PsychEd Case Rounds 1 with Dr. David Gratzer

Dr. Graetzer, you've made such an impact on Canadian psychiatry from working at multiple big centers, giving presentations, highlighting research, your impact in education.

Could you tell us a bit about where your interest in psychiatry started and how it's evolved over the years?

Well, I thank you very much for the very kind introduction and these kind comments.

Um, I, uh, I'm somebody who didn't gravitate towards psychiatry, uh, in training.

Actually, when I went into med school, I thought I wanted to become an internist.

Uh, really it wasn't until I started to do work on the awards, uh, and, uh, at Health Sciences Center at St. Boniface Hospital at the University of Manitoba that I fell in love with psychiatry.

A couple of reasons for that, including that it's a young field and that it's evolving.

And here we are a couple of years later, and I'm just as enthusiastic and passionate.

It's been a good career.

So for this episode, you've prepared a number of cases for us to go through.

Is there anything that you want to say about the cases before we get into them?

You know, I think the temptation is is to pick cases where I look really smart.

So grand rounds often follows that format, as you know.

So somebody will say, look, here's this very confusing case.

No one could get the diagnosis right.

I got the diagnosis right.

Now let me tell you for the next hour or so how smart I am.

But the dirty little secret in healthcare, something you and I know as doctors, is that we often learn the most from our mistakes.

And so I wanted to pick cases that actually didn't necessarily put me in a good light.

The first case, my mistake almost killed the patient.

But I thought that was important to bring forward because, again, we learn the most from our mistakes.

Also made me think a lot about lithium made me think about suicide prevention, made me think about other things as well.

So these choices do not put me in an amazing light in terms of me doing everything right from the get-go.

I guess the listeners will decide if I redeem myself over time.

I wonder if it'd be helpful to give any context for the kinds of settings that you've worked in in psychiatry and then where these cases come from.