Doctors Say Giffords’s Condition Points to Survival

by JENNIFER MEDINA

TUCSON — Just three days after a bullet passed through Representative Gabrielle Giffords’s brain, and one day before the president was scheduled to come here to address the shooting rampage in which she was wounded, doctors said Tuesday that Ms. Giffords’s chances of survival were certain. She is able to breathe on her own, although she remains on a ventilator as a precaution.

What her recovery will look like, however, and how long it will take remain unclear.

“She has a 101 percent chance of survival,” said Dr. Peter Rhee the director of medical trauma at the University Medical Center, where Ms. Giffords is being treated. “I can’t tell whether she’s going to be in a vegetative state. I hope that she’s not and I don’t think she will be in a vegetative state, but I know that she’s not going to die.”

President Obama will deliver a speech here Wednesday evening at a memorial service for the victims of the attack. His aides said he would focus on the theme of service to country and avoid the debate about whether the state’s political climate might have played a role in the tragedy.

Instead, Mr. Obama, who was still working with his speechwriters on Tuesday, will call for unity among Americans, while trying to hold up the lives of the victims, including their service to government, as an example to all Americans. He will share some anecdotes about the victims from private phone calls he has made to the families, aides said.

Meanwhile, across Tucson, there was a flurry of efforts to address the psychological effects of Saturday morning’s shootings, which left six dead and 14 wounded. Two churches held memorial services Tuesday night, drawing large crowds.

In Phoenix, the State Legislature quickly passed an emergency law to block a controversial church that protests outside funerals from getting too close to the services planned in Tucson.

The measure, which keeps protesters 300 feet back from funerals, is intended to head off members of the Westboro Baptist Church in Kansas, who have praised the shooting and plan to picket the funeral on Thursday of Christina Green, a 9-year-old victim, and a service on Friday for Judge John M. Roll of Federal District Court.

“I was physically sick when I heard this,” said State Senator Kyrsten Sinema, who sponsored the measure. “Then I decided to do something. Nothing happens in one day in politics, but this did. This tragedy is nonpartisan. It’s human.”

Community volunteers were mobilizing to plan their own street-side memorial service to counter the protesters, with some planning to wear angel wings.

At the hospital, Ms. Giffords’s doctors said the outcome could have been far worse. They said she had done remarkably well so far. But they cautioned that there was little more they could do medically to help her improve.

Over the last several days, Ms. Giffords has repeatedly given nonverbal responses to her doctors’ commands, they said, and CAT scan X-rays have shown that there is no swelling, which continues to be the most serious threat. So far, doctors said, she has shown only slight movement on the right side of her body, raising questions about her functional neurological status. Doctors again declined to give some specific details about Ms. Giffords.

“This is the phase of the care where it’s so much up to her,” said Dr. G. Michael Lemole Jr., the hospital’s chief of neurosurgery, during a news conference Tuesday morning. “As long as we don’t backslide and as long as she holds her own, that’s good. That keeps us hopeful. But we have to play this really according to her timeline, not ours.”

Dr. Lemole said Ms. Giffords would remain connected to a ventilator as a precaution, to prevent pneumonia or infections in her windpipe. But because she cannot talk it is so far not possible for doctors to assess more complex brain functions.

For the last three days, Ms. Giffords has repeatedly gripped hands or flashed a finger after doctors prompted her. Dr. Rhee said Ms. Giffords appeared to be responding without prompts now, repeatedly flashing a thumbs-up at doctors and her husband, Mark Kelly, an astronaut.

“She has no right to look this good, and she does,” Dr. Lemole said.

Five other victims remained in the hospital on Tuesday, including Suzi Hileman, who had taken 9-year-old Christina Green to the event Saturday. Ms. Hileman is expected to recover from at least three gunshot wounds and a shattered hip. The most difficult path ahead will be grappling with the emotions, and guilt, over Christina’s death, her husband, Bill Hileman, said Tuesday.

Several times in the last three days, Mr. Hileman said, his wife has screamed “Christina! Christina!” as though she were having a flashback. “She keeps talking about how they had this incredibly tight grip on each other” when the shots began, he said. “She told me that they were almost breaking each other’s hands.”

Reporting was contributed by Lawrence K. Altman and Helene Cooper in Washington and Marc Lacey, Ford Burkhart, Ron Nixon, Lisa Button, Carli Brosseau, Will Ferguson and Clayton Norman in Tucson.

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2nd Suspect Sought in Arizona Shooting

By MARC LACEY and DAVID M. HERSZENHORN

The parking lot in Tucson where Representative Gabrielle Giffords of Arizona and others were shot.

TUCSON — Representative Gabrielle Giffords, an Arizona Democrat, and 18 others were shot Saturday morning when a gunman opened fire outside a supermarket where Ms. Giffords was meeting with constituents.

Six of the victims died, among them John M. Roll, the chief judge for the United States District Court for Arizona, and a 9-year-old girl, the Pima County sheriff, Clarence W. Dupnik, said.

A 22-year-old suspect was in custody, law enforcement officials said. But at a Saturday evening news conference, investigators said they were looking for an accomplice, believed to be in his 50s, who may have assisted in the attack.

Ms. Giffords, 40, who the authorities said was the target of the attack, was said to be in very critical condition at the University Medical Center in Tucson, where she was operated on by a team of neurosurgeons. Dr. Peter Rhee, medical director of the hospital’s trauma and critical care unit, said that she had been shot once in the head, “through and through,” with the bullet going through her brain.

President Obama said at a news conference that the director of the Federal Bureau of Investigation, Robert S. Mueller III, was on his way to Arizona to oversee the investigation.

Investigators identified the gunman as Jared Lee Loughner, 22, and said that he was refusing to cooperate with the authorities and had invoked his Fifth Amendment rights.

Pima Community College said Mr. Loughner had been suspended for conduct violations and withdrew in October after five instances of classroom or library disruptions that involved the campus police.

The authorities were seen entering the Loughner family house about five miles from the shooting scene — an unincorporated area north of Tucson.

The shootings raised questions about potential political motives, and Sheriff Dupnik blamed the toxic political environment in Arizona. There were immediate national reverberations as Democrats denounced the fierce partisan atmosphere in Ms. Gifford’s district and top Republicans quickly condemned the violence.

Mark Kimble, an aide to Ms. Giffords, said the shooting occurred about 10 a.m. in a small area between an American flag and an Arizona flag. He said that he went into the store for coffee, and that as he came out the gunman started firing.

Ms. Giffords had been talking to a couple about Medicare and reimbursements, and Judge Roll had just walked up to her and shouted “Hi,” when the gunman, wearing sunglasses and perhaps a hood of some sort, approached and shot the judge, Mr. Kimble said. “Everyone hit the ground,” he said. “It was so shocking.”

The United States Capitol Police, which is investigating the attack, cautioned lawmakers “to take reasonable and prudent precautions regarding their personal security.”

Because of the shootings, House Republicans postponed all legislation to be considered on the floor this week, including a vote to repeal the health care overhaul. The House majority leader, Representative Eric Cantor, Republican of Virginia, said lawmakers needed to “take whatever actions may be necessary in light of today’s tragedy.”

Speaking of Ms. Giffords’s condition, Dr. Rhee said at a news conference, “I can tell you at this time, I am very optimistic about her recovery.” He added, “We cannot tell what kind of recovery, but I’m as optimistic as it can get in this kind of situation.”

Several aides to Ms. Giffords were wounded, and her director of community outreach, Gabe Zimmerman, 30, was among those killed. The Arizona Republic said that the girl had been identified as Christina Taylor Green, a third grader. Dorthy Murray, 76; Dorwin Stoddard, 76; and Phyllis Scheck, 79, also died at the scene, according to the Pima County Sheriff’s Department.

Ms. Giffords, who represents the Eighth District, in the southeastern corner of Arizona, has been an outspoken critic of the state’s tough immigration law, which is focused on identifying, prosecuting and deporting illegal immigrants, and she had come under criticism for her vote in favor of the Democrats’ health care law.

Friends said she had received threats over the years. Judge Roll had been involved in immigration cases and had previously received death threats.

The police said Ms. Giffords’s district office was evacuated late Saturday after a suspicious package was found. Officers later cleared the scene.

Ms. Giffords, widely known as Gabby, had been speaking to constituents in a supermarket alcove under a large white banner bearing her name when a man surged forward and began firing. He tried to escape but was tackled by a bystander and taken into custody by the police.

Jared Lee Loughner

The event, called “Congress on Your Corner,” was outside a Safeway supermarket and was the first opportunity for constituents to meet with Ms. Giffords since she was sworn in for a third term on Wednesday.

Ms. Giffords was part of the Democratic class of 2006 that swept Democrats into the majority in the House. She narrowly won re-election in November, while many fellow Democrats were toppled and the House turned to Republican control.

“I saw the congresswoman talking to two people, and then this man suddenly came up and shot her in the head and then shot other people,” said Dr. Steven Rayle, a witness to the shootings and former emergency room doctor who now works at a hospice. “I think it was a semiautomatic, and he must have got off 20 rounds.”

Dr. Rayle said that Ms. Giffords slumped to the ground and that staff members immediately rushed to her aid. “A staffer had his arm around her, and she was leaning against the window of the Safeway,” the doctor said. “He had a jacket or towel on her head.”

At least one of the other shooting victims helped Ms. Giffords, witnesses said.

Television broadcasts showed a chaotic scene outside a normally tranquil suburban shopping spot as emergency workers rushed to carry the wounded away in stretchers. Some of the victims were taken from the site by helicopter, three of which had arrived.

Law enforcement officials said that the congresswoman had received numerous threats.

Congressional leaders of both parties issued statements throughout the day expressing outrage at the shooting as well as concern and prayers for Ms. Giffords and her family.

The new House speaker, John A. Boehner, said: “I am horrified by the senseless attack on Congresswoman Gabrielle Giffords and members of her staff. An attack on one who serves is an attack on all who serve.

“Acts and threats of violence against public officials have no place in our society. Our prayers are with Congresswoman Giffords, her staff, all who were injured and their families. This is a sad day for our country.”

Senator John McCain of Arizona, a Republican who serves in Washington with Ms. Giffords, issued one of the strongest statements, saying: “I am horrified by the violent attack on Representative Gabrielle Giffords and many other innocent people by a wicked person who has no sense of justice or compassion. I pray for Gabby and the other victims, and for the repose of the souls of the dead and comfort for their families.”

He added, “Whoever did this, whatever their reason, they are a disgrace to Arizona, this country and the human race, and they deserve and will receive the contempt of all decent people and the strongest punishment of the law.”

Ms. Giffords is a centrist Democrat who won re-election in part by stressing her strong support for gun rights and for tougher immigration controls, including tighter border security, even though she opposed the controversial Arizona law.

Last March, after the final approval of the Democrats’ health care law, which Ms. Giffords supported, the windows of her office in Tucson were broken or shot out in an act of vandalism. Similar acts were reported by other members of Congress.

In August 2009, when there were demonstrations against the health care measure across the nation, a protester who showed up to meet Ms. Giffords at a supermarket event similar to Saturday’s was removed by the police when the pistol he had holstered under his armpit fell and bounced on the floor.

In an interview at the Capitol this week, Ms. Giffords said she was excited to count herself among the Democrats who joined the new Republican majority in reading the Constitution aloud from the House floor. She said she was particularly pleased with being assigned the reading of the First Amendment.

“I wanted to be here,” she said. “I think it’s important. Reflecting on the Constitution in a bipartisan way is a good way to start the year.”

As a Democrat, Ms. Giffords is something of anomaly in Arizona and in her district, which has traditionally tilted Republican. Last year, she barely squeaked to victory over a Republican challenger, Jesse Kelly. But she had clearly heard the message that constituents were dissatisfied with Democratic leaders in Washington.

At the Capitol last week, Ms. Giffords refused to support the outgoing Democratic House speaker, Nancy Pelosi of California, in her symbolic contest with the Republican, Mr. Boehner of Ohio. Instead, she cast her vote for Representative John Lewis, a Georgia Democrat and hero of the civil rights movement.

“It’s not surprising that today Gabby was doing what she always does: listening to the hopes and concerns of her neighbors,” Mr. Obama said during a news conference Saturday, calling her a “friend of mine” and an “extraordinary public servant.” “I know Gabby is as tough as they come,” he said. “Obviously, our hearts go out to the family members of those who have been slain.” “We’re going to get to the bottom of this, and we’re going to get through this,” he said.

The shooting mobilized officials at the White House and throughout the highest levels of government, including the Department of Homeland Security and the Justice Department.

Rabbi Stephanie Aaron, who in 2007 officiated at the wedding of Ms. Giffords and the astronaut Mark E. Kelly, and leads Congregation Chaverim in Tucson, said the congresswoman had never expressed any concern about her safety.

“No fear. I’ve only seen the bravest possible, most intelligent young congresswoman,” Rabbi Aaron said. “I feel like this is really one of those proverbial — seemingly something coming out of nowhere.”

At Ms. Giffords’s district office, a group of about 50 people formed a prayer circle. Chris Cole, a Tucson police officer whose neighborhood beat includes the district office, said of the shooting, “This kind of thing just doesn’t happen in Tucson.”

Behind the office, in the parking lot, campaign volunteers stood around a car with the door open, listening to a live radio broadcast of a hospital news conference updating the congresswoman’s condition. A cheer went up when it was announced that she was still alive.

The volunteers included Kelly Canady and her mother, Patricia Canady, both longtime campaign workers.

Patricia Canedy had worked for Ms. Giffords since she served in the State Senate while Kelly, her daughter, moved to Tucson 13 years ago and was active in last year’s campaign and in the health care debate.

“She’s one of those people who remembers you. She always spoke to me by my first name,” Kelly Canady said. “She loved everybody. She was very easy to talk to. She was one of the main reasons I will stay involved in politics.”

Marc Lacey reported from Tucson, and David M. Herszenhorn from Washington. Reporting for the Arizona shooting coverage was contributed by Emmarie Huetteman, Janie Lorber, Michael D. Shear and Ashley Southall from Washington; Lisa M. Button, Ford Burkhart, Devlin Houser, Ron Nixon, Nancy Sharkey and Joe Sharkey from Tucson; J. David Goodman and Sarah Wheaton from New York; and Kitty Bennett from Tampa, Fla.
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