AS HIGH FLYERS LOSE ALTITUDE: DETECTING DETERIORATION

It was an awkward task. Professor Richard Gates had been invited to lunch, not for the pleasure of the meal or the company, but to conduct an informal evaluation.

He was there to assess the behaviour of the chief executive of a major Australian company. (Professor Gates acknowledges the ethical dilemma inherent in observing an individual for professional judgement without the person’s consent. In some cases, he says, there are no alternatives and past experience shows that both the individual and the company benefit.)

This man had been acting strangely for a few months and had made business decisions that no-one else in the company could understand. They were out of keeping with his past history and were causing considerable damage. Gates was then an associate professor of marketing and management at the University of New England and a retired neuropsychologist. Neuropsychologists focus on the way that physical changes in the brain affect thinking and behaviour. Although the lunch was fairly relaxed, Gates says it was obvious the chief executive was in difficulty. His behaviour was inappropriate and he didn’t appear to realise it. He had always been reserved, and there he was, sitting in a quiet restaurant making loud and embarrassing suggestions to the waitresses.

‘From the way he ate his food and the way he conducted himself at the table, I was certain something was wrong,’ says Gates. ‘Without having any alcohol, he was acting with the disinhibition typical of drunks.’

But physically he looked fine. He was in his late 50s, welldressed, fit and a picture of corporate success. He drove himself to work, could conduct a lucid conversation and, apart from his odd behaviours, seemed to be functioning well.

Whenever his colleagues suggested he see a doctor, he would aggressively reply that he was very well. Through Gates’s intervention he eventually agreed to seek help. A CAT scan showed he had suffered a stroke that had damaged one of the frontal lobes of his brain. This was difficult for him to accept because he had no obvious sensory loss or disability. He did recall that he had felt a bit ‘off for a few days at some stage.

At any time, there are a small number of men in industry, government and the nonprofit sector who are beginning to fail neurologically. This impacts on their work and their decisionmaking and can have a deleterious effect on their organisations.

If such a man is embedded in a board of directors in which everyone else is functioning well, his problem may not have a significant effect. Hut if he is the chairman or the chief executive officer, his impairment can be profoundly destructive.

Age is an important factor because the probability of disease generally increases with age, but many men continue to function at a very high level way past the compulsory retirement age, while others fall in their 40s.

Various (actors can create disturbances in brain function. Their impact depends on the part of the brain involved and on the man’s role in an organisation.

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