The Path Back to Work Following Brain Injury

A day in the life of a high school assistant principal brings hundreds of decisions, most of them made on the spot. And for Kerri McDougal, that’s certainly the case on a sunny Friday in October.

She dispenses necessary discipline in the morning – tardy slips, dress code infraction notices, detention sentences for class-cutters – conducts a job interview and handles some truancy issues. At lunch, she rewards students with passing grades with free ice cream coupons and monitors the cafeteria for any inappropriate behavior. Meetings and briefings in the afternoon are followed by the dismissal of 1,700 students at day’s end.

But for Kerri, this ordinary day at Sprayberry High School in Marietta, Ga., is actually quite extraordinary:  She’s able to demonstrate quick thinking from start to finish, despite having sustained a serious brain injury less than a year earlier.

Rewind to Nov. 9, 2012:  Kerri and her boyfriend are hanging curtains in their Midtown Atlanta condo. After her boyfriend left the room, Kerri thought she could continue the task on her own, so she climbed up a ladder they had been using. Then, she fell off.

After two weeks at Atlanta Medical Center – where she was placed in a medically induced coma and underwent surgery to relieve the swelling on her brain – Kerri was transferred to Shepherd Center’s Acquired Brain Injury (ABI) Program. There, she worked to regain strength and balance and to perform tasks that require “executive functioning” – skills such as planning, organizing and multi-tasking.

Those three weeks at Shepherd were stressful, she recalls. The simplest tasks – walking, picking up objects, making itemized lists – were difficult to perform. She struggled to work the logic puzzles the staff gave her to test cognitive function. “I’m very independent,” Kerri says, “so it was hard to be supervised and have people help me all the time. It was also really frustrating to not be able to do things that I could do before.”

The hope of returning to work someday began to look like a pipe dream.

That began to change when Kerri graduated to Shepherd Pathways, the hospital’s outpatient rehabilitation program for people with brain injury. A primary goal of Pathways is community re-entry, whether that is transitioning to school or work, or a focus on gaining independence at home.

“Early on, it became clear to us that Kerri would be able to return to work,” says Debbie Page, the case manager for vocational services at Pathways. “Her judgment was not impaired, so the basic qualities of good decision-making were intact. That’s an essential function.”

At Pathways, Kerri worked on real-life activities. “I would bring in my emails from work, and the therapist would help me read them and respond,” she says. “I also continued to do logic puzzles to help with my problem-solving skills.”

Like many Pathways patients, Kerri gained offsite work experience by volunteering at MedShare, a non-profit organization that redistributes surplus medical supplies and equipment to healthcare facilities in developing countries. Volunteers sort medical supplies into categories based on type and expiration date.

“This activity helps our clients build physical and cognitive endurance by performing simple to complex tasks,” Debbie says. “It also helps them to navigate an environment and interact with other people.” Observing how patients perform in this setting, she adds, gives the Pathways staff a lot of insight into how patients function and where improvements are needed.

Although Kerri regained strength and cognitive function, she was unsure she could handle all of her duties in the fast-paced environment of a high school.

“Before, I felt confident to make those quick decisions,” she says, “but I really felt doubtful about coming back. I thought everyone would be judging me if I couldn’t do the things I did before, and I didn’t want to disappoint anyone.”

Debbie acknowledges that the return-to-work process can be overwhelming. “We don’t wait until you’re 100 percent to send you back,” she says. “The only way you get back to 100 percent is to start doing it. It’s challenging.”

The key for Kerri was going back gradually. In March, she began working from home for a few hours three days a week. She built up to working full days at home, and then at the school a few days a week before eventually returning full time. By taking on small tasks, working at her own pace and having the Pathways therapists help her troubleshoot situations, she was able to regain her confidence.

“It was a good way for her to be able to transition into communication with faculty members on a limited basis and take on some projects that could be done from home and through email,” says her principal, John Kelly. “It ended up being a very good thing for her and for us.”

Kerri has a bigger monitor on her desk and uses a magnifier to help with lingering vision issues. Other than those modifications, she is back doing her job as before, with confidence.

“Kerri is a huge asset to Sprayberry High School,” John says. “She truly cares about our students and works very hard to support our teachers. We are very blessed and thankful that she has come through this ordeal and that we have her back as part of our team.”

Story by Sara Baxter

Photography by Louie Favorite