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How Gabby Giffords used music to regain speech

It provides a valuable lesson in the brain’s ability to heal even after unspeakable trauma.

It was 10 years ago this week that US Representative Gabrielle Giffords was shot in the head at close range at a meet-and-greet with constituents in Arizona. The bullet entered near her left eye, passed through the left side of her brain, and exited at the back of her skull. The injury was devastating, and Giffords’s life was forever changed.

But a decade later she is going strong, and the story of her amazing comeback includes a music therapist who helped her find her voice again. It provides a valuable lesson in the brain’s ability to heal even after unspeakable trauma.

A bullet passing through the brain does almost incalculable damage to the structures within it. Not only does the bullet destroy tissue along its path, it also breaks vital neural connections and causes swelling as the brain reacts to the trauma. (The swelling is so dangerous that neurosurgeons commonly remove a portion of a patient’s skull for a few days to allow the brain to expand until the swelling goes down.) As the brain starts to heal, however, it is capable of creating new connections. In Giffords’s case, an excellent rehabilitation programme helped retrain her brain and make those new connections.

The left side of the brain, where the bullet made its way, not only controls movement on the right side of the body, it also includes two critical regions that affect speech and language: Broca’s Area, which controls our ability to produce speech, and Wernicke’s Area, which gives us the ability to comprehend language. Of course, speech also requires us to use memory (to find the vocabulary), motor skills (to produce the words), and cognition (to develop the thoughts). To say that it’s a complicated function is an understatement—in many ways, speech is what makes us human.

When Giffords woke up after the incident, she was partially paralysed and unable to speak. She understood what others said, which meant that her speech and language centres were not beyond repair. But how to retrain her brain to allow her to speak again?

Enter Maegan Morrow, a music therapist at TIRR Memorial Hermann, a rehabilitation hospital in Houston, where Giffords was transferred to be near her husband, former astronaut (now US Senator) Mark Kelly. The remarkable way music is processed in the brain is what allowed Morrow to use it to help Giffords re-learn how to speak.

Unlike speech, which is concentrated in those two highly specialised areas of the brain, music is processed by a much wider range of brain structures. Music involves so many of the senses — it’s an auditory experience, of course, but it also involves emotion, memory, rhythm, and language. Importantly for Giffords, lyrics are processed with those language centers in the left hemisphere but sounds and music are interpreted in the right hemisphere. The centrally located hippocampus controls memory, including song lyrics (which is why we sometimes have trouble coming up with a common word but can remember every line of the theme song from our high school prom).

Neuroscientists have long observed that many individuals with aphasia (meaning those who cannot speak) are remarkably able to sing songs even though they could not form those same words otherwise. Children who are speech delayed, patients with Alzheimer’s disease, and those with brain injuries like Giffords’s — all have been known to sing even if they cannot speak.

Even as a specialist in the brain, I find it to be a source of wonder — we humans are so much more complicated, with brains so incredibly intricate and mysterious, than anyone fully comprehends. I am grateful for Giffords’s recovery, and for the skilled therapist who made it possible.

Philip E. Stieg is the Neurosurgeon-in-Chief of New York-Presbyterian/Weill Cornell Medical Center and host of the podcast This Is Your Brain.