Slowed by a Stroke

A veteran executive faces a difficult situation honestly and gets some advice on making adjustments that will keep him productive

Q: I'm an engineer who moved into marketing/sales about 20 years ago. I was promoted to a marketing manager for a company division that grew significantly under my watch. I was then promoted to a position overseeing a large group responsible for hundreds of millions of dollars in revenue.

Unfortunately, I had a major stroke several years ago. I'm now in my mid-40s, and physically I have recovered almost completely. Here's the problem: I have some limitations carrying out higher-order executive functions, and I tire quickly.

My company has been extremely supportive. It continued to pay me the same base salary, while giving me a different job. I'm afraid, however, that I haven't been doing a very good job at my most pressing duty, managing a complex -- and top-priority -- product-development project.

So, I feel my position is tenuous at best. I've decided I need to get some sort of an evaluation to determine what kind of job I should pursue. How would you recommend I do this?

---- Name Withheld

A: First, our best wishes to you. We salute your courage in recognizing and confronting what must be a difficult problem. You can take comfort in the following: Your youth, the powerful intellect that drove your earlier career success, and a supportive employer all bode well for you.

"Especially with people who were functioning at an extremely high intellectual level pre-stroke, it would be a mistake to think that a stroke wipes out your intellectual skills," says Bernard Brucker, a rehabilitation psychologist and chief of psychology at the University of Miami Medical School. "The way to look at it is, you have some specific losses." And Michael Feuerstein, a specialist in occupational medicine at the Georgetown University Medical Center in Washington, D.C., says, "Both research and common sense indicate that employer support, supervisor support, is a key predictor of success in returning to work."


  The evaluation you're asking about requires three steps, Brucker says. A neuropsychological assessment will pinpoint your "higher order" deficiencies -- functions such as memory, concentration, and sequential thinking. To find a neuropsychologist, your best bet is a major medical center with a rehabilitation program accredited by the Committee on Accreditation of Rehabilitation Facilities, Brucker says. Ideally, choose one with a neurological rehab unit.

Your next stop is a rehabilitation psychologist, who will use the neuropsychological assessment to decide how best to help you. You'll probably get some combination of exercises to recover what is possible, and tricks to compensate for some of the losses. For example, Brucker says, executives like you are used to absorbing and organizing huge volumes of information. If you can't do that any longer, you can learn to accomplish the same thing by going back to those old high school term-paper steps: Put information on note cards, spread them out in front of you so you can see all of them, then arrange them so they make sense to you.

You finish up with a vocational counselor. This person connects your diagnosed mental abilities to a list of jobs and even suggests retraining programs, if that seems to be the way to go.


  But underlined and in capital letters, all of our experts say your first, best bet is making things work where you are, if at all possible. The impulse to bolt is common, they say, because high-achieving people such as yourself cringe at not rising to your old, superhigh standards. Fight that urge.

You're smart not to let things ride, though. If you think you're not getting the job done, it's a good guess your bosses do, too -- even if they haven't said anything to you about it, says David Opton, CEO of ExecuNet, an executive career-management organization in Norwalk, Conn. Opton suggests you approach your manager with a pitch along these lines: "As a good manager, my assessment is that I've recovered quite well, but I'm not doing this job up to my standards or yours. I'd like to find some way to contribute to this organization at a level I think you deserve."

There are all kinds of creative options. Your company could decide to give you an assistant to cover part of the job and keep you where you are. Brucker knows one financial genius whose stroke diminished his sense of decorum. He started coming to board meetings in shorts and sandals. The company's solution was to hire a personal secretary who selected his clothes every morning. Your company might also modify your job -- maybe peel off some responsibilities -- to make it more manageable. Or you could agree on a move to a different job.


  Since you know the company, you can even suggest some new job options to your bosses. If they go for one of these, up their comfort factor even more by agreeing to a reevaluation three months out. "Essentially, you design your own pilot project," says Pam Lassiter, principal of Lassiter Consulting, a career-management agency in suburban Boston.

It sounds like your company is run by good people. But just so you know your legal rights, the Americans with Disabilities Act requires an employer to provide disabled workers with whatever "reasonable accommodations" they need to get their job done, says Minneapolis attorney Susan Segal. If the needs go beyond reasonable, the company then has to consider the worker for other open positions.

If ultimately you need to go knocking on other doors, career counselors offer this advice: You're going to meet some narrow-minded customers, so be up front with them about your limitations, or you'll be wasting your time. Consider approaching companies you dealt with in your earlier work, because they know you. Also consider companies likely to be more enlightened about all kinds of diversity, such as nonprofits or perhaps a health-care organization.

Just remember: You're the product you're marketing now.

Have a question about your career or workplace issues? E-mail us at, or write to Ask Careers, Business Week Online, 6th Floor, 2 Penn Plaza, New York, NY 10121. Please include your real name and phone number in case we need more information. Only your initials and city will be printed. Because of the volume of mail, we won't be able to respond to all questions personally. Questions may be edited for length and clarity.

H.J. Cummins has covered workplace, personal-finance, and work and family issues for more than a decade at Newsday/New York Newsday and the Minneapolis Star Tribune