A Masterful Performance

WOW! In this profession it's good to see your teachers in action in the real world from time to time. Today one of my favorite profs did a dementia assessment behind one-way glass for us to watch. She was absolutely amazing! Yes, I have done nearly all the tests she performed, but not the way she did them or with the breathtaking proficiency and sensitivity she demonstrated. In very short order it became clear that the WAIS-III scores weren't going to be meaningful due to acute short term memory loss, so she swiftly shifted from the standardized presentation format to information gathering mode, with a neuropsych perspective. She skipped around through the subtests looking for specific information and focusing on specific brain areas, all without a pause in her patter. She also sprinkled mental status exam questions and some neurological tests (squeeze my hands as hard as you can. Hold out your arms straight, now close your eyes etc) between subtests. In 45 minutes she knew that there were problems in the client's right frontal lobe, left parietal lobe and the entirety of the occipital lobe and that what was going on was probably not dementia and more likely a case of post-anesthetic anoxia. But the most wonderful thing to watch was the rapport that she established and the amazing way she instilled both hope and comfort to the client.

It's easy when doing psych tests to become an automaton, especially when you're new and trying to be sure you go verbatim from the manuals. Having seen this example I know every test I do from here forward will be a little more 'human' regardless of who I work with. I think the level of proficiency she showed, knowing how to shift around among tests and when to shift mind sets and so forth can only come with years of familiarity, but she certainly set a big bright goal for us to strive for!