mentors, you know, because I don't even know if I would call this a regret, but I do think that um maybe had I had that, I would, I have a beautiful, healthy five-year-old son, but I might have had you know maybe one or two more children. I think if you know I had started, if we had started trying for a family sooner, and I'm an older mom, I had my son when I was 38,
19:27.33
Sarah Menacho
um I sort of had this mindset, you know, can't get pregnant as a resident can't get pregnant as a fellow, you know, it'll overburden my colleagues, you know, and I wish someone had sat me down and been like, the time to start a family is when you and your family are ready and not what anyone else thinks. And that's the advice I give to our female residents now. ah As recent as last week, I was talking to someone about this. So again, it's not really a regret, but you know maybe if I had you know started um trying for a family at 30 or 32 instead of 37,
20:01.61
Lorie Jones
Mm hmm.
20:01.69
Sarah Menacho
um You know, my both my husband and I are like, oh yeah, we probably would have had a couple more. But then you also, we count our blessings that we have a healthy child, you know?
20:11.26
Lorie Jones
Right.
20:12.15
Sarah Menacho
And and so again, it's not more of a regret. It's just more something maybe I could have done differently.
20:18.45
Lorie Jones
Yeah, like you might end in his to say that you wouldn't end up at exactly the same place making exactly the same decisions that you didn't make.
20:25.08
Sarah Menacho
Absolutely.
20:26.29
Lorie Jones
But but that that is interesting that um if you had maybe had an example of a of someone in your field that had navigated that space successfully, it might have given you a different viewpoint on it.
20:39.68
Sarah Menacho
Yeah, I think it it would have been nice to just have someone say, it's okay to to do this, you know, because at the end of the day, the advice I give now is when people are like, what's the right time?
20:50.51
Sarah Menacho
And I'm like, the right time is when you're ready, you know, and not anyone else, you know, um and maybe if I had had that, you know, things would have been a little bit differently.
20:52.95
Lorie Jones
you
21:01.26
Sarah Menacho
Yeah, would have turned out a little bit differently. But again, I'm really happy. you know One of the anesthesiologists a few months ago said, you're the happiest neurosurgeon I know.
21:06.37
Lorie Jones
Yeah.
21:10.42
Sarah Menacho
And I said to him, what do I have to be unhappy about?
21:10.83
Lorie Jones
ah
21:13.73
Sarah Menacho
I have a great job. you know It pays well.
21:16.63
Lorie Jones
yeah
21:16.96
Sarah Menacho
My husband loves me. I have a healthy son. I mean, really, what ah you know I have some times where I might have a bad day. But I mean, why wouldn't I be happy? so
21:25.45
Lorie Jones
I love that. I love that my, ah my goal for the year is positivity. So I love i to just like bloom where you planted or just be happy with who you are and what you have because
21:31.53
Sarah Menacho
Yeah.
21:37.95
Sarah Menacho
Absolutely. Yeah. I mean, you can't sit around you know wishing your life away. You know what I mean? so
21:44.41
Lorie Jones
Well, and you worked so hard to get here. It makes it nice that in the end, you can look back or you're not at the end, you're not anywhere close to the end. But, you know, after all that effort and work, you kind of look back and say, I'm, I'm glad I did that.
21:52.84
Sarah Menacho
Yeah.
21:57.77
Lorie Jones
And I'm happy now. And, and, you know, there were hard times and easy times and, but I
22:03.93
Sarah Menacho
yeah Absolutely. And I hope that, you know, when people, prospective students who are interested in neurosurgery see that, that it dispels some of the myths that, you know, we're miserable, angry people who live at the hospital and their divorce rates high and we don't see our families.
22:22.67
Sarah Menacho
You know, I think there's a lot of negative stereotypes that swirl around out there.
22:23.81
Lorie Jones
Yeah.
22:27.07
Sarah Menacho
So
22:27.44
Lorie Jones
good
22:28.76
Sarah Menacho
I mean, in no profession are you going to be happy all the time, but I hope that when people meet with me they see that, you know, I'm doing what I love and I'm happy doing it.
22:38.11
Lorie Jones
yeah So if you could go back Sarah and talk to yourself at say age 20, do you have any advice for her?
22:47.26
Sarah Menacho
Yeah, I thought about this question too. And I was like, I'd figure out how to stay age 20 so that my joints don't ache when I get out of bed these days. no But in the absence of time travel, you know ah I think I would probably tell myself to just um not worry as much about what people think, you know which which sounds a little cliche.
23:07.53
Lorie Jones
No.
23:08.98
Sarah Menacho
But you know I just distinctly remember back then that it was um really important to me to you know hear the opinions of others, you know, and I sort of got, I would get caught up in silly little dramas, you know, with these, not even friends, sort of like acquaintance circles, you know, and of course you're in college and, you know, you're experimenting with like a lot of things for the first time, being away from home and things like that, you know, but I honestly just wish that I would have just, you know, not worried so much about maybe things like fitting in and,
23:45.85
Sarah Menacho
and you know and just enjoyed enjoyed the experience. Because when I look back on it, I'm like, oh, man, I wish I go back to those college years you know when you thought you had responsibility, but you really didn't.
23:56.65
Sarah Menacho
Yeah, you know
23:56.95
Lorie Jones
I know, I know. Like what are you responsible for? Like nothing, right?
24:01.25
Sarah Menacho
yeah I mean, homework and things like that. But I mean, you know there's you're not married. there There's no kids. You're you know living in away from home with a bunch of people your age.
24:07.11
Lorie Jones
you
24:10.42
Sarah Menacho
you know I mean, I'd love to do that now.
24:12.72
Lorie Jones
Yeah, yeah.
24:13.48
Sarah Menacho
so Um, that's probably what I would tell myself.
24:18.26
Lorie Jones
Did anything scare you when you started your career and does it still scare you or did you learn how to work with it?
24:27.00
Sarah Menacho
Yeah, I think when, when I first started as an attending, you know, I think early on I had those kind of doubts a little bit creeping in of, Oh, can I really do this? You know, like I'm making the decisions now, you know,
24:43.16
Sarah Menacho
Everything that happens with this patient um comes back on me. You know what I mean? Like, can I really cut it? Do I have the skills? But then, you know, probably six months to a year in, you know, and early on, the advice that you get is to not jump into anything too complex in the OR, you know, just fresh out of fellowship, just get a lot of basic cases under your belt.
25:06.33
Sarah Menacho
So I did that and I think that was great advice.
25:07.32
Lorie Jones
Mm hmm.
25:08.33
Sarah Menacho
and then Did a few complex cases and then you start to realize, okay, like I can do this, you know, I put in the work.
25:14.60
Lorie Jones
yeah
25:16.64
Sarah Menacho
I did my fellowship, you know, and now I'm in charge, but like, you know, the patients are, are doing well and. And every surgeon is going to have complications, you know, and any surgeon that tells you that they haven't is either lying or hasn't done that many cases, you know.
25:30.02
Lorie Jones
yeah
25:30.27
Sarah Menacho
but So I'm certainly not going to sit here and say that, you know, I haven't had complications, but I think, you know, definitely those nerves the first few months of like, um, you know, I'm hired here at this big academic center.
25:37.94
Lorie Jones
Yeah.
25:42.20
Sarah Menacho
Can I really cut it? You know, um, and, and those are mostly gone at this point.
25:45.37
Lorie Jones
well but So it's just like repetition, just doing the thing until you're like, oh yeah, I can do this.
25:47.15
Sarah Menacho
So.
25:53.70
Sarah Menacho
Yeah, exactly. Just, you know, thousands of hours, you know, um practicing. And even as an attending now, I'm technically not in training, but I mean, i've I've learned so much and there are cases that I've learned how to do since I've been back here, you know, from my colleagues that I'm doing now that Um, I hadn't done for whatever reason as a resident or a fellow.
26:16.42
Lorie Jones
know
26:16.76
Sarah Menacho
So, um, you know, really, even though I'm technically not in training, I'm still learning, you know, and, and the field has evolved.
26:19.95
Lorie Jones
Mm-hmm. Mm-hmm.
26:25.34
Sarah Menacho
There's new technologies. minimally invasive stuff that's better for patients. that and And in the age of the internet and social media, right, patients are going to know about this.
26:32.81
Lorie Jones
Oh yeah.
26:34.00
Sarah Menacho
They're going to come in and say, well, so-and-so does it minimally invasive. Can you do that? And you want to be able to say, oh, I can.
26:40.15
Lorie Jones
Mm-hmm.
26:40.77
Sarah Menacho
you know and And now I can. Or they'll ask about, you know what's that laser thing for brain tumors? you know And I'll be like, yep, we do that.
26:46.65
Lorie Jones
but
26:47.91
Sarah Menacho
Let me walk you through it. you know So you have to be evolving with the you know with the times otherwise. you know I think you won't really advance your career.
26:58.86
Lorie Jones
yeah And that's, and that does have to be like, that's a scary thing to get out of school and get out of your residency and have someone's brain in your hands.
27:13.18
Sarah Menacho
It is, yeah. And you know, I tell patients, um you know, whether it's supposedly, quote unquote, a straightforward small case or, you know, a complex case that's going to take all day, I say every brain surgery is major brain surgery, no matter how big or small it is. Because, you know, at the end of the day, these people are entrusting their brain to me in my hands, you know, so I never take any case lightly, even if it's a common one, you know, that I've done 500 times to that patient, that's their first time having a brain surgery.
27:47.97
Sarah Menacho
And, you know, they're trusting me with, you know, in my opinion, the most precious organ in the body, you know, so ah it's important not to take that for granted.
27:55.26
Lorie Jones
Yeah. Yeah, yeah, I see that. its It would be a great responsibility. it would it It would be a lot of responsibility, but I think that and also you treat that with respect.
28:10.17
Lorie Jones
you can
28:10.55
Sarah Menacho
Yeah, you absolutely have to. And and myself and my colleagues instill that in the residents, you know, just because this is a quote unquote straightforward procedure, you know, it doesn't mean that we're going to blare loud music and talk about our weekend plans.
28:23.80
Sarah Menacho
You know, it's the same focus as if we were doing, you know, a complex brain tumor that we know is going to take 10 hours.
28:31.07
Lorie Jones
Yeah.
28:31.25
Sarah Menacho
So you have to have that that respect, as you mentioned.
28:33.23
Lorie Jones
Yeah. So did you face any unique challenges because you were a woman?
28:40.72
Sarah Menacho
Um, I mean, definitely as, as we sort of talked about earlier, you know, there was certainly the passive aggressive comments, you know, uh, and frankly, I still get those today.
28:51.73
Sarah Menacho
You know, you walk into someone's room and, um, you know, they think you're the nurse or the person coming to take their dinner order, or, you know, and again, you gotta let that, you gotta let that roll off.
29:00.88
Lorie Jones
boy
29:04.37
Sarah Menacho
You know, it was challenging. Um, When I came back from maternity leave, and by the way, my chairman and this department were incredible and in terms of the maternity leave.
29:17.01
Sarah Menacho
And we had no policy because they had never had a woman of childbearing years on faculty.
29:20.52
Lorie Jones
Oh my gosh!
29:22.35
Sarah Menacho
So and we created our own policy and it was great, but it was certainly challenging to come back. You know, I had a three-month-old at home. I was breastfeeding and pumping.
29:34.44
Sarah Menacho
um And i sort I missed him.
29:36.58
Lorie Jones
Yeah, oh yeah.
29:37.00
Sarah Menacho
you know um I wanted to be with him. And you know I was taking a call again. and and And again, nobody was really forcing me to. I just i felt like it was time to go back. you know um And so I think that was very challenging.
29:52.23
Sarah Menacho
I sort of ah pump in between cases or you know real quick pump before and after and um I might run home from the hospital in between cases to just say good night to him or even though he was three months old he's not going to remember I'm like well I remember you know so
30:07.41
Lorie Jones
I remember, yeah, yeah baby snuggles.
30:10.75
Sarah Menacho
Exactly. you know um And also just sometimes to give my husband a break, you know because we don't have any family in the area, neither one of us. So a lot of times it was just the two of us.
30:19.39
Lorie Jones
ah you
30:21.91
Sarah Menacho
And and we certainly had an excellent nanny, but you know she's got to go home at some point.
30:24.99
Lorie Jones
She leaves you alone.
30:25.74
Sarah Menacho
you know so Yeah, so you know that was definitely challenging. But you navigate navigate through it. and And we made it through.
30:36.84
Sarah Menacho
And even now, you know as I mentioned, he's five. And you know he's funny, I'll say, oh, mommy's got to go into work. And he's like, does someone have an accident? you know Because he'll know I'm on trauma call.
30:46.19
Lorie Jones
oh
30:47.79
Sarah Menacho
you know and then Or he'll say, oh, does someone have cheese in their brain? you know That's his word for like a tumor.
30:53.62
Lorie Jones
ah
30:55.12
Sarah Menacho
He's like, do you have to go take out cheese from someone's brain? And I'm like, yeah, buddy, mommy's got to go. So he's starting to sort of get it. And he's like, OK, mommy, good luck, you know things like that.
31:06.35
Lorie Jones
know
31:07.08
Sarah Menacho
so
31:07.38
Lorie Jones
I love that example.
31:08.26
Sarah Menacho
But certainly the newborn years were challenging. Oh, sorry. Excuse me.
31:11.26
Lorie Jones
No, and no, no, that's fine. I love that example. I love that, um, I love that our kids are watching us do these hard and and be successful at these really hard careers and do these hard things because, ah you know, I hear a lot of times from women, just the mom guilt, I'm not spending enough time, I'm not eating, blah, blah, blah.
31:15.24
Sarah Menacho
you
31:18.10
Sarah Menacho
here
31:29.96
Sarah Menacho
Yeah.
31:31.59
Lorie Jones
but But I don't think that we recognize probably the other half of that, which is our kids are getting a really good example of ah a very successful career, a successful professional.
31:42.57
Lorie Jones
and And they take that, you know, there's been studies that show that they take that into their lives and mimic those things.
31:49.74
Sarah Menacho
Yeah.
31:51.24
Lorie Jones
So I think they're teaching them more than we know.
31:52.30
Sarah Menacho
Yeah.
31:55.04
Sarah Menacho
I certainly hope so. Yeah. And I, and I do think he understands that, you know, if I'm leaving, uh, if we made plans to go to the zoo or whatever, and you know, I have to go to the hospital instead, he knows that I'm not just going to like hang out with my friends or, you know, he's like, Oh, you got to go to help, to help someone, you know?
32:13.90
Sarah Menacho
And so it's amazing what they can pick up on, even when they're, when they're so young, so.
32:19.50
Lorie Jones
Yeah, even at Young, I love that. I love that he gets that example and that he knows that mom is going to help and that they her skills are needed and that no one else can can be there to do that.
32:32.13
Lorie Jones
So I love that.
32:32.30
Sarah Menacho
Right, no, exactly exactly. But the mom guilt is definitely a real thing. I'm sure dad guilt is a real thing too.
32:38.15
Lorie Jones
Yeah.
32:39.37
Sarah Menacho
So that was that was certainly challenging to navigate. But again, you just you just make it work, whether it's getting up earlier you know, putting him to bed and then I do my notes that I have to dictate, you know, or something like that. You just, you find a way to make it work.
32:53.80
Lorie Jones
Maybe AI will make it easier on all of us, right?
32:56.95
Sarah Menacho
Yeah, there are actually AI generated note templates now, which cuts down the work, but you know, unfortunately you still got to go on and, you know, fill in the blanks since it's debatably, it's debatably faster.
33:00.52
Lorie Jones
yeah yeah
33:06.30
Lorie Jones
yeah
33:09.59
Sarah Menacho
So.
33:09.91
Lorie Jones
Well, we'll keep working on it. those That next generation of tech, they can give they can fix this problem for us, right?
33:13.00
Sarah Menacho
Yeah, exactly. Exactly.
33:18.77
Sarah Menacho
Well, my son, even when he was, you know, two or three, they ah it's amazing how quickly they learn to like swipe, you know, on your phones, they figure that out. And I'm like, how did you know how to do that?
33:29.16
Sarah Menacho
You know, so yeah I might just be ingrained at this point.
33:29.38
Lorie Jones
ah
33:31.80
Sarah Menacho
So.
33:32.15
Lorie Jones
and I know my it was really funny my daughter was maybe three years old and I realized that we were not the same like we didn't even grow up in the same world because she picked up the phone and it had a screen on it and she started like bashing at the screen and like me like there are buttons there that's what you do you push the buttons right but my daughter was the air era that like
33:32.92
Sarah Menacho
but
33:47.05
Sarah Menacho
Yeah.
33:52.07
Sarah Menacho
Yeah.
33:55.78
Lorie Jones
She didn't even know there were buttons there. It was just the screen she was trying to push.
33:58.57
Sarah Menacho
Right. Yeah. Now it's it's amazing what they pick up on, you know, watching you and then all of a sudden, you know, let him play with my phone and he can like get to the keypad and we taught him our phone numbers, you know, just in case and he can type it in and I'm just like, holy cow, you know. So.
34:15.91
Lorie Jones
yeah So what, Sarah, is the thing that you are the most proud of?
34:23.19
Sarah Menacho
Yeah, I thought about this question quite a bit. Honestly, probably being a mom, you know, and I was I thought about being like, I mean, being a being a brain surgeon, you know, but it's like, no, it's like being a mom. I love it. You know, um you know, we talked about some things, um you know, where I have to make and break plans from time to time. But watching him grow and develop and teaching him how to like ride a bike or every once in a while I'll take him in to like round with me and he just kind of hangs out on his iPad. You know, I'm talking to patients like I love that, you know, so I I'm obviously proud of the hard work that got me to where I am now. But I mean, I wouldn't trade being a mom for anything.
35:08.87
Lorie Jones
Yeah, that's it's good that all those naysayers that were saying you'd never get married and you'd never have kids were wrong.
35:14.80
Sarah Menacho
Yeah. Yeah. And then the ones that say that I'll never see him and, you know, and then I'm going to get divorced, you know, and I'm like, well, so far, so good, you know, so.
35:21.95
Lorie Jones
They keep telling you all those fun.
35:24.51
Sarah Menacho
You know, the critic they they don't stop the criticism.
35:24.72
Lorie Jones
not
35:26.91
Sarah Menacho
They just sort of change it, you know, so. But what can you do? Like I said, you know, in one ear and out the other, you know, i the people that know me and care about us don't say those things.
35:34.66
Lorie Jones
Yeah.
35:38.18
Lorie Jones
Mm hmm.
35:40.23
Sarah Menacho
And those are the opinions that matter, you know, so I can't I can't be bothered by white noise.
35:45.97
Lorie Jones
Yeah. I like that. I like the idea too to kind of tune out those messages that it it's not like you're turning tuning out messages that are filling you up or making you better or helping you change in constructive ways.
35:59.03
Lorie Jones
You're just tuning out the white noise, the stuff that does make a difference and in your mind.
36:01.55
Sarah Menacho
Yep. No, absolutely. And it took a while to learn how to do that. You know, especially early on, someone would say, Oh, yeah, you want to, you won't ever go home. You'll never find a, you know, a partner.
36:15.16
Sarah Menacho
And you know a couple of times I'm like, are they right? You know what I mean? um But again, the people that care about you, that know you are like, that's ridiculous. you know and And don't listen to whoever is saying that.
36:28.59
Sarah Menacho
And it certainly wasn't just men. you know Certainly women were saying it too. um And so after a while, you start to realize that what they're saying isn't true.
36:39.50
Sarah Menacho
And then at that point, it just becomes what the white noise. you know
36:42.21
Lorie Jones
Yeah. Yeah.
36:43.06
Sarah Menacho
so
36:44.88
Lorie Jones
So any advice for a young lady who's just starting down this path that you're already successful at, what would you tell her?
36:53.03
Sarah Menacho
Yeah, i I feel like I have these conversations pretty frequently and sort of touched on it a little bit. I would just say to try to expose yourself to the specialty as much as possible.
37:04.62
Sarah Menacho
Come in, shadow some cases, follow us in clinic on rounds. And just as much as much as possible, try to make sure that this is what you want to do for the reasons that we mentioned, the time commitment, the length of the residency, you know the challenges.
37:19.50
Lorie Jones
and
37:21.13
Sarah Menacho
um And I tell people, you know I love it, but you are going to work so hard and you're going to be so tired. you know and And like I said, your friends that did other specialties are going to be done and making money, you know? So just make sure that it's what you want to do. And again, you certainly can start a residency and switch, but that's extra stress, right? Like in order to make the best decision, informed decision that you can up front, just expose yourself as much as possible. Talk to women, talk to men, you know, talk to your family and just see as much as you can.
37:59.70
Lorie Jones
That's interesting. I was reading something about a job posting for like some sort of, they were going on some sort of boat adventure or something like that.
38:10.54
Lorie Jones
And the job posting was something like you have to like staying up for, you know, 24 hours at a stretch being freezing cold, not eating for three days and stuff like that.
38:19.52
Sarah Menacho
Yeah. sorry Yeah.
38:20.14
Lorie Jones
So it sounds like like like you're like telling them all the things that could you know like you have to be prepared for those those
38:30.60
Sarah Menacho
yeah Yeah. You don't just want to say, Oh, you know, I think the surgeries that you do are cool because yes, they are, but you have to understand the journey that it's going to take to, to get you there. So.
38:42.19
Sarah Menacho
Yeah, just exposure, you know, as as much as possible. And I think the students are are doing that, you know, like I said, they email me, they come into the OR, you know, we talk and but a lot of times a month or two later, I'll get an email. Oh, thank you so much. But I decided to go into, you know, anesthesia or a different surgical specialty or a non-surgical specialty like neurology. And I'm like, great.
39:06.19
Lorie Jones
Mm hmm.
39:06.26
Sarah Menacho
best of luck, you know, this is, that's why you come in and and you shadow me so you can decide whether you want to do it or whether you don't want to do it, you know, but they're almost apologetic.
39:13.39
Lorie Jones
Yeah.
39:15.84
Sarah Menacho
And I'm like, no, like, if I helped you determine the right career for you, then great, you know, I don't care what it is.
39:21.34
Lorie Jones
um Yeah, I like that. Well, Sarah, thank you so much for spending some time with me today, especially I know how busy you are.
39:29.11
Sarah Menacho
A problem.
39:29.89
Lorie Jones
And I really appreciate you spending some time just chatting and sharing your story. If I have listeners that are interested in getting in touch with you, how do they do that?
39:39.51
Sarah Menacho
Yeah, email is probably the best. It's just sarah.minacho at hsc.utah dot.edu. And I try to check that every day at least. Sometimes I'm not the best, but I will get back to you and we can chat or set up a time. If you want to shadow, there's a few basic you know paperwork things I have to do, um but always happy to have people around, you know, come come watch.
40:07.74
Lorie Jones
Well, thank you. Thank you for sharing your time and thank you for sharing your story. I appreciate it.
40:12.49
Sarah Menacho
Thanks for having me. It was fun.