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Dementia and me

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I must confess that why I work with dementia is not something that I really planned. But one of the pleasures of living life is that things take their own course and you don’t know what’s going to happen next. We like to think that we make our own choices and take our own decisions – that’s true, and so does a canoeist in a white water stream. It’s just that you have to take into account the torrent as well as the paddling.

I studied Medicine having rather drifted into it. My father would get enthusiasms for different careers for his children and when Medicine was suggested it sounded OK, so off I went. I assumed that I would be a GP as that was the only sort of doctor I knew anything about, but I got interested in Psychiatry after having some great experiences and good teaching.

At first my interest was in mental illness as brain illnesses, so as a form of neurology really, and I read a lot of books about psychiatric conditions associated with brain disorders. My first experience of research was in this area, studying a condition called Wilson’s disease. I found the interplay between the brain and changes in mood and behaviour extremely interesting.

My training progressed in general adult psychiatry, so not dealing with dementia very much at all. However, I was finding it unsatisfactory for various reasons, mainly to do with the conflicting pressures upon and responsibilities of psychiatrists, so I didn’t fancy becoming a consultant in that field. I started to look around for alternatives…

Among these the best option was old age psychiatry: (a) I had enjoyed a 6-moth post as a junior trainee; (b) there was plenty of scope for looking at the interaction of brain disease (dementia) and behaviour; (c) there were plenty of jobs; (d) the prospects for career progression looked good. Therefore I changed track and I was appointed to succeed my previous consultant back in Cambridge.

That was in 1991 and I stayed there until last year when I had a very exciting opportunity to come to Nottingham. I now find myself in a role I could not possibly have expected, as a Professor. Adapting to a new place and a very different role has been quite a challenge, but I am pleased I have taken it up rather than staying where I was. Obviously the issues that arise in this job are something that I hope to share in this blog.

Over time my interests have changed and I had a sudden flash of recognition a little while ago that actually what really enthused me about my work was not the rather abstract thinking about the brain and behaviour (although that’s interesting) but just hearing people’s stories. I am insatiably curious and being able to ask people about their lives is a very special experience. I am often humbled by the circumstances they find themselves in and the obstacles they have to contend with. In return, my responsibility is to offer respect and hopefully also good advice and appropriate treatment. And in whatever little way I can, to do something about dementia through research and teaching. Let’s see how it goes.

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