Stories: Dr. Sara Jo Grethlein, M.D., MBA

Dr. Sara Jo Grethlein

New year, new hope

As we usher in the new year, we are excited to announce the arrival of Swedish Cancer Institute’s incoming executive medical director, Sara Jo Grethlein, M.D., MBA.

Dr. Sara Jo Grethlein doesn’t treat cancer. She treats patients.

Showing compassion and empathy while developing deep bonds with those she’s caring for are skills Dr. Grethlein learned from her father. And it’s those skills that will guide her as the new executive medical director of the Swedish Cancer Institute (SCI). Most recently the medical director for cancer services at IU Health’s NCI Designated Comprehensive Cancer Center in Indianapolis—where she oversaw the development of the new Joe & Shelly Schwarz Cancer Center at IU Health’s North Hospital—Dr. Grethlein has spent more than 25 years caring for patients and educating the next generation of physicians as a professor of clinical medicine. Before packing up and heading west, she spent a few minutes with us to discuss her approach to care, her relationship with philanthropy and her vision for the future of cancer care at SCI.

Your father was a nephrologist and researcher. What kind of an influence did he have on your decision to pursue medicine as a career?

I grew up in his research lab, playing with his beakers. And I had the privilege of traveling the world with him as he was visiting professors at hospitals in Europe, Turkey and Egypt. So I was never pushed into medicine. I was romanced into it.

What continued to draw you to the field as you got older?

I’d go on rounds with my father, and he always made it a point to get to know his patients. He’d find that one had a record on the R&B charts or was a Golden Gloves champion—all of these people who had these great stories. That’s what I fell in love with, knowing that the people that we were working hard to care for were all people with a great story. My mother gets a lot of the credit for inspiring me as well. She dealt with chronic and acute health issues my entire life—everything but cancer. Through her, I learned about resilience and grit: I observed how much of a patient’s story happens outside of the view of their doctor and how a brief interaction can reverberate through a patient’s experience.

What did you enjoy so much about teaching medical students?

If you teach trainees—whether they’re medical students, residents or fellows—that’s your legacy. Just think of the hundreds and thousands of patients who will be cared for by people you taught. When I run into a student 10 years later and they tell me that they use a phrase or a technique that I’ve taught them for being compassionate and present with patients, that’s so powerful.

How has your relationship with philanthropy grown throughout your career?

I’ve learned that most donors want to be a partner in making a dream come to life. The donor who named the new cancer center that we built at IU Health was one of my patients. His widow remembered how much better he would feel after getting IV fluid hydration during his journey. When I was speaking with her and working with her, we talked about how their gift was going to support a same-day clinic where patients could get in and get hydration and connect to those things that had been so powerful during her husband’s journey. Sometimes it’s about connecting to what the donor connects with. And sometimes it’s about helping them visualize a dream that they can be a part of bringing to reality.

What excites you about the future of cancer care, particularly at Swedish?

We are at the beginning steps of an incredible journey in getting the patient’s immune system to fight their cancer for them. Over the past five years we’ve seen an absolute explosion of immunotherapy. When you align the right patient and disease with the right treatment, the therapy can be dramatically less toxic and significantly more effective. And if we can continue down that path, then we are really going to be changing what cancer care feels like for the patients. Now we’re faced with a new, wonderful challenge: If you have someone who has a metastatic cancer that patients in the past would have died from within a year but who is now two years down the road and their disease is under  control and they’re taking the treatment without side effects, should you stop or keep going? We don’t know the answer to that yet. So that’s one of the next phases of therapy, where we’re looking to continue to become more effective and less toxic.

If I could talk to your younger self and tell you that at this stage in your career you would be talking about the successes of immunotherapy, how would you have responded?

“You’re crazy.” I graduated medical school in 1988, so when I was finishing my fellowship we were just starting to use antibody treatments against cancer—and I was fairly skeptical of that. Almost none of the tools that I use on a daily basis now existed when I was in training.

You’re originally from Brooklyn, and you’ve spent the last seven and a half years in Indiana. Moving to the upper left corner of the country has to be a big change for you, personally.

It’s going to be a blast. I’ve actually taken call at Swedish before. Twenty-eight years ago I came and did a six-week training block at Fred Hutch as a fellow, to study bone marrow transplant. And I was on call overnight at Swedish. I brought my two-year-old daughter, and they gave me an apartment to stay in. So my husband, my mother and my mother-in-law each came out for two weeks at a time to take care of the baby while I was on call. It was a wonderful experience. I loved Seattle then, and I’m glad to be back.

You’ve already been sitting in on SCI leadership meetings. What’s your snap assessment of where we’re at and where we could go next?

To start, this team is incredible. I am so impressed by their knowledge and expertise, both in terms of treating patients and in applying the latest research to what they offer their patients. And there are some very exciting things coming, including the significant expansion of our research efforts, particularly related to immune-oncology and the molecular and genomic aspects of cancer. We look forward to sharing more with the community soon. The future is extremely bright.