The early days...
Very early on in my career I became convinced that clinical neuropsychology was the best tool for understanding the brain and the human condition. This enlightenment came about while I was still studying at night as a psychology undergraduate at Birkbeck College, London (having ‘spent’ my grant years in secretarial college and doing a law degree which I hated).
Across the square Elizabeth Warrington ran the clinical neuropsychology department at the National Hospital, Queen Square and in her publications I had been amazed at the insight her work with patients with localised lesions provided into the organisation of visual perception, the real independence of short vs. long term memory and semantic vs episodic memory.
I applied successfully for a day job as a research assistant in Elizabeth’s department and never looked back. A year long fling with psychiatric work only convinced me further that clinical neuropsychology had a more effective handle on forwarding our understanding and ability to help patients dealing with many sorts of pathologies, including many traditionally labelled psychiatric.
So from mid 1970s until retirement in 2008, I worked in assessment and rehabilitation with neurological patients day in and day out and remain convinced that this affords the best window into how our brains actually work.
Well trained by Elizabeth, research and teaching was an intrinsic daily part of my clinical routine (and evenings and weekends, so exciting was this journey of discovery). This symbiotic relationship between research and clinical practice, both intense daily experiences, produced not only insights into how brain systems worked but also easily informed the making of new tests. The Rookwood Driving Battery (RDB), published by Pearson, is but one example.
This way of working is unique in my experience of clinical practice where, once trained, most clinical psychologists cease to do any research. A corollary of this model of working is to court volunteers constantly to act as controls so that I have assessed literally thousands of people on the test and research protocols that have stemmed from Elizabeth’s model of practice and research.
"In my late 50s, I was delighted to test volunteers in
their 80s in their own home and witness their vitality
and joie de vivre...I thought 'if this is older
adulthood, bring it on!'"
This not only provides normative data but gives invaluable experience of what sorts of materials and questions are fitting for folk across wide spectra of demographic variability. On the RDB, I was delighted, in my late 50s, to test volunteers in their 80s in their own homes and witness their vitality and joie de vivre (not to mention the best home made Welsh cakes ever) so that, approaching retirement, I thought ‘if this is older adulthood, bring it on!’
Retirement and beyond...
So, by the time I retired, I had spent the first half of my adult career based in an acute inpatient neurological and neurosurgical setting in London and the second in a neurorehabilitation setting in Wales, becoming a tired Consultant Clinical Neuropsychologist and Head of Department and thinking ‘just give me six weeks to do nothing and I shall die happy’.
As it happened, life provided me with yet more challenges which I could not resist: to agitate and be a Friend of our wild and wonderful Bute Park to save it from ‘development’; an executive member of our Civic Society aiming to inform the Local Development Plan and, again, stop developers destroying heritage and style; and to continue my longstanding role as a Trustee of Headway Cardiff, our local charity for people with acquired brain damage and their families.
The biggest challenge of all, for my husband and I, is to be main carers for our sixth ‘addition’ of a baby granddaughter while her parents are working full time.
Now this is turning out to be a great joy, not just because she is a gorgeous little creature but because it allows me once again to study the marvel of ontogenetic development of my favourite organ, the brain.
Who knows, Ella might provide my second wind – I already know from my work with primary school children (yes, even small children provided norms for my test of semantic memory) that they are ready to master the concepts of animals and fruits and vegetables before man-made objects and can name them far better but what else might I observe and explore in her development? A single case study beckons! Or, and my heart sinks, would I need ethical approval to do this?
Away from work...
So here I am aged nearly 65, with a very full life but knowing emotionally, not just cognitively, that it will actually end within 20 years or so, which is no time at all. It has got better as it has gone along and I feel very fortunate. But life is a complex challenge for most of us most of the time, a mix of light and shade. Best of all I love to laugh, rollicking stomach-holding laugh but these days not on a full bladder.
And wine – but I did have January off like the celebrities just to prove I don’t have a dependency (which I do). In another life I would have loved to be a dancer (not ballet), writer, artist, yogi and definitely live deep in the country and not the city.
"I sat in a car every Tuesday am for the best part
of a decade jointly observing with our driving instructor the
ability of a driver to control the car safely and be aware
of the road situation"
I don’t have a favourite book but like lots of them. I don’t have a favourite album or musician, just love most genres except trad jazz. Vin Garbutt is a folk singer who has a touch of genius, more so for being ever so modest and not courting fame (look him up if you don’t already know him). He makes you laugh in spite of yourself and then sings the most heartrending songs in a gravelly, earthy voice from, of all places, Tyneside.
But you are reading this because I have published The Rookwood Driving Battery.
So my last words should address driving and why this test is so relevant. I sat in a car every Tuesday am for the best part of a decade jointly observing with our driving instructor the ability of a driver to control the car safely and be aware of the road situation.
I am now more aware than most of the steady progression of not only pathology but age on our nervous system and how this impacts on our ability to drive (and just about everything else). This test has all the essence of Elizabeth Warrington’s training and my experience of how to do it well, embedded firmly within the ecological experience of on-road assessment.
Patricia McKenna is author of the Rookwood Driving Battery.
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Date posted: January 29, 2013