Giffords finds her words.
Ten years after Gabrielle Giffords was shot in the head in front of a supermarket outside Tucson, she still is finding words to speak up.
“Today, I struggle to speak, but I have not lost my voice,” said Giffords, who was an Arizona congresswoman at the time. “America needs all of us to speak out, even when you have to fight to find the words.”
Giffords spoke Thursday at an event sponsored by The Arizona Republic, USA Today and the Arizona Daily Star to mark the 10th anniversary of the mass shooting.
Six people were killed that day, Jan. 8, 2011: U.S. District Judge John Roll, Giffords’ staffer Gabe Zimmerman, nine-year-old Christina-Taylor Green, Dorothy Morris, Phyllis Schneck and Dorwan Stoddard.
Thirteen were injured: Giffords, two of her staff members, Ron Barber and Pam Simon, Bill Badger, Kenneth Dorushka, Eric Fuller, Randy Gardner, Suzi Hileman, George Morris, Mary Reed, Mavy Stoddard, James Tucker and Kenneth Veeder.
“I’ve known the darkest of days. Days of pain and uncertain recovery. But confronted by despair, I summoned hope,” Giffords said to open the event. “Confronted by paralysis and aphasia, I responded with grit and determination.”
She put one foot in front of the other, mustered one word and then another. Her recovery is a daily fight. She said it is making her stronger.
Giffords answered questions with Fabi Hirsch, her speech-language pathologist at the Aphasia Center of Tucson, who has worked with Giffords for eight years, helping her find her words.
KARINA BLAND: Fabi, you’ve lived in Tucson for 24 years. You must have been shaken by a mass shooting in your own community.
HIRSCH: I remember exactly where I was when I heard about the shooting. I didn’t know Gabby personally at the time, but she was my representative. They initially announced that she had been killed. I was shocked. I was scared. I was scared for my family, for our community. Fortunately, they then announced that she had survived.
For months, I paid very close attention for anything in the news about Gabby’s recovery. I think everyone in Tucson did. We wanted some sort of hope to come out of that day.
Because my area is aphasia, I was especially interested in any news about how she was doing with her communication skills. Was she able to speak? Was she able to read, to write?
BLAND: Gabby, it was 19 months after the shooting that you were able to leave Houston, where you were receiving treatment, and return to Tucson, your home. Were you excited to return to Tucson?
GIFFORDS: So excited! The mountains, the desert. I’m HOME.
BLAND: Fabi, what was it like for you to get that call asking if you could help Gabby?
HIRSCH: I was really excited to get that call. I mean, this is what I do. I work with people who have aphasia to help them regain their communication skills. To get that call, to be asked to help Gabby, I was really honored.
But I have to admit I was really nervous, Gabby, the first meeting. I’ve worked with a lot of people who have aphasia but never somebody who has had a gunshot wound to the head, because most people don’t survive that.
I met Gabby at her house, and I was sitting at the kitchen table, and she came right in, walked into the kitchen, sat down across from me, and gave me this huge, determined smile. All the nerves just faded away, and I knew we’d be a really good team.
We have spent — right, Gabby? — lots and lots of hours at that kitchen table doing therapy.
BLAND: Fabi, you mentioned “aphasia.” I think most people don’t know what that is. Can you tell us more about it?
HIRSCH: Aphasia is when someone loses at least part of their ability to communicate. It could be speaking or understanding, or reading or writing or any combination of those because of an injury to the language parts of the brain. The important thing to keep in mind is that it’s a problem with language, not with cognition or thinking skills.
Those thinking skills are all still intact. It is those language skills that have been impacted. If you can imagine knowing exactly what you want to say but not being able to get those words out, that’s aphasia.
BLAND: Gabby, Fabi explained what aphasia means medically. What does aphasia mean to you personally?
GIFFORDS: Really, really sucks. The tip of the tongue. Gabby Giffords speaks, speaks, speaks. So quiet now.
BLAND: Gabby, I heard that early in your recovery, you only had a couple of words that you could say.
GIFFORDS: What? What? What? Chicken, chicken, chicken. Chicken, chicken, chicken. Chicken, chicken, chicken.
BLAND: Fabi, when you first started working with Gabby, how did you determine what she was capable of, and did that determine your approach to therapy?
HIRSCH: We started with a very thorough evaluation of those language skills, looking at what she could do really well — her strengths — and the things that were really hard. For Gabby, strengths included things like auditory comprehension, her ability to take information in was a real strength. But things like getting those words out, making sentences, those were really hard, so we looked carefully at those and then we sat down and talked about goals.
It’s not just a matter of, “This is hard,” so we’re going to work on it. We wanted to really know, what’s important? What do you want to be able to do every day so you can have a really full, meaningful life? We needed goals that were really meaningful.
So we did the evaluation, and then talked about goals and used that to develop a therapy plan. That is something that is always evolving as Gabby continues to improve.
BLAND: Fabi, what does Gabby’s treatment entail on a day-today basis?
HIRSCH: We work on a lot of different things, but I’ll focus on the speaking part as an example. We work on techniques and strategies to get to individual words that are hard. We work on techniques to build sentences so Gabby can say more fluent sentences more easily. One thing that’s really unique, at least for me, in working with someone who has aphasia, is we work on speeches, actual formal speeches, because prior to the shooting, those were a big part of Gabby’s life. She can get up in front of a group of people and just inspire and motivate them to be their best. So that is a really important and meaningful part of our therapy sessions.
And homework. We do a lot of homework.
BLAND: It does sound like a lot of work. Gabby, what is therapy like for you?
GIFFORDS: Homework. A lot of homework. Homework, homework, homework. A lot of homework.
BLAND: Fabi, this kind of therapy isn’t like stitching a wound or setting a bone. There’s no guaranteed outcome. All aphasia cases are different. Everyone responds differently to therapy. How do you deal with that uncertainty, with the unknown?
HIRSCH: You’re absolutely right. No two people who have aphasia are alike. It’s really my role to meet people where they are. Find out where their strengths are, where their difficulties are, what their own meaningful goals are and work toward those goals. Everything is very personalized, but there are some things that are really important across everyone I work with.
It’s always very important for me to bring things like optimism and hope and determination to therapy sessions, and certainly humor because, like Gabby said, it sucks. To be working for hours and hours on trying to get words out, it’s not always fun. Being able to take the time and laugh is really important.
Let me talk about uncertainty just for a moment. There’s no way I can ever know exactly how someone’s going to respond to therapy, so I don’t worry about that. I don’t focus on it. I focus on what I do know and what I can do, and I know that I have to be flexible. If something’s not working, we try something else.
Just as an example, with Gabby, when we work on speeches, it’s really hard to know in advance if a line is going to be easy or hard to learn. It’s not like you might expect. It’s not like if it’s a long sentence with a lot of long, complex words, those can come really easily sometimes. It’s often the small words — the, it — those can be the harder words. So we never really know.
But we never think ( grimaces), we just jump right in and get to work. Gabby’s very involved. When we first get a new speech, we’re there with our black markers and we go through it, and Gabby’s like, “Nix it!” if there’s something that doesn’t reflect how she feels about something. Then we work really hard and sometimes there are words that are hard to get to, or phrases that are hard to get to, and we’ll have to adapt things so that Gabby can get to them.
We don’t worry about the unknown or the uncertainty. But one thing I am certain about is that Gabby continues to improve, and that everybody I work with can continue to improve with hard work. From my experience, I don’t see people just stopping at any point. I worry that sometimes people think after some sort of an injury to the brain that there’s this magical time when all of a sudden things stop. I think sometimes people are told that, that there is maybe a six-month window or a 12-month window, and then somehow, strangely, you’re just done. But that hasn’t been my experience at all. With hard work, people just continue to improve.
Gabby is such a beautiful example of that. Think about that, right? Chicken, chicken, chicken and what? At the beginning and now to be able to say these long, powerful speeches.
It’s just a testament to that determination and that ongoing recovery.
Gabby, I’m just so proud of you that you put yourself out there so people can see that. They can see you continue to improve, so health care professionals can recognize that and, importantly, that other survivors can take hope from that and know that if they continue to work, they can also continue to improve
BLAND: Gabby, You’ve made remarkable gains in your ability to speak. You’ve come a long way since chicken, chicken, chicken. Are you optimistic about your continued recovery?
GIFFORDS: It will be a long, hard haul, but I’m optimistic.
BLAND: Another question for you, Gabby. Not being able to say out loud everything you are thinking must be horribly frustrating. Do you ever want to give up?
GIFFORDS: No way, Jose!
HIRSCH: She’s so determined. I will open my computer in the morning and my inbox will just be full of homework that she’s done later into the night. She will never give up.
BLAND: Gabby, what do you tell yourself when things are difficult?
GIFFORDS: Move ahead! Move ahead!
BLAND: Gabby, on top of your therapy, what kinds of things have you been doing? What are your days like?
GIFFORDS: I’m so busy. Lot of Zoom calls. Work, work, work. Speech therapy. A lot of homework. Yoga twice a week. French horn. Spanish lessons. Riding bike. Walking on my treadmill. Watching movies. It’s Groundhog Day!
BLAND: Gabby, in 2013 you founded a gun violence prevention organization that’s now called Giffords. What do you hope to accomplish with Giffords this year?”
GIFFORDS: Save lives.
BLAND: Fabi, it would have been easy for Gabby to disappear from the public eye, to hide out and focus on herself. I don’t think anyone would have blamed her for that. What are you learning about courage from Gabby?
HIRSCH: For me, Gabby IS Courage. I have the opportunity sometimes to go to events with her, and she will go up to absolutely every single person and start a conversation with them. For me, if I wasn’t sure I could get a word out, if I wasn’t certain I would be able to have a conversation and get across what I wanted to get across, I’m not sure I would be brave enough to just approach different people, people I didn’t even know.
Another example I think a lot of people could maybe relate to is her public speaking events. I don’t know many people who don’t get nervous about getting in front of a crowd and speaking. To get up in front of a crowd for most of us takes some courage. But to get up in front of a crowd, even though you’ve practiced and practiced and practiced, you’re not sure those words are going to come out. To get up there is front of thousands and thousands of people, I think takes tremendous courage.
It doesn’t always work out perfectly. Sometimes Gabby will come off a stage and she’ll be a little down. But for a moment and then, like she said, she says, “Move ahead.”
GIFFORDS: Move ahead!
HIRSCH: And we’re right back to work.
BLAND: Gabby, is your recovery a process of discovering a new Gabby Giffords or a fight to reclaim the old Gabby Giffords?
GIFFORDS: The new one — better, stronger, tougher.
BLAND: Your husband, Mark Kelly, now Senator Kelly, has been a big part of your recovery. Can you tell me about your teamwork with Mark?
GIFFORDS: He is my best friend. He’s so funny! I love to laugh. I miss him. Miss him a lot.
BLAND: Gabby, it’s been 10 years since you were injured. What have you learned from your experiences over the last 10 years?
GIFFORDS: To be grateful for friends and family, and to live every day to the fullest.
BLAND: Gabby, one last question for you. I love your positive attitude. It’s contagious, I think. What is it that makes you so optimistic?
GIFFORDS: I want to make the world