Dr. Gerard Erker

Text version of Dr. Gerard Erker's keynote remarks

I'm Gerard Erker, SSM Rehab's Director of Neuropsychology. We help people cope after life altering illness or injury as they work to regain independence.

When Vickie Horst invited me here, I had to wonder what she had seen me do that looked like courageous leadership. In answer, I thought about the similarities between what I've had to do as an administrator and what I've had to do as a clinician caring for agitated brain injured patients.

While many rehab patients show inspiring courage in the face of catastrophe, some have such severe brain injuries that their reasoning ability, memory, impulse control and self-awareness are, for a time, lost to them.

Mr. H, a 6' 6" man, had a cardiac arrest and anoxic brain injury, leaving him confused and agitated with no recent memory, yet still strong and fairly mobile. He couldn't perceive his own impairments, so it angered him that we wouldn't release him, and he released himself from the locked Brain Injury Unit.

When I was called to the scene, Mr. H. had made his way to the end of the long hall, where he felt trapped. He and I were face-to-face. Onlookers watched him menacingly grinding his fist into his hand. I knew he couldn't reason logically; I made no effort at persuasion. I simply presented myself.

He stared down at me and said, "I really want to hurt you."

I'd already said my prayers-for my safety, but also for inspiration to guide my steps and speech, because I believe God is with us in what we do.

Although it all seemed very urgent, I listened before I talked.

I reminded myself that he couldn't see things as I did. So I listened to learn his perspective and to find a common goal that might transcend the immediate tug-of-war.

Of course, I suggested to him that he didn't really want to hurt me, and I did my best to act calm.

The solution in the end wasn't elegant or sophisticated. I just asked patiently and persistently what he wanted. We identified some basic needs-he wanted to call his family, change into clean clothes, and get off his now tired feet.

When he seemed convinced I would arrange for these basic needs, and that I expected him to follow me, I turned and began walking toward the Brain Injury Unit and said, "Let's go." And follow me he did.

So what does leading an agitated patient have in common with leading colleagues through difficult changes?

Both situations call for calm to manage the instincts that flow from fear and anger.

Both require listening for what is essential to the other person, to identify a transcendent goal.

Most importantly, both require the leader to have the clearer picture of where they are, and where they are to go.

It is a privilege to practice where the Mission is defined in terms of the healing presence of God; this helps us know where it is we are to go.