7:45 A.M. I'm in my car driving to work, listening to National Public Radio, running over the day in my head, worried already because I will barely make it to work on time. The blame for my tardy start rests solely on the shoulders of Ralph and Serena. It's amazing—the extent of chaos two dogs can cause in 15 minutes!
8:00 A.M. I'm pulling into the parking lot so I'm sure this counts for being at work on time. A brisk walk to my office in the reconstructed trailer that is now a clinic and research building. Next I make a frantic and breathless phone call to the Psychiatry Emergency Services (PES). "This is Dr. Bonner … I'm covering for Dr. X, who's out on vacation … Any patients for me?" I'm informed that the staff is delayed because of weather and no patients await.
No problem. I've got a lot to do. I log on to the system.
8:15 A.M. to 9:25 A.M.—Answering e-mails and returning phone calls. Importantly, I review e-mail related to my new position on a community board aimed at addressing the health care needs of African American elders in the Puget Sound area. I had been asked to join the board because of my presentations at local churches and health fairs on the impact of Alzheimer's disease in the African American community.
I reflect upon the importance of fostering a relationship between the department of psychiatry and the local African American community. Although I know teaching and research are cornerstones of a successful academic career, I view participation in local community activities as one of the most important and enjoyable missions of Academic medicine. Too often, minority communities do not feel that their health care needs are being adequately addressed by academic medical institutions. The legacy of slavery, segregation, and Jim Crow continue to foster distrust of the health care system in general. As an African American female growing up on the South Side of Chicago, I too felt that exact same fear and distrust. I know that my outreach efforts alone will not be enough to close the gap between the department and the African American community, but they will represent a step in the right direction.
I realize that I need to know more about the role the University plays in the provision of services to the local geriatric population and write a note to myself to call one of my colleagues for additional information. I also order a few articles for an upcoming paper.
9:30 A.M. to 9:45 A.M. Usually this time is reserved for the weekly nursing home research team meeting, which is always an interesting mixture of education, patient care, and administration related activities. Attendees usually include physicians, nurses, physician assistants, study coordinators, and other team members. I am the team leader at one site in our service, supervising a team of nurses and study coordinators. Today, secondary to my PES coverage, I meet with our senior research nurse (instead of a full meeting); and we discuss the status of patients in our nursing home consult service and our Alzheimer's disease nursing home related clinical trials.
9:45 A.M. to Noon I've been paged, so I'm off to PES. A slow but steady influx of patients, with a variety of mental, physical, and spiritual needs. I suspect it's especially difficult for all of us today—physicians, nurses, social workers, therapists, and patients—in light of the fact that Thanksgiving is only 3 days away. Most of the staff will spend the day with family and friends in a warm environment full of love and cheer, whereas many of our patients may have no place to go. A few of the patients voice distress outright, stating how much more difficult it is to deal with their mental illness during the holiday season. I reflect upon how much these veterans have sacrificed for all of us. I am humbled by their determination and perseverance. I am honored to be able to provide even minor solace to these brave men.
Noon to 2:30 P.M. I nuke a quick microwave lunch, and I'm off to my geriatrics clinic. HOORAH! One of my favorite duties. This clinic provides services to veterans aged 65 and older, the majority of whom have a dementia diagnosis. A few of the patients I see today were treated in an open label trial of a medication for posttraumatic stress disorder and report doing well. Once again, I'm struck by the holiday sadness that permeates the clinic of Korean and World War II (WWII) veterans. However, despite this sadness, many of my patients and their families are determined to fully enjoy the holidays. I truly enjoy spending time with the older veterans and their families. In retrospect, patient care is the most fulfilling duty I perform as an academic psychiatrist.
2:30 P.M. to 6:15 P.M. The end of the day and still a lot to do. I return a series of pages, e-mails and phone calls relating to patient care, education, consultation, scholarship, and community activities. I notice an e-mail reminding me of upcoming residency program interviews and make a mental note to straighten up my office prior to each interview. I quickly flip through a few articles I ordered to provide background for another project.
I start my review of patient charts for tomorrow's resident supervision session. I have found resident supervision to be the most challenging part of my academic career. I supervise two residents in a once-a-week hourly session. The sessions are a mixture of lectures and factual gathering, journal club, patient management, and mentoring. Our contact is not limited to the scheduled hour. I frequently communicate with the residents via telephone or e-mail about various issues. In addition, I have to read and review their notes and try to develop an overall view of their psychiatric skills. It's actually a two-way assessment. They provide me with feedback about my teaching, supervision, and mentoring skills. I realized early that effective teaching requires skills not necessarily taught in residency and medical school. I am glad that I've had the opportunity to participate in a variety of department sponsored programs aimed at teaching the art and science of teaching. I then realize that the supervision session has been canceled. That's ok.
Now I can focus on continuing preparation for a lecture next week for the school of nursing. I was asked to develop a 1.5 hour lecture for the nurse practitioner Master's degree training program on dementia, delirium, and depression. I have decided to present a series of case vignettes to illustrate various clinical points. This lecture is one of a series of lectures I have prepared for audiences ranging from patients and their families to various health care professionals. The topics have focused on various aspects of dementia, including diagnosis, clinical management, and recent advances in treatment. In addition, I've given a series of lectures on the various Alzheimer's disease clinical trials offered at our institution. I complete the basic outline of the lecture and realize that its time to go home.
6:15 P.M. I'm logging off. I've had a productive day. And despite my initial late start, I've enjoyed my work. I feel fulfilled and happy. I know how lucky I am to be part of a supportive team and to have a job that allows me to combine patient care, scholarship, community outreach, and educational activities. More importantly, I have the unwavering love and support of friends and family that helps sustain me throughout the year.
Although I could not solve all of my patients problems, I realize I did as much as I could. I hope that today I made a positive contribution to their lives, and I am grateful for the opportunity to share in their life journey.
6:20 P.M. Unfortunately, I can't delay my departure any longer. Time to walk those silly dogs, pick up some take-out, and—I almost forgot—watch Monday night football. Can't wait to see what John Madden and Al Micheals have to say. I wonder who will be the horse trailer player of the game?
Supported by the Department of Veterans Affairs and NIH R01 AG18644