First and foremost, the nonspecialist should understand that when Kim and the other doctors on the team speak of progress, it is in relative terms, given that the patient has suffered severe brain damage. “‘Leaps and bounds’ means much faster recovery than the average patient from a similar type of thing,” Kim says. When he says that he is having conversations with Giffords, he means that he has asked her a question (“How are you today?”) and that she has answered (“I’m better”). Kim adds that there is a bottom line for all such patients, whatever their recovery curve. “If somebody has a severe brain injury, are they ever going to be like they were before? The answer is no. They are never going to be the exact same person.”
Dr. Gerard Francisco, the physiatrist in charge of the Giffords medical team, says he is quite pleased with his patient’s progress, although he acknowledges that outsiders, especially the media, might be misinterpreting what the doctors and therapists are trying, however circumspectly, to describe. “It’s how we measure the change,” Francisco says. “Some people will expect changes to be big. I’m happy with small changes, as long as I see these changes every day, and that’s why I’m very encouraged. Some people would like things to get better within an hour, within a day, within a week. Rehab is not measured that way. It is a long-term process.” What Francisco and his rehab team aim for is an optimized “new normal” for each patient. “Everyone around her needs to understand, hey, this is a different situation,” says music therapist Meagan Morrow, who is working with Giffords. “After you have a brain injury, you are a different person. It doesn’t matter who you are.”
For a politician such as Giffords, one key ambition of the rehabilitation process is helping to restore the ability to speak. Giffords speaks haltingly, stringing together three- or four-word responses to questions, and is beginning to formulate entire sentences. Morrow is working to help her recapture the ability to use language through song—the rhythmic strains of a familiar tune, such as “Happy Birthday,” triggering compensatory language activity in undamaged parts of the brain. “Language is messed up…But the brain can make up for itself. What doctors have found is that whenever you sing a song, the motor areas are lighting up, the emotional areas—all these different parts of the brain are working to get that song out. So, I’m going in through another way, to create a new pathway to language.”
Because of the near-mystical way in which the brain heals itself, it is impossible for doctors to predict precisely what the new normal ultimately will be for a given patient. Even so, Kim, the neurosurgeon, remains optimistic. This is partly because the bullet that went through Giffords’s brain injured the left hemisphere, which controls speech and movement on the right side of the body. Partial paralysis may result, but in the context of recovering from brain injury, doctors place less emphasis on that than on other factors. “Motor weakness, for example, is not that big a deal, compared with cognitive things,” Kim says. “So, first of all, is your personality going to be like it was before? Are you going to have the same kind of mental abilities, and think through things, and understand? And the social-relationship part—how sensitive are you to other people’s emotions? Do you want to relate? A lot of that function, it turns out, is in the right side of the brain.”
In Giffords’s case, the answer to Kim’s questions about cognitive ability is an emphatic yes. “We joke around, and I tell her all the funny things that happen in Washington, and she laughs,” says Pia Carusone, Giffords’s chief of staff. “When we say her personality is there, I mean, she’s like 100 percent there.” Carusone, who travels to Houston each week, says that Giffords communicates with her through “a combination of body language, personality, and speech. It’s some words, it’s expressions on her face.”
What a great love story.
. I love the story about the teddy bear, too 
