MELISSA BLOCK, host:
Congresswoman Gabrielle Giffords is expected to be moved to a rehabilitation hospital in Houston tomorrow, less than two weeks after she was shot in the head. Today, at the hospital in Tucson where she's being treated, her doctor said she's doing very well, that she has stood, with assistance, and scrolled through an iPad. Giffords' husband, Mark Kelly, called her a fighter like nobody else I know.
Mr. MARK KELLY: I imagine the next step is here. She'll be walking, talking and in two months you'll see her walking through the front door of this building.
BLOCK: To get a sense of Gabrielle Giffords' rehabilitation to come, we turn to Dr. Jonathan Fellus, director of brain injury services at the Kessler Institute for Rehabilitation in New Jersey. He says one of the first steps is to see how the patient reacts to handheld objects.
Dr. JONATHAN FELLUS (Director of Brain Injury Services, Kessler Institute for Rehabilitation): The occupational therapists would start by putting various common daily tools in her hand, such as a comb or toothbrush and see if she used them properly. And that would let us know whether she's at a point where she can participate in her activities of daily living, her EDLs - bathing, dressing, grooming, hygiene.
The speech therapist is going to assess her ability to swallow, of her ability to communicate. That will quickly lead to, hopefully her being part of her own goal setting, which is a major focus in rehabilitation, is you want to incorporate the patient's own goals and have them express what they hope to achieve.
What we're really trying to do is take a comprehensive look at the cognitive, the behavioral and the psychological problems that are longest-lasting, hardest to treat and really get at the core of who we are as human beings.
BLOCK: One thing that's apparently still unclear is whether Congresswoman Giffords is able to speak. Talk a bit, if you could, about the process of language, assessing whether someone can speak, how much they can speak, and what you do to rebuild that.
Dr. FELLUS: Well, you know, we're particularly concerned about language. Obviously, as human beings, it's an almost uniquely human capacity. So it is of concern. We know that language generally, anatomically lives in the left side of the brain in the vast majority of individuals. We know that women tend to do better with language recovery, generally speaking, because their language circuits are more widely distributed throughout the brain than men.
But we also know that there's really not a backup system in the brain for language, because language is such a unique human capacity. It means it hasn't been around very long in the evolution of brains. And so, it hasn't developed backup systems the way, say, walking and running has. But language is really - it's a dedicated area in the brain and you just don't start cobbling together other areas of the brain to take up the slack when there's been a strike sort of at ground zero for language function in the brain.
BLOCK: I wonder, Dr. Fellus, with a case like this, where every step of Gabrielle Giffords' progress has been watched and reported on and heralded as miraculous, whether part of the job of the team at the rehab center is also managing expectations for the family of what they can realistically expect.
Dr. FELLUS: It's - certainly managing expectations is an ongoing challenge. I think the earlier you try and predict things, the more likely you are to be wrong. You'll either be overly optimistic or overly pessimistic. And I say that very clearly to families and sometimes even patients. It is simply guesswork early on in the individual case to try and guess what will be.
Now, that said, we know that more likely than not, there will be, if she is to have lingering significant problems, they're most likely going to be in the area of language, maybe some vision, maybe some other aspects of cognition or memory or behavior and likely some problems with dexterity or function of her right arm?
BLOCK: When you hear, Dr. Fellus, that Congresswoman Giffords has removed the wedding ring from her husband's finger and rubbed his neck, do those strike you as surprising, good signs?
Dr. FELLUS: You'd always rather have human recognizable behavior, behaviors that are typical to her personality. Obviously you'd rather have them than not have them. But I think it really is just too early to say and it's trying to infer too much from these tender moments, these over-rehearsed or over-practiced. These are, I don't want to say they're reflexive behaviors, maybe at worst they're complex reflexes, but I just don't think that we can take those - nor should we - take those and run with it.
BLOCK: Well, Dr. Fellus, thanks very much for talking with us today.
Dr. FELLUS: You're welcome.
BLOCK: That's Dr. Jonathan Fellus. He's director of brain injury services at the Kessler Institute for Rehabilitation in West Orange, New Jersey.