Terence Arthur Ketter, MD, an emeritus professor of psychiatry and behavioral sciences, died from complications of atypical Parkinson’s disease on Nov. 1, surrounded by his wife and medical school friends. He was 74.

In 1995, Ketter joined Stanford Medicine, where he founded the Bipolar Disorders Clinic, which studies and treats patients with bipolar and other mood disorders. His research at the clinic drew international attention.

“Terry was a leader in his field and will be deeply missed by the Stanford Medicine community,” said Lloyd Minor, MD, dean of the Stanford School of Medicine and vice president for medical affairs at Stanford University. “His work will live on through his impact on patient treatment and fostering the next generation of psychiatric experts.”

Ketter was a significant figure in bipolar disorder research. He published extensively, writing over 450 scientific articles and book chapters and editing two books on bipolar disorder treatment (Advances in Treatment of Bipolar Disorder and Handbook of Diagnosis and Treatment of Bipolar Disorder).

“Terry was extremely successful at Stanford – he was one of the real national and international players in bipolar disorder,” said Alan Schatzberg, MD, the Kenneth T. Norris, Jr. Professor in Psychiatry and Behavioral Sciences. “He felt very passionate about studying mood disorders and educating the public. He had a big influence on the department as well as his patients and their families.”

Ketter had a significant impact on psychiatry through those he trained. “People would come from all different parts of the world to train with him – and they would go back home as leaders in their field,” said Po Wang, MD, a clinical professor of psychiatry and behavioral sciences. “He was a fantastic mentor. He was always generous – sharing project ideas and citations in published work. More than anything, he was very, very generous with his time.”

Math to jewelry to medicine

Ketter was born on April 20, 1950, in the suburbs of Toronto. His father, Arthur Ketter, was an engineer at the Dymo company who built label-making machines; his mother, Patricia Ketter, managed things on the home front.

Ketter started his higher education by earning a bachelor’s degree in mathematics from the University of Toronto in 1973, then earned a master’s degree in mathematics from Sydney University in 1976. After that, Ketter decided to tour Southeast Asia for what would ultimately be a four-year span. He started a jewelry-making business during his travels, buying and exchanging goods for stones and setting them into jewelry.

During a stay in Indonesia, Ketter became interested in how the traditional Balinese healers approached mental health care. They treated conditions such as depression and anxiety but also helped solve relationship problems with interventions such as separate kitchens for mother-in-law and daughter-in-law, his wife, Nzeera Ketter, MD, said. This sparked his interest in mental health care.

He sold his jewelry business to pay for medical school, enrolling at the University of Toronto in 1980 when he was 30. When asked why he started medical school so late in life, he said he took a scenic route. He would tell people that it prevented him from wasting his youth on medicine, Nzeera Ketter said.

The two met while at medical school in Toronto. They bonded over a love of medicine and science. She worked with the National Institutes of Allergy and Infectious Disease and then with large pharmaceutical companies running vaccine clinical trials and studies testing treatments for neurological disorders.

After Ketter graduated, they moved to the Bay Area where he was an intern and then a resident at the University of California, San Francisco, where he worked on the epilepsy and cross-cultural psychiatry units. After the residency ended in 1988, Ketter worked with Robert Post at the National Institute of Mental Health in Bethesda, Maryland, studying brain imaging and treating bipolar disorder with drugs that were traditionally used for seizures caused by epilepsy.

“His interests came together in a strange way – his jewelry making made him very good at putting in intravenous and arterial lines and performing lumbar punctures, and his math skills enabled him to do all his own imaging analysis,” Nzeera Ketter said. “He put mathematics, jewelry and medicine together and could traverse all three of them with comfort. It was quite impressive and seamless.”

In 1997, he joined Stanford Medicine as an associate professor in the Department of Psychiatry and Behavioral Sciences, retiring 20 years later. Ketter trained junior faculty and got many others interested in studying bipolar disorder Schatzberg said.

“He was always very egalitarian – he was not into being called doctor or professor; he thought that was so abhorrent,” Nzeera Ketter said. He was most proud when his students learned something new and he saw their eyes light up. “He was very friendly and humorous but could be exacting,” his wife added. “He wanted his students and mentees to care for patients by being thorough, careful and efficient, and not cutting corners.”

Focused on bipolar patients

At Stanford Medicine and throughout Ketter’s career, his interests spanned from directly caring for patients to studying their brains and advancing therapeutic interventions for bipolar disorder.

Ketter’s human touch was a defining characteristic of his approach to psychiatry. “He was a very decent soul,” Schatzberg said. “He combined an encyclopedic knowledge of drug and device efficacy in bipolar illness with an extremely generous and humanistic approach to his patients. That combination endeared him, not only to his colleagues, but to those patients.”

He used advanced brain imaging methods to better understand how the brain works in mood disorders and the differences in the brains of those with and without bipolar disorder. He also used those techniques to create better treatments for patients with bipolar disorder.

His mind for math helped him develop a statistical approach to determining the most effective treatments for bipolar disorder. That undergirded the advancements in bipolar treatment over the last few decades, including showing the effectiveness of many Food and Drug Administration-approved medications through large-scale studies.

“His work testing the real-world effectiveness of these treatments advanced the field,” Wang said. “He helped develop the set of pharmaceuticals that we currently use for bipolar disorders, including treatments for a difficult part of bipolar that wasn’t appreciated at the time, bipolar depression.”

He was also interested in understanding the link between psychiatric conditions and creativity. Ketter noticed that patients who came through the bipolar clinic were extraordinarily bright, motivated people who “tended to lead interesting lives,” even though their disorder also made life extremely challenging.

This interest was present in his home library, which was filled with hundreds of biographies of creative people with mental illness. “He was very interested in art and creativity and madness,” Nzeera Ketter said. “He would buy every book and knew every painting of these artists with mental illness.”

Well-rounded world traveler

Ketter retired in 2017 to travel the world. He and his wife had always been prolific travelers but took it to the next level upon his retirement – including a four-week expedition to Antarctica to see penguins and whales in their element.

“We were opposites in a lot of ways, but we had a lot in common in our love of travel,” Nzeera Ketter said. On their trips, the couple often took cooking lessons from locals. They visited China, Chile, Argentina, Japan, Korea and Thailand, among many other places. “He loved to experience new cultures, new foods and new ideas,” she said.

They would also visit museums on their trips. Ketter sought out works by mentally ill artists, Nzeera Ketter said. He was an avid photographer, shooting throughout his travels. He was also a musician, busking with his guitar on the streets of Montreal one summer during medical school.