Gabby

by Gabrielle Giffords

  After Kristy left the room, I moved my chair around and went to hold Gabby’s right hand. Using her good left hand, she lifted my hand off of hers and plopped it back in my lap.

  I tried to explain myself. “Sweetie, we talked about my trip ahead of time,” I said. “You told me it was OK. I was only gone four days. And it was a pretty important opportunity.”

  Gabby glared at me. Then she rolled her wheelchair out of the room.

  I ended up talking to Carl Josehart, the chief executive officer at TIRR, who used to be a marriage counselor. He sat down with both of us to help iron things out. He started by asking Gabby to express her feelings.

  “Mad,” she said. “I’m mad.”

  “Well, that’s understandable,” Carl said. “Mark was away for several weeks, then he came home for a few days and then he was gone again. A lot of wives wouldn’t like that.”

  Carl asked me to tell Gabby how I was feeling.

  I wanted to explain myself. “Honey, you know I’m in this with you for the long haul,” I said. “This is a lifelong marathon that you and I are on together. I’m not going anywhere. But early on, after you were injured, people gave me advice. They said I’d need a life outside of caring for you or I’d get burned out. I’ll need my own time sometimes.”

  That said, I knew I needed to admit that, in the case of her birthday, I had made a mistake. “I thought I could sneak away for four or five days. Boy, was I wrong. I wish I could undo all this and make a different decision. But I can’t. I just hope you’ll forgive me.”

  Gabby is a very smart woman. She understood my commitment to her, and appreciated my willingness to admit to screwing up. She accepted my apology, reached over, and gave me a kiss.

  “Could you forgive Tilman, too?” I asked.

  She smiled. “Yes, Tilman, too.”

  Given Gabby’s continuous improvement, physically and cognitively, her doctors at TIRR set her release date for June 15. She was walking better. Her ability to comprehend what people were saying was at 99 percent or better. The thin scar on her forehead was fading. After five months, she was ready to go.

  Once she was released, she’d become an outpatient, returning to one of TIRR’s satellite facilities for daily rehab. “Gabby is on the verge of complete sentences,” said Angie, her speech therapist, who expected great progress in the weeks and months to come.

  Tilman and Paige invited us to move into their guesthouse, closer to downtown. “Stay three years if you want,” said Tilman, whose generosity seemed to know no limit. But Gabby felt she’d be more comfortable at my home, twenty-five miles south in League City, even though that meant she’d be spending a lot more time in the car being driven to daily rehab.

  As her departure date approached, Gabby got sentimental about TIRR.

  She had almost no memory of anything she experienced between January 8 and her arrival in Houston on January 21. TIRR was the place where she pretty much woke up and became aware after the shooting. In a lot of ways, the rehab hospital was now a comfortable and safe place for her. It was home.

  Sure, she had complained about being there. Especially in March and April, she often said “Gotta get out of here” or “Get me out of here!” But as she got closer to leaving, Gabby was having separation anxiety. She didn’t say she wanted to stay, but she stopped saying she wanted to leave.

  Gabby oversaw the packing up of her belongings. She pointed out which items should be loaded into boxes bound for Tucson, for storage, or for my house. All the posters—of Tucson, the Grand Canyon, me and Gabby—were taken down from the walls, and her mom’s artwork was parceled out to the doctors and nurses whose portraits she had painted.

  On the day she said goodbye to Dr. Kim, he asked her how she felt.

  “Emotional,” she answered.

  As a going-away present, nurses on the night shift gave Gabby a journal they’d been writing in after she went to sleep. Their entries, often unsigned, were addressed to Gabby, chronicling her progress at TIRR. The nurses hoped she’d someday be able to read what they’d written, and be proud of how far she’d come.

  The journal’s first entry was from January 26, the night Gabby arrived at the rehab center, barely aware of her surroundings. “A somewhat restless night,” a nurse wrote, “but a magic tonic is discovered. You love to have your feet massaged.”

  January 30: “You gave your first thumbs-up as a sign for yes!”

  February 9: “We all feel privileged to be part of your miraculous recovery. In my twelve years here, I’ve never seen a more dramatic healing process.”

  February 14: “You were asleep until the pain started in your right leg. You cried. While I rubbed your leg, you said ‘Superman’ three times. Then you concentrated for a moment, and said, ‘Super nurse.’”

  February 25: “You went outside again today. Your enthusiasm and joy at being outside is wonderful. You wave and greet anyone we pass. (I’m sure those people would vote for you if they could!)”

  March 2: “After dozing off, you woke up and I read the Wall Street Journal to you. Your face lit up as we toured Libya, Egypt, China, Russia, and finally, Wisconsin. So much to catch up on!”

  June 10: “Last night may have been the last time I got to take care of you, if you are discharged as planned. I’m sad! You’ve been a delight. I can only hope to have the same optimistic outlook that you have. I do hope to see you again under better circumstances!”

  Gloria read some of the entries aloud to Gabby. She talked to Gabby about what beautiful care she had received, and what a lovely gesture the journal was. Gabby agreed.

  Gabby was lucky that her workers’ compensation coverage as a federal employee allowed her to stay at TIRR for so long—more than five months. “Gabby’s rehab was once the norm, but it’s not anymore,” Dr. Francisco told me. In his early days at TIRR, in the mid-1990s, patients with severe brain injuries often stayed for half a year. Now, given changes in reimbursements, some insurance plans allow such patients to stay only one month.

  “Think of rehab as an antibiotic,” Dr. Francisco explained. “If you have a bladder infection, you have to use the right antibiotic and the right dose. The same is true for rehab. You need the right rehab program for the right length of time and the right frequency each day.

  “Here’s a crude analogy. If you go into McDonald’s and you only have ninety-nine cents, don’t expect to buy the Big Mac. Gabby was able to get the Big Mac of rehab because she had insurance coverage that allowed it. I wish every patient had the same opportunities.”

  As a health-food proponent, Gabby would find it amusing that her doctor chose McDonald’s to make his analogy. Still, Dr. Francisco’s words resonated with Gabby, and with all of us in her family and on her staff. We read about brain-injured soldiers who weren’t getting the best possible care, and we saw other brain-injured patients at TIRR whose insurance coverage was limited. Some of TIRR’s patients would return to the facility each year for one month, year after year, because that was all their health-care providers would allow.

  Learning all of this, Gabby’s office took the lead on several fronts. Her staffers called on Health and Human Services Secretary Kathleen Sebelius to ensure that all Americans with traumatic brain injuries have access to high-quality, comprehensive care. They asked her to end the “treatment gap” by defining rehabilitation care as part of the essential benefits package in the federal Patient Protection and Affordable Care Act. More than 1.7 million Americans sustain traumatic brain injuries each year.

  Gabby’s staffers also proposed initiatives to a defense-spending bill that would create better guidelines for the rehab treatment of brain-injured soldiers. A staggering 115,000 U.S. soldiers experienced traumatic brain injuries in Iraq and Afghanistan, often from roadside bombs. After the House Armed Services Committee approved the bill, Pia didn’t mince words in the statement she released as chief of staff:

  “Congresswoman Giffords is receiving excellent medical treatment. She was injured while she was o
n the job and her rehabilitation is covered by workers’ compensation under the Federal Employees’ Compensation Act. The members of the military who step forward to serve our nation deserve no less if they suffer a traumatic brain injury.”

  After Gabby left TIRR, the doctors, nurses, therapists, and patients she left behind had high hopes that she’d continue to recover her voice, and that she’d use her voice for a high purpose.

  “Gabby, you can become a national advocate for why rehabilitation is important,” Carl Josehart, TIRR’s chief executive officer, suggested.

  From early on in rehab, Gabby had been upset to learn that the treatment she received was out of reach for many brain-injury patients. And she was heartened to think that all the attention to her traumatic brain injury might have a direct, positive effect on members of the armed services. I have no doubt that when she gets back to work, righting this wrong will be a new priority for her.

  During her early months at TIRR, Gabby would often say “Tucson, Arizona.” Sometimes she said it wistfully, sometimes with determination. Eventually, she was able to say exactly what she was feeling: “I miss Tucson.” Those of us who love her knew how badly she longed to return, so as soon as she was released from the rehab facility, we made the trip. It was Father’s Day weekend.

  Gabby was excited to be returning home, but she was visibly nervous, too. On the way there, I asked her, “How do you feel?”

  “Mixed emotions,” she said.

  Tilman had again graciously lent us his plane, which enabled us to fly low over the wildfires that had been raging in Arizona, including in her district, near Sierra Vista. Gabby had been keeping tabs on the fires in the newspaper, and she wanted to see the devastation with her own eyes. As she looked out the window of the plane, she was transfixed. She was every bit the congresswoman, surveying the scene.

  We landed at Davis-Monthan Air Force Base on Friday evening, and Gabby walked down the stairs to the tarmac. She headed straight for Air Force Brigadier Gen. Jon Norman, who was waiting for her along with the base commander Colonel John Cherrey.

  “Congresswoman Giffords, so nice to have you back,” the general said.

  “Thank you very much,” Gabby answered. “Nice to be back.” It was as if she had fallen right back into her congressional persona.

  We drove south to Gabby’s parents’ house, which is in an isolated spot deep in the desert. It is so remote that you spend twenty minutes on a dirt road and drive through two creeks to get there.

  Gloria and Spencer hosted a dinner for friends and family, and everyone said Gabby looked great and seemed to be doing well. Ron Barber, her district director, saw Gabby for the first time since they both were injured on January 8. It was an emotional experience for both of them. Gabby stroked the new dimple in his cheek where one bullet had passed, and she examined the scars on his leg from another bullet. Gabby showed him her scars from the bullet and her surgeries, and they compared the progress each of them had made in walking again. They held hands as they ate dinner.

  There had been news reports that we were returning to Tucson for a private family visit, so locals knew we were there. The next day, Saturday, we drove downtown and passed the Rialto Theater. Gabby read aloud from the marquee, “We love you, Gabby,” and then she got a little teary. I’d been ready for this weekend, with tissues in my pocket. I handed them to her.

  Later we stopped by her condo. Gabby hadn’t been there since the morning of January 8. Her friend Brad Holland had kindly replaced the fish that died after the shooting, and he’d been coming to the condo to feed the fish tank’s new residents.

  “Beautiful fish,” Gabby said when she saw them.

  Gabby went around her condo, looking at the artwork, mostly Latin American folk art, remembering what she liked about each piece. She also went “shopping” in her closet. I had packed a couple of suitcases for her when we departed Tucson in January, but I’d left a lot behind. Gabby was happy to find outfits she’d been missing and, with her nurse Kristy’s help, she stuffed them in her suitcase.

  Gabby was also able to nap in her own bed. I napped, too.

  That afternoon, Gabby visited her new district office, which was bigger and in a more secure location. It was a weekend, so there were few staffers there, but she walked around trying to figure out who occupied each desk or office.

  Later in the evening, we attended a dinner for Gabby and her staff at the home of her district office manager, Joni Jones, and Joni’s husband, Gary. It was encouraging to see that Gabby didn’t have an issue remembering anyone’s name, even a new staffer she’d met only a couple of times. Gabby gave each of them a hug and thanked them for their continued hard work. It was exhilarating and emotional for everyone.

  Gabby still was unaware that Gabe Zimmerman was one of those killed on January 8, and no one told her. I had prepped the staff in advance: Until she could ask questions herself, we’d been advised by doctors not to give her the full details of the tragedy.

  Even though her staffers saw that her communication skills were still compromised, they were uniformly impressed by Gabby. She was sharp the entire weekend. When the Capitol Police officer driving us made a wrong turn on a Tucson street, she’d point him in the right direction. When I couldn’t find her rental property that I’d been to several times, she showed the way.

  The two-day visit was much too short, however. After an early Father’s Day breakfast with Gabby’s parents, we headed for the Air Force base. When we arrived, Gabby saw a group of officers about fifty yards from the plane. She walked toward them, shook all their hands, and gave them each a hug. “Gabrielle Giffords,” she said. “Nice to meet you. Thank you.” Then she turned and boarded the plane. She needed to get back to Houston for therapy in the morning.

  Once she was home with me in League City, Gabby settled in very nicely and pretty happily. She was soon able to walk around the house unassisted. We’d also walk slowly around the neighborhood, and Gabby made it her mission to bend over and pick up every speck of trash she came upon. She was used to trying to make a difference in the world. Though her abilities were now limited, she was doing what she could.

  Gabby was eager to contribute to the housework, too, by washing dishes, watering the plants, and doing the laundry. She strove to be self-sufficient.

  One day, Kristy was the home nurse on duty and she saw Gabby struggling to fold laundry with her left hand. Gabby’s right hand, as usual, sat limp.

  “Let me help,” Kristy offered.

  At first Gabby rebuffed her, but then Gabby said, “Kristy, left hand.”

  Kristy agreed to use only her left hand to fold the laundry. And so that’s how it went, the two of them using two hands between them to get the laundry folded.

  Gabby didn’t mind that the piece of her bullet-scarred skull was in the freezer. In fact, when we’d have friends over, she’d sometimes walk to the freezer, pull it out, and show them. Some visitors were intrigued. Others were squeamish; one nearly fainted. Gabby got a kick out of seeing people’s reactions. (Hospital staffers in Tucson had also given me Gabby’s bloody hair, which was shaved off on January 8. The hair was in my backpack for a couple of days, but it was soaked with blood and started to smell. I threw it in a trash can in Tucson and it is now somewhere in an Arizona landfill.)

  All of us in Gabby’s life kept getting indications that she understood pretty much everything and that her long-term memory was clear. Traveling in the car one day with Leslie, one of Gabby’s nurses, and two Capitol Police officers, we listened to the radio and played “Name That Tune.” We heard three songs, and Gabby got them all right. The first was AC/DC’s “Back in Black.” The second was “Only the Good Die Young” by Billy Joel. She was the only person in the car able to identify the band that performed the third song, “Amanda.” The band was Boston.

  Such positive signs of Gabby’s cognitive strengths and sharp recall were tempered, however, by the frustrating moments between us, when she struggled to express herself. S
ometimes, Gabby would try to communicate with me, saying the same word repeatedly, and I wouldn’t understand her point. She’d try again, and I’d still be lost. A few times, she was so discouraged that she put her head down on the table. On one especially frustrating day, I had to leave for an appointment. As I headed for the door I promised Gabby: “Listen, I’m going to think about what you were saying to me all day, and we’ll get back to it when I get home tonight. We’ll figure it out.”

  Sometimes, Gabby was able to find her way to the right word on her own. One morning I said to Gabby, “What would you like to do today?”

  She responded, “Hospital.”

  I was surprised. “Why would you want to go to the hospital?”

  She closed her eyes and thought for a long time, trying to pull out the appropriate word, and then she said, “Nursing home.”

  She wanted to see my ninety-five-year-old grandmother in the nursing home where she lives, not far from our house. Whenever Gabby visited Houston, she had always tried to see my grandmother. So we got in the car and headed over there. My grandmother, who has some dementia, did most of the talking, and Gabby was happy to listen.

  Sometimes, the communication failures between Gabby and me would last for hours, but then we’d finally figure it out and it was as if we’d struck gold. We felt like screaming “Eureka!”

  One day, for instance, Gabby kept saying to me, “Block of time.”

  I didn’t know what she was trying to tell me. “Block of time,” she said again. It went on like that for thirty minutes and I never understood her. Eventually, we had to give up.

  Then, the next day, I said to her, “Hey, Gabby, I’m going to go to the gym to get some exercise.”

  “Block of time!” she exclaimed, gesturing with her left hand for emphasis.

  And then I understood. She recognized that as a caregiver, it was important that I take time for myself. She wanted me to have a “block of time” to work out at the gym.

  “OK, Gabby,” I said, “I’m going to take a block of time at the gym and then I’ll come home.”