YSM Issue 90.1

ALUMNI PROFILE
DR. RALPH GRECO, M.D. ‘68
CARING FOR THE CARETAKERS
►BY ANUSHREE AGRAWAL
Dr. Ralph Greco, a talented physician at Stanford Medical School,
conducts research, but his biggest contribution to the field of medicine
does not involve a pipette. Greco’s biggest contributions have
been his improvements to the surgical residency program at Stanford.
When asked about his motivation for researching resident wellbeing,
Ralph Greco recites the chilling story of a promising student’s
suicide. This incredibly talented man had graduated from the Stanford
program and was completing further training in Chicago when
he died. Greco recalls the memorial service he held in his house as
particularly somber since the resident had left notes for his parents,
recounting the verbal abuse he experienced daily from a surgeon in
the program.
The history of resident abuse can be charted back to a specific doctor
from the 1800s. Greco cites surgeon William Stewart Halsted as
the father of both the modern residency program and the cruelty
associated with it. Greco’s theory is that Halsted’s implementation
of the residency program at Johns Hopkins University had a basis in
verbal abuse and authoritarian behavior, likely the result of his cocaine
addiction. Because Halsted formally trained the first chairs of
many medical schools, the cycle of abusive role models continued.
After his resident died, Greco wanted to create a change and prevent
further resident abuse.
Greco, along with other esteemed academics interested in resident
wellbeing at Stanford, began to break the cycle. Stanford was among
the first institutions to implement a mandatory 80-hour workweek
for residents: a precedent that other medical schools soon followed.
He also created the Balance in Life program at Stanford—a program
focused on promoting physical, psychological, professional, and social
balance among residents through events, mentorships, healthy
food and mental health initiatives. Since then, Greco has devoted
the latter part of his career to improving the residency system, and
he hopes to stop mentors from participating in abusive behavior targeted
at residents.
Not all medical professionals support Greco’s intentions, however.
Greco recognizes that hospitals are reluctant to pour money into resident
wellbeing—and into medical schools in general—because they
want to maintain their efficiency. He has also had difficulty changing
the mindset of doctors who once dealt with abusive behavior themselves.
“Just as people who are abused sometimes become abusive
parents, and learn to do that, this mindset becomes part of the upbringing,”
Greco explains. The cycle is difficult to break.
Greco has not limited himself to the pursuit of scientific endeavors.
He is also an avid sculptor, and has been since he picked up the
IMAGE COURTESY OF RALPH GRECO
►Dr. Ralph Greco is a physician at the Stanford School of Medicine,
where he has started the Balance in Life program to improve resident
wellbeing.
hobby at Princeton when an art teacher “took him under her
wing.” Greco now considers stone his favorite medium. Art is extremely
important to Greco, and he connects the activity to his focus
on resident wellbeing. By pursuing his passion for art, he hopes to
model a healthy work-life balance and show residents and doctors
that they can make time for the hobbies that they love. He admits
that finding this balance is difficult during residency, but creating a
foundation for students to have a healthy mindset is critical.
Greco cites Yale as an important place that opened doors for him
as a physician scientist. He still talks with friends from medical
school, and he continues to attend reunions. Greco plans to formally
retire from Stanford next year, but he does not anticipate problems
with his program after his retirement. He has already recruited the
next leader of the program, and Greco is confident that she will continue
working to educate residents and improve their lives at work.
In retirement, Greco hopes to advance his artistic prowess and continue
creating stone sculptures, although he does point out that stone
is not the lightest material to work with.
www.yalescientific.org
December 2016
Yale Scientific Magazine
37