Gabby

by Gabrielle Giffords

  On some fronts, Dr. Rhee was positive almost from the start. “Your wife has a 101 percent chance of survival,” he said. “She will not die. I do not give her permission.” We knew that nine out of ten people shot in the head don’t survive. So Gabby was a success story just by virtue of still being in this world. But we all wanted more, and Dr. Rhee couldn’t say for sure that she wouldn’t end up in a semivegetative state. “It’s too soon to tell,” he said.

  Those of us who love Gabby had a lot to learn about the brain, and part of what we learned was that so much is unknown. The brain has “redundant circuits” for some functions, such as walking. So it was possible that Gabby would be able to walk again. Language, which is far more complicated, could be harder to recover.

  Even when doctors remove a piece of skull and look inside someone’s head, they don’t discover much that can predict a patient’s likely progress. During brain surgery after people suffer a bullet wound, it’s hard to tell which parts of a brain will recover since, as Dr. Lemole said, “It all looks bad.” The doctors reminded us that the scars we saw on the outside of Gabby’s body reflected what was going on inside her body. The trauma was severe.

  How far might Gabby go? How close could she come to returning to her former self? Could she meet the expectations of her constituents? “Those answers won’t come until rehab in the weeks and months ahead,” the doctors said. “Some answers may not come for years.”

  My resolve defined me in those first days. My instinct was to take charge. I was going to supervise Gabby’s recovery and get her back as quickly as possible. Maybe I wasn’t always realistic, but that attitude helped me stay focused in the early going. I was tired, I was angry, but I just kept running on adrenaline. I was on a mission.

  I had a place to stay at the Arizona Inn, but I never went there until about a week after the shooting. I just couldn’t leave Gabby. On the third night, hospital staffers kindly found an empty room for me in the pediatric intensive-care unit. I was able to sleep there for several hours each night, and I developed a routine. On my way to or from bed, I’d stop by the nurses’ station to see how all the little patients were doing. “How are the babies today?” I’d ask the nurses.

  “They’re going to be OK,” they’d say. “And how is the congresswoman?”

  I’d see young mothers holding their babies, most born prematurely or with serious health issues. Those mothers were like Gabby’s mom, wishing they could take away their children’s pain, hoping that their love would serve as a form of medicine. When I was away from Gabby, Gloria sat beside her. “I feel like my breathing is helping Gabby breathe,” Gloria said. “I just want to share the air in the room, like maybe my breath will sustain her.”

  My intimate moments with Gabby were not fully private. There were always people hovering over her—nurses, doctors, aides. For protection, the U.S. Capitol Police were with us twenty-four hours a day. Tucson police were in the hallway. At one point, even the director of the FBI, Robert Mueller, showed up and asked if he could speak to me outside Gabby’s room. The FBI wanted to know about any previous threats to Gabby’s life, and whether she had enemies. I told him about the political climate in Arizona, and he vowed to use every resource possible to investigate the attack.

  Meanwhile, Gabby’s sister, Melissa, and our friends signed up on a duty roster to be available, night and day, to sit at Gabby’s bedside. Gloria felt, and I agreed, that we didn’t want Gabby to be by herself—ever.

  As I sat with Gabby, e-mails poured into my BlackBerry from friends, family, colleagues, and just about anyone who had or could get my e-mail address. It never stopped. I didn’t know many of those who’d written to us, but I appreciated their concern and support.

  I was especially touched that so many astronauts, dating back to the Mercury program, sent heartfelt notes. “We hope you will sense God’s strength and presence in Gabrielle’s recovery, as well as in your cockpit during your upcoming space adventure,” wrote Jack Lousma, the pilot of Skylab 3 in 1973 and later a space shuttle commander.

  Neil Armstrong tracked down my e-mail address and wrote: “Dear Mark, We know that you need not be in a combat zone to be in harm’s way. But Gabby was just doing the kind of thing that she should be doing.” The previous summer, he had gone to Congress to discuss space exploration issues. He wrote that Gabby had been a huge help to him: “Her questions of witnesses were the absolute best.” His graciousness extended even to the last line of his e-mail. “Please do not bother to answer this, but know that we are pulling for her—and for you. Most sincerely, Neil Armstrong.”

  In 2006, when Gabby and I were dating, I’d given her the book First Man: The Life of Neil Armstrong as a gift. She loved it. My hero became hers. Three years later, she had changed the channels on the television in the House cloakroom so her colleagues could watch that NASA TV special on the fortieth anniversary of Armstrong’s moonwalk. Now, sitting with her in the ICU, I wished I could have tapped Gabby on the shoulder to somehow wake her out of her coma so I could read her his e-mail.

  I also wished she could know what was going on outside University Medical Center. It was a remarkable sight. Strangers were leaving thousands of get-well wishes, flowers, gifts, blankets, prayer shawls, candles, and handwritten notes with prayers. The spontaneous memorial was a massive outpouring for the dead and the wounded, and it grew each day. A total of nine hundred stuffed animals were left there and would later be donated to two children’s hospitals in Tucson. On the day Gabby was shot, a young soldier from the war in Iraq left his Purple Heart for her, saying she deserved it more than he did. Another Purple Heart was left by a Vietnam veteran who described himself as a conservative Republican. He wanted Gabby to have it because she “had been through a battle.”

  A World War II veteran wrote a note saying that on October 10, 1944, his twenty-second birthday, he suffered a brain injury. He was hospitalized for a year. He wrote to offer Gabby encouragement. “I went on to graduate from college, get married, have three kids, and work as a sales manager until I retired in 1985. I played softball and volleyball until last year. I’m now eighty-eight and still kicking. Perseverance conquers all.”

  C. J. Karamargin, Gabby’s communications director, handled media interviews outside the hospital, along with Pia. They were touched that the local reporters, having covered Gabby for years, were especially upset by the tragedy. Gabby had a good rapport with journalists, and some of them had tears in their eyes as they asked questions about her condition. One cameraman asked to restart an interview because he was crying and shaking the camera.

  I’d sometimes head outside and walk around the displays after dark, just so I could feel the goodwill and positive energy. Wearing a hat so I wouldn’t be noticed, I’d pass signs on the front lawn with messages such as: “Fight Gabby Fight!” Gabby would be greatly moved if she knew that so many of her constituents were praying for her. These were the people whose doors she had knocked on over the years. Now they were coming out of their homes to wish her well.

  Every night a mariachi band arrived to play on the front lawn of the hospital complex. They came to be part of something special—a spontaneous vigil for those who died and those still recovering. Maybe they knew Gabby was a huge mariachi fan. They weren’t expecting that she’d hear them, but their music did make its way up to her hospital room.

  The Tucson Girls Chorus also came by to perform, as did Native American singers from the Tohono O’odham Nation. And every morning, in the darkness before sunrise, a lone drummer would arrive outside the hospital and start beating her drum very slowly. She’d keep beating until an hour after the sun had risen. One morning, I spoke with her. “I am doing this out of respect for my congresswoman,” she said. “I hope and pray this will help her heal.”

  To me, it was only a drumbeat. But who knows? Maybe she was playing a role in Gabby’s recovery.

  In those earliest days, I determined that the best thing I could do to help Gabby was to become her fiercest ad
vocate. She had several doctors caring for her, including Dr. Rhee, the chief trauma surgeon, Dr. Lemole, her neurosurgeon, and the ophthalmologist Lynn Polonski, who would need to perform ocular surgery.

  I was grateful to her doctors—they had saved her life—but I was also insistent. “I want Gabby to have the best possible care,” I told Dr. Rhee. “You guys have been great, but I want to get the best people in the country to weigh in on the medical decisions we’re making.”

  Dr. Rhee didn’t act on my first or second request. Maybe he didn’t fully recognize how serious I was. So in a third conversation, I was more firm. “Let me tell you about my wife,” I said. “No matter what she’s doing, Gabby is all about putting together the very best team. When she recovers, she’s going to ask me what I did to put together a group of doctors who’d give her the best care possible. She’ll ask: Did I get the best second opinions I could?”

  I was not going to tell her, “Sorry, honey, that didn’t occur to me.”

  So I let Dr. Rhee know that the second opinions were going to happen with or without his help. I told him I’d been speaking to Admiral Mike Mullen, chairman of the Joint Chiefs of Staff, about this very issue. As the senior officer in the military, and a Navy admiral, he was essentially my boss. Dr. Rhee is a retired Navy surgeon, so Admiral Mullen used to be his boss, too. My request to Dr. Rhee finally sank in.

  Several hours later, he stopped me in the ICU corridor and said, “I have Geoffrey Ling and Jim Ecklund from Walter Reed on their way here. These guys literally wrote the book on penetrating head injuries and both had experience treating soldiers in Iraq and Afghanistan. Are you happy now?”

  “Yes,” I told him, and I was.

  When Drs. Ecklund and Ling arrived, they spent time reviewing the many CAT scans and pages of medical records, and conferring with Gabby’s Tucson doctors. They felt that Gabby had received excellent care from Dr. Lemole, Dr. Rhee, and their teams. They did make recommendations to change some of Gabby’s treatment in the ICU. Their advice, and their analysis of the good work being done by the medical teams in Tucson, was very reassuring to me. But there were still a great many medical decisions ahead.

  Gabby needed an additional operation to rebuild the upper half of her fractured right eye socket. (Although the gunshot was to the left side of her head, the force of the bullet fractured both orbits. The right side was in worse shape and required additional surgery.) After speaking with Dr. Rhee again about my desire to have second opinions, he invited two Navy ophthalmologists that he knew from San Diego to fly in and examine Gabby. Once they arrived, I asked if I could get them together with the Tucson doctors and residents for a short meeting.

  There were eight or nine of us in the room, and the doctors were discussing whether to do the surgery from inside Gabby’s eye socket or to do it by cutting through her skull above the eyebrow. I decided to take a moment to tell them what I had learned at NASA about decision-making. I explained that phrase posted on the wall of the conference room used by the Mission Management Team during space shuttle flights: “None of us is as dumb as all of us.”

  “It means,” I said, “that when you get a group of people together to make a critical decision, groupthink can set in. There’s all this technical information, a critical decision needs to be made, and everyone starts marching in the same direction. There might be some people who think it’s the wrong direction, but they don’t say anything. They just remain a part of the group.

  “At NASA, we’ve learned that groups can make stupid decisions that no single individual in the group would make. We had a couple of terrible space shuttle accidents—Challenger, Columbia—and when we looked back in hindsight, they may have been preventable. There were individuals who had the right information, or in the case of Columbia, had seen the issue before. If people spoke up, perhaps those catastrophes could have been avoided.”

  I looked around the hospital meeting room. I was searching for the youngest, most inexperienced person, and settled on an ophthalmology resident sitting in the back. She looked to be in her late twenties. I pointed at her. “So yesterday, the plan was to go through the eye socket to approach the fractured area from underneath,” I said. “Now, today, everyone is saying that it’s better to go through Gabby’s forehead and make the repair from above. You’ve been listening to the whole discussion. I need to know if you think this is the correct approach.”

  She seemed a little nervous. She never expected me to single her out. She took a breath. “I agree with the plan,” she answered.

  I thanked her. I thanked all of them. The next day, the doctors made their incision above Gabby’s eyebrow and removed a piece of her skull and several bone fragments. Using titanium mesh, screws, and the pieces of bone, they rebuilt the top of her eye socket on a table in the operating room. Then they lifted up the right frontal lobe of her brain, which had been pushing into the orbit, and reinstalled this thing that looked like it was built from a kid’s erector set. The surgery couldn’t have gone better.

  While Gabby was in a coma in those early days, tens of millions of people who’d never heard of her before were quickly becoming familiar with her. More familiar than she could have imagined. Video clips of her in Congress played all over television. The highlights of her bio and the particulars of her politics were discussed by pundits as if they knew her. And though she had always preferred to be known as Gabrielle in public, within hours of the shooting she had become “Gabby” to the world. It was President Obama who ushered in that instantaneous transition when he gave a three-minute televised statement on the afternoon of January 8.

  He started off by referring to her as Gabrielle Giffords. He said she was fighting for her life and he talked soberly about the other victims. Then he got more personal. “Gabby Giffords was a friend of mine,” he said. “It’s not surprising that today Gabby was doing what she always does—listening to the hopes and concerns of her neighbors. That is the essence of what our democracy is all about. That is why this is more than a tragedy for those involved. It is a tragedy for Arizona and a tragedy for our entire country.”

  Once the president said “Gabby,” the media picked up on it, and it spread from there. People developed affection for Gabby and her nickname. Maybe it helped make her seem more like a regular person. She wasn’t some stuffy congresswoman named Gabrielle. She was just Gabby, eager to meet her neighbors, and now struggling to stay alive.

  Gabby admired the president, but she wasn’t even sure he knew who she was until late 2010 when she came to the White House for a meeting and he said, “I like your new haircut!” She had, indeed, gotten her hair cut that week. His comment made her day because she didn’t really like the new hairstyle.

  She hadn’t backed Obama right away when he ran for president in 2008. During the Democratic primaries, Gabby was torn. As a young female politician, she found that Hillary Clinton’s historic candidacy spoke to her. (Gabby has always encouraged women to run for office, believing that if more women serve, compromise on issues will come more easily.) But during that primary season, she was also drawn to Obama. Knowing she needed to be careful politically, she remained neutral for months.

  One day in the spring of 2008, Gabby and I were driving somewhere and the phone rang. It was Senator Clinton, hoping to win Gabby’s public support, and her vote as a so-called superdelegate at the upcoming Democratic convention. I heard only Gabby’s side of the conversation, but she was very complimentary, telling Clinton how much she respected her. Senator Clinton never came out and directly asked for her vote. She ended the conversation by asking Gabby, “Would it be OK if I called you back sometime?”

  “Of course,” Gabby said.

  When Gabby got off the phone, I asked her what she was going to do. Would she endorse Hillary? “For now, I’ll just wait until she calls me back,” Gabby said. She knew how to buy time. She believed that it was sometimes best to defer a hard decision. You might make a different choice if you wait.

  In the case of C
linton versus Obama, she held off until the very end, when Obama’s delegate count proved insurmountable. She was part of that large last wave of Democrats who endorsed him.

  Her political instincts were always sharp. Her staffers likened her to a chess player, always thinking three or five moves ahead. She combined strategic thinking with a gut-level understanding of how politics can matter in people’s lives. I think that’s what made her formidable as a public servant.

  Gabby had ambitions to possibly run for the U.S. Senate. But unlike a lot of politicians, she didn’t fantasize about her own run for president. She always thought men are more apt to have that ambition, and history certainly has proved that true. “Women don’t generally have the ego to think they could be president,” Gabby once told me. “And when women lose elections, you rarely see them again. A man loses and he feels the need to come back, to try again, to run for something else.”

  Gabby thought men often have a harder time facing rejection in the work world. She believed women generally have a greater ability to move on and go in a different direction, or to return to their families with a renewed sense of purpose. If Gabby ever lost her seat in Congress, she figured it would be her last election. She’d do something else. “There are a lot of capable people who can do this job,” she’d say. “I don’t need a lifetime hold on the office. There are many things I can do with my life, and many other ways I can make a contribution.”

  Gabby was certainly ambitious. She just resisted being obsessive and unrealistic about it. And she felt a bond with smart, driven women who tried to think the same way.