“Freedom of speech,” she’d say.
“What’s the second amendment? The right to . . .”
“Arms,” Gabby said.
“Yes, the right to bear arms.”
“How about this, Gabby. Four score . . .”
“And seven more,” she said.
“You’re close. It is ‘four score and seven years ago.’”
Gabby developed a great ability to sum up hospital food. “What did you have for lunch today?” I asked her one evening.
“Warm juice. Meat salad,” she said, and then she burst out laughing.
We saw that Gabby’s long-term memory was excellent. Looking at a photo of a certain female politician, Gabby had a recollection she couldn’t resist sharing. “Man hands,” she said.
Gloria, Spencer, and I had many consultations with doctors, but they couldn’t fully explain the mysteries of the brain. People with serious head injuries all respond in different ways, they said, so it was impossible to fully predict how things would go for Gabby.
A lot of brain-injury patients struggle to understand humor. They may appreciate the slapstick stuff, but anything subtle, including the punch line of a joke, is beyond them.
There are patients who can read but not write. Others can write but they can’t read; they could write a letter to a loved one without a problem, but couldn’t go back to read what they had written.
Some patients understand perfectly everything said to them, but they will never be able to utter a word. Others are the opposite. They can speak normally, but what they hear is gibberish.
In Gabby’s case, as time went on, we saw that her comprehension was nearing 100 percent. She understood jokes, and also found her own ways to be funny, with facial expressions, eye rolls, and a word here or there. She didn’t slur her words, which was a great sign. If people with brain injuries slur their words from the start, the slur usually remains throughout their lives.
Another issue: People who survive a gunshot to the right side of their brain often find that their personality changes drastically. They may have trouble interacting with others. They may be depressed. They may act out inappropriately. Gabby, shot on the left side, was able to retain her personality. We all saw that pretty clearly, and were intensely relieved.
Dong Kim, Gabby’s neurosurgeon at TIRR, explained that what people consider a part of the human soul is actually a series of distinct brain functions. Depending on where people suffer their head traumas, they may become more or less religious, or more or less empathetic. “There are great strides coming in brain science,” Dr. Kim promised. He compared the breakthroughs ahead to the progress made in cardiology in the late 1950s. We could only hope these advances would come in time to help Gabby.
Gabby’s biggest problem, besides the partial paralysis on her right side, was her inability to communicate.
Often, she’d say yes when she meant to say no, or vice versa.
“Gabby, do you want to take a walk?” I’d ask.
“Yes, yes,” she’d say, and when I’d stand up to help her, she’d tell me, “No, no, no!”
She knew what she wanted to say. It’s just that the wrong words came out—often, the opposite of what she wanted to say. For some reason, “no” was much easier for her to say than “yes.”
Carl Josehart, who ran the operation at TIRR, was good at explaining this problem in everyday language. “Think of the brain as a filing cabinet,” he said. “Imagine dumping a lot of the files on the floor and then randomly putting them all back in the cabinet. That is what Gabby is dealing with. When she reaches to say a word, it might be in the wrong folder. She may not even realize right away that she has used the wrong word. But even if she does realize it, she can’t help herself and correct it. She still says the wrong word. And it’s common to get hooked on one word, and to say it over and over again.”
One day, Gabby was saying “no” in response to every question. Her well-meaning father took it upon himself to talk to her about it. “Let me give you some ideas about when you’d use the word ‘yes,’” Spencer said to Gabby, and then he began rattling off situations in which answering “yes” would be appropriate. “For instance, if I asked you if the sky is blue, you’d say ‘yes.’”
Spencer gave her about a dozen examples. “No, no, no,” Gabby said. I could see she was getting upset.
“Not ‘no,’” Spencer said. “You’d use the word ‘yes.’”
Gabby knew exactly when you’re supposed to say “yes” versus “no.” After all, she comprehended almost everything. It’s just that, for some reason, she wasn’t able to deliver the word “yes.” Her father’s heart was in the right place, but he just wasn’t seeing the faulty circuits in his daughter’s brain.
“No, no, no, no, no . . . !” Gabby said the word about twenty times until Spencer backed off. I’d never seen her that angry with him. Gabby and her father always had a special bond, which had gotten ever stronger after she came home to run El Campo. Who could have imagined that they’d one day be at odds over the definitions of “yes” and “no”?
One day, a while later, Gabby and I were alone and she said to me, “Voice in my head.”
“Whose voice?” I asked her. She didn’t answer. She was struggling to find the words to explain herself, but couldn’t.
“Is it someone else’s voice?” I asked.
“No, no, no,” she said.
“Is it your voice?”
“Yes,” she said. “Hear my voice.”
“So you can hear your voice, but you can’t get your voice out. Is that what you’re trying to say?”
“Yes,” she answered. “Very frustrating.”
To ease her frustration, I tried my hardest to interpret what she meant when she used a wrong word or phrase.
“Room for pillow,” she said one night when we were in her hospital bed together. She was waving her hand over her head.
“Gabby, you have your pillow,” I said. In fact, there were multiple pillows and plenty of space for them on her bed. “Room for pillow!” she said several more times.
I was at a loss to figure out what she wanted, and she was growing more agitated about it. It went on for fifteen minutes of her saying “room for pillow” and me trying to guess what that could possibly mean.
Finally, it hit me. She wanted the head of her bed tilted backward. She couldn’t come up with the word “tilt.” I showed her the button to use to move her bed up and down, and then I blamed myself. “Gabby, it’s not you,” I said. “It’s me. I’m a moron.”
“Yes,” she said. “Moron.”
Because I knew Gabby so well, I didn’t always have to ask her to explain things. One day early in her hospitalization, I was home and needed to take a look at her online bank statement to make sure her mortgage was being paid. But I had a problem. I didn’t know her password and she wasn’t well enough yet to tell me. To get a new password, the bank’s website prompted me to reply to a few questions that Gabby had answered when she set up the account.
Question #1: “What is your favorite flower?”
What would Gabby have answered? I typed in “tulip.” That was correct.
Question #2: “Who is your best friend?”
“Raoul,” I typed. Correct again.
I was given a new password and breezed into Gabby’s records.
I later told her how easily I’d cracked her code. “You don’t have to tell me what’s in your head,” I said. “A lot of times, sweetie, I just know.”
Gabby’s doctors and nurses were patient in trying to help us understand brain science. They explained that some babies are born with half a brain and they grow up relatively normal. That’s because either side of our brain is capable of doing pretty much everything. The problem for adults is that it’s difficult to rewire a brain later in life. It’s doable, but it takes a lot more time. The brain’s ability to change itself is called “plasticity of the brain.” In Gabby’s case, the right side of her brain would need to pick
up some functions that for forty years had been performed by the left. Her brain literally had to rewire itself, and that’s a slow, inexact, not-always-successful process.
Like many brain-injury patients, Gabby was often exhausted. An hour of speech or physical therapy took a lot out of her. Doctors explained that sleep helps the brain heal, and Gabby took seriously her need to rest. She slept thirteen or fourteen hours a day, then woke up ready for therapy. “Work, work, work,” she’d say.
There isn’t a lot of shiny, expensive equipment used to rehabilitate brain-trauma patients. In Gabby’s case, physical therapy often involved some white PVC piping and an Ace bandage. Her right hand would be tied with the bandage to contraptions built from the piping. The contraptions were designed so that as Gabby moved her left hand, her damaged right hand would follow suit. The purpose of this was to try to train her brain to start giving signals to her right hand, just as it did to her left. By moving her hands in tandem, the hope was that the brain might begin rewiring itself to better acknowledge her right hand.
Later in the day, Gabby’s speech therapist would arrive with a box of cards featuring pictures of objects, or she’d bring the objects themselves. Sometimes they’d play tic-tac-toe. They’d also leaf through People magazine, discussing what the celebrities were wearing and doing. This was sometimes an exercise in futility because, even before Gabby was shot, she couldn’t tell you anything about celebrities and what they were up to. She didn’t pay attention to celebrity culture. So why would she know now? Still, it was helpful if Gabby looked at clothing, objects, and scenery, and tried to identify the names of things.
Often, Gabby and her speech therapist would just talk. Sometimes they would sing. “American Pie” was a favorite.
Music therapy may seem like an idle entertainment to help patients pass the time, but it’s a crucial and fascinating part of healing. Singing familiar lyrics, a right-brain activity, helps those injured on the left side of their brain. Stimulating a part of the brain that wasn’t damaged can help rebuild a patient’s broken circuitry. When a patient undergoes an MRI while singing, many different areas of the brain light up. “Singing,” the doctors told us, “is a pathway to language. It’s great exercise for the brain.”
Because lyrics to well-known songs are imprinted in people’s minds, those with brain injuries often find it easier to access lyrics than spoken conversation. Many can sing in sentences before they can speak in sentences. In Gabby’s case, music therapy also helped her with physical issues. Sometimes, while she walked the hall, a certain rhythm was played, and the cadence helped her improve her gait. And, of course, there were also emotional connections when she sang, such as the memories evoked when she and her mom shared duets of “Tomorrow.”
Gabby’s parents sat through countless hours of therapy, and they appreciated seeing it all unfold. In those months, they were staying at a friend’s home in Houston, but they were reluctant to leave the hospital at night. “I’m afraid if I go, I’ll miss something,” Gloria told me. Sometimes she’d return to the hospital at 5 a.m. She couldn’t stay away. “I realize that even while Gabby is sleeping, bits and pieces of her brain are rebooting and coming on line,” she said. “I want to be there when things happen. I want to watch her get better.”
Sometimes, Gabby would repeat the same sing-song phrase: “Wondering what’s happening to me.” She wasn’t exactly singing it, but almost. Her delivery was mischievous, as if she were really saying, “There’s something you guys aren’t telling me.”
“Wonder what’s happening to me,” she’d say again, her inflection rising.
I’d respond in my own sing-song voice: “You’re getting better. That’s what’s happening to you.”
Gabby often used the word “hazy” to describe her memory. And then one night she couldn’t think of the name of Longworth, her office building in Washington. “What I know I can’t remember,” she said.
For a while, she also repeatedly said, “I’ve been beaten.” I didn’t like hearing that. Did she mean her injury had beaten her? That she was down for the count?
“You haven’t been beaten,” I told her. “You’ve just been beaten up.”
She’d pump her fist when I said that. “Yes,” she’d say, and give me a half smile.
Sometimes, I’d ask her what she missed about the life she left behind. “The office,” she said. She was referring to her congressional office. And then she said: “The people are important.” She hadn’t forgotten her constituents, either.
Pia, Gabby’s chief of staff, spent a lot of time in Houston, and often gave Gabby updates on legislation and issues in her district. Gabby listened intently, though she couldn’t formulate questions.
I didn’t want Gabby to forget that she was a formidable politician. In early April, Speaker John Boehner came to Houston to attend the NCAA Final Four tournament. Considering that she was a member of Congress and he was the highest-ranking member, we thought he’d ask to visit Gabby, or at least give a call to see how she was doing. Our only contact with him had been a simple get-well card he’d sent a few days after Gabby was injured.
When he came to town for the basketball games and we didn’t hear from him, I told Gabby that maybe she had scared him off. “Remember before the 2010 election, when we saw him in that restaurant?” I said to her. Gabby remembered.
We had been at a restaurant in Washington and spotted Boehner, then the House minority leader, at another table. He was wearing a white shirt and a crisp tie, and was dining with ten other middle-aged men, all in white shirts and similar ties. Gabby wasn’t intimidated. As we were leaving the restaurant, she stopped by their table—a young female Democrat unafraid to stand before a group of older male Republicans and speak her mind.
“Hey, Leader Boehner, how are you doing? How’s everything going?” she said. He knew who she was. He nodded politely.
She got right to the point. “You stay out of my district,” Gabby said to him, a big smile on her face. “OK? Remember. Stay out of my district!” She was trying to be funny, but she was also giving him notice. She didn’t want him using the Republican war chest in the campaign against her. And she didn’t want him coming to Tucson to do fund-raisers for her opponent.
To my eyes, Boehner had an uncomfortable look on his face as Gabby spoke. He barely said hello, and no one else said a word.
“Well, good seeing you,” Gabby said to him, still smiling. Then she turned and waved, and we walked toward the door.
Now, less than a year later, Gabby was no longer able to deliver such self-assured patter. So much had changed since that night in Washington. But I wanted Gabby to know she still had it all in her. “Maybe Boehner doesn’t want to see you because he’s worried you’ll tell him to stay out of your district,” I said.
She smiled at me, and I could see the same twinkle in her eye that had carried her through that Washington restaurant.
Gabby still had a long way to go. I saw that. But in so many vital ways, she remained the person she always was. Her daily journey had been difficult and painful, but she had blossomed in this rehabilitation hospital. And it was exciting to contemplate the progress to come.
Sometimes, I felt almost elated. The parameters of a miracle were widening.
CHAPTER EIGHTEEN
STS-134
The launch of my mission on space shuttle Endeavour, postponed several times, was finally slated for April 29, 2011, a Friday afternoon. In the weeks leading up to it, doctors repeatedly said they could envision Gabby being well enough to travel to Florida to see me and my crew off. They didn’t commit to giving their blessings, but they thought it was appropriate for Gabby to make that a goal of her rehabilitation.
“See the launch,” she’d say repeatedly.
In mid-April, she went on a secret practice run to the airfield she’d fly out of, so the logistics of her departure could be ironed out. A special chair was brought along to get her up the stairs of the jet. Gabby vowed that on the day she ac
tually traveled, she’d walk up the stairs if she could.
On April 24, we got the final OK from her medical team. Gabby was good to go. In their words she was “medically able.” It was a milestone. “Awesome!” was Gabby’s response when she learned the news.
Her doctors looked at it as a kind of field trip. Patients often left TIRR to attend special events or family functions, to help reacclimate them into their former lives. In Gabby’s case, her life before she was injured included her role as an astronaut’s wife. This would be a nice coming-out for her, and maybe helpful to her recovery.
By then, I had already begun serving seven days of quarantine at NASA’s Johnson Space Center. My crew and I were being kept away from other people and their germs so we’d remain healthy before the mission. Being quarantined at NASA, twenty-five miles southeast of TIRR, was hard for me. I didn’t like the separation from Gabby. Her mom and Pia could tell me how Gabby’s days were going, but I wanted to see with my own eyes.
I was able to call Gabby and ask her questions, but she couldn’t really answer or initiate much. Mostly it was me talking. But then, on the night of April 26, Gabby and I were on the phone and during a pause in the conversation, she said, “I miss you.” It took me by surprise. Until then, Gabby was almost never able to deliver a line like that unless someone else said it first. This was a new sentence, delivered all on her own, and it was a sentiment that went straight from her heart to mine.
TV networks and newspapers that day were full of stories about Great Britain’s Prince William and Kate Middleton, who would be getting married on the very morning of our scheduled launch. The royal wedding was gearing up with unprecedented pageantry. It was the biggest love story of the year, with satellite feeds to a billion people.
Yet on this day, I was reminded that love can also be small and simple. I was alone in quarantine. Gabby was stuck in the hospital and in her own mind. All we had was a phone line. And all it took was three words: “I miss you.”
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