Gabrielle Giffords may be unable to return to Congress, her chief of staff has revealed.
In a interview with the Arziona Republic newspaper, Gabrielle Gifford’s  chief of staff, Pia. 
Carusone spoke with candor about the congresswoman’s recovery and her prospects of re-entering the political sphere.
Giffords miraculously survived a mass shooting on January 8, in which six people were killed and 12 injuired. Carusone revealed she is “not close” to returning to Congress.
"We're about halfway through the process that is the most important time for recovery. Patients recover for the rest of their lives, but it's the first 12 to 14 months that you make the biggest jumps. . . . In the doctors' minds, it's not even close to when you begin to make the final prognosis for the quality of her life." Carusone said.
Her chief of staff said that Gifford’s ability to communicate has been badly affected by the accident.
"We do a lot of inferring with her because her communication skills have been impacted the most," Carusone said. “She is borrowing upon other ways of communicating. Her words are back more and more now, but she's still using facial expressions as a way to express. Pointing. Gesturing. Add it all together, and she's able to express the basics of what she wants or needs. But, when it comes to a bigger and more complex thought that requires words, that's where she's had the trouble."
When asked about who is making decisions for the congresswoman, the chief of staff said it was combination of herself, her husband Mark Kelly,  her family and her staff.
Talking about Gifford’s desire to speak with the media, it seems it’s a long way off.
“"I've told her that we've been approached by every media outlet in the world, at this point, and that when she is ready, there are plenty of options for how we do it. She does not want to do that right now. And that's understandable.”
“I think that we're getting close to the time when Gabby will feel comfortable releasing a photo. Then, we go from there," she added.
The true extent of the damage done is still unknown as an MRI scan can not be completed as shards of bullets remain in her head.
“That is a problem that shooting victims have. They have to use a CT scan. If she had suffered a stroke, they could do an MRI and get a much better picture of the damage to her brain. But that will never happen,” said Carusone.
"There's so much that is unknown," Carusone said. "With cancer or a heart issue, doctors can tell you a lot more. With brain injuries, they can't. ... A lot of this is a waiting game. That is a difficult thing to explain when speaking to the public. But she was a perfectly healthy 40-year-old who was injured on the job. I'm hoping that buys her a little more patience. But it's a brutal world out there."
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