Ralph Green: South African with an entrepreneurial flair

Ralph Green, MD, PhD, stepped down recently as chair of medical pathology and laboratory medicine at the University of California-Davis after 13 years. He remains at the school to focus on research, teaching and clinical service as a professor of pathology and internal medicine after a one-year sabbatical that included trips to England, Denmark and Italy.

Green is a first-generation South African, the son of a father who left Latvia to escape czarist Russia and a mother who fled the country later to avoid the advance of Nazism. He has four sons — three are physicians and one an oncologist — one daughter and eight grandchildren.

Ralph Green

Green began his career in Johannesburg General Hospital in 1964 before moving to the United Kingdom to further his career and to get away from apartheid. In 1975, he came to the United States and joined the Scripps Clinic and Research Foundation in La Jolla, Calif. After stints at Ohio State University and the Cleveland Clinic, he returned to California in 1996 to become chair at University of California-Davis.

What do you enjoy doing when you’re not practicing medicine?

Walking, which sounds very pedestrian, if you’ll forgive the pun. I find walking is not just good for my body; I have an opportunity to reflect. When I’m walking with my wife, I can talk to her uninterrupted from distractions such as the phone. It’s quality time for us.

If you hadn’t gone into hematology/oncology or medicine, what would you have done?

The tongue-in-cheek answer is that I’d probably be retired and have more money. I’ve learned that I have a bit of an entrepreneurial flair. If I hadn’t been in medicine, I think I would have ended up in some kind of entrepreneurial enterprise and probably made a ton of money. As it is, I ended up making a lot of money for my department. I am glad to have done so.

What I really wanted to do was become a physicist. That’s where my intellectual interests lay. I ended up in medicine almost by default. I was too insecure when I went to university and contemplating graduate studies to go out on a limb and become a pure scientist. I followed my late father’s admonition that you need a profession that is portable and will give you security anywhere in the world.

What would you consider one of your biggest successes in your specialty?

I would let others judge this, rather than express an opinion that might be filled with hubris. Mentoring of younger hematologists, pathologists and scientists has been my biggest success. Many of them have moved on to successful careers, providing me a great amount of pleasure and satisfaction.

What is the best advice you’ve ever received?

Somebody once advised me that, in a new place, I should ask a bunch of people, “What are the three most important things to know?” There was a guy working in the lab at Scripps, Bob Yelenosky, who shared this Yogi Berra-like wisdom. He said, “Remember that Tuesday is trash day.” I’ll never forget that because you’re in pretty big trouble if you forget which day is trash day.

And from my late father, I got: “Good friends are always there.”

Who do you consider a mentor?

Bill Crosby, a well-known hematologist, was my first mentor in the United States and the best and most generous mentor I ever had. He said, “Ralph, if you’re convinced that you’re right, don’t give up.”

It’s not about being stubborn. He was saying, if you believe in what you believe in, stick to it. There will be a lot of people trying to deflect you, but if you think you’re right, stick it out.

I should also mention Crosby’s successor at Scripps, Ernie Beutler, who was instrumental in opening many doors of opportunity for me.

What do you think will have the biggest influence on hematology/oncology in the next 10 years?

We are developing ever-smarter forms of targeted therapies for disease. Parallel to this is the development of personalized treatment protocols. It’s one thing to develop smart drugs; it’s another to ensure that the form of treatment is appropriately tailored to an individual. No matter how smart the drug and the drug design is, it may not be good for everyone because of genetic differences among individuals.

To take that a step further, it’s not just the genetic makeup of the individual — it’s also about the genetic makeup of the tumor. We’re dealing with several variables there.

Part and parcel of the direction in which we’re moving is developing ever-smarter methods of identifying and diagnosing the type of tumor by appropriate fingerprinting at the gene level and the level of protein signature, in other words, the whole field of proteomics.

Lastly, I see the impact of physics and the use of microparticles and optical techniques mapping a better understanding of structure-function relationships.

Although I can’t think of anything else on the horizon that is going to revolutionize medicine, I’m ready to be surprised.

What is the last book you read/art collection you saw/CD you bought? Why, and what did you think of it?

I just recently finished Youth by J.M. Coetzee, who won the Nobel Prize for literature a few years back. He’s South African, so his writing resonates with me, but it’s not just that. While in Oxford this summer, I had the opportunity to hear Coetzee speak and to meet him in person.

Youth is the second part of an autobiographical trilogy that describes the years he spent in youth in the 1960s in London. This strikes a chord with me because I was in London in the late 1960s during the Czech uprising against communism, the post-Cuban missile crisis, the moon landing and the 1968 Chicago Democratic Convention. I found it an absolutely fascinating book. It’s not light reading, but it’s engrossing.

What kind of diet and exercise regimen do you have?

I walk, of course. I have a lot of good intentions to get to the gym. Apart from the usual weakness for chocolate, we eat a pretty good diet and prefer Mediterranean food to the bad stuff.

What is your favorite travel destination?

Italy. We’ve traveled to a lot of places, and some places on several occasions, but Italy is way ahead on the list. We always want to go back there. I spent part of my sabbatical in Milan and took two weeks on the Ligurian coast.

Scenically, it’s beautiful. It’s steeped in history, and so there is a lot to explore, especially in the major cities. Good food, good wine and great people.

What is your favorite restaurant?

I’ll be provincial. There’s a restaurant in downtown Sacramento called The Waterboy. The food is excellent, the ambience is good, and what tells me that it’s really good is that all my successful recruitments started with dinner at The Waterboy — I think I’m batting 100%. So now, the ones who look good, I take to The Waterboy.