Not many people know what a neuropsychologist is, so Lynette Abrams-Silva explains it this way: “It’s part detective, part novelist and part demon hunter.”
What that entails is trying to figure out what’s wrong with someone’s brain when other doctors are stumped, rooting out the bad thing that’s harming the patient and then writing a “very long, very boring” report about it.
It’s clear right away — Abrams-Silva loves her job.
She’s director of the Psychology Department Clinic at the University of New Mexico, where she teaches and oversees clinical training experience. She also has a private neuropsychology practice, and she chairs an American Psychological Association effort to diversify the profession.
Abrams-Silva says she’s rare in New Mexico, because there aren’t many Hispanics nor are there many homegrown New Mexicans practicing neuropsychology.
“It’s really important to me that I’m a native New Mexican, and that I’m practicing here. It’s not just that I work with this population, but it’s my population. It’s where I come from.”
Her fascination with neuropsychology began during graduate school at UNM, when she was working on a degree in clinical psychology and had a “meet-cute, love-at-first-(sight) kind of moment with neuropsychology.”
Her fellow students were stumped by an assignment that required them to trace the path of a bullet through a fictional victim’s head, based on the cognitive problems that resulted.
“When I heard the question, it’s like the whole world was black and white, and all the volume was turned down,” she says. “And I went up to the blackboards — we had blackboards in those days with actual chalk — and I drew the brain. I could visualize it happening, where the bullet would have to enter to cause certain deficits, where it would have to stop to preserve other cognitive functions.”
“In that moment, I knew this is what I was supposed to do. This is why I’m on this Earth. I thank my lucky stars every day.”
And, no, she doesn’t mind writing boring reports. Unlike other doctors, she gets to spend a full hour with a patient while getting their complete history and probing their “perception, cognition, emotion.”
“It’s the foundation of (their) humanity,” she says. “It’s quite an honor to be able to do that.”
Tell me more about the detective part of your job.
“If you fall down and hit your head, which please don’t, and you don’t necessarily feel like you got back to where you were before, then typically your doctor will send you to someone like me, and we will do a very long battery of tests. Sometimes we get really well-crafted questions from physicians like, ‘Is this Lewy body dementia, or is it Alzheimer’s dementia?’ This is a very specific referral question, but sometimes we just get ‘memory problems.’ Or sometimes we get nothing. Sometimes we get, ‘We don’t know what’s going on with this person. Figure it out.’ Which I actually take as a compliment, that they believe neuropsychology is magical, because I believe it’s magical.”
Is there a case you’ve figured out that you’re particularly proud of?
“By the time you get to a specialist, a patient has usually seen many, many other providers and many other specialists, and they do tend to get fatigued by the time they come to us. And that means, too, that the mystery is harder to solve because eight people have already evaluated this patient in various ways. I have had a couple of patients that have been difficult to solve and that I have successfully figured out. And it ranged in age. One was a young adult who had a very rare autoimmune condition, and I was able to figure that out and direct care. Some conditions … if you let them go, they could cause irreversible, cognitive changes, and this was one of those cases where letting it go could have been dangerous. But the most satisfying aspects of my job have been training others.”
What were you like as a kid?
“Isolated and odd. I couldn’t really relate to my peers. I actually remember the moment I became self-aware of my otherness was when I was talking about The Muppet Show, and I said to a friend of mine, ‘On the last episode of The Muppet Show …’ I meant the most recent, but I didn’t get any more out because the other kid said, ‘It’s still going; there’s no last episode.’ And I just realized I’m never going to be able to communicate with people. I sort of felt this weird existential despair for a 4-year-old. Honestly, it’s really never gone away. I still do feel fairly separate. Part of it does come from sort of being in the middle. I am New Mexican, I’m Hispanic, Mexican-American, but also Converso (Jews who were forced to convert generations ago), so I was never necessarily Mexican enough, I was never white enough. When I was in Jewish school, I wasn’t Jewish enough. Then later, I was too Jewish. There’s never been a place where I fit in just right. I’ve always been just adjacent to what’s going on.”
Tell me about your efforts to diversify your field. How are you doing that?
“Blood, sweat and tears. So many tears, and you know I don’t sleep anymore. It’s a lot of work. I was trained almost exclusively by Caucasian men. And … they are fantastic. They’ve been very invested in my career and very supportive. Some of them started to ask me, ‘Where are our competent bilingual neuropsychologists?’ By then, I had built up enough gumption to tell them, ‘Well, you probably didn’t admit them to your program.’ Because the diversity factors that we now value like bilingualism tend to actually serve as barriers to higher education. I’ve tried to put my money where my mouth is and mentor trainees of color. We have a shortage of post-doctoral fellowships that will necessarily accept nontraditional trainees, so I created one … to be able to train a bilingual fellow from Puerto Rico. He’s been with us since September, so not only am I contributing to the production of a bilingual neuropsychologist who’s going to be competent out in the world, but while he’s training with us, we can provide Spanish-speaking neuropsychological evaluations, which are very difficult to come by.”
How do you wind down?
“My husband and I really do like to go to Santa Fe and take in the nature of Santa Fe or the surrounding area. We love the terrain of New Mexico, so going to the Jemez or even further north, but when we can’t leave town, I play video games. It’s hard for me to not think about things and … if I have a solvable problem in front of me, that tends to actually calm me down. So if I want to relax, it’s video games. This is why my husband and I don’t have children. Because we are children.”
THE BASICS: Lynette Abrams-Silva, 47, born in Albuquerque; married to Ian Abrams-Silva since 2016; two cats, Scout and Gordie, and two dogs, Sadie (half German shepherd) and Ezra (mutt with 10% Great Pyrenees); Ph.D., clinical psychology, University of New Mexico, 2012; master’s, clinical psychology, UNM, 2009; bachelor’s in English, Stanford University, 1996.
POSITIONS: Director, UNM Psychology Department Clinic, since 2020; clinical director, Brain and Behavioral Associates, since 2020; director of assessment, Parkland Hospital, Dallas, 2014-2017; assistant professor, University of Texas Southwestern, Dallas, 2014-2017.
OTHER: Chair, Ethnic Minority Affairs Committee, and co-chair, Strategic Planning Committee, American Psychological Association, neuropsychology division; established training rotations for UNM psychology students at All Faiths Children’s Advocacy Center and Hopeworks, and working to begin one for Sandia Pueblo; created a post-doctoral fellowship for two bilingual psychologists.