Rep. Gabrielle Giffords' Traumatic Brain Injury

by John M. Curtis
(310) 204-8700

Copyright February 16, 2011
All Rights Reserved.                                             

                  When Rep. Gabrielle Giffords (D-Ariz.) was shot Jan. 8 at point-blank-range through the left cerebral hemisphere, few expected her to survive, let alone recover enough brain function to return to her former occupation.  Since surviving the incident, the medical emphasis has been dealing with life-threatening swelling, stabilizing her condition enough to transfer her to a post-acute hospital rehab facility.  When she was transferred Jan. 21. to  Houston’s Memorial Hermann Tir Rebah hospital, there were high hopes for her eventual recovery from nearly lethal traumatic brain injury.  Her emergency medical team at University of Arizona Medical Center, including neurosurgeons Dr. Michael Lemole and Dr. Peter Rhee,  marveled at her responses following her gunshot wound.   Now that there’s more known about her recovery, a post-traumatic picture begins to fall in place.

            Giffords’ chief of staff Pia Carusome admitted Jan. 16 on CBS’ “Early Show” that the congresswoman didn’t know the circumstances of her injury, namely, whether she was shot in the head at a Tucson shopping center meet-and-greet event, resulting in six deaths at least 15 serious injuries.  Calling her recovery “miraculous,” her doctors refer not only to her survival but the extent of her capacity early on to respond to doctors’ questions.  Carusome shared that Giffords’ doctors spared her the details of the shooting incident because the state of her recovery doesn’t yet fully allow her to comprehend what happened.  “The Long-term issues are really going to be focused on language—her communication abilities, reading, writing, and of course moving that right arm as well,” said Memorial Hermann Tir Reb center neurologist Dr. Jonathan Fellus giving the first clue about Giffords’ real condition followed the shooting.

            Responding to simple yes-or-no questions following traumatic brain injury doesn’t tell the extent of neurological deficits, including, her capacity to comprehend the big picture.  Giffords’ friends say “long-term issues” are just manageable obstacles she’s committed to overcoming.  Giffords can have all the motivation in the world but if her brain injuries are sufficiently disabling, she’s going to have great difficulty returning to normal brain functioning.  Friends, family and constituents all want to see Gabby fully recover but the extent of her brain injuries will determine how far she can go.  Carusome admitted that Giffords doesn’t know the circumstances under which she was shot by 22-year-old assassin Jared Loughner.  She doesn’t know that Loughner remains in federal custody awaiting trial for first-degree murder.  Carusome revealed that Giffords doesn’t know details of the Jan. 8 incident.

                Patients recovering from traumatic brain injury recall and comprehend only what they’re capable of processing.  Given Gifflords’ condition, it’s more likely that the nature of her injuries prevent her from processing detailed information.  Carusome said her doctors believe she isn’t yet ready to process details of Loughner’s Jan. 8 rampage, or, for that matter, how many people, including herself, were killed or injured. Doctors’ reluctance to fill patients in on the details isn’t based on re-exposing patients to unnecessary trauma but to giving them too many incomprehensible details.  Traumatic brain injury patients can’t fully absorb details related to traumatic incidents.  Patients’ amnesia over traumatic incidents have more to do brain injury than whether they can handle emotionally painful memories.  Giffords’ current recovery reflects the extent of her traumatic brain injuries.

            Political considerations, regarding the very real possibility that Giffords’ brain injuries prevent her from ever discharging responsibilities of her job, also prevent doctors from giving more factual information.  Carusome nuanced her answers the “Early Show,” refusing to speculate about Giffords’ future recovery.  “You could see she really wanted to engage.  And she wanted to be responsive and she really responds with facial expressions and smiles and frowns. But I also saw little frustrations wanting to responds, because she understood and she wasn’t yet able to [respond’,” said Rep. Debbie Wasserman Schultz (D-Fl.), admitting neurological limitations prevent Giffords from responding more fully.  “Giffords has a long recovery ahead of her, but doctors have repeated that her healing has been nothing short of miraculous,” said CBS correspondent  Don Teague.

            Reading between the lines, Giffords has undeniable brain damage following her Jan. 8 shooting incident.  Her doctors, staff and friends, including her chief of staff Pia Carusome, are all reluctant six-weeks out from the incident to characterize Giffords’ brain injuries and permanent and disabling.  Calling her recovery “miraculous” doesn’t mean that the 40-year-old congresswoman hasn’t sustained permanent disabling brain damage preventing her from returning to Congress.  Neither Causome nor her doctors are leveling with the public about the extent of Giffords’ traumatic brain injuries.   Whether she improves and acquires more cognitive functions in the future doesn’t mean she can return to her pre-morbid state of functioning.  Whether it’s a stroke or any other traumatic brain injury, most physical and cognitive functions return within a month or it’s going to be a very tough recovery.

John M. Curtis writes politically neutral commentary analyzing spin in national and global news. He's editor of OnlineColumnist.com and author of Dodging The Bullet and Operation Charisma.

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