Tragedy in Tucson: Details on Giffords' Brain Injury

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Rick Wilking / Reuters

A portrait of U.S. congresswoman Gabrielle Giffords is part of a makeshift shrine outside the hospital where she and other shooting victims from Saturday's rampage are being treated in Tucson, Ariz.

Rep. Gabrielle Giffords remains under heavy sedation in an intensive-care unit at a Tucson hospital, a day after being shot in the head by a gunman at a local shopping center. The rampage killed six and wounded 13 others in addition to the Congresswoman, leaving a stunned city searching for answers and investigators scrambling to reconstruct the tragedy.

After Giffords was airlifted to the hospital late yesterday morning, doctors used a special saw to remove a piece of her skull in order to alleviate pressure on her swollen brain, says Dr. Peter Rhee, the hospital's trauma director. That fragment of bone, which stretched from her left eyebrow back to the upper-left side of the congresswoman's skull, is being stored in a hospital refrigerator, Rhee told TIME, to aid its reattachment when the swelling goes down.

The doctor stressed that it was too soon to know which tissues were damaged by the gunshot, which entered the back left side of her head, passed through her brain and exited through the front of her skull, near her left eye-socket. "We're very worried about what's called secondary brain-injury," he says, referring to the risks posed by swelling tissue and lack of oxygen to parts of the brain. "We're trying to minimize that any way we can," he says.

According to news reports, Giffords has been responding to commands, but her prognosis is uncertain. The left side of the brain physically controls the right side of the body, as well as math, language and logic skills. "In the brain, there are so many pathways we don't know what's going to be permanent, and what will be restructured by the brain itself and what will be compensated," Rhee says.

Giffords is the only shooting victim who remains in critical condition. Her attacker, identified by police as Jared Lee Loughner of Tucson, was charged in federal court Sunday afternoon with five counts of murder and attempted murder against the congresswoman. FBI Director Robert Mueller, who briefed reporters in Tucson Sunday morning, said those charges did not preclude the possibility of additional counts, including domestic terrorism charges.

Saturday's tragic encounter was not Giffords' first brush with Loughner, 22. According to court documents, law-enforcement officials on Saturday scoured Loughner's 1,400 sq. ft., low-slung home, surrounded by large cacti on a ramshackle block northwest of Tucson. Among the evidence seized was a safe containing a letter addressed to "Mr. Jared Loughney" [sic] from Giffords, written on congressional stationary and dated Aug. 30, 2007. The note thanked Loughner for attending one of her town-hall style events at a local mall. According to court documents, the safe also contained an envelope with hand-written messages that read: "I planned ahead," "My assassination," and the congresswoman's name, along with what appeared to be Loughner's signature.

As Tucson residents mourned, law-enforcement officials began to reconstruct the timeline of events that led to the massacre. Loughner, 22, took a cab to Giffords' Saturday morning event, dubbed "Congress on Your Corner," at a shopping center in a tony neighborhood on the northwest outskirts of this city of 500,000. According to local news reports, officials said after Sunday's press conference that the cab driver, who had previously been cited as an unidentified person of interest in the investigation, had entered the Safeway with Loughner after the passenger requested change from a $20 bill.

At 10:11 a.m. local time, according to court documents, the shooter approached Giffords as she chatted with constituents, and shot her once in the head. The assailant then fired the remaining 30 rounds in his Glock 9 mm pistol, purchased legally at a local Sportsman's Warehouse on Nov. 30, officials indicated at a Sunday morning press conference at the Pima County Sheriff's Department in Tucson.

The carnage could have been worse. According to the sheriff's department, as Loughner fumbled to load a second clip, one of the 20 victims wounded by gunfire — a woman whose name has not been released — approached the assailant and was able to wrest the clip away. Loughner subsequently loaded a second clip, but its spring jammed. He was then tackled by two "brave, quick-thinking individuals" who pinned him until authorities arrived, Mueller said.

The six deceased were identified as John Roll, 63, a federal judge in Arizona who came to the event to thank Giffords for drawing attention to the backlog of cases bogging down court dockets; Gabriel Zimmerman, 30, Giffords' director of community outreach; Christina Greene, 9; Dorothy Morris, 76; Phyllis Schneck, 79; and Dorwin Stoddard, 76. A local news report indicated Stoddard heroically stepped in front of his wife, who was shot but survived.

Officials confirmed that Giffords was the target of the massacre, but declined to speculate about the motives of the alleged shooter, who has been transferred to federal custody to await his arraignment at 2 p.m. Monday in a Phoenix federal court. Mueller said law-enforcement officials were working in concert to decipher the trail of screeds and rambling videos Loughner left on the Internet. Mueller suggested the gunman had acted alone, and noted that the cesspool of vitriolic content available online makes it more difficult to track lone wolves on the verge of violent eruptions. "The ubiquitous nature of the Internet means that threats, hate speech and other inciteful speech [are] much more readily available to individuals than eight to 10 years ago, and that absolutely presents a challenge to us," Mueller said.

As the facts trickled out Sunday, locals struggled to come to grips with the tragedy. "I vacillate between extreme sadness and sorrow and shock and extreme anger," said Pima County Sheriff Clarence Dupnik, who issued a blistering assessment of the state's lax gun laws. "I think we're the tombstone of the United States of America," Dupnik said. "I have never been a proponent of letting everybody in this state carry weapons under any circumstance they want, and that's almost where we are."