Giffords' ability to speak holds promise

HOUSTON — Rep. Gabrielle Giffords is able to speak: She asked for toast at breakfast one recent morning.

Her ability to say even just a word, a month after being shot in the head, pleased her family, friends and doctors. It may also provide valuable clues about the condition of her injured brain.

"We're elated at this," said her spokesman C.J. Karamargin, who added that she is speaking "more and more." "We always knew Gabby is a fighter and that she's not going to let this thing win. And you know, every day is proof of that."

Few details have emerged about her recovery since she began intensive rehabilitation at TIRR Memorial Hermann hospital late last month. But doctors not involved in her care said her simple request for toast could indicate higher-level cognition.

The lawmaker was apparently asking for something in an appropriate context, said Richard Riggs, chairman of physical medicine and rehabilitation at Cedars-Sinai Medical Center in Los Angeles.

"It was a desire. It was a want. It was something that would be preferable rather than just a basic need," Riggs said. "It was encouraging. I was very excited to see it and the fact that it was an appropriate context gives it more meaning."

Brain injury patients who regain speech typically begin to do so about four to six weeks after the incident, Riggs said.

"We're beginning to see what her true abilities will be," he said. "We'll also see her impairments."

Since Riggs has not seen or treated Giffords, he could not say how her speech might develop and progress. Depending on the extent of the injury, its position in the brain and the patient, that can vary greatly, he said.

"That's what's so mysterious and great about this, because she is recovering and no one can really give you the goal line and when it will be finished because it's really unknown," Riggs said.