Eighteen months prior to his scheduled meeting with me, Mr. Harcourt, the president and CEO of an international energy company, was seriously injured while helicopter skiing in British Columbia. Not wearing a helmet, he suffered severe brain injury when he careened at high velocity into an ice-hardened snow bank. After three weeks he emerged from coma with manifestations of prefrontal and left-brain injury including right hemiparesis, a severe expressive aphasia, and neuropsychiatric symptoms including impulsivity, impaired social judgment, affective lability, and depression. His intellect and cognition were spared. Over the next year and a half, he worked diligently with his team of rehabilitation professionals and made excellent progress with articulated speech and ambulation. Nonetheless, Mr. Harcourt spent most of his time at home where he would have temper tantrums elicited by seemingly minor frustrations in which he would scream expletives and throw and break objects. He reacted especially vehemently to Mrs. Harcourt’s efforts to assist him when he lost his balance and fell.