S'pore neuropsychologist explains why she is like a brain detective


Dr Catherine Cox

AGE: 39

OCCUPATION: Acting head and senior psychologist at the psychology service of KK Women's and Children's Hospital

Dr Cox's ability to bake scones and crochet blankets, scarves and jewellery, as well as her knowledge of oldies from the 1920s to the 1940s, can be traced back to her work stints in several aged care institutions.

After she graduated from Deakin University in Australia in 1996, she worked in a nursing home coordinating activities. She made handicraft, cooked and organised outings for the elderly residents.

She enjoyed the experience so much that she decided to sub-specialise in neuropsychology so she could continue to work with elderly people who have stroke and dementia.

Her own grandmother had Parkinson's disease, which first got her interested in caring for the aged.

She now works with children at KKH who have epilepsy, head injuries and other neurological disorders. Her assessments of some children with epilepsy help the doctors plan for surgery, which involves removing the part of the brain causing seizures.

There are no more than 10 neuropsychologists like her in Singapore.

Dr Cox is married to a 42-year-old Australian businessman. They moved here in 2008 and have two sons aged nine and six. She is expecting another boy next month.

I specialise in neuropsychology because...

This field is about the relationship between the brain and one's behaviour and thinking skills.

Disorders such as stroke and diabetes can affect brain function.

There are children with developmental delays or learning difficulties that are related to medical conditions. Adult patients are usually affected by stroke, brain tumours or substance abuse, while the elderly usually have dementia or stroke.

The brain is fascinating because...

There is a great deal that we still do not know about it, for example, where one's memories are stored long-term.

We already know that some brain regions which are far from each other actually work together so we can do things easily, such as learn to dance.

Toddlers have more connections between their brain cells than people of other ages. As one grows and the brain gets more efficient in performing certain tasks, it gets rid of connections that are not needed and less brain cells are used.

If I were to give an analogy for what I do, I would be...

A detective. I try to find out what is troubling my patients, what is causing it and how to help them.

I use standardised psychological tests to examine a patient's thinking and behaviour, in areas such as attention, memory, speed and intellectual ability, among others.

At other times, I test my suspicion of what the patient's difficulty could be. I may tell the patient my name and then cover my name badge and test him about it.

A typical day for me starts...

With a cup of tea when I wake up at around 6am.

I start work by 7.30am. Assessing a patient takes about five hours, done over several days or visits.

After this, I think about what the results mean and how they fit with the patient's diagnosis or if they answer any questions that the doctor has. Sometimes, I have to do research into the problem.

I also supervise other staff, teach students and perform administrative duties. Work ends at around 5.30pm.

When I get home, I supervise my children's homework and music practice. Then, I relax by reading and watching television after the children are in bed.

I have come across all types of cases...

With patients ranging from three to 22 years of age. I see many children with epilepsy, followed by those with head injuries, brain infections and tumours.

I work with the child, his family, domestic helpers and even schools.

I enjoy working with patients who...

Have rare and unusual conditions, such as genetic disorders or rare brain tumours.

I like to learn new things and to observe how a disorder impacts the brain and its development.

I also think that I can help the family to better understand how to help their loved one by teaching them about the disorder.

People who get my goat are...

Parents who may not understand that the child has a real problem and is not simply lazy.

The child may have a memory impairment, dyslexia or be very slow in learning, but these problems may come across as lazy behaviour - for example, when the child hides his homework, takes a very long time to do something or is easily distracted.

One little known fact about neuropsychology is...

Our tests are very sensitive.

For example, a brain scan can be normal in the early stages of dementia for some brain infections or even head injuries. But our tests can pick up the patient's response to treatment or even the illness itself.

Things that put a smile on my face are...

Seeing patients who were really sick improve and learn to cope with their condition. I also enjoy working with a multi-disciplinary team of doctors, occupational therapists, speech-language therapists and physiotherapists.

It breaks my heart when...

My patients get very sick or suffer a relapse, with some even dying.

It is also sad when they cannot access interventions like rehabilitation or medication because they do not believe these work, or say they lack the time to try them.

I would not trade places for the world because...

I get to help people, train the next generation of psychologists and I enjoy what I do.

My best tip...

To help your brain function well, get sufficient sleep and keep it busy with activities.

Parents who read to their children and let them play a lot usually have children with better literacy, social skills and, overall, intellectual ability.

The same goes for adults - do the things that you enjoy and there is no need to buy expensive brain training games. Be physically active, eat well and learn new skills such as crocheting or ballroom dancing.

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