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Faculty Spotlight: Thomas Farrer, PhD

Wednesday, September 6, 2017

Clinical neuropsychologist Thomas Farrer, PhD, is the subject of this week’s Faculty Spotlight interview. We talk to the new addition to our faculty about his work assessing how neurological conditions affect patients’ thinking and behavior, how the works of Oliver Sacks and V. S. Ramachandran got him hooked on neuroscience, and his loves of classic movies, photography, cooking, and travel when he’s not at Duke.

What are your responsibilities as a clinical neuropsychologist?
My clinical practice is primarily with adult populations. While I have a special interest in memory disorders and dementia, I see a broad range of patient groups. As a clinical neuropsychologist, I’m tasked with conducting evaluations to characterize the cognitive and behavioral impact of CNS disease or injury. The results of this evaluation are often used to determine a new baseline when changes are expected in the future, or to establish the magnitude of change to an individual’s level of functioning.

At times, the evaluation is diagnostic in nature, with the aim of establishing whether a person has dementia and the likely etiology. At other times, the evaluation is simply a part of the patient’s overall work-up for epilepsy, Parkinson’s, or oncology surgical intervention. As part of the Clinical Neuropsychology Service, my clinic day typically includes clinical interview with a new patient, oversight of the formal psychometric testing with a testing technician, case conceptualization and documentation, and occasional direct feedback of results to a patient and their family. I also occasionally consult with a referring doctor or other members of a patient care team to discuss patient issues and treatment recommendations.

As a neuropsychologist, I am also active in scholarly work, with ongoing writing projects and research in post-operative cognitive decline, performance validity testing, TBI, dementia, neuroimaging, and meta-analysis investigations into neuro-epidemiology and neurocognitive outcomes in a broad range of conditions. I also look forward to building new research relationships and I hope to establish new projects with faculty with similar interests.

How did you get interested in clinical neuropsychology? What interests you the most about the field? What are the most enjoyable and most difficult parts of your work?
My interest in clinical neuropsychology began as a freshman undergraduate. I was enrolled in an introductory psychology class, which included a chapter on brain function and cognition. The instructor was an experimental neuropsychologist and he taught with so much energy and excitement that it was simply contagious. He took the class to a cadaver lab so we could view post-mortem brains, which was pretty exciting as an undergraduate. By way of my instructor’s recommendations, I also began reading Oliver Sacks and V. S. Ramachandran books and I was simply fascinated by the neurocognitive and behavioral consequences of specific brain lesions.

That was all it took to get me hooked. I changed my major to psychology with a concentration in neuropsychology and completed a minor in neuroscience. I haven’t looked back. Now, the thing I love most about my field is the opportunity I have to take several pieces of clinical data to try to understand the complex puzzle before me and then to provide valuable information back to the referring doctor, to the patient, and their family.

You’re joining us after completing a two-year fellowship in clinical neuropsychology here at Duke. What aspects of the fellowship were the most useful or memorable to you? How have you changed the most since you started your fellowship?

I was very lucky to secure excellent training throughout my journey in clinical neuropsychology. My capstone experience of clinical fellowship here at Duke provided me an outstanding opportunity to take everything I previously learned and try to apply it in clinical practice. Learning and growth has come from several wonderful patients, didactic experiences, and great supervision. I was blessed to be surrounded by excellent board certified neuropsychologists who pushed me along and helped me grow in areas I needed most. I was also very lucky to be able to shadow a few clinicians in neurology, which really augmented my clinical understanding. The best part of my fellowship has been the interdisciplinary nature of the department – It is always beneficial to be able to reach out to someone down the hall about clinical or research questions.

What’s one thing you wished more patients knew about your work?
This is a tough question because there are many things about neuropsychology that patients misunderstand. However, I guess I wish patients were more aware of the connection between the mind and the body. Anecdotally, I feel most patients fail to realize that their general health status can play a very large role in their cognitive health. One of my goals as a clinician is to help patients understand this connection.

What passions or hobbies do you have outside of the Department?
Outside of work, I am blessed to have two wonderful daughters who keep my wife and I very busy. As a family, we enjoy heading out of town on weekend adventures, going on hikes, playing at the beach, watching sporting events, etc. My personal hobbies lately have been centered around classic movies, trying to learn photography, and reading. I really enjoy learning new things related to anthropology, astronomy, cooking, language, travel, and more. I really enjoy documentaries about social-political or psychological issues.

Farrer and family enjoy a visit to Chimney Rock State Park.