As a clinical researcher and nurse practitioner, Raymond Romano appreciates the holistic approach he is able to take in his role with the Vanderbilt Memory and Alzheimer’s Center. With a Ph.D. in Nursing Science, his primary research interest involves helping find new ways for primary care practitioners to diagnose and care for Alzheimer’s disease patients. Raymond spends his free time working on his cooking skills, gardening, and practicing yoga.
Tell us about your background: Where you’re from, what first piqued your interest in medicine, and ultimately neurology.
I grew up in New Jersey in a multigenerational household, which included my grandparents, a great aunt and my cousins—basically a house full of people. I went to Marymount Manhattan College and majored in biology. I was first exposed to research under Dr. Ann Aguanno in her cellular molecular lab. I knew I wanted to be in the medical field, but at that time I wasn’t sure what that would look like. I did my Master’s in Public Health at Boston University and studied international health. I got to work on a project in Kenya, which was really a foundational experience in my life. We were evaluating a Ministry of Health community health worker program, and we interviewed people, surveyed women around their household, looking at various public health topics like water, birthing, etc. While I was starting with that I met a nurse practitioner and started to learn about that kind of role. I realized I liked the nursing model and the approach of care for the person as a whole, and that provoked me to apply for nursing programs and become a nurse practitioner. I came to Vanderbilt for my Master’s in Nursing. I started practicing as a family care provider at Vanderbilt. While I was doing that, the research thing stuck with me and I did my Ph.D. After that, I made the transition to cognitive neurology.
Talk a bit more about that transition. What are your research interests?
My Ph.D. is in Nursing Science, and my research was in Alzheimer’s diagnosis. The projects I ended up working toward involved how pain experiences differ between people with normal cognition and people at risk for Alzheimer’s. I worked with Todd Monroe [from Ohio State University] and Michael Carter from [University of Tennessee]. I want to figure out a way where primary care practitioners can diagnose Alzheimer’s faster and more easily. A lot of diagnoses rely on lumbar punctures or other testing not possible in the primary care setting, so I hope to find ways to improve that.
What does a typical day look like for you?
I am working with the [Vanderbilt Memory and Alzheimer’s Center]. I work on the two large cohort studies that the Center runs. I perform the physical exam, neurological assessment, clinical interviews and lumbar punctures for our studies. Besides data collection, I also help with the outreach and recruitment side of the center. I help run our VMAC registry (compiling information on potential participants). I help recruit them, identify studies they’d be the best fit for, and get them enrolled. I interact with participants about 70% of the time, and the other time is data-driven.
What excites you about the future of your field?
I think that the focus on Alzheimer’s research is becoming more relevant and a higher priority because it needs to be. That’s exciting because when you get a bunch of minds working together [on a problem] you’ll find a way to solve it faster. There are some cool drug developments happening, as well as great work focused on caregiver burden and figuring out ways to improve and reduce burnout for the “unpaid workforce.” In short, there are lots of exciting things happening because of the growing attention to the field.
Why is that?
With the population aging, we have a workforce that’s not ready to handle that large influx of older adults. The country as a whole is finding ways to plan better and deal with the changing population needs proactively. For example, Tennessee needs about 29 times the amount of providers than it currently has to care for older adults in order to meet the expected population at 2050.
Who or what inspires you? Who have been some of the most influential people along the way (personally and/or professionally)?
Most of my inspiration comes from my patients. You see someone and care for them and learn about their life, and that inner desire [as a practitioner] is to figure out how I can help this person. That helps drive the research questions you have and get you going every morning.
I’ve had a lot of fantastic mentors—officially and unofficially. Dr. Aguanno is one of them. I didn’t know research existed in undergrad, and she opened my eyes to that. Another one is Dr. Angela Jefferson. I worked with her in Boston and basically followed her here to Vanderbilt. She taught me the bulk of what I know about research. Michael Carter and Todd Monroe helped me solidify myself as a nurse scientist, professional, and clinician, and gave me that confidence and guidance to navigate the professional world. I rely a lot on mentors and value everything they do for me.
What are some of your interests and hobbies aside from work?
I’m trying to teach myself to cook. When the pandemic happened, I bought a culinary school textbook. I practiced knife skills and mise en place. It’s been a great outlet for me. I’ve become interested in gardening. It’s a good way to get out and experience the earth, be outside, and recharge. I’ve also been doing a lot of yoga. This stems from my patients; I know that as people get older, balance and flexibility get harder, so I wanted to proactively do that for myself. It's good time to be in silence and find balance in my life.
What are some highlights of working at Vanderbilt?
Vanderbilt gives me the opportunity to work with leaders in the field and learn from the best. It’s an environment where we encourage growth. Vanderbilt wants you to succeed.
What do you like about living in Nashville?
Nashville’s just a cool city. I never expected I would live in the South, but of all places Nashville is a great place to be. It’s grown tremendously, but it’s the right size of city. There’s always something to do, and there’s greenery within a short drive anywhere. Snow also doesn’t hang around long!
