In a news conference at University Medical Center in Tucson, the doctors said they were pleased that Giffords (D-Ariz.) opened her unbandaged left eye "spontaneously" Wednesday night in response to the presence of friends from Congress, and they said they were glad that President Obama disclosed the development in his speech shortly afterward at a memorial service for the victims of Saturday's shootings at a Giffords constituent event.

G. Michael Lemole Jr., the hospital's chief neurosurgeon, and Peter Rhee, the head of emergency care, said Giffords since then has also been able to sit on the edge of her bed and dangle her legs over the side, move both of her arms and legs and open both of her eyes.

"This is a major leap forward," Lemole said. "This is a major milestone for her, and we're hoping she crosses through many more."

Rhee said Giffords, 40, is "becoming more and more alert . . . and she's making much more spontaneous movements as we have completely stopped all the medications that might blunt her mental status."

"She's starting to become aware of her surroundings," Lemole said. "And that's a very important step on her next move forward."

The doctors said removal of her breathing tube would be the next major milestone, because then they could see whether Giffords can talk and, if so, assess her verbal skills. Rhee said the breathing tube could be taken out in the next few days and that doctors are "optimistic" that they can avoid having to perform a tracheostomy, a surgical procedure to create an opening in the neck to the trachea, or windpipe.

Lemole said he was present when Giffords opened her left eye spontaneously when her friends from Congress were in the room with her immediately following a visit Wednesday night from Obama. He said that was different from previous times when she opened her eye in "response to stimulation" as doctors deliberately woke her up. Among those visiting her at the time were Rep. Debbie Wasserman Schultz (D-Fla.), Sen. Kirsten E. Gillibrand (D-N.Y.) and House Minority Leader Nancy Pelosi (D-Calif.).

"I think it was a combination perhaps of the unexpected but familiar that really prompted her to open her eyes and look around," Lemole said. "And that's important . . . because it implies that not just those parts of the brain that process commands are there, but the parts of the brain that let us awake from sleeping, our arousal center. Those are starting to work spontaneously."

He said he heard that Giffords opened her eyes later Wednesday night "with nothing more than the TV on" in her room. He said it might have been tuned to the memorial event at which Obama delivering a stirring eulogy but that he was not sure.

"We have seen the eyes begin to track," Lemole said later. "We're just starting to see those signs" that reflect "a level of alertness." He said Giffords also has "used her hand to communicate" with her family members. "I think there is that communication going on."

Rhee said Giffords has made further progress Thursday. "She has vision," he said. "Her eye stays open for longer periods of time. . . . You can tell she can see."

Lemole added that when the bandage on her right eye was removed, Giffords was able to open both eyes.

Rhee said the congresswoman was keeping her eyes open Thursday morning for 10 to 15 minutes at a time.

"It means that she's making the progress that we could hope for her," Lemole said.

Giffords, who remains in critical condition, is one of five wounded patients who were still at the hospital Thursday morning. Rhee said four others are in fair condition. One is having surgery, and another is being discharged Thursday, he said.

"Everybody is making fantastic forward progress," Rhee said.

Six people were killed and 13 wounded when a gunman opened fire at Giffords and her aides and constituents Saturday morning as she was holding a "Congress on Your Corner" event outside a Safeway supermarket in Tucson. The alleged shooter, Jared Lee Loughner, 22, was tackled at the scene and later charged with federal counts of murder and attempted murder. Loughner, who has been described as mentally unbalanced, also faces impending state charges.

Giffords was shot through the left side of her skull with a 9mm bullet from a Glock 19 semiautomatic handgun.

Rhee said doctors did "very aggressive physical therapy with her" Thursday morning and got her to sit up and put her legs over the side of her bed.

"She is able to move both of those legs to command," Lemole said. The doctors said they hope to get Giffords to sit in a chair Friday.

Despite her progress, the doctors remain concerned about possible setbacks such as blood clots and pneumonia.

"Going forward, we want to make sure she doesn't backslide," Lemole said.

Branigin reported from Washington.

http://www.washingtonpost.com/wp-dyn/content/article/2011/01/13/AR2011011300952_pf.html

Jan.13, 2011