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Dr. Rick Hodes, a Life Dedicated to Service – Podcast #188

Podcast #188 Show Notes: Dr. Rick Hodes, a Life Dedicated to Service

The work of Dr. Rick Hodes in Ethiopia is inspiring. He is working in an international inter-religious, interfaith, inter-ethnic environment to make the world a better place. He is the doctor we wrote we wanted to be in our medical school admission essay. We talk about how he got started practicing medicine internationally, the interesting work that he has done, and the many people that he has been able to help. We discuss the finances behind work like this and the effort put into fundraising. Some people have criticized international aid programs, saying they are doing more harm than good, and we get into that, too. Many of our profession are suffering from burnout. Dr. Hodes has some advice on that, as well, 30+ years into his career. We also talk about how you can help. For not a lot of money, we can help a lot of people. Rick shows us what a true calling in medicine can look like. Take a listen and see if you find this interview as inspiring as I did.

Sponsor

This podcast is sponsored by Bob Bhayani at drdisabilityquotes.com. He is an independent provider of disability insurance planning solutions to the medical community in every state and a long-time White Coat Investor sponsor. He specializes in working with residents and fellows early in their careers to set up sound financial and insurance strategies. If you need to review your disability insurance coverage to make sure it meets your needs or if you just haven’t gotten around to getting this critical insurance in place, contact Bob at drdisabilityquotes.com today by email [email protected] or by calling (973) 771-9100.

Quote of the Day

Our quote of the day today comes from Thomas J. Stanley of “Millionaire Next Door” fame. He said,

If you’re not wealthy yet, but want to be someday, never purchase a home that requires a mortgage that is more than twice your household’s annual realized income.

We recently recorded an interview with his daughter Sarah Stanley Fallow, who co-wrote The Next Millionaire Next Door with her father prior to his passing. We had a great discussion about America’s wealthy and the changes that occurred between the publishing of the two books. Watch for that episode to drop on Christmas Eve.

WCI Conference

Our Physician Wellness and Financial Literacy conference will be March 4th through 6th. If you register before January 5th, we will send you a swag bag containing several books, a WCI t-shirt, and other goodies, but you have to register before January 5th. Register here!

Zero to Freedom Through Cash Flowing Rentals

If you’re interested in direct real estate investing but aren’t quite sure how to do it, there is an online course designed just for you. It’s called “Zero to Freedom”. Get on the wait list before December 12th to get a $300 discount when you buy the course. You have until December 20th to buy at full price. But either way, if you go through our links, you will also get a signed copy of the White Coat Investor’s Financial Bootcamp and our online course WCICON Park City with 13 extra hours of awesome content from folks like Jonathan Clements, Bill Bernstein, and Mike Piper.

 

Dr. Rick Hodes, a Life Dedicated to Service

Back in July we published a guest post from Crispy Doc about Covid 19 and Physician Burnout. In the article, he mentioned having worked with Dr. Rick Hodes, an internist who has spent his career in Africa caring for the sick and destitute. Rick is an observant Jew serving as medical director. He has worked with Catholic nuns treating Muslim and Ethiopian Orthodox Christian patients. Rick shows us what a true calling in medicine can look like.

dr rick hodes

He did his pre-med at the University of Alaska, medical school at University of Rochester, training in internal medicine at Johns Hopkins Bayview, and somewhere along that path got interested in global health. He said there weren’t a lot of role models 0r opportunities, so he made them for himself.

As a medical student, he spent a summer in Bangladesh and a winter in South India. As a resident, he would take his vacation and work in refugee camps in Africa. He was offered a Fulbright fellowship to be a professor, a lecturer in medicine at Addis Ababa University, and taught internal medicine there for two and a half years. After that, a job with the World Health Organization fell through because of a revolution in Burma, and he ended up back in the states working in a practice but desired to go back overseas.

Israel and Ethiopia re-established diplomatic relations in 1987. Ethiopian Jews heard about this and they started coming to the capital. He contacted the American Jewish Joint Distribution Committee, which is an organization on the ground there. They hired him to go back to Ethiopia in 1990 to be the doctor for the Ethiopian immigrants to Israel. There were about 25,000 Ethiopian Jews, and he became their doctor. Someone had been there for a couple of months before and helped start a medical program. He took over after that and had a clinic that was going 12 hours a day, seven days a week with a nutrition program, immunizations, and a program for TB. He ended up diagnosing 3.5% of the population with active tuberculosis. It was his first big-time introduction to tuberculosis, and tuberculosis has in one way or another taken over his life since then. He has spent nearly his entire career in Ethiopia.

Ethiopia

When I was growing up in the 1980s, the only thing I knew about Ethiopia was that everyone there was starving. Our parents would say, “finish your dinner, there are starving kids in Ethiopia!”

Prior to teaching there, Dr. Hodes went as a relief worker in 1984 at really the height of the famine. I asked him how that experience impacted his life and career plans.

Oh my gosh. Tremendous. So, what happened was Haile Selassie was the leader of Ethiopia and he was overthrown in about 1974. He was taken over by Mengistu Haile Mariam, who was a dictator in every sense of that word. Haile Selassie had what we would call a capitalist economy. Mengistu changed it to a socialist/communist economy, completely ran it into the ground.

So, while there was 10% to 12% economic growth in the final years of Haile Selassie, it just went downhill from there. And it was a disaster in many ways. So, number one, you have a lot of economic issues. Number two, you had the bad luck and partly bad policies causing the famine. And so, in 1984, there was this tremendous famine, and the whole world heard about that.

So I went and I was working with another one of the Jewish organizations and I was in charge of the healthcare in one of the camps. So, we had a cholera epidemic. We had meningitis. We had a lot of starvation. We were rehabilitating these people nutritionally. And of course, if you’re starving and you’re in an environment like Ethiopia, you’re wide open to infectious disease. So, there’re a lot of consequences.

So, it was a very important experience for me, and I learned so much trying to work with these people and keep them alive. And Ethiopians are wonderful people. I love them, but it was my first introduction to sort of mass casualty medicine.

As a Fulbright fellowship professor, he asked what area they needed help in. They said cardiology. He was the closest thing they had to a cardiologist. He would see more rheumatic heart disease in one day than he saw in all his residency. He was able to send some patients to America for heart surgery.

One kid, literally, who was carried by piggyback to my office. Somebody knocked on the door, opened up the door and it was an older brother carrying his brother piggyback, and I said, put your brother down. And he said, okay. And his brother stood. And I said, let’s walk into my office. And he picked him up again. And he was so hypoxic he couldn’t take more than three steps. So, his brother carried him everywhere by piggyback.

I got him accepted for surgery at Stony Brook. Back then they were doing surgeries in two stages. They were putting in a shunt for stage one, then a year later doing the final correction. So, we flew him to America, plugged him into the Stony Brook system. This guy is now a soccer coach in Ethiopia.

All of that was done for free, as Dr. Hodes raised the money for his airfare.

Financial Need

I asked Dr. Hodes, when he sends these letters asking for doctors to take care of these patients for free, what percentage of the time do they say yes? He said you actually need five things. You need a passport, visa, place to stay, free surgery, free anesthesia. He is now doing spine. So, you need spine implants. It all has to come together. If you only get one or two or three, it’s not enough. He said his success rate is around 15%.

You plant a lot of seeds and you see what grows and you see what happens, but sometimes you get these offers. There’s a small Greek community in Ethiopia. And I had this kid with tetralogy and he said, “Rick, can we send them to Greece?” And I said, “Yeah, why not?” This is a kid from Mother Teresa’s mission. And he said, let me call Greece. And so, he calls Greece, got this kid accepted for heart surgery. And he flew the kid to Greece. The guy had successful heart surgery, stayed for six months in Greece, came back speaking Greek, because he’s a little kid, and rejoined his family.

We discussed the challenge of doing this type of work for doctors that are now graduating with $200-$400K in student loan debt. How can these doctors do something similar, making $30,000 a year? Can this still be done today? Dr. Hodes’ medical school tuition was $4500, so he could take a low-income job for a longer time period without that student loan burden. There has to be a different model today.

International Medicine

Prior to surgery

We discussed what a model for practicing international medicine might look like for today’s graduates. Some people have criticized international aid programs, saying they are doing more harm than good. Now, personally, I’ve had a few international medical experiences where I felt I wasn’t accomplishing much long-term good, anyway, and maybe even doing harm. I asked him, what do you think is the key to effectively aiding others in less developed countries without doing harm to them on an individual or a community level?

You need to ask yourself, “Is this needed? Is it effective? And is it sustainable?” And if it’s not, like for example, somebody wanted me to send a C-arm to one of the hospitals, but the hospital had no interest in the C-arm. It was the outside doctor who was saying, “These people need a C-arm” because he knew that to do good orthopedic surgery, they should have a C-arm. But they had no interest in the C-arm. They weren’t asking for the C-arm at all. And I just said, “No, I just don’t think at this point that it’s a good way to spend money.”

Now in Ethiopia in 1984, the gross national income was $210 per person per year. Now it’s up to $850. So, we are actually on the upward trend, and development is going in the right direction. Part of it is because we have a change in government and we have much more of a capitalist system than we did when the communists were running it. And communism, we all know is not a good economic policy.

So, you need economic development. You need education. If you educate a bright and motivated person, then that person’s going to take off a lot. And so, one of the things that I like to do is send people to school, and there’re programs to do that. And another thing that I like to do is help individuals not become handicapped. And that has to do with the spinal deformities.

People who have a skill like eye surgery can come and do a procedure and teach others how to do it. That is the best way to practice international medicine, transfer the knowledge to partners on the other side of the globe. But it has to be done in a very careful and planned way, partnering together. He shared a story of when a surgeon came to Ethiopia and had an arrangement with a hospital and arrived with his team all ready to do surgery. But they had no patients for two days.

Finally, somebody knew of me and called me and said, “Rick, do you have any spine patients?” And I said, “Do I have spine patients? I have a hundred, how many do you want?” And they said, “We have a surgeon here right now.” Then the rest of the second half of his trip was very successful, but only because I stepped in. Now he cut out that hospital, and the relationship is between him and me. And I’m the one who sends him his patients.

Dr. Hodes shared a great story about how he got involved with spine patients. He ended up adopting three orphans that needed surgery. He couldn’t get the donations for it, so he adopted them and put them on his health plan. Now, serial adoption is probably not the answer to spinal deformity, and he was able to come up with a better solution.

His better solution was a doctor from Ghana that was successfully practicing in the United States. He moved back to Ghana and opened up his own hospital and is doing spine surgeries there now. Dr. Hodes sends patients from Ethiopia to Ghana for surgery.

He also has teams coming into Ethiopia to operate inside the country. That is a lot cheaper, and they are also training Ethiopian doctors. Dr. Hodes’ ultimate goal is to put themselves out of business and be the advisors and have the Ethiopian doctors doing all of this themselves. It is remarkable what he has been able to accomplish over the years. He said he has a sign over his desk, from an old Rabbi. It says “Stop thinking about what you need and think about what you’re needed for.”

Fundraising

Post Surgery

Dr. Hodes has the support of his organization, the American Jewish Joint Distribution Committee. But they have to raise all of the money to fund the project. He is probably in the States 20% of the year visiting family and doing fundraising. At his website, it lists the prices for the services they provide in Ethiopia. The expensive ones are $10,800 for a full heart surgery and $29,800 for a full spine surgery. Some of these are pretty big-ticket items per patient. I asked him how he raises the funds for this cause.

We don’t charge our patients anything. Occasionally they will have a relative in the states who will raise money. Recently, I had a patient from Eritrea who needed spine surgery, and I contacted the relatives in the states. They raised the money through the Eritrean community in America and sent it. But I have a website, people contact me. Some people send me $20 a month. Some people send me $100 a month. Some people give me $50,000. We put all the money into our project and that’s what we want to keep on doing.

$29,000 does seem like a lot of money for a surgery. That same surgery in America could be a million dollars. I mean, if you’re putting somebody into traction, in the hospital for three, four months, and then you’re operating, that runs into millions. For example, I know of a case of a specific patient in New York City who had very good insurance, who had traction and surgery, and his medical bill was $1.5 million.

 So, in that respect, it’s an incredible value. You can also donate frequent flyer miles to the cause. It helps transport patients from Ethiopia to Ghana or India. I asked how that worked.

People contact me, and it’s not a formal program, but we do it by private arrangement. And we’ve had patients say “I have 50,000, I have 100,000 miles. Can you use them?” And depending on the airline and so on, we can work out a way of using that to pay for our patients to go to Ghana for surgery, or to go to India for heart surgery.

Operation Solomon

You have probably not heard of this. It happened in 1991.  This was essentially a covert Israeli military operation to airlift Ethiopian Jews to Israel over 36 hours. In 1991, they airlifted 14,325 Ethiopian Jews in 36 hours. It includes a record that is almost unbelievable, 1088 people on a single plane, which was made possible because no one brought any luggage and everyone was so thin. Dr. Hodes was right in the middle of that, getting patients out of the hospital to get on that plane. He talks about what those incredible 36 hours were like in this episode.

The Committee was the 15 most educated people in this population of 15,000. Now educated means maybe they had a high school education. We said to them, go to every single house of all the Jewish people, tell them, drop everything and come immediately to the Israeli embassy. Bring only your family and any medical records you might have, because people had kept their X-rays themselves sometimes. And that’s it.

And they went out to spread the word. My job was getting people out of the hospital. Now all of this had been worked out on our computer system. So, each person had five people he needed to tell. Each of them had five people that they needed to tell, and so on so we could get a message out inside the Jewish community and keep it there, at least for a while.

They went out to spread the word. My job was getting people out of the hospital. So, I drove across the city to the leprosy hospital, and it had a boy who is 10 years old, very malnourished, who had both tuberculosis and leprosy. They wouldn’t let him go. I waited till they turned around. I picked him up and put him over my shoulder and I started running to put him in my car and drive away. Literally kidnapping this kid from the hospital. And Ethiopians were running after me.

It is a remarkable story. At the end of the day, 14,000+ people flew to Israel with 39 flights.

Burnout

Now while doing all of this international work, none of which I presume pays well, if at all, has he been able to save anything up for retirement at all along the way? He said he has been able to save and invest and has a retirement plan with JDC. Many physicians I run into feel burned out on medicine. They want to save up money and get out of medicine as soon as possible.

This sort of thing was clearly never in his plan. How has he been able to sustain his passion for medicine and service over so many decades? And what advice does he have for doctors who feel they’re losing that passion?

What motivates me is the fact that I know that I’m personally making a difference. And if I don’t go to work, somebody is going to die. It keeps me going. One of my patients wrote something a few weeks ago for my website. This is just this amazing thing that she came up with. She said, “You can’t change the world, but you can change one person’s world.” And so, when you change enough ‘one person’s worlds,’ you’re changing a lot of worlds.

So that’s what I tried to do. But I understand the problem. And I understand if you’re too pressured and you don’t have balance in your life, then life becomes terrible. So, we have to somehow work to restore a balance.

 

Ending

It is really inspiring to talk to people like Dr. Rick Hodes. If you want to get in touch with him, you can reach him through his website. He does academic talks, pediatric grand rounds, medical grand rounds, neurosurgery grand rounds. You can meet with him over Zoom.

He mentioned that he’d been introduced at a conference in New York City as “Rick is the doctor that I wrote that I wanted to be in my medical school admissions essay.” I think there’s a lot of truth to that. I mean, we all wrote in our essays that we really love science and just really want to help people. And you look at somebody like Rick, and he’s actually doing it. He’s right. $30,000 is a lot of money, but it changes a life. And it’s a bargain. It’s a million and a half bucks if we do it in New York City; it’s $30,000 if we do it in Ghana. So, I’m pretty inspired by that.

Katie and I want to donate money to Dr. Hodes. Now this is a great organization. This is run through the American Jewish Joint Distribution Committee. If you look this up on Charity Navigator, you will see that it gets a very high rating. They get a four-star rating, a 92% financial score, and 100% transparency score. This is a good charity to donate to. They’re obviously doing some fantastic work.

We are going to match every dollar you donate to rickhodes.org. Donate some money and shoot us an email. Tell us how much you donated, and we will donate that amount, as well. We’re going to donate a minimum of $10,000. We will match your donations up to $50,000. Let’s get some of these people fixed so they can have a healthy life.

Full Transcription


Intro:
This is the White Coat Investor podcast where we help those who wear the white coat get a fair shake on Wall Street. We’ve been helping doctors and other high-income professionals stop doing dumb things with their money since 2011. Here’s your host, Dr. Jim Dahle.
Dr. Jim Dahle:

This is White Coat Investor podcast number 188 – Rick Hodes, a life dedicated to service.
Dr. Jim Dahle:
Thanks for what you do. Life’s not easy these days. I saw a COVID patient the other day in the ER, who was not that sick could actually go home, shot a chest X-ray, looked pretty good and his oxygen looked good. And so, I was going to let him go home. And we got his wife on the phone and we’re all talking together and she threatened to sue me if anything bad happened to him. What a great job we have that people are constantly threatening just to sue us in case anything bad happens even if our actions were completely reasonable.
Dr. Jim Dahle:
So, I actually got them a pulse oximeter, send them home with that, told them to drink a bunch of water because he was a little dehydrated and called him the next day to make sure he was doing okay. And he said, “Yeah, I really was very dehydrated and just needed to do that. I’m feeling much, much better today”.
Dr. Jim Dahle:
So obviously she’s not going to sue me, but it’s tough having a job where you have that liability hanging over your head all the time, where people just walk up and threatened to sue you for millions of dollars for killing their spouse. So, thanks for what you do.
Dr. Jim Dahle:
Let’s have a word from our sponsor. This podcast is sponsored by Bob Bhayani at drdisabilityquotes.com. He is an independent provider of disability insurance planning solutions to the medical community in every state and a long-time White Coat Investor sponsor.
Dr. Jim Dahle:
He specializes in working with residents and fellows early in their careers to set up sound financial and insurance strategies. If you need to review your disability insurance coverage to make sure it meets your needs or if you just haven’t gotten around to getting this critical insurance in place, contact Bob at drdisabilityquotes.com today. You can email [email protected] or call (973) 771-9100.
Dr. Jim Dahle:
All right. Our quote of the day today comes from Thomas J. Stanley of “Millionaire Next Door” fame. He said, “If you’re not wealthy yet, but want to be someday, never purchase a home that requires a mortgage that is more than twice your household’s annual realized income”.
Dr. Jim Dahle:
If you haven’t heard yet that we have a WCI con conference at Physician Wellness and Financial Literacy conference, it’s going to be March 4th through 6th. If you register before January 5th, so you can use your 2020 or your 2021 CME money to pay for it because it is going to be eligible for CME.
Dr. Jim Dahle:
But if you register before January 5th, we’re going to send you a swag bag and we’re known for the best swag bags in the industry. So, it’s going to contain several books, WCI t-shirt, et cetera, but you have to register before January 5th. And you can get that at whitecoatinvestor.com/conference. And you can register for that.
Dr. Jim Dahle:
Also be aware if you are interested in being a landlord, if you’re interested in direct real estate investing, but aren’t quite sure how to do it, there is an online course designed just for you. It’s called “Zero to Freedom”. It’s put together by a couple of docs, very popular. We had a lot of White Coat Investors register for it last time, and it is open for enrollment right now.
Dr. Jim Dahle:
For the next few days, you can sign up for it. It’s at whitecoatinvestor.com/rental. And if you do so through our links, you will get $300 off the course, if you register right away before the wait list sale ends. But if you go through our links, you will also get a signed copy of the White Coat Investor’s Financial Bootcamp, and we will give you our online course WCI con Park City. That’s got 13 extra hours of awesome content from folks like Jonathan Clements and Bill Bernstein and Mike Piper. So, check that out today – whitecoatinvestor.com/rental is the link for that.
Dr. Jim Dahle:
All right. We have an awesome guest today. Let’s get him on the line. My special guest today is Rick Hodes, who you may have heard of before. He is actually well known. He’s been mentioned once on the blog before actually in a guest post from Crispy Doc who had mentioned that he had worked with him in the past.
Dr. Jim Dahle:
And you may have looked him up at that time, but if not, he has been doing some fantastic work in Ethiopia for a good chunk of his career. And we’re going to get into a lot of the details of it. So, I don’t feel a need to give him a big, huge introduction. I think by the end of this podcast, you’re going to feel, that you know him and his heart very well. So, Rick, welcome to the white coat investor podcast.
Dr. Rick Hodes:
My pleasure. Thank you.
Dr. Jim Dahle:
Now tell us, briefly about your upbringing and how it affected your views on life, medicine and the way you live your life financially.
Dr. Rick Hodes:
Okay. I’m from Syosset, a town in Long Island. I went to public school. I came from a middle-class family. My father had an insurance business. I went to Middlebury college in Vermont, got a degree in geography. I lived in Alaska for several years. I like to wander around, you’ll get that picture. And thought about my life. And then I thought the best thing I can do with my life is go to medical school.
Dr. Rick Hodes:
So, I did pre-med at the University of Alaska, went to medical school at University of Rochester, moved down to Baltimore and trained in internal medicine at what’s now called Johns Hopkins Bayview. And I also somehow along the way, got interested in global health. And I knew that that’s what I wanted to do with my career. Even though there were no role models and I didn’t have a lot of opportunities. So, I made them for myself.
Dr. Rick Hodes:
As a medical student, I spent a summer in Bangladesh in a winter in South India. As a resident, I would take my vacation and work in refugee camps in Africa. And then I thought, “Well, I’m going to spend one-year teaching in Africa after residency”. So, I had no money and I applied to a bunch of different things and I got offered a Fulbright fellowship to be a professor, a lecturer in medicine at Addis Ababa University and they were going to pay me. So, I said, “Okay, you want to pay me? I will go”.
Dr. Rick Hodes:
So, I went to Addis Ababa University and I taught there for two and a half years. I taught internal medicine. It was completely different spectrum of medicine. Here I am coming from Baltimore and there we had people dying of rheumatic heart disease, people dying because they couldn’t get their valves replaced, things like that.

Dr. Rick Hodes:
So, it was a major challenge for me and I was able to intervene and help send a bunch of people to America for surgery. And then I left to try to take a job with a World Health Organization, but that fell through because of a revolution in Burma. So, I ended up back in the states and I got a job working in a practice. But I really wanted to go back overseas. Israel and Ethiopia re-established diplomatic relations in 1987. And Ethiopian Jews heard about this and they started coming to the capital out of Addis Ababa.
Dr. Rick Hodes:
So, they had a major health problem. I contacted the American Jewish joint distribution committee, which is an organization on the ground there. They hired me to go back to Ethiopia in 1990 to be the doctor for the Ethiopian immigrants to Israel. So, in 1990, I went back to Ethiopia to be the doctor for the Ethiopian immigrants to Israel. There was about 25,000 Ethiopian Jews who were stuck on the ground.
Dr. Rick Hodes:
So, I became their doctor. And somebody had been there for a couple of months before and helped start a medical program. I took over after that and polished it. And we had a clinic that was going 12 hours a day, seven days a week. We had a nutrition program. We immunized people and started a program for TB. I ended up diagnosing 3.5% of the population with active tuberculosis.
Dr. Rick Hodes:
Dr. Jack Adler from New York came in, who was head of TB for New York City. We started them on a six-months 62 dose TB regimen. And they did very, very well. And it was my first big time introduction to tuberculosis. And tuberculosis has in one way or another taken over my life since then.
Dr. Rick Hodes:
So, I’ve been a doctor in Ethiopia now for 33 years. And even though, I stepped out because of COVID, I can’t wait to go back and I’ve really spent my whole entire career in Ethiopia.
Dr. Jim Dahle:
It’s interesting. We actually went to Alaska at the same year. I was born on vacation while my parents were living in Anchorage and they brought me home from the hospital and we went to Alaska in 1975. Same year you went to Fairbanks to do your pre-med work. So, we have that connection.

Dr. Jim Dahle:
But when I was growing up in the 1980s, the only thing I knew about Ethiopia was that everybody there was starving. This was the example that your parents would give you. If you don’t eat, eat your potatoes, there’s kids starving in Ethiopia.
Dr. Jim Dahle:
Prior to going there to teach, you went as a relief worker there in 1984 and really the height of the famine. How did that experience impact your life and career plans?
Dr. Rick Hodes:
Oh my gosh. Tremendous. So, what happened was Haile Selassie was the leader of Ethiopia and he was overthrown in about 1974. He was taken over by Mengistu Haile Mariam, who was a dictator in every sense of that word. Haile Selassie had what we would call a capitalist economy. Mengistu changed it to a socialist/communist economy, completely ran it into the ground.
Dr. Rick Hodes:
So, while there was 10% to 12% economic growth in the final years of Haile Selassie, it just went downhill from there. And it was a disaster in many ways. So, number one, you have a lot of economic issues. Number two, you had the bad luck and partly bad policies causing the famine. And so, in 1984, there was this tremendous famine and the whole world heard about that.
Dr. Rick Hodes:
So, I went and I was working with another one of the Jewish organizations and I was in charge of the healthcare in one of the camps. So, we had a collar epidemic. We had meningitis. We had a lot of starvation. We were rehabilitating these people nutritionally. And of course, if you’re starving and you’re in an environment like Ethiopia, you’re wide open to infectious disease. So, there’s a lot of consequences.
Dr. Rick Hodes:
So, it was a very important experience for me and I learned so much trying to work with these people and keep them alive. And Ethiopians are wonderful people. I love them, but it was my first introduction to sort of mass casualty medicine.
Dr. Rick Hodes:
Fast forward years later, when there were the problems in Rwanda and Zaire, I flew to Goma Zaire and was in charge of the health care of 25% of refugee camps. So, what I learned in Ethiopia in round one became big time in round two, because the camp had 200,000 people. So, my team was in charge of 50,000 people. We had a cholera epidemic, which is a massive, massive watery diarrhea. Then we had meningococcal meningitis epidemic and we were able to handle this in quite a nice and creative way.
Dr. Rick Hodes:
One of the tricks for cholera, for example, that I introduced, and I had learned this in the first Ethiopian cholera epidemic was peritoneal hydration. So, when somebody is severely dehydrated, instead of fishing for vain, you can just go into the peritoneum and you go in an intro to below the umbilicus, after the bifurcation of the aorta. And then you make a Z track in, you put in a needle and you fill them up with lactated ringers.
Dr. Rick Hodes:
And for an adult, you can put seven or eight liters in. Even in a kid you can put in about 10% of their body weight and rehydrate them. And it works marvelously. I’ve done it hundreds of times.
Dr. Jim Dahle:
Just like the opposite of paracentesis.
Dr. Rick Hodes:
Exactly. It’s the opposite of paracentesis.
Dr. Jim Dahle:
Awesome. So, you went to medical school in Rochester, you trained in internal medicine in the Johns Hopkins system. You clearly had this overseas medicine interest right at the beginning. But this is really interesting. You came out of training, you went to Ethiopia as medical school faculty and started giving lectures. Can you tell us more about that experience? What was that like to just go to another country and start teaching medicine there?
Dr. Jim Dahle:
You said you had a scholarship. I assume that probably paid some basic living expenses, but I’m sure you weren’t making any significant amount of money doing that. Tell us about that experience, what that was like.
Dr. Rick Hodes:
So, I got this idea that I could apply for a Fulbright fellowship and I applied for the Fulbright and the Fulbright people said, “Doctors don’t apply for this”. And I said, “Is there a problem with it?” And they said, no. And they said, there’s two types of Fulbright’s and you can apply for both. One is a research Fulbright, and one is a professor Fulbright. And I said, what’s the difference? And they said, well, professor Fulbright pays more and you’re talking about maybe $25,000 – $30,000 a year. They said, but you need three years teaching experience. So, I thought fast. Here, I am right at the end of my residency and said, “Oh, I’ve been teaching medical students for three years”.
Dr. Jim Dahle:
Perfect, perfect.
Dr. Rick Hodes:
And they said, Oh, okay. And obviously when you’re a senior resident, you’re teaching the younger ones. So, I got a Fulbright fellowship. I arrived at the Addis Ababa University. I was assigned to the faculty of medicine. And I said, what area do you need help in? And they said cardiology. So, I said, okay. I said, I’m the closest thing you have to a cardiologist.
Dr. Rick Hodes:
And so, cardiology in America, as we know, is largely ischemic heart disease. And cardiology, especially back then was more rheumatic heart disease. I actually published a series of a 100 or 200 consecutive cases in my outpatient clinic. And it was 55% rheumatic and 3% ischemic.
Dr. Rick Hodes:
So, I would see more rheumatic heart disease in one day than I saw in all my residency. So, I got very good at listening to hearts. I would make the diagnosis by putting them in different positions, listening for the murmur of mitral stenosis, sitting them forward to hear the murmur of aortic regurgitation. People would come in with these complex congenital lesions.
Dr. Rick Hodes:
If they came in, for example, with hypoxia, the question is, do they have Eisenmenger’s or do they have uncorrected tetralogy and they’re 12 years old. And if they’re lucky, they’re going to have uncorrected tetralogy. And by then I had written enough letters to doctors in America that they started accepting my patients for free.
Dr. Rick Hodes:
I was able to send some patients to America for heart surgery. One kid literally, who was carried by piggyback to my office. And I stood outside my office. Somebody knocked on the door, opened up the door and it was an older brother caring. And his brother was piggyback and I said, put your brother down. And he said, okay. And his brother stood. And I said, let’s walk into my office. And he picked him up again. And he was so hypoxic he couldn’t take more than three steps. So, his brother carried him everywhere by piggyback.

Dr. Rick Hodes:
I got him accepted for surgery at Stony Brook. Back then they were doing surgeries in two stages. They were putting in a shunt for stage one, then a year later doing the final correction. So, we flew him to America, plugged him into the Stony Brook system. This guy is now a soccer coach in Ethiopia.
Dr. Jim Dahle:
Awesome.
Dr. Rick Hodes:
And all of that was done for free. I just had to raise money for his airfare.
Dr. Jim Dahle:
So, I’m curious when you send these letters and ask docs, will you take care of this patient for free? And I assume you got asked the hospital too, because the operation care has to be given somewhere. What was your hit rate? I mean, what percentage of the time did they say, “Yes, we’ll do this for free?”
Dr. Rick Hodes:
So, you actually need five things. You need a passport, you need a visa, you need a place to stay. You need free surgery. You need free anesthesia. Now I’m doing spine. So, you need spine implants. And it all has to come together. If you only get one or two or three, it’s not enough. So, the success rate 15% like that. It’s low. The best batter is never going to hit 75%.
Dr. Rick Hodes:
You plant a lot of seeds and you see what grows and you see what happens, but sometimes you get these offers. There’s a small Greek community in Ethiopia. And I had this kid with tetralogy and he said, “Rick, can we send them to Greece?” And I said, “Yeah, why not?” This is a kid from Mother Teresa’s mission. And he said, let me call Greece. And so, he calls Greece, got this kid accepted for heart surgery. And he flew the kid to Greece. The guy had successful heart surgery stayed for six months in Greece, came back speaking Greek, because he’s a little kid, and rejoined his family.
Dr. Jim Dahle:
Huh. Pretty awesome. It makes me wonder. I hear about you doing this a few years ago. And then I know I talked to all these doctors coming out of their training owing $200,000 – $300,000 – $400,000 in student loans. How can these doctors do something similar or go to Ethiopia or wherever on a Fulbright fellowship, make $30,000 a year and still do this? Can this still be done today do you think?

Dr. Rick Hodes:
It’s tough. Like my first year of medical school at University of Rochester in 1978, tuition was $4,500. My last year it was $9,500 and I got a $5,000 scholarship. These days if you’re coming out and you owe $300,000, it’s very tough to take a low-income job or a no income job for a long period of time. So there has to be a different model.
Dr. Rick Hodes:
People who have a skill like eye surgery, arthroscopy, things like that, can come and do a procedure and teach how to do the procedure. That’s the best way to do it, to transfer the knowledge to partners on the other side of the globe. But it has to be done in a very careful and planned way. There’s lots of this crazy stuff that goes on. People showing up with great intentions, but without a partner on the other side, or without a lot of planning, it doesn’t work out.
Dr. Rick Hodes:
One of my partners right now, a wonderful guy named Ted Bellinger who’s in Dallas is a wonderful deformity surgeon. He came to Ethiopia, had an arrangement with one of the hospitals, arrived with his team already to do spine surgery. They hadn’t set up any patients. And the first two days, they just waited to see if any spine patients would show up.
Dr. Rick Hodes:
Finally, somebody knew of me and called me and said, “Rick, do you have any spine patients?” And I said, “Do I have spine patients? I have a hundred, how many do you want?” And they said, “We have a surgeon here right now”. So, I spoke to him. I find out the type of patients he wanted, not too difficult to start off. I sent them a bunch. And then for the rest of the second half of his trip was very successful. But only because I stepped in. Now he cut out that hospital and the relationship is between he and me. And I’m the one who sends him his patients.
Dr. Rick Hodes:
Let me just say something about spines because it’s completely changed my life. I was taking care of the Ethiopian immigrants to Israel, and it’s the same time I was volunteering at Mother Teresa’s mission. So, I’m a Jewish doctor from Long Island and I was working with the Catholic nuns, taking care of Ethiopian Orthodox Christians and Muslims. It was the whole world working together. It was just beautiful. And we all work together, we love each other. It’s fantastic.
Dr. Rick Hodes:
In 1999, I got an admission one day of two abandoned orphans and they had TB of the spine. We all know that TB is a lung disease. TB also causes spinal deformities and it causes a symmetrical V-shape to the spine. While scoliosis is obviously an S when you look at a patient straight on, you’ll see an S in their spine. TB’s have straight spines when you look from the front or from the back, but from the side, it causes a tremendous V.
Dr. Rick Hodes:
And so, of these boys, one of them had a 90-degree angle, and one of them had 120-degree angle. I knew one of them was quite young. He was like six or seven. The other one was early puberty. And I knew if you have multi vertebral TB, and you’re in puberty, you’re in your growth spurt, you’re likely to become paralyzed. There’s likely to become spinal cord involvement. He was just starting to become myelopathic and was hyperreflexic.
Dr. Rick Hodes:
So, I wanted to help these guys, but I couldn’t get them free surgery. I had no connections in the spine world, and it’s even now very difficult to get free spine surgery outside Ethiopia. So, I was walking around and I got this brilliant idea one day that I could adopt them, add them to my American health insurance and get them surgery in the United States.
Dr. Rick Hodes:
Now, the problem is when you adopt an abandoned orphan, who has no known relatives, they become yours for life. So, on one hand, I could get them surgery. On the other hand, we’d have to spend the rest of our lives together. Like this is not a joke. And did I want that much permanence in my life? So, I said, wait a minute. I said to myself, Rick, think about this. So, I’m walking along one day, I looked up at the sky and I said to the Almighty, “What do you want me to do?” Like in a bit of an obnoxious tone, actually.
Dr. Rick Hodes:
But three days later, and I’m not like one who gets messages from God. But three days later, I got a fax sent to my brain and the answer was there. And it said, I’m offering you a chance to help these boys. Don’t say no. So, I said, okay. And again, nothing in Ethiopia is easy, but I went ahead. I adopted them. I added them to my health insurance. I brought them down to Texas Scottish Rite hospital in Dallas. And they had successful surgery.
Dr. Rick Hodes:
Of those two, one of them is now in pharmacy school in Atlanta. And the other one is a businessman in Ethiopia. Another kid came along and he had a bad back and I adopted him and added him to my insurance and got him surgery the same way.

Dr. Rick Hodes:
Now, serial adoption is probably not the answer to spinal deformity. So, I had to come up with a better solution. Now the better solution has a very unusual name. His name is Oheneba Boachie-Adjei.
Dr. Rick Hodes:
Dr. Boachie, as he’s known is in my opinion, I don’t want to insult any of your fine listeners, but I think he’s the best spine surgeon in the world. He is a great American success story. At 18 years old, he flew from Ghana to Brooklyn, with $20 in his pocket, worked his way through Brooklyn college, Columbia University medical school.
Dr. Rick Hodes:
He was AOA. I was not AOA. He did his orthopedic training at special surgery. He did his spine training in Minnesota, which at the time had the best deformity program in the United States to became a super surgeon. He was in Minneapolis, he was on the West coast. Then he went and he was chief at special surgery for years. He made money that way.
Dr. Rick Hodes:
He moved back to Ghana and opened up his own hospital, which is called FOCOS -Foundation for Orthopedics and Complex Spine. And he does fantastic surgery there. Now I did a neurosurgery presentation at Mount Sinai hospital some years ago. And the chief of neurosurgery said to me, “Rick, the surgery that you’re doing in Ghana, we can’t do here at Mount Sinai”. Like that’s how complicated it is.
Dr. Rick Hodes:
And so, working with Dr. Boachie, we first met in 2005. We spent a day together and we decided we could work together. But he also needed money because he said he and his team worked for free, but they still have to pay their Ghanaian staff and they have to pay the Ghanaian hospital system. At the time they didn’t have their own hospital. They were working at a government hospital called Korle-Bu.
Dr. Rick Hodes:
So, I raised some money. In the spring of 2006, we sent five kids to Ghana for spine surgery. It was a learning curve for all of us. So, we sent one staff. The one staff was not enough. We later found out. So, what happens in the Ghana hospitals at night, 10 o’clock at night, the nurses sit down, they put a blanket over their head and they go to sleep.

Dr. Rick Hodes:
And so, we have to take care of the nursing care of our patients. That’s crazy. And so, so later on, we sent more staff. And then later on, Dr. Boachie opened up his own hospital. So that now it’s a real hospital and we don’t have to provide the nursing care.
Dr. Rick Hodes:
In fact, because I also take care of kids who are rheumatic and congenital heart disease and have a partnership with the Hindu hospital in India. And so, when I send patients to them the first time, I specifically sent a nurse so that she would assess, somebody I like and trust very much, so that she could assess the nursing care. She came back and he said, “Dr. Rick, the Indian nurses are great. They work all the time. They don’t sleep for one second at night”. She said, “You don’t need me. You just need a translator”.
Dr. Rick Hodes:
So, I opened up my spine practice in 2006. And that year I got 20 new spine patients and we did 11 surgeries. I’m the only doctor practicing spinal deformity care in the country that I know of. And we are now getting about 500 new deformities a year. And so, I now have really the largest collection of the worst spinal deformities in the world.
Dr. Rick Hodes:
We had a paper in the European Spine Journal last year with nomenclature for three new deformities. We have an Alpha we have a Gamma and we have an Omega spine based on these new shapes that we’re discovering that we can’t put words to so we’re using Greek letters.
Dr. Rick Hodes:
I’m raising money. We’re sending people to Ghana for spine surgery. And in Ghana, we’re putting them into ambulatory traction, Halo gravity traction invented at Scottish Rite in Dallas. So, they drill four holes in the skull. They put a halo around, they stretch them 23 hours a day when they sit, when they stand and when they lie down. And then they go ahead and they operate after say two, four, six months. And they still have to do major surgery, including removal of vertebra, which is called the VCR. And that’s a very big deal. But they’re doing all of that. We’re getting very nice results.
Dr. Rick Hodes:
And then I also have teams coming into Ethiopia to operate inside the country. That’s a lot cheaper. And we’re also training Ethiopian doctors because our ultimate goal is to put ourselves out of business and be the advisors and have our fine Ethiopian doctors doing all of this themselves.

Dr. Jim Dahle:
That’s pretty remarkable what you’ve been able to accomplish over the years there. And at the rate you’re moving, I’m sure you’ll be able to accomplish that goal and get yourself fired eventually here.
Dr. Rick Hodes:
Yeah. I have the support of my organization, the American Jewish Joint Distribution committee. They are sponsoring us. We have to raise all of our money to fund the project. And I work on that. I’m probably in the states on a normal year, 20% of the year. And I’m a visiting family and doing fundraising.

Dr. Jim Dahle:
Let’s talk just for a minute about that fundraising. It sounds like you do a fair amount of it. At rickhodes.org, which is your website it lists the following dollar amounts, $100 for an MRI, $500 for pre-surgical tests, $1,000 for two weeks attraction, $10,000 for a set of spine rods and screws, $1,900 for a full cancer treatment. $10,800 for a full heart surgery and $29,800 for a full spine surgery. Some of these are pretty big-ticket items per patient. How do you raise the funds for this cause?
Dr. Rick Hodes:
Yeah, well, we don’t charge our patients anything. Occasionally they will have a relative in the states who will raise money. Recently, I had a patient from Eritrea who needed spine surgery and I contacted the relatives in the states. They raised the money through the Eritrean community in America and sent it.
Dr. Rick Hodes:
But I have a website, people contact me. Some people send me $20 a month. Some people send me $100 dollars a month. Some people give me $50,000. We put all the money into our project and that’s what we want to keep on doing.
Dr. Jim Dahle:
Awesome.
Dr. Rick Hodes:
But then the thing is like $28,000 does seem like a lot of money for a surgery. That same surgery in America could be a million dollars. I mean, if you’re putting somebody into traction, in the hospital for three, four months, and then you’re operating, that runs into millions. For example, I know of a case of a specific patient in New York City who had a very good insurance, who had traction and surgery, his medical bill was $1.5 million.

Dr. Jim Dahle:
So, in that respect, it’s an incredible value.
Dr. Rick Hodes:
So, it’s incredible value.
Dr. Jim Dahle:
We ought to be sending this guy to Ghana to have it done.
Dr. Rick Hodes:
Absolutely. And in fact, like I’ve spoken to the Ghanaian doctors and I said, get yourself accredited as an American hospital and you’re going to get people coming over from America. And now they’ve become an international resource. So, people through my website contact me. Dr. Boachie, he has patients coming from the Philippines, from Rwanda, from all over the place.
Dr. Rick Hodes:
One of my dear friends is a doctor in South Sudan and she brought me a patient. I brought the kid to Ghana. He had surgery and now we’re trying to get him back to South Sudan. And so, one of the things I was working on this morning was getting my son, the businessman in Addis a visa for South Sudan, so that he could fly to Ghana, pick up this kid and bring him back. He’s somewhat paralyzed now. We expected to get better. We find that many of the paralyses do get better over time, but it takes time.
Dr. Jim Dahle:
Now you can also donate frequent flyer miles to the cause. It helps transport patients from Ethiopia to Ghana or India. How does that work exactly?
Dr. Rick Hodes:
Yeah. So that actually is possible. People contact me and we do it the way, it’s not a formal program, but we do it by private arrangement. And we’ve had patients say “I have 50,000, I have 100,000 miles. Can you use them?” And depending on the airline and so on, we can work out a way of using that, to pay for our patients to go to Ghana for surgery, or to go to India for heart surgery.
Dr. Jim Dahle:
That’s awesome. So, if you’d like to donate to this cause it’s really easy. If you go to rickhodes.org, you can just follow the links and it’s relatively easy to donate money or even donate extra miles that you have to this cause.

Dr. Jim Dahle:
Now I want to turn the page back a little bit to this interesting chapter in your life in 1991, where you participated in operation Solomon, which I will bet most of my listeners have never heard of.
Dr. Jim Dahle:
This was essentially a covert Israeli military operation to airlift Ethiopian Jews to Israel over 36 hours. In 1991, they airlifted 14,325 Ethiopian Jews in 36 hours. And it includes a record that is almost unbelievable. 1088 people on a single plane, which was made possible because nobody brought any luggage and everybody was so thin. What was that like to be part of that incredible 36 hours?

Dr. Rick Hodes:
I can take another hour of your podcast to talk about this. I was hired to be the doctor for the Ethiopian immigrants to Israel. And we had all of these people who needed to get to Israel. There were secret negotiations between the Israelis and the Ethiopians to try to get people out. And the Ethiopians at first said a thousand people a month could go. So, I was hired at the beginning of this. And so, it seemed like there were 25,000 people. It was going to take a while.
Dr. Rick Hodes:
Meanwhile, in May of 1991, Mengistu Haile Mariam, the dictator of the country fled. There were about 15,000 Ethiopian Jews still left in Ethiopia at the time. The Ethiopians contacted through George Bush Senior, contacted the Ethiopian government again and got permission for operation Solomon. So, I was walking across the lobby of the Hilton hotel.
Dr. Rick Hodes:
Oh, let me back up because this story gets better. I had a woman who had come in from Sudan. She was pregnant and she had malaria. Now malaria in pregnancy is a terrible situation because the placenta becomes like a magnet for the malaria parasite. And it’s very easy to lose the mom and it’s very easy to lose the fetus. So, this becomes like a medical emergency and you often have to give they hemolyzed and you need to give them blood transfusions.
Dr. Rick Hodes:
So, I needed to give her a blood transfusion. Her husband, who was with her weighed less than 50 kilos. So, he didn’t weigh enough to give the blood. I said, okay, I’ll give you one unit, but we have to find somebody else. I went to a shoeshine boy and I said, “How much do you make in one month?” He said $5. I said, great. I said, “I’m going to pay you $20. I want you to donate blood with me”. He said, “Great, let’s go”.
Dr. Rick Hodes:
We went down to the blood bank. Ethiopians culturally don’t like donating blood. And it’s a perfectly hygienic place, it’s done very well. I have no hesitation. But he just said, “There’s no way I’m donating blood”. And I said, “There’s a pregnant woman who can die. You can save her life”. He said, “I don’t care”.
Dr. Rick Hodes:
So, then I needed to find a blood donor. I said, okay, people, we knew that operation Solomon was going to be the next day. We who had inside information, knew all of this. So, I went to the Hilton hotel and I knew there must be Israelis around. So, I was slowly walking around, just listening for Hebrew. And there were four guys speaking Hebrew.
Dr. Rick Hodes:
So, I said, “Shalom. My name is Dr. Rick Hodes. I’m a medical director of the American Jewish Joint Distribution committee. I need somebody to donate blood with me right now”. And they looked at me, didn’t say a word. 30 seconds passed and I said, “Okay. Shalom. My name is Dr. Rick Hodes. I’m a medical director at the American Jewish Joint Distribution committee”. I repeated myself.
Dr. Rick Hodes:
One of them looked at me and he said, “I can’t donate blood”. And I said, “Why not?” He said, “Tomorrow’s going to be very busy day. I don’t want to be tired.” And using more profane language than this, I said, “Doesn’t anyone give a damn?” I said, “There’s a pregnant woman who can die and you’re worried about being tired?”
Dr. Rick Hodes:
And I turned around and I walked out. This guy got up and he ran after me and he grabbed me and he said, “Doctor, let’s go”. And I said, “What made you change your mind?” He said, “I have a pregnant wife”. And so, we donated blood together. It turns out he was the lead correspondent for one of the Israeli newspapers. So, he wrote about all of this. I had no idea who the guy was. He later became Israeli ambassador to Mauritania. So, he wrote about this.
Dr. Rick Hodes:
The next day we call it together. A group called the Committee. The Committee was the 15 most educated people in this population of 15,000. Now educated means maybe they had a high school education. We said to them, go to every single house of all the Jewish people, tell them, drop everything and come immediately to the Israeli embassy. Bring only your family and any medical records you might have because people had kept their X-rays themselves sometimes. And that’s it.

Dr. Rick Hodes:
And they went out to spread the word. My job was getting people out of the hospital. Now all of this had been worked out on our computer system. So, each person had five people he needed to tell. Each of them had five people that they needed to tell and so on so we could get a message out inside the Jewish community and keep it there at least for a while.
Dr. Rick Hodes:
They went out to spread the word. My job was getting people out of the hospital. So, I drove across the city to the leprosy hospital and it had a boy who is 10 years old, very malnourished who had both tuberculosis and leprosy. They wouldn’t let him go. I waited till they turned around. I picked him up and put him over my shoulder and I started running to put them in my car and drive away. Literally kidnapping this kid from the hospital. And Ethiopians were running after me. Do you know Ethiopians are good runners?
Dr. Rick Hodes:
But I got him into my car, covered him with newspaper, which I had prepared. And we drove out and delivered him to my office. Then there was actually something miraculous that took place. I went to another hospital, there’s a kid with meningitis. And I said to the mom, I speak on Amharic, Ethiopian language. And I said, “You and your kid can go to Israel. Let’s go right now”. This is 10 in the morning. She said, “No, I have to be here at three o’clock in the afternoon. My brother’s going to meet me”. So, I just lied and I said, “Your brother is waiting for you at the embassy”. And she said, “No, I’m not going”.
Dr. Rick Hodes:
So, I went to the Israeli embassy, not knowing what I was going to do. I walked in, there’s a crowd of people walking in. It’s like people going into Yankee stadium. I mean, just thousands of people because the word was out and a lot of strangers were there as well, trying to get in.
Dr. Rick Hodes:
Somebody tapped me on the shoulder and said, “Doctor, you need to help me. My sister is in the hospital. Her kid has meningitis. What do you want me to do?” And I said, “Oh my gosh, you were sent by the almighty. Let’s go”. We got in my car, took him to the hospital and she left.
Dr. Rick Hodes:
So, at the end of the day, I had 12 people I had gotten out of the hospital. We put them on mattresses and my head nurse came to me. She said, “Dr. Rick, you need to eat and they need to eat”. I said, “Do we have any food?” And she said, we have the Kita.

Dr. Rick Hodes:
Now this is interesting. This is May of 1991. I worked for a Jewish organization and we had sent them a large quantity of Matzo, which Jews eat on Passover, except that it took some time to clear and it wasn’t cleared until a week after Passover. So, we had this packing crate in our front yard. So, we opened up our container and everybody got a whole bunch of Matzo.
Dr. Rick Hodes:
Mr. SlimFast had donated thousands of packets of SlimFast to us. And so, we gave them SlimFast to eat. We gave them Matzo to eat. And I sat there and I wrote my medical summary and I thought, “Isn’t this appropriate?” I said when the Jews were during the Exodus in Egypt, we ate Passover, we ate Matzo in the desert and they’re in the middle of their Exodus and they’re eating Matzo on their mattresses here.
Dr. Rick Hodes:
So, at the end of the day, 14,000 something, people flew to Israel, 39 flights. The 747 that took off with, I don’t know, 1,079 people, landed with 1,080 people because one baby was born on the plane.
Dr. Jim Dahle:
Yeah. That’s pretty awesome. Now this is a financial podcast. I have to at least ask some financial questions along the way. Now while doing all of this international work, none of which I presume pays well, if at all, have you been able to save anything up for retirement at all along the way?
Dr. Rick Hodes:
I have been able to save for retirement and I have some investments and I have a retirement plan because I work for JDC. So, I don’t have the new retirement plan. I have the better old retirement plan. So, I do have some potential to retire and I’m also paying into social security.
Dr. Jim Dahle:
Okay. Now, many physicians I run into feel burned out on medicine. They want to save up money and get out of medicine as soon as possible. They want to FIRE is what the acronym is in the community – Financial Independence Retire Early.
Dr. Jim Dahle:
This sort of thing was clearly never in your plan. How have you been able to sustain your passion for medicine and service over so many decades? And what advice do you have for doctors who feel they’re losing that passion?

Dr. Rick Hodes:
I have a monthly Zoom call with people that I was residents with. And I’m very much in touch with some of my classmates. So, I know the stresses and the problems of being a doctor in America right now. And doctors are losing control. We have managers telling us the number of patients we should see and bean counters and so on. And I certainly sympathize with the situation that many American doctors find themselves in.
Dr. Rick Hodes:
What motivates me is the fact that I know that I’m personally making a difference. And if I don’t go to work, somebody is going to die. If I don’t do this. It keeps me going. One of my patients wrote something a few weeks ago for my website. This is just this amazing thing that she came up with. She said, “You can’t change the world, but you can change one person’s world”. And so, when you change enough one person’s world, you’re changing a lot of worlds.
Dr. Rick Hodes:
So that’s what I tried to do. But I understand the problem. And I understand if you’re too pressured and you don’t have balance in your life, then life becomes terrible. So, we have to somehow work to restore a balance. And what I do at least, like I take real vacations, but I at least leave the country and I’ll have lots of frequent flyer miles. So, I’ll fly somewhere and work from somewhere else for a week, take half day off every day, and just walk around Bombay or Bangkok or anchor water, something like that, just to have a change of scenery.
Dr. Jim Dahle:
Now some people have criticized international aid programs is doing more harm than good. I looked and found a quote from a New Yorker, William Easterly, who is a professor of economics at NYU and the co-director of their development research institution, who said, “We’ve already spent as official donors, $600 billion in aid to Africa over the past 45 years. And after all that children are still not getting the 12 cent medicines to fight malaria. There were still between 1 million and 3 million deaths from malaria last year.
Dr. Jim Dahle:
So, aid would be a great thing if it worked, but the sad tragedy is that, and this is really one of the scandals of our generation, money meant for the most desperate people in the world is simply not reaching them. $600 billion in aid in Africa over the past 45 years. And over that time period, there’s basically been zero rise in living standards”.
Dr. Jim Dahle:
Now, personally, I’ve had a few international medical experiences where I felt I wasn’t accomplishing much long-term good anyway and maybe even doing harm. What do you think is the key to effectively aiding others in less developed countries without doing harm to them on an individual or a community level?
Dr. Rick Hodes:
This is a great question. Thank you for asking this because you see so much nonsense going on. I mean, you see, for example, NGOs that spend thousands of dollars for the nicest cars. Like a so-called Christian NGO spending $3,000 for their sound system in the car so that they have the best stereo sound system. Like my car doesn’t have a radio. Or a British group who thinks that they’re doing wonderful things by shipping an old cat scan to Ethiopia. It ends up in the hospital. It does twelve cat scans. It dies and that’s it.
Dr. Rick Hodes:
So, all this money that they send for the cat scan went into doing twelve cat scans and that’s it. While maybe if they had invested in handheld ultrasounds, they could have gotten a lot, lot more bang for their buck.
Dr. Rick Hodes:
So, you need to ask yourself, “Is this needed? Is it effective? And is it sustainable?” And if it’s not, like for example, somebody wanted me to send a C-arm to one of the hospitals, but the hospital had no interest in the C-arm. It was the outside doctor who was saying, “These people need a C-arm” because he knew that to do good orthopedic surgery, they should have a C-arm. But they had no interest in the C-arm. They weren’t asking for the C-arm at all. And I just said, “No, I just don’t think at this point that it’s a good way to spend money”.
Dr. Rick Hodes:
Now in Ethiopia in 1984, the gross national income was $210 per person per year. Now it’s up to $850. So, we are actually on the upward trend and development is going in the right direction. Part of it is because we have a change in government and we have much more of a capitalist system than we did when the communists were running it. And communism, we all know is not a good economic policy.
Dr. Rick Hodes:
So, you need economic development, you need education. If you educate a bright and motivated person, then that person’s going to take off a lot. And so, one of the things that I like to do is send people to school and there’s programs to do that. And another thing that I like to do is help individuals not become handicapped. And that has to do with the spinal deformities.
Dr. Rick Hodes:
Now, in a $26,000 or something for a spine surgery, that’s a lot of money compared to for example, that a cataract surgery is some small percentage of that. On the other hand, as we know, there’s 3% of Americans with spinal deformities and in Ethiopia, we have old polio, 5% of my patients have neurofibromatosis. One third of my patients have TB of the spine. So, there’s lots of other reasons that Ethiopians have spinal deformities and I don’t think that we can just forget them.
Dr. Jim Dahle:
Thank you for sharing that. Now there’ll probably be 30,000 to 40,000 people that listen to this podcast. Most of them are doctors, but doctors and other high-income professionals. You now have their ear. What should they know that we haven’t already talked about in this podcast?
Dr. Rick Hodes:
Well, they’ve heard a lot. They’ve heard how I’m working to bring the world together. That I’m working in an international inter-religious, interfaith, inter-ethnic environment to make the world a better place. And that for not a lot of money, we can help a lot of people.
Dr. Rick Hodes:
If they would like to contact me, if they would like to read more about our work on the website, if they’re interested in doing a difficult case, or maybe not so difficult case in America, I have lots of potentials. If there’s a spine surgeon out there, I can send you very, very interesting patients.
Dr. Rick Hodes:
I have a kid right now, for example. I just have to tell you about this because this is so amazing. This guy, he could look up, he could look down, but he could not look horizontally to the right or to the left. And he had a severe scoliosis. So, there’s like 60 people in the world who have horizontal gaze palsy with progressive scoliosis. It’s a robo three gene, but the very, very amazing thing is his brain has no decussation.
Dr. Rick Hodes:
So, the right side of his brain controls the right side of his body. The left side of his brain controls the left side of his body. Like I had no idea that that ever occurred and in this small number of people, it actually does.
Dr. Rick Hodes:
Now it’s interesting in albinos, it’s the opposite. Albinos over decussate, and it’s not 50/50. But we have a lot of very interesting stuff that we’re able to offer people if they might be interested.
Dr. Rick Hodes:
The other thing is that I do academic talks and I give pediatric grand rounds, medical grand rounds, neurosurgery grand rounds. If anyone is interested, they can contact me and I’m happy to work that out. And now that we’re all used to Zooming, I don’t have to fly into Salt Lake City. I can Zoom in in a second. So, thank you so much.
Dr. Jim Dahle:
What is the best way for them to contact you if they’re interested in reaching out or helping what you’re doing or to reach you for a grand round or something like that? What’s the best way to contact you?
Dr. Rick Hodes:
Just through my website is fine.
Dr. Jim Dahle:
rickhodes.org. Awesome. Well, Rick, you are an inspiration to us all. I tell my readers all the time, thanks for what they’re doing, but thank you for what you do. You have made a dramatic difference in the lives of hundreds and hundreds of patients.
Dr. Rick Hodes:
Thank you very much. I have the sign that I keep over my desk. It’s from one old Rabbi but it says “Stop thinking about what you need and think about what you’re needed for”.
Dr. Jim Dahle:
Awesome. That’s good advice.
Dr. Rick Hodes:
That’s the thought that I start every day with. So, I want to thank you and wish you all blessings for a good year and a good life.
Dr. Jim Dahle:
Thank you very much.
Dr. Jim Dahle:
Wasn’t that great? It’s really inspiring to talk to people like Rick. He mentioned that he’d been introduced at a conference in New York City as Rick is the doctor that I wrote that I wanted to be in my medical school admissions essay. And I think there’s a lot of truth to that. I mean, we all wrote in our essays that we really love science and just really want to help people. And you look at somebody like Rick and he’s actually doing it.
Dr. Jim Dahle:
He’s right. $30,000 is a lot of money, but it changes a life. It takes him from having no life to having an incredible life. And it’s a bargain. It’s a million and a half bucks if we do it in New York City, it’s $30,000 if we do it in Ghana. So, I’m pretty inspired by that.

Dr. Jim Dahle:
In between the time I recorded that interview and now that I’m recording the end of this podcast, I texted Katie and said, “Can we donate some money to this guy?” And she said we could.
Dr. Jim Dahle:
So, here’s what we’re going to do. We’re going to match every dollar you donate at rickhodes.org. Now this is a great organization. This is run through the American Jewish Joint Distribution center. If you look this up on Charity Navigator, you will see that it gets a very high rating. They get a four-star rating and they get a 92% financial score and 100% transparency score.
Dr. Jim Dahle:
So that’s pretty good for a charity. This is a good charity to donate to. They’re obviously doing some fantastic work. You got somebody like Rick Hodes directing it down there. I mean, it’s wonderful.
Dr. Jim Dahle:
So, we’re going to match every dollar you donate. So, if you will go to rickhodes.org and donate some money, this holiday season, shoot us an email as well. Tell us how much you donated it and we will donate that amount as well. We’re going to donate a minimum of $10,000. We will match your donations up to as high as let’s say, $50,000.
Dr. Jim Dahle:
You guys donate $50,000, I’ll donate $50,000 to rickhodes.org and get some of these people fixed so they can have a real life. Awesome stuff. And as I sort out what I’m going to do with my life, just like you guys do, I hope that I can have as much impact as somebody like Rick has had.
Dr. Jim Dahle:
All right. Let’s have a word from our sponsor Bob Bhayani at drdisabilityquotes.com. Bob is an independent provider of disability insurance planning solutions to the medical community in every state and he has been a sponsor right here at the White Coat Investor for a long time.
Dr. Jim Dahle:
He likes to work with residents and early career doctors, fellows etc. to get them sound financial and insurance strategies. If you need your disability insurance coverage reviewed or if you just need this critical insurance in place, contact Bob at [email protected] or (973) 771-9100.

Dr. Jim Dahle:
Don’t forget about WCI con 21. That registration is going all the way through the event. But if you sign up before January 5th, you get the swag bag, which is going to be awesome. We’re going to mail it out to you. It’s got books, conference t-shirt, et cetera.
Dr. Jim Dahle:
Also, the “Zero to Freedom” course. You only have a few more days to get the $300 off that. Also, if you sign up through our links, we’ll give you our WCI con 18 online course. This is WCI con Park City. And we’ll also give you a signed copy of the White Coat Investors Financial Bootcamp. So, check that out.
Dr. Jim Dahle:
You can check out the conference at whitecoatinvestor.com/conference. You can check out the “Zero to Freedom” course for direct real estate investing at whitecoatinvestor.com/rental.
Dr. Jim Dahle:
Thanks for those of you who are leaving us a five-star review and telling your friends about our podcast. Our latest review comes from Omega CRNA. They left this review on Halloween saying, “Worth your time. I’ve been following the blog since 2012 and credit much of my knowledge and financial literacy to the White Coat Investor. His focus on helping us get a fair shake on Wall Street by empowering us with the knowledge has expanded greatly since he launched the podcast. Great job, Jim! Keep up the good work and congratulations on growing your business while helping others succeed in theirs”. Five stars.
Dr. Jim Dahle:
Thanks for that review. Those reviews actually do help get the word out about this message to your peers.
Dr. Jim Dahle:
Head up, shoulders back. You’ve got this and we can help. We’ll see you next time on the White Coat Investor podcast. Stay safe out there.

Disclaimer:
My dad, your host, Dr. Dahle, is a practicing emergency physician, blogger, author, and podcaster. He’s not a licensed accountant, attorney or financial advisor. So, this podcast is for your entertainment and information only and should not be considered official personalized financial advice.

The post Dr. Rick Hodes, a Life Dedicated to Service – Podcast #188 appeared first on The White Coat Investor – Investing & Personal Finance for Doctors.

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