Personal Take on Brain Injuries and Senate Bids

by Stuart Rothenberg February 18, 2011 · 11:01 AM EST

While the buzz is still only a whisper, the idea that Rep. Gabrielle Giffords (D) might be well enough to run for Arizona’s open Senate seat next year is suddenly a hot topic.

Giffords’ “rapid recovery from the shooting creates at least the possibility that she could make the race, according to her allies,” Chris Cillizza of the Washington Post wrote recently.

One of the Congresswoman’s Arizona colleagues, Rep. Raúl Grijalva (D), went even further when he was quoted in The Hill newspaper as saying there was a “distinct possibility” that she would run for the seat.

Given the lack of details about the Congresswoman’s recovery and my concern that media reports may have presented an overly upbeat description of her progress, I’m conflicted by talk from Democrats and the media of Giffords running for the Senate this cycle. Like everyone else, I wish her the speediest and most complete recovery from the tragedy, but that hope is not inconsistent with a clear-eyed assessment of her ability to run a Senate race.

Every brain injury is different and every person’s body responds differently, so it’s impossible to know what tomorrow will bring for the Congresswoman. I’m not a medical doctor, but after my son’s serious car accident a little more than a year ago, I probably have more experience than the average reporter or Capitol Hill staffer when it comes to brain injuries.

My son didn’t have a bullet rip through one side of his brain, but he did have a life-threatening traumatic brain injury that put him in a coma for days, rendered the left side of his body without movement for weeks and raised questions for a time about the quality of life that he could expect.

We hear repeatedly what dramatic progress the Congresswoman has made since doctors in Tucson, Ariz., saved her life, how she is giving her husband a neck massage, smiling at friends, talking with visitors and identifying a photo of President George W. Bush.

On Jan. 19, Fox News reported “Giffords walking on her own two feet.” The next day, a headline declared that she was “on her own two feet, looking out window.” And a few weeks later, (and others) noted that she “has recovered enough ... to ask for toast.”

More recently, her husband, Mark Kelly, told NBC’s Brian Williams that “you ask her a question and she will answer it.”

“You two are having what would have to be called conversations,” Williams glowed.

These are all terrific steps in what will be a long recovery, but they convey the sense that Giffords is doing everyday things, that her life is more or less returning to normal. I wonder whether that is the case, though I certainly understand the joy and excitement that family and friends feel from every small step forward.

What we aren’t hearing is what she can’t yet do. Nor have we heard about those reversals of progress that virtually all brain injury patients encounter at some point along the way.

When my son regained consciousness in the intensive care unit of Suburban Hospital in Bethesda, Md., after five days in a coma, he started to “talk,” then swallow, then suck on an ice cube.

But while we were thrilled with this great progress, about 85 percent of what he said was impossible to understand. He was lethargic and seemed to be in a fog, and we didn’t know how much or how quickly his brain would heal. We were also worried about whether complications would develop.

Indeed, after a day and a half of progress, he slipped back into a less responsive state. His temperature rose. He started to have trouble breathing, which led to additional tests. And we grew more worried about what his new baseline would be a year from the accident.

Five days later, he came around again. After a total of two weeks in the ICU, he was transferred to National Rehabilitation Hospital in Washington, D.C. This is standard procedure. Once the patient is stabilized, doctors like to get them to rehab as soon as possible. It beats lying in a bed all day, we were told.

Like Giffords, my son had made “amazing” progress that made his transfer to one of the best rehabilitation hospitals in the country possible. Still, trying to understand what he was saying was a chore. He couldn’t lift his head, roll over, feed himself at anything more than a snail’s pace or do a million things that you and I take for granted. He certainly couldn’t start thinking about whether he would ever be capable of mounting a race for the Senate.

Just three weeks after his accident, my son was speaking as if he had never been in an accident. But there were still plenty of deficits to overcome and questions to answer.

The lack of anything negative — or even an acknowledgment of any deficits at all — coming from the Congresswoman’s family, friends and medical team makes me wonder whether the widespread reports of progress tell the whole story. I know what it means to have a “conversation” with somebody who has serious verbal and cognitive issues.

My wife and I started using the free CaringBridge website about 10 days after my son’s accident to keep family and friends up to date on his condition. We noted when and how he was progressing, as well as where he wasn’t.

Each family (and each person in a family) responds to such situations differently, and I’m certainly not suggesting the way we dealt with a traumatic brain injury is the right way for others to handle things. But I would think a Member of Congress might have an obligation to be more forthcoming with information, not less.

Obviously, my son’s experience and the Congresswoman’s are very different, and not only because of the nature of the brain injury. He was unconscious for days; she apparently was conscious the entire time, except when briefly in a medically induced coma.

My son was lucky not to have a serious swelling problem, while Giffords did and doctors were forced to remove a part of her skull. His injury was to the right side of his brain, while hers is on the left. My son was on a ventilator for 24 hours, while Giffords was on one for days and subsequently underwent a tracheotomy.

And of course, my son was 27 years old when his accident occurred, while the Congresswoman is 40. Doctors in the ICU repeatedly told us that the age of the patient is a crucial factor in brain injury outcomes.

I pray that Giffords has a full recovery. Given the advances in medicine and therapy, anything is possible and we should all be hopeful. Thankfully, my son walked out of the hospital not quite two months after his accident. Now, about 15 months after he incurred a very serious brain injury, he is completely recovered. Giffords could do the same.

But at this point, given what I learned about traumatic brain injuries and the snippets of information that have been released about the Congresswoman’s medical condition, any talk about a possible Giffords Senate run in 2012 seems premature and seriously ill-advised.