Five days after being shot in the head, Rep. Gabrielle Giffords opened her eyes of her own accord.
In a display that surprised doctors and elicited tears of joy from her loved ones who were present, Giffords reportedly reached out toward husband Mark Kelly in an attempt to give him a hug.
Doctors say it is difficult to tell whether the frequent company and physical contact she has had with her loved ones contributed to what her physicians are calling a quick recovery -- but some medical experts say it is possible.
Giffords began the struggle to open her eyes and lift her left arm in response to the support and encouragement of friends Sen. Kirstin Gillibrand and Rep. Debbie Wasserman Schultz, who visited Giffords at the hospital Wednesday evening.
"It was just, really, it felt like a miracle," Schultz, a Florida Democrat, recounted to reporters on the return trip from Tucson aboard Air Force One. "It felt like we were watching a miracle. [W]e just both wanted so badly to be there for her as her friends.
"But you could ... clearly see the determination in her face that she was struggling to get her eyes open because she was responding to our voices. It was like she wanted us to know that she knew we were ... there."
In response to the doctor's examinations, Giffords had been partially opening her eyes starting Sunday, but Wednesday evening marked the first time she opened them voluntarily in response to the "familiar" presence of others.
Such a response is "very different" in terms of measuring recovery, Giffords' doctor, Dr. Michael Lemole, said at a news conference today.
Soon after opening her eyes in response to commands, Giffords' husband urged her to give them the thumbs up, and instead she stretched her left arm toward him
"And we were just in tears of joy watching this and beyond ourselves, honestly," Gillibrand, a New York Democrat, told reporters. "And then Mark said, 'You know, touch my ring, touch my ring.' And she touches his ring and then she grabs his whole watch and wrist. And then the doctor was just so excited.
"He said, 'You don't understand, this is amazing, what's she's doing right now, and beyond our greatest hopes.'"
Dozens of doctors across various medical specialties expressed their thoughts to ABC News on how patients might be helped by touching and other forms of physical contact with friends and loved ones.
Some supported the idea; others were skeptical. But Lemole, chief of neurosurgery at the University of Arizona, agreed with Gillibrand and Schwartz that the presence of close friends had made all the difference.
"Dr. Lemole ... literally said to us, 'You know, I've discounted ... emotion ... and friendship and family -- really, I've sort of discounted that as meaningless out loud,'" Schultz said. "He said, 'I just witnessed the impact of friendship and what you guys' -- he said, 'you did this here today.'"
Giffords Makes Strides in Recovery
In a hospital news conference today, Lemole reported that Giffords has reached several milestones in her recovery since that visit. Although she remains in critical condition, Giffords has been yawning, rubbing her eyes, moving both right and left sides of her body, and continues to respond to commands. She has also begun physical therapy and was sitting up with her feet dangling off the bed.
"The most important thing with neurological recovery is consistency," he said, noting that ongoing responses to prompts from her friends and family is a good sign.
Concerning her first voluntary eye opening Wednesday in the presence of friends from the Senate and Congress, he said, "It was the combination of the unexpected but the familiar [that] really inspired her to open her eyes and look around. This is the part that doctors have the hardest time with. We can't quantify that component that family and friends bring, but we know that it exists."
When asked if Giffords' recovery should be considered miraculous, he replied: "Yes, miracles happen everyday and, in medicine, we like to contribute them to what we do [as doctors], but a lot of medicine is outside our control and we're wise to acknowledge miracles."
The next step in gauging Giffords' progress will be the removal of the breathing tube and assessment of her verbal ability, but this will not occur for a few days, he said.
Can Love and Support Speed Healing?
Past research showing the positive healing affects of prayer (even when the patient is unaware that they are being prayed for) has been controversial, but most doctors admit that they can see the difference in a patient's response, healing and mood when they are cared for and touched in a loving way.
"There is no question that love and support from family, friends and others one is close to can make an enormous difference in the recovery process," said Nadine Kaslow, vice chair of the Department of Psychiatry and Behavioral Sciences at Emory University in Atlanta.
Other doctors noted that providing reassuring touch as a doctor was also an important element to encouraging healing.
"I ... believe that a doctor's 'healing touch' is very important to patients," Dr. Joan Von Feldt, professor of medicine at the University of Pennsylvania in Philadelphia, said. "The patients somehow feel reassured when you lay your hand on their shoulder, or place your hand on their forearm. It may be placebo, or it may not be, but I believe that if patients think they are cared for or loved, they improve."
But quantifying the extent to which loving touch or emotional support affects recovery, as Lemole noted in the news conference, is difficult, if not impossible, leaving some doctors dubious about whether the presence of loved ones, especially in instances of coma or unconsciousness, really has any impact.
There is preliminary research from Northwestern University, however, that suggests that even those in comas may benefit from having familiar voices around. Theresa Pape, a research assistant professor of physical medicine and rehabilitation at Northwestern, has found that those in a vegetative show brain activation when listening to familiar voices, but not to unfamiliar voices. Another study is underway to determine if listening to recorded "stories" told by family members several times a day will help speed neurological recovery for those with traumatic brain injury.
Once the patient is able to perceive the presence of others, however, many doctors counted doctor, family and friend support as an important booster to a patient's will to pull through particularly exhausting recovery processes.
"Recovery from most trauma is a biological process, but the unquantifiable element is the will to progress," Dr. Bruce Chabner, clinical director of the Massachusetts General Hospital Cancer Center, said. "Without it, any recovery is difficult. Especially in recovery from a neurological injury, which is a notoriously slow and painstaking process, will is key in sustaining progress."
Rep. Wasserman Schultz noted that Giffords' efforts to open her eyes, which took about 30 seconds of effort, seemed motivated by sheer will, and said that they could see "all the strength pouring out of her to touch her husband."
By bolstering the patients motivation to soldier on through the difficult stages of healing, having loved ones around can be essential to the recovery process, many doctors note.
Giffords Aware of Surroundings
Dr. Alan Weintraub, medical director of the Brain Injury Program at Craig Hospital in Denver, said that because family members can often elicit response or action in brain trauma patients, more so than health professionals, he tells families that they "are the medicine for wakefulness and purpose."
"The core emotional centers of the brain are very deep and frequently provide the fuel to jump-start a person's more wakeful and purposeful capacities," he added.
With Giffords, Lemole said, her response to her husband and her friends shows that not just the parts of her brain that process simple commands are there "but the parts of the brain that allow us to wake from sleeping. She's starting to become aware of her surroundings ...," he said, "and that's an important step in her recovery."