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I got the first tip about upheaval and concerns over patient care in the Benefis cardiology department early last November. It came out of the blue, and almost immediately, I was out of my depth.
I called my colleague, Mara Silvers, who had been Montana Free Press’ healthcare reporter and had worked on impactful, personal stories like the report on families grappling with questions about longtime cancer doctor Thomas Weiner in Helena.
I knew this tip about a specific valve replacement program at Benefis, known as TAVR, would require a lot of digging to learn about the internal deliberations that take place at hospitals, out of patients’ view. I had no idea what the story would become — and what in the world was a TAVR, anyway?
TAVR stands for transcatheter aortic valve replacement, and it’s a relatively new procedure to replace a heart valve. Doctors perform the procedure through a smaller incision in an artery rather than the traditional open-heart surgery. A TAVR procedure can be easier to manage for elderly patients, and recovery is typically quicker than the open-heart route. The French doctor who pioneered TAVR remarked in an interview that he drank champagne with his patient hours after the first procedure.
Mara and I spent a lot of time on the phone with cardiologists, just learning fundamentals. What types of conditions warrant a TAVR? How is a cardiology department staffed? What are industry norms for physician training and qualifications? That kind of information might only translate into a sentence or a paragraph in the story, but it’s foundational to the rest of the work.
But this piece wasn’t just about the technical aspects of TAVR. It was about a cardiology department that was, apparently, in turmoil. We learned that doctors at Benefis hospital in Great Falls had concerns about the TAVR program that they felt were ignored by the program’s lead cardiologist and hospital administration. Doctors said there had been a highly collaborative environment at Benefis — one that welcomed input from experienced colleagues on patient care when doctors face difficult clinical decisions. That collaboration, doctors told us, broke down as the TAVR program ramped up.
We understood this situation to be part of a broader story, too, about what it takes to bring a specialty heart procedure to a competitive rural healthcare market. It turns out it’s expensive, not only because these new heart valve devices can cost tens of thousands of dollars, but also because hospitals often expect to cover those costs themselves to meet Medicare’s volume requirements. Those requirements are in place so hospitals can improve the quality of their procedures before the federal insurer begins paying for them.
Finally, we found the family of a deceased patient, Bette Albright, who bravely agreed to share the story about her unsuccessful TAVR procedure at Benefis and her sharp health decline in the weeks after her surgery. It takes a lot of trust to allow journalists to dig into personal health details, but that perspective helped readers connect to the real patients relying on this program.
The family’s perspective shed light on how difficult it can be to navigate — and trust — complex medical care decisions. The photos of Albright’s daughters, taken by MTFP photographer Lauren Miller during a long and emotional interview, really capture the love they have for their mother.
If you haven’t yet, please read our investigative story about the Benefis TAVR program.
— Matt Hudson
Gist 📌
The Montana Department of Environmental Quality announced Monday that it has cleared an Australian company to explore for gold and silver outside of Lincoln.
The authorization DEQ granted to Great Plains Mining allows the Sentinel Metals subsidiary to drill 21 holes about a half-mile into the earth and disturb up to 1.5 acres on ground “previously disturbed by exploration activities.” The company aims to use samples collected from a private 430-acre inholding within the Helena-Lewis and Clark National Forest to obtain a more comprehensive picture of the subsurface mineral deposits.
The approval, enabled by a $340,000 bond the company paid, comes three months after Sentinel Metals filed its exploratory drilling request. The request was submitted as an amendment to an exploratory drilling authorization that has gone through several ownership transitions in the last 30 years. In 2016, Great Plains Mining, a subsidiary of Sentinel Metals, obtained the exploratory drilling license following CR Montana’s bankruptcy proceedings.
CR Montana was associated with the Seven-Up Pete Joint Venture, a cyanide heap-leach mine that hit legal roadblocks, including a ballot initiative that banned the practice in Montana on the heels of public outcry over inadequate and abandoned mine clean-up at sites like Zortman, which is facing serious water quality threats with no end in sight.
Despite an abbreviated comment period, the Columbia Mine proposal generated more than 8,700 public comments, according to DEQ.
On its website, Sentinel Metals writes that the Columbia Mine, its flagship project, benefits from the extensive exploratory drilling that’s already been done at the site. It also describes Montana as a good place to do business, given its “stable regulatory environment and strong infrastructure.”
Sentinel Metals did not respond to an email from MTFP seeking comment on the exploratory mining authorization.
The Montana chapter of Trout Unlimited describes the project as a threat to one of “Montana’s greatest trout waters,” the Blackfoot River. The group added that the gold’s quality is likely low, which could drive Sentinel to mine cheaply or to mine extensively, both of which spell trouble for the fishery that supports westslope cutthroat trout and bull trout, a federally protected species. Trout Unlimited also argues that too much has been invested in cleaning up the Blackfoot to put the watershed at risk again.
“Our organization, many partners, landowners and the public have invested decades of effort in restoring the Blackfoot fishery, river health and workings lands from the impacts of previous mining in the watershed, including $70 million-plus in public funds to clean up and perpetually treat acid mine drainage from the Mike Horse Mine that devastated the Blackfoot River not so long ago and not so far from the proposed Columbia Gold Project,” the group wrote in a recent newsletter to its members.
A full-scale mining permit would go through a more rigorous process, which often takes years. Per the 140-page environmental assessment DEQ released, the company has until Sept. 2 to complete its exploratory drilling and must clean up the site within two years.
— Amanda Eggert
Following the Law ⚖️
A flurry of court filings has landed at the Montana Supreme Court over the last few days, mapping a course for the dispute between the state’s Republican attorney general, Austin Knudsen, and the Democratic Gallatin County attorney, Audrey Cromwell.
The most recent filings debate whether the question should be considered by the Supreme Court at all.
The back-and-forth began in October, when U.S. Immigration and Customs Enforcement asked Cromwell to share confidential criminal justice information. Law enforcement agencies generally exchange such information with one another, but members of the public, including the media, must go through an onerous process to obtain it. (The particular piece of information here, for instance, remains a mystery to the public.)
At Cromwell’s direction, one of her aides denied ICE’s request, indicating that her office does not believe ICE is entitled to the information it was requesting.
In April, Knudsen “exercised supervisory powers” over the Gallatin County Attorney’s office, but whether he can mandate that Cromwell share the information remains contested.
According to Montana law, “supervisory powers” grant the attorney general “the power to order and direct county attorneys in all matters pertaining to the duties of their office.” And so, arguing that he had control of Cromwell’s office, Knudsen ordered Cromwell to share information with ICE.
Cromwell didn’t. Instead, she filed a petition with the Montana Supreme Court. She said that ICE shouldn’t have automatic access to confidential criminal justice information for immigration purposes. She noted that immigration matters are generally handled in civil, not criminal, court.
Both Cromwell and Knudsen have submitted arguments to the Supreme Court over whether Montana law requires the information to be shared with ICE. But the dispute has now shifted from what Montana law requires to who gets to decide what Montana law requires.
“Entertaining this petition would chart a path for any county attorney to run to this Court to resolve any interpretive or policy disagreement she had with the Attorney General,” Knudsen wrote.
Cromwell replied with a court filing that called Knudsen’s argument “illogical.”
“Accepting this reasoning would make the AG a singularly powerful office, exempt from judicial checks and balances in a manner that eclipses the role of any other governmental office,” Cromwell wrote in a filing this week.
Knudsen has until Monday to file a response to Cromwell’s latest argument.
The court has not indicated when it will rule.
— Zeke Lloyd
3 Questions For ❓
This Sunday, the Ultimate Fighting Championship will come to Washington, D.C., for fights featuring some of the sport’s biggest names, including Helena native and former UFC bantamweight champion “Suga” Sean O’Malley. UFC Freedom 250 has also been at the center of political controversy due to the fight’s venue: the White House South Lawn. While the fights are meant to celebrate the country’s history and honor veterans, Sunday is also President Donald Trump’s birthday. Despite all the hubbub, Freedom 250 has a direct Montana tie we wanted to highlight.
O’Malley’s father, Dan O’Malley, still resides in Helena and spoke with MTFP this week about his son and his participation in the card of fights at the White House. His comments have been lightly edited for length and clarity.
MTFP: Walk us through how Sean first got into fighting?
Dan: So, fortunately for me, I have four kids. All of them are super good athletes. Sean was particularly amazing in sports, just one of those gifted kids. He was always kind of the little kid on the team. And come around his sophomore year, he told me that he wasn’t a huge fan of organized sports.
He said, “Dad, I wanna do a sport one-on-one where I can show my own talent rather than being on a team.” So I told him, “Yeah, what do you wanna do?” And he said he wants to box, which I thought was hilarious ’cause out of the three boys, he is the most timid, non-confrontational kid of all of them.
We had a friend named [Ray Moore]. He was a Golden Gloves boxer, and he lived kind of up in the hills in North Valley in Helena. I would drive Sean up there for a couple weeks, and about the second week into it, the coach said, “Dan, I’ve never seen anybody with this speed and this much power.”
MTFP: From Helena to the White House, how does Sean reflect on making it big?
Dan: Sean just fought in front of three million people [in 2023] when he beat [Aljamain Sterling] and won the belt to make him the greatest in the world, and there’s a lot of pressure there. Two weeks later, we’re at Grizzly Stadium [in Missoula]. Sean and I, we have to hide in the back of the weight room because it’s supposed to be a surprise who comes out and raises the flag. There are 19,000 people at Grizzly Stadium. Sean looked at me and said, “Dad, you need to get me a shot [of alcohol].” Hardly ever does Sean drink.
He’s like, “I am so nervous because I wanna do so good for Montana that I wanna be a little more calm when I come out there.”
He’s a Montanan kid, and he wants to perform for all Montanans, and he’s super proud to be a Montanan. When he called and told me, “Pack your bag for the White House.” As a dad, you could feel all the excitement in his voice, but Sean likes to be super chill. Like, it was not that big a deal, but you could tell Sean was super jacked. Sean’s super excited to represent the United States of America.
MTFP: What has Sean shared with you about the politics and pushback surrounding Sunday’s event?
Dan: Really, we haven’t gotten into it. Sean is probably the least political guy you’ll ever meet. I don’t think he knows the difference between a Democrat and a Republican.
As far as politics go, I read the articles, too. I see there’s a lawsuit that they’re trying to stop it. That frustrates me. I think the general public needs to know that Sean O’Malley is fighting in front of the White House on the lawn, and it’s the same damn house that Obama and Clinton and Biden lived in. Now Trump lives there. Sean’s not a huge Trump supporter. Sean’s not doing this on Trump’s behalf. Sean’s doing this as a professional elite athlete.
When people yell and scream about this, to me, if you don’t wanna watch it, don’t watch it, and that’s Sean’s attitude. I’m not telling anybody to come watch the fight. If they don’t want to, I’ll understand. I appreciate their respect for their political views, but if you don’t wanna watch it, don’t watch the damn thing.
— JoVonne Wagner
By the Numbers 🔢
The possible number of American Indian Caucus members in the 2027 Montana Legislature, if seven Native American candidates win their elections for the state House and Senate in November.
Montana’s American Indian Caucus is an organized group of Native American lawmakers who work together to advance legislation they say is good for Indian Country, guided by the principle that what’s good for tribal communities is good for Montana as a whole. During the 2025 legislative session, the caucus had 12 members, all Democrats. That group touted historic success last legislative session; together, they worked to advance legislation that established Indigenous Peoples’ Day, bolstered the state Missing and Murdered Indigenous Persons Advisory Council and created financial accountability mechanisms for the state’s commitment to Indigenous education.
But the American Indian Caucus didn’t always have a significant number of members. In 1995, there was just one Native American lawmaker in the state Legislature. By 2019, the caucus had 11 members, representing about 7.3% of the state’s lawmakers, close to the Native American population in Montana at the time.
Heading into the general election this November, at least six members of the American Indian Caucus are all but guaranteed.
State Sen. Jacinda Morigeau (Confederated Salish and Kootenai Tribes) is not up for re-election and will retain her seat. Sen. Shane Morigeau (Confederated Salish and Kootenai Tribes) and Reps. Mike Fox (Gros Ventre) and Jade Sooktis (Northern Cheyenne) all ran unopposed in the primary and will not face a challenger in the general election.
Lona Running Wolf (Blackfeet), who would be new to the caucus but who is married to caucus Chair Rep. Tyson Running Wolf (Blackfeet), ran unopposed in the primary and does not have an opponent in the general. And Natalie O’Neal (Fort Peck Assiniboine and Sioux Tribes) beat Lance FourStar, (Fort Peck Assiniboine and Sioux Tribes), who previously directed the American Indian Caucus, in her primary for House District 31. O’Neal will not face a challenger in the general election and will likely replace Rep. Frank Smith (Fort Peck Assiniboine and Sioux Tribes), who was on the 2025 caucus and did not seek re-election.
While Sen. Jonathan Windy Boy (Chippewa Cree) was not on the ballot and will therefore retain his seat, he has fielded calls to resign amid sexual abuse allegations.
Five American Indian Caucus incumbents, Reps. Sidney Chip Fitzpatrick (Crow), Shelly Fyant (Confederated Salish and Kootenai Tribes), Thedis Crowe (Blackfeet), Tyson Running Wolf (Blackfeet) and Donavon Hawk (Crow) will face Republican challengers in the general election.
Rep. Katie Fire Thunder (Oglala Lakota), who was appointed to her post by Gallatin County commissioners in December when a state lawmaker resigned, will also face a challenger in November, and Erin Farris-Olsen (Brothertown Indian Nation) will face a Libertarian opponent in the general election.
Keaton Sunchild, government and political relations coordinator for Western Native Voice, said he and his colleagues are “fairly confident” the incumbent caucus members will be successful in November. Farris-Olsen’s Senate race for a district that includes Helena, he added, could be “more of a toss-up.” Though Rep. Tyson Running Wolf is running a new race, this time for a state Senate seat, Sunchild is “cautiously optimistic” of his chances, especially considering the Senate district overlaps with the Blackfeet Reservation, where Running Wolf has name recognition.
If each of the seven beat their challengers, Montana’s American Indian Caucus could have at least 14 members for the 2027 legislative session — the largest cohort ever.
— Nora Mabie
Highlights ☀️
In other news this week —
• Victoria Eavis reports that a group aiming to limit dark money in Montana politics has gotten most of its financial backing from a nonprofit that doesn’t have to disclose its donors.
• Bozeman Creek travels through a tunnel under the city’s busy Main Street. Now, as freelance journalist Isabel Hicks reports, a local group is asking: What if it didn’t?
• More than 35 years after the murders of two elderly women in a Missoula nursing home, prosecutors — aided by enhanced DNA technology — charged a Clinton man with those crimes. You can read Katie Fairbanks’ coverage here.
On Our Radar
Nick — I know there’s a lot going on in the world, but I’m still geeking on the tip-in from OG Anunoby that capped the New York Knicks’ comeback win in the NBA Finals this week. It must be fun to be so good.
Jacob — Montana picked up a bronze medal in a category nobody asked for. WalletHub ranked the state third nationwide for gambling addiction, with only Nevada and South Dakota scoring higher. The analysis considered 20 metrics, including lottery sales per capita and the share of adults with gambling disorders. According to the website, Montana has the second-highest number of gaming machines per capita, and around 2.5% of residents have a gambling disorder.
Zeke — I learned early that the only thing less likely than a U.S. pope was a U.S. championship in the men’s World Cup. Well, Bob’s pope. But I just watched this eight-minute, 46-second video that talks about every team in the upcoming tournament. I’m not holding my breath.
Stephanie — I love learning a little bit about everything, so I was excited to recently discover the podcast Ologies with Alie Ward. In each episode, Ward interviews an expert in a different field and asks all the questions the rest of us are curious about. Topics range from sciuridology (the study of squirrels) to volcanology (the study of volcanoes) and 500+ other subjects. The show makes even the most niche topics accessible, and it’s equal parts educational, funny and fascinating.
Mara — Speaking of podcasts, my friends and I were discussing some of the most sophisticated scams and phishing attempts we’ve recently heard about or experienced firsthand. I remarked that, without a doubt, I would read a journalistic profile of a modern-day scammer. Luckily (or unluckily, in the grim scheme of things), my friends told me, there’s a podcast for that.
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Lowdown is edited by Nick Ehli with additional copy editing by Mara Silvers.