Video: Husband: Giffords able to answer questions

  1. Transcript of: Husband: Giffords able to answer questions

    MATT LAUER, co-host: Now the latest on the recovery of Representative Gabrielle Giffords , just over a month after she was shot in the head. Her husband, astronaut Mark Kelly , spoke with NBC 's Brian Williams and opened up about his wife's remarkable progress.

    Captain MARK KELLY: The communication is getting better every single day. She, you know, it was reported just a few days ago, you know, that she said, you know, a single word and what the word was. But, you know, since then, you know, this has really accelerated. So you can have -- you know, I guess what would be relatively a normal conversation with her on some level. So we do communicate. I talk to her in the morning when I'm there and I talk to her in the evening.

    BRIAN WILLIAMS reporting: So actual if not complete sentences, chains of words enough so that you are having what you would define as a conversation?

    Capt. KELLY: Yes. I can ask questions, she can answer them. And, you know, the communication is coming back very quickly.

    WILLIAMS: That's been an extraordinary recovery. All the brain experts, brain injury experts say that no two are alike. They've been compared to snowflakes in their uniqueness. There was no road map for you to follow regarding her recovery. And I guess this is just going to be the pace of her recovery.

    Capt. KELLY: That is true. Gabrielle 's neurosurgeon, Dr. Don Kim , reiterated to me, you know, that she is on this lightning fast trajectory. So he's incredibly optimistic about -- you know, the slope of the curve has a lot to do with how far you're going to get and she's proceeding very rapidly.

    WILLIAMS: And in the two departments of recovery, mental and physical, are you convinced that both are coming along on par?

    Capt. KELLY: Absolutely. The team at TIRR at Memorial Hermann is doing an incredible job. She spends most of her day in some sort of rehab and she's working very hard. And the progress in all areas has been very good.

    WILLIAMS: And I keep hearing, Captain, that the congresswoman, your wife's appearance is resuming to normal, it's coming back so that, you know, a glint in her eye that you would recognize, facial expressions, things like that, much easier to detect, which always makes communications easier.

    Capt. KELLY: Oh, absolutely. I mean, all that stuff is 100 percent. I mean, she is in a great mood. Well, she's always a very upbeat and positive person. It's, you know, humbling and, you know, it's just interesting for me to watch her go through this. And she continues to be an incredibly positive person and just really works really, really hard and understands how important this is. And she's really putting everything she has into it.

    WILLIAMS: And you have become an expert at counting your blessings, I presume.

    Capt. KELLY: I have been, and am also an expert at appreciating other people, how much they're praying for her, how much they care about her and just the incredible support that we're getting.

    WILLIAMS: This is stunning news that you two are having what have to be called conversations. And by no means do I want to pry into your relationship, but give me an example of a sentence she has spoken in the last 24 hours.

    Capt. KELLY: Well, I mean, she'll put together some small sentences with regards to, you know, dinner, or just, you know, kind of daily living or if I ask her a question. The speech therapist was saying to me that a few days ago she was having to get Gabby to speak some more. Now she's trying to get her to slow down, and make sure she hears the question first before giving the answer. As an example of that, you know, there were three cards laying on the table, one with a picture of President George Bush , President Barack Obama , President George Washington and before she was asked the question she would just pick up the -- she picked up the card and said -- held it up and said George Bush . So she's a hard worker and she's trying and she's speaking a lot and at some level they're even asking her to slow down a little bit.

    LAUER: And of course, you can see more of Brian 's interview with Mark Kelly . That's tonight on " NBC Nightly News ." And once again, here's Meredith .

updated 2/14/2011 7:58:21 AM ET 2011-02-14T12:58:21

Compared to a sleek new laptop, that three-pound mass of fatty tissue called the brain may not look like much. But when it's injured, it adapts and rewires its circuits in new ways.

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That's the kind of flexibility that doctors and rehabilitation specialists hope to encourage in Gabrielle Giffords, the brain-injured Arizona congresswoman.

Details about her recovery have been thin. But members of her staff say she recently began speaking for the first time since the Jan. 8 attack by a gunman in Tucson. Brain injury patients who regain speech typically begin to do that about four to six weeks after the injury, experts say.

Still, recovery for the 40-year-old Giffords will be a long, tough journey, as it is for anyone with a significant brain injury. Patients can make remarkable progress. But experts caution that they shouldn't expect to return to exactly the way they were before.

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Too little has been revealed and it's too early to say if Giffords might be able to return to her job in Congress. One expert questioned whether that would be the best thing for her to do.

Most people with such injuries have some level of impairment for the rest of their lives.

The New York Times on Sunday reported that some of Giffords' efforts to relearn how to speak include mouthing the words to song lyrics, such as "Twinkle, Twinkle, Little Star," and briefly talking with her brother-in-law by telephone while he orbited aboard the International Space Station.

Giffords has also been receiving bedside briefings from aides on the uprising in Egypt and last week's decision by Republican Sen. Jon Kyl of Arizona not to seek re-election, The Times said.

Her chief of staff, Pia Carusone, says Giffords definitely understands what is being said and has been providing short, verbal responses.

How the brain repairs itself
Scientists are still unraveling just how the brain works to recover from traumatic injury and how to help it repair as much as possible.

They're dealing with an organ about the consistency of cold porridge. It contains maybe 100 billion densely packed nerve cells, each of which is connected to 1,000 or so other nerve cells, called neurons. Those connections form circuits that are the foundation of the brain's activity.

Brain injuries can disrupt that in several ways. A car accident can smash a head, stretching and tearing brain tissue across a wide area. A penetrating injury like a bullet causes more localized damage, but the force of the impact can also damage neuron connections some distance away from the projectile's path.

Either way, brain injury produces an "utter quagmire" of specific disruptions in brain functioning that doctors have only blunt tools to fix, said Dr. Jonathan Fellus, director of the brain injury program at the Kessler Institute for Rehabilitation in West Orange, N.J.

Story: Giffords speaks, asking for toast

What all this disruption means to the patient depends on what brain circuits have been affected. People might have trouble reasoning, finding words, remembering things, organizing priorities, recognizing faces, understanding what's said to them, or doing multiple things at once. Or they could have problems walking, reaching, getting dressed or feeding themselves.

So how can the brain get better?

In some cases, brain cells that were impaired or stunned but not killed by the initial injury get back on track. Another surprising factor is that the brain's wiring is not fixed. In response to an injury, neurons can alter their patterns of connections.

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For example, if the damaged part of the brain is small enough, new connections might bring in neighboring neurons to stand in for dead ones. Or existing connections can be strengthened, allowing neurons to work together more efficiently than they had to before.

Rewiring can bring in a whole different brain circuit to compensate for a damaged one.

So a person who used to find his way to work just by instinct may come to rely on memorizing the route more formally. Or somebody who struggles to find words may emphasize facial expressions more than before. A patient who has trouble remembering what he sees may compensate by telling himself what he's looking at, bringing in his verbal memory circuitry.

Patients may develop compensation strategies on their own, though more typically they're guided by doctors and therapists, said Dr. Bruce Dobkin, director of the neurologic rehabilitation and research program at the University of California, Los Angeles.

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Fellus compares brain rewiring after injury to taking back roads when an interstate highway is damaged. It's a less efficient way to get a job done, he said, and the added effort may help explain why brain injury patients often feel tired or simply fail to accomplish some tasks.

"They have to pace themselves, they have to do things in a more organized way," staying more focused on a task like memorizing a phone number than they had to before, he said.

That's certainly the case with Kim Towns, 47, of Chesapeake, Va., even 23 years after she was shot in the forehead.

Video: Husband: Giffords able to answer questions (on this page)

"I can't really concentrate like I used to. I get tired really easily, I get depressed," she said. Rather than doing several things at once, "I have to really just sit down and concentrate on one particular subject."

In any case, brain rewiring — scientists call it plasticity — is driven by what a patient is learning and experiencing, said Jordan Grafman, director of the Traumatic Brain Injury Research Laboratory at the Kessler Foundation Research Center in West Orange.

That's why patients should get into rehabilitation as soon as possible, where "people are paid to stimulate you," providing skilled expertise as well as respite for exhausted caregivers, he said.

Course of recovery varies
The time course of recovery can be long. It's most dramatic in the first year, with probably more than a third of patients who survive severe injuries showing improvement by the end of that time, said Dr. Alan Faden of the University of Maryland.

Grafman said progress often slows in the second six months of the first year, becoming perhaps not evident to those who see the patient every day, but noticeable to someone who drops by only every three months.

During the second year, gains are usually minimal but can sometimes be significant, said Grafman. After that, many people show no further improvement, but some do, he said.

The course of recovery depends on things like age — with patients from teens to 40 recovering better than those over 50 to 60 — and how motivated, young and healthy a patient is, the size and location of the injury and even a genetic predisposition to recovery.

But for the most part, brain injury patients will always have some degree of impairment, Grafman said.

That's not necessarily a recipe for misery; it just means people need to adjust, said Grafman, who has studied Vietnam veterans with brain injuries for 30 years.

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"I'm always impressed ... at seeing how may of them have lived quite successful lives, having families and kids and working at jobs," he said. They "wind up living, in some sense, an ordinary life."

Giffords might have to make the same kind of adjustment.

Without knowing details of her progress it's impossible to say whether she could return to Congress, Grafman said. A supportive staff might make it possible, he said, but "would it be the best thing for her?"

Impairment can add stress for those who strive to return to a high-pressure job, Grafman said. And over a long period, that added stress could harm their mental abilities even more. Persistent stress kills neurons, he said, and can interfere with memory and decision-making beyond the long-term effects of the brain injury itself.

As it stands now, "Giffords will have strengths that remain. That's what you want to play into," he said, even if it leads to a productive life outside the halls of Congress.

Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Photos: Former Ariz. Representative Gabrielle Giffords

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  1. Gabrielle Giffords, the former congresswoman who was shot and left handicapped after a gunman opened fire at an event in Tucson, Ariz., and her husband retired Navy Capt. Mark Kelly prepare to testify before a Senate Judiciary Committee hearing on gun violence in Washington, D.C., on Jan. 2013. (Jim Lo Scalzo / EPA) Back to slideshow navigation
  2. U.S. Senator Richard Blumenthal, D-Conn., former U.S. Rep. Gabrielle Giffords and her husband, former astronaut Mark Kelly, leave the Newtown Municipal Building in Newtown, Conn. on Jan. 4, 2013. Giffords met with Newtown officials on Friday afternoon before heading to visit with families of the victims of the Sandy Hook Elementary School massacre. (Michelle Mcloughlin / Reuters) Back to slideshow navigation
  3. Gabrielle Giffords waves to the Space Shuttle Endeavor with her husband, former astronaut Mark Kelly as it flies over Tucson, Ariz. on its way to Los Angeles, on Sept. 20, 2012. Kelly served as Endeavour's last space commander months after Giffords survived serious head injuries because of a 2011 shooting. (P.K. Weis / Southwest Photo Bank via AP) Back to slideshow navigation
  4. Gabrielle Giffords blows a kiss after reciting the Pledge of Allegiance during the final session of the Democratic National Convention in Charlotte, N.C. on Sept. 6, 2012. (Eric Thayer / Reuters) Back to slideshow navigation
  5. Gabrielle Giffords stands on top of a peak in the French Alps with her husband Mark Kelly, right,, and mountain guide Vincent Lameyre, July 23, 2012. On her first trip out of the country since her injury in 2011, she rode a two-stage cable car to a station for spectacular views of Mont Blanc. (Denis Balibouse / Reuters) Back to slideshow navigation
  6. Ron Barber, right, celebrates his victory with Giffords, left, prior to speaking to supporters at a post election event, Tuesday, June 12, 2012, in Tucson, Ariz. Barber, Giffords' former district director, won her seat in a special election after she resigned to focus on her recovery. (Ross D. Franklin / AP) Back to slideshow navigation
  7. Democratic Florida Rep. Debbie Wasserman Schultz, read Rep. Gabriell Giffords resignation speech on the House floor on Wednesday, Jan. 25, 2012. The day after President Obama's State of the Union speech, Giffords formally offered her resignation to Speaker John Boehner. Weeping, Shultz applauded the strength of her friend and colleague, "I'm so proud of my friend." (MSNBC) Back to slideshow navigation
  8. President Barack Obama hugs retiring Congresswoman Gabrielle Giffords as the president arrives to deliver his State of the Union address on Tuesday, Jan. 24, 2012. (Pool / Reuters) Back to slideshow navigation
  9. Rep. Gabrielle Giffords, D-Ariz., left, and Pelosi, right, posing with Giffords husband, former astronaut Mark Kelly of the Navy, at his retirement ceremony with Vice President Joe Biden in the Old Executive Office Building on the White House complex in Washington, Thursday, Oct. 6, 2011. (House Leader Nancy Pelosi's office / AP) Back to slideshow navigation
  10. Rep. Gabrielle Giffords returns to the House for the first time since she was shot, making a dramatic entrance on Monday, Aug. 1, 2011, during a crucial debt vote. She drew loud applause and cheers from surprised colleagues. (NBC News) Back to slideshow navigation
  11. Rep. Gabrielle Giffords poses for a photo the day after the launch of NASA space shuttle Endeavour and the day before she had her cranioplasty surgery, outside TIRR Memorial Hermann Hospital May 17, in Houston, Texas. Aides of Rep. Gabrielle Giffords posted two recent photos of the congresswoman to her public Facebook page, the first since the January 8 shooting that killed six people and wounded a dozen others. (P.K. Weis / Giffords Campaign / Getty Images) Back to slideshow navigation
  12. Emergency workers use a stretcher to move Rep. Gabrielle Giffords after she was shot in the head outside a shopping center in Tucson, Ariz., on Saturday, Jan. 8, 2011. (James Palka / AP) Back to slideshow navigation
  13. In this Jan. 5, 2011 file photo, House Speaker John Boehner re-enacts the swearing in of Rep. Gabrielle Giffords on Capitol Hill in Washington. (Susan Walsh / AP) Back to slideshow navigation
  14. Rep. Giffords, left, speaks during a candidates debate with Republican candidate Jesse Kelly at the University of Arizona in Tucson, Ariz., on Oct. 18, 2010. Kelly is an Iraq War veteran and was the Tea Party favorite for the 8th congressional district seat. (Joshua Lott / The New York Times via Redux Pictures) Back to slideshow navigation
  15. Rep. Gabrielle Giffords meets with constituents in Douglas, Ariz., in 2010. Giffords, 40, took office in January 2007, emphasizing issues such as immigration reform, embryonic stem-cell research, alternative energy sources and a higher minimum wage. (Reuters) Back to slideshow navigation
  16. Rep. Giffords speaks during a press conference in Washington, D.C., where members of Congress called on the President to secure the border with the National Guard on April 28, 2010. (James Berglie / Zuma Press) Back to slideshow navigation
  17. This picture provided by the office of Rep. Gabrielle Giffords on Monday, March 22, 2010, shows damage to her office in Tucson, Ariz. The congressional office was vandalized a few hours after the House vote overhauling the nation's health care system. (AP) Back to slideshow navigation
  18. Rep. Gabrielle Giffords, D-Ariz., center, gives a tour of Statuary Hall in the Capitol to Shuttle Discovery STS-124 astronauts Mission Specialist Akihiko Hoshide, of Japan, and her husband, Commander Mark Kelly, on Thursday, July 17, 2008. (Bill Clark / Roll Call Photos) Back to slideshow navigation
  19. From right. Rep. Ken Calvert, Rep. Dennis Moore, Rep. Gabrielle Giffords, and Rep. Heath Shuler, attend a House Ways and Means Subcommittee on Social Security hearing on current and proposed employment eligibility verification systems on May 6, 2008. The hearing provided a forum for lawmakers on both sides of the immigration debate, focusing on a system to verify the legal status of workers and job applicants. (Scott J. Ferrell) Back to slideshow navigation
  20. Gabrielle Giffords with U.S. Navy Cmdr. Mark Kelly, a NASA astronaut, at their wedding in Amado, Ariz., on Nov. 10, 2007. Kelly's twin brother, also an astronaut, is a commander on the International Space Station. "We have a unique vantage point here aboard the International Space Station. As I look out the window, I see a very beautiful planet that seems very inviting and peaceful. Unfortunately, it is not," said Scott Kelly of the tragedy that befell his sister-in-law. (Norma Jean Gargasz for The New York Times / Redux Pictures) Back to slideshow navigation
  21. Representatives-elect including Dean Heller, top right, and Gabrielle Giffords, next to Heller, prepare for the freshman class picture for the 110th Congress on the House Steps on Nov. 14, 2006. (Tom Williams / Roll Call Photos) Back to slideshow navigation
  22. Rep. Gabrielle Giffords rides horseback in 2006. In an interview with NPR last year, she recalled working with horses during her adolescence in Tucson. "I loved cleaning out the stalls, and I did that in exchange for riding lessons. And I continue to ride most of my life. And I learned a lot from horses and the stable people ... I think it provided good training, all of that manure-shoveling, for my days in politics ahead." (Reuters) Back to slideshow navigation
  23. A page entitled, "Just do it!" in La Semeuse, the Scripps College yearbook in 1993. The photo at right shows Giffords in traditional Mennonite clothing. That same year, she won a Fulbright award to study Mennonites and other Anabaptist groups in Northern Mexico. Gifford's senior thesis was titled "Wish Books and Felt-Tipped Fantasies: The Sociology of Old Colony Mennonite Drawings." (Scripps College) Back to slideshow navigation
  24. Gabrielle Giffords' senior portrait from the 1993 Scripps College yearbook. Giffords double-majored in Latin American studies and sociology. A Dean's List student, Gifford won several awards during her time at Scripps. (Scripps College) Back to slideshow navigation
  25. Gabrielle Giffords, right, laughs with her mom, Gloria Kay Fraser Giffords, in a photo published in the Scripps College yearbook. Gabrielle received a B.A. in Sociology and Latin American history from Scripps College in Claremont, Calif. in 1993. (Scripps College) Back to slideshow navigation
  26. University High School portrait of Gabrielle Giffords, class of 1988. Dr. John Hosmer, taught history to the future lawmaker. He tells msnbc.com, "Gabrielle sat in the front row. She was inquisitive ... She was a very mature person from the moment she walked in the door." (University High School) Back to slideshow navigation
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