4/28 update: AHCJ video of Lemole’s talk.

Arizona neurosurgeon Michael Lemole was coming off the golf course with his son when he got the call about a shooting at a shopping plaza. As he was driving to trauma unit at the University Medical Center, he heard the incorrect radio report that U.S. Rep. Gabrielle Giffords had died from a gunshot wound to the head.

But, when he arrived, he learned that she was still alive. But, just how and where the bullet passed through her brain – and the medical team’s response — would play a huge role in her odds of survival and recovery, he told a group of health writer gathered in Philadelphia on April 16. He recounted the steps he and the hospital’s trauma team took that allowed Giffords to survive and become well enough to travel to Cape Canaveral this Friday to NASA to watch her husband’s shuttle launch. Today’s Arizona Republic reports “that she can stand on her own and walk a little but is working to improve her gait.” The use of her right arm and leg “is limited but improving” She speaks most often in a single word or declarative phrase: “love you,” “awesome.. and can wheel “herself to the doors at the end of the hall to peer out,” according to the report.

Her outcome was impossible to predict 15 weeks ago. Generally, the odds of dying from a gunshot wound to the head range from 56 to 94 percent, Lemole said. If the path of the bullets goes through the geographic center of the brain, through the ventricles or through multiples lobes, the prognosis is not good. In Giffords’ case, the bullet did not cross from one side of the brain to the other, but travelled through the left side.

The patient’s level of consciousness at admission is another factor, he said. At the time, Lemole was quoted as saying that Giffords was able to follow simple commands from the doctors

The first procedure he and his team performed on Giffords was a decompressive craniectomy “We basically take part of the skull off and let the swollen brain relax,” he said. The procedure can relieve pressure on the brain but it can also worsen edema – the build-up of fluid that can cause an “outward herniation.” They also had to remove damaged parts of the brain to “save the good brain underneath.”

The procedure is informed by data gathered during surgery on soldiers injured in the Iraq war, he said. At some point, surgeons will replace the bone or use a prosthetic.

A week later the team performed an “orbital osteotomy” to repair her fractured left eye socket and remove bone fragments. Giffords’ team also performed a ventriculostomy, the insertion of a tube into the brain to drain fluid and measure pressure, Lemole said.

He credits the use of growing use of simulation in surgical training for allowing doctors to successfully perform operations like the ventriculostomy.

The role of human interaction is also key. When Giffords was on the roof waiting for the helicopter to take her to TIRR Memorial Hermann Hospital in Houston, she was conscious and opened her eyes, he said.

Through all this, he was asked by the family to keep the press up to day. Lemole said he chose his words carefully.

“I don’t think I gave a rosy account,” he said, describing his careful use of the term “functional recovery” instead of terms like “full recovery” or “back to normal.”

In addition to simulation training, Lemole said the “flawless” EMT response and the multidisciplinary nature of trauma team combined to improve Giffords’ odds.

As far as all the attention goes, Lemole said “This was not a search for celebrity. This was the desire to get the right information out. ”

As far as Gifford’s current status, find more in today’s Arizona Republic.

Her hair is short, maybe 2 inches long, says Pia Carusone, her chief of staff, so there are scars on her scalp that show through. Eventually, her hair will cover them. A thin scar across the top of her forehead is healing well and fading, and her face, though sometimes swollen, is otherwise the same as before, Carusone says.

Giffords speaks most often in a single word or declarative phrase: “love you,” “awesome,” even “get out” to doctors in her room at the end of a taxing day. She longs to leave the rehab center, repeating “I miss Tucson” and wheeling herself to the doors at the end of the hall to peer out. When that day comes, Giffords told her nurse, she plans to “walk a mountain.”

Longer sentences frustrate Giffords. She must search her brain for the words she wants, which feels like trying to pull out the name of a familiar face you can’t quite place, her doctors say