First photos of Giffords released since shooting

Gif­fords takes part in a reen­act­ment of her swearing-in on Capi­tol Hill in Wash­ing­ton, on Jan. 5, 2011, three days before she was shot as she met with con­stituents in Tuc­son, Ariz. (Asso­ci­ated Press | Susan Walsh)

Gif­fords is seen May 17, 2011, at TIRR Memo­r­ial Her­mann Hos­pi­tal in Hous­ton, the day after the launch of space shut­tle Endeav­our and the day before she had her cran­io­plasty. (Asso­ci­ated Press | P.K. Weis)

AMANDA LEE MYERS

RAMIT PLUSHNICK-MASTI

Asso­ci­ated Press

HOUSTON — Two por­traits of a smil­ing Rep. Gabrielle Gif­fords gave the nation its clos­est look yet at the congresswoman’s remark­able recov­ery less than six months after she was shot in the head at point-blank range out­side a supermarket.

The pic­tures posted Sun­day on Face­book were the first clear pho­tos of the Ari­zona con­gress­woman who rose to national promi­nence after a gun­man opened fire on her in Jan­u­ary as she met with con­stituents in Tuc­son. Six peo­ple were killed and 13 oth­ers wounded.

But the images left unan­swered many ques­tions about her cog­ni­tive abil­i­ties and when — or even if — she will be able to resume her job in Congress.

“The image doesn’t tell us the inner men­tal state or the brain itself, how it’s func­tion­ing,” said Jor­dan Graf­man, direc­tor of the Trau­matic Brain Injury Research Lab­o­ra­tory at the Kessler Foun­da­tion Research Cen­ter in West Orange, N.J., explain­ing that many brain-injury patients look good within months of being hurt.

“What’s their social skills? Do they have a nuanced sense of humor? Can they par­tic­i­pate in activ­i­ties? All that is what’s impor­tant,” asked Graf­man, who has not treated Giffords.

In one of the images, Gif­fords smiles broadly and looks straight at the cam­era like a high school stu­dent pos­ing for a year­book. In another, more can­did shot, she is grin­ning along­side her mother. In both, her smile is largely unchanged, though her hair is shorter and darker. The pic­tures give few indi­ca­tions she has been hurt, let alone shot in the forehead.

Gif­fords’ aides say she could be ready to be released from a reha­bil­i­ta­tion cen­ter later this month or in early July. The idea was to dis­cour­age a “paparazzi-like frenzy” of pho­tog­ra­phy when she attends out­pa­tient ther­apy in a more pub­lic set­ting, they said.

The congresswoman’s staff said the images had not been altered or touched up in any way. But other than say­ing the pic­tures were taken May 17 at the Hous­ton reha­bil­i­ta­tion hos­pi­tal where Gif­fords has been under­go­ing treat­ment, her staff offered no fur­ther insight into her recovery.

For months, they have closely guarded Gif­fords and infor­ma­tion about her con­di­tion. Her doc­tors, in the absence of per­mis­sion from the fam­ily to speak pub­licly, remain mum. So the release of the pho­tos attracted intense interest.

Gif­fords was shot in the left side of the head, the part of the brain that con­trols speech and com­mu­ni­ca­tion. Doc­tors, friends and fam­i­lies have said she can speak, sing some of her favorite songs and engage in some conversation.

Rep. Deb­bie Wasser­man Schultz told NBC’s “Meet the Press” she had a “won­der­ful con­ver­sa­tion” Wednes­day with Gif­fords on the phone, and that this time her col­league even ini­ti­ated some of the top­ics they discussed.

Since she was wounded, the public’s only other glance of Gif­fords came in grainy images from late April that showed her slowly walk­ing up the steps of a NASA jet that flew her to Cape Canaveral, Fla., to watch her hus­band, astro­naut Mark Kelly, rocket into space.

The launch was delayed, forc­ing Gif­fords to make a sec­ond trip to Florida in May, when she watched the blastoff from a wheelchair.

Gif­fords spokesman C.J. Kara­mar­gin acknowl­edged that the con­gress­woman looks dif­fer­ent now than in the pho­tos. Her hair is shorter because her head was shaved ahead of surgery to repair a gap in her skull that had ini­tially been left open to allow her brain to swell. Doc­tors also fixed what appear to be sub­tle inequities between her eyes seen in the pic­tures, he said.

The pho­tos were released to help sat­isfy “intense inter­est in the congresswoman’s appear­ance.” And they seemed to please the pub­lic and her admirers.

Hun­dreds of peo­ple com­mented under the images, which were posted on count­less web sites. More than 3,000 peo­ple clicked “like” on Gif­fords’ Face­book page.

Some of the com­ments also men­tioned Jared Lee Lough­ner, 22, the shoot­ing sus­pect who has pleaded not guilty to charges stem­ming from the shoot­ing. He is being held at a Mis­souri facil­ity where pros­e­cu­tors hope his com­pe­tency can be restored after a judge declared him unfit to stand trial.

Oth­ers raised ques­tions about the actual extent of Gif­fords’ progress.

“It would be nice to get a truly hon­est assess­ment of her inter­nal cog­ni­tive expe­ri­ence,” wrote Alex Hakki­nen, who told the AP he works with brain injury patients at a rehab cen­ter in Lawrenceville, N.J.

Hakki­nen said Gif­fords’ staff has an oblig­a­tion to bring her out in pub­lic at some point so con­stituents can assess her abil­i­ties, maybe in a “fire­side chat” of sorts. Or they should acknowl­edge that she’s inca­pable of doing so right now, he said.

Chief of Staff Pia Caru­sone indi­cated in an inter­view pub­lished Thurs­day in the Ari­zona Repub­lic that, despite reports that Gif­fords is talk­ing and walk­ing, she remains a shadow of her bub­bly self. The con­gress­woman, she said, can ver­bal­ize her basic needs, but strug­gles to string together more com­plex thoughts.

If her recov­ery “plateaued” now, Caru­sone said, Gif­fords’ qual­ity of life would be far less than what she had known before the shooting.

Caru­sone stopped short of answer­ing the most crit­i­cal ques­tions: Will Gif­fords’ resume her post in the House of Rep­re­sen­ta­tives and will she run for the Senate?

Until the Jan. 8 shoot­ing, some Ari­zona Democ­rats viewed Gif­fords as one of their best hopes for gain­ing votes in the Senate.

The shoot­ing has cre­ated some­thing of a vac­uum, with few can­di­dates will­ing to declare their inter­est until Gif­fords’ sit­u­a­tion is clar­i­fied. Caru­sone has only said that the con­gress­woman has until May 2012 to decide.

In the short-term, the pho­tos focused atten­tion on Gif­fords’ appearance.

Of the two pic­tures, one is more clearly posed, that of a smil­ing Gif­fords look­ing directly at the cam­era. The left side of her head appears slightly dis­torted and swollen, and a healed scar from a breath­ing tube can be seen in her neck. A sec­ond photo shows Gif­fords in a more casual light — smil­ing while sit­ting along­side her mother, Glo­ria Gif­fords, with the hospital’s green­ery behind them.

The pic­tures were taken by Tuc­son pho­tog­ra­pher P.K. Weis, who said he has known the con­gress­woman for at least 10 years.

But brain expert Graf­man noted the cam­era is angled toward Gif­fords’ right side, her bet­ter half since the bul­let struck her on the left.

For some, sim­ply see­ing the con­gress­woman smil­ing and radi­ant was encouraging.

Susan Hile­man, who sur­vived three gun­shot wounds in the ram­page, said she spent Sun­day morn­ing smil­ing while look­ing at pho­tos of Giffords.

“I am delighted and pleas­antly sur­prised,” said Hile­man, who was hold­ing the hand of 9-year-old shoot­ing vic­tim Christina-Taylor Green when the gun­fire erupted. “Look at that smile. How could you not be happy look­ing at that smile?”

The pic­tures, Hile­man said, gave her hope as she endures her own painful rehabilitation.

“It’s a mir­a­cle she’s alive … It’s going to be a long road, but if any­body is well-positioned to do it, it’s Gabby,” she said. “She’s phys­i­cally fit. She’s smart. She’s dri­ven. She’s young … She has all the pieces in place.”

Those ele­ments will ulti­mately help her long-term recov­ery, experts say. A person’s edu­ca­tion, intel­li­gence, envi­ron­ment and life expe­ri­ence affect recov­ery from a brain injury.

“It’s strik­ing. She does look great,” said Dr. Richard Riggs, chair­man of phys­i­cal med­i­cine and reha­bil­i­ta­tion at Cedars-Sinai Med­ical Cen­ter in Los Angeles.

Still, Riggs, who has not been involved in Gif­fords’ treat­ment but has been track­ing her progress, said the months after her release will be critical.

Patients who have suf­fered trau­matic brain injury can become eas­ily dis­ori­ented, have trou­ble pri­or­i­tiz­ing, suf­fer mem­ory loss and have dif­fi­culty rec­og­niz­ing peo­ple. Some strug­gle to do sev­eral tasks at the same time.

Most cog­ni­tive recov­ery occurs in the first six months to a year after an injury, though it becomes less notice­able as time pro­gresses. In the sec­ond year, progress sharply drops.

“The pic­ture tells us that phys­i­cally she’s hav­ing what would appear to be a strong recov­ery from that stand­point,” Riggs said. “But it does not tell us any­thing about the cog­ni­tive capa­bil­i­ties or where she is on the path of inde­pen­dent liv­ing much less going back to a job.”

Posted by AP News on Jun 12 2011. You can follow any responses to this entry through the RSS Feed. Comments can be made below.