Congresswoman Gabrielle Giffords: The Lost Story

Feb 23, 2011

Just over a month ago, Congresswoman Gabby Giffords (D-AZ) was shot in the head during a mass shooting in her home city of Tucson.   In this incomprehensible event, numerous others were killed or injured.   The nation’s hearts have been wracked with grief for this terrible tragedy.  As is always true with such events, the news media pounced on the story.     The public (myself included) looked forward to learning of what happened as the story progressed.  We all wanted to know that Giffords had survived.

For several weeks following Gifford’s tragic shooting, the media was filled with images of heroic “scrub clad” surgeons describing the specific details of the brain surgery, and her immediate post-operative recovery.   Descriptions of her early cognitive and motor responses (eye contact, hand squeezing) and removal of her ventilator filled newspapers and TV shows.  Discussions of her inability to communicate (attributed inappropriately to her tracheostomy) were presented repeatedly.  

Once her condition was stable, Congresswoman Giffords was transferred to a rehabilitation hospital in Houston, Texas.   Her husband, Mark Kelly, explained to the media and the world that now that she was moving into rehabilitation, he hoped that their privacy would be respected and that they would not give regular news briefings.  This decision, after such an exhaustive course of events, is completely understandable.  We respect this decision, of course.   Unfortunately, this is just the beginning of a very long story about which the media rarely focuses.

Most of us at the Institute—nurses, physical therapists, speech-language pathologists---all know that the story hardly ended upon discharge from the University of Arizona Hospital.   That was the preface to what is guaranteed to be a long docudrama.     My wish is that the heroes and heroines of the next several chapters of the story had the chance to share their contribution—just like that skilled surgeon.   What would the story sound like?   What would be the plot?

Anyone reading the story would know that the coordination, skill, inter-professional competence, 24 /7 basic and advanced care in a highly integrated set of daily events would be the setting.  The characters involved in this narrative would be graduate level professionals—like those that we educate---who would monitor the congresswoman’s physical and cognitive status on a moment-to-moment basis.  They would develop specific strategies, based on research evidence, to guide her in the direction of recovery.  Those steps in care would involve pharmacologic, behavioral, physiological, and psychological interventions.     Complexities of motor function, cognition, language, speech, swallowing, social and executive functions would be assessed daily, weekly, and monthly using sophisticated measures, technologies, and expert observational skills.   The mental health needs of this important patient and her family would need to be addressed and advanced methods of counseling and support will be used to deal with the emotional complexities of brain recovery and establishing positive skills in coping.    

And the dramatic outcome of the story that started with a bullet will include a whole person, restored as fully as possible to someone who solves problems, socializes with friends, enjoys others, independently carries out needed activities and in that most hoped for outcome, returns to work again. 

I wish that when the media tells their version of the story that they would name the “other” heroes who contribute to this long drama.   The nurses, physical and occupational therapists, the speech-language pathologists and psychologists could all have a dramatic message that would really complete Congresswoman Gabrielle Gifford’s lost story.     

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