Fabi Hirsch Kruse had just started her private practice when she was asked to help one of her field鈥檚 most famous patients.
had been shot during a 2011 鈥淐ongress on Your Corner鈥 event in 蜜柚直播. One of her primary challenges: aphasia, a condition nearly 85% of the country has never heard of, according to the .
This summer鈥檚 release of Giffords鈥 documentary, along with actor Bruce Willis鈥 recent diagnosis, have brought more attention to this devastating condition affecting roughly 2 million Americans 鈥 and over 6,000 Pima County residents.
Aphasia is often brought on by a stroke or, as in Giffords鈥 case, a brain injury. Other causes can include a brain tumor or infection. Kruse said they are now also seeing more cases related to brain degeneration, leading to a type called
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Kruse, who earned her doctorate in speech and hearing sciences at the University of 蜜柚直播, said her interest in aphasia started when she was completing her master鈥檚 degree, and began working with a police officer who鈥檇 had a stroke.

Speech-Language Pathologist Fabi Hirsch Kruse, left, fist bumps former Congresswoman Gabrielle Giffords after Giffords formed a sentence for her journal during a speech therapy session at Giffords鈥 home in 蜜柚直播.
鈥淲hen I first started looking into speech therapy as a career, I thought I would work with children,鈥 she said. 鈥淚 had never heard of aphasia, and didn鈥檛 really even know that adults could have speech and language difficulties that require therapy.鈥
Kruse remembers being struck that someone could lose such critical abilities: speaking, understanding language, reading, writing.
鈥淚 was touched both by the tragedy of aphasia, and the incredible determination people demonstrated in the face of it,鈥 she said. 鈥淚 felt that if I could have any impact on making their lives better through my work, that was what I wanted to pursue.鈥
Friends of Aphasia
Giffords has been living with aphasia for 11 years after a bullet damaged the left side of her brain, which is where language function is centered.
鈥淕abby is very unique,鈥 Kruse said. 鈥淎 gunshot wound to the head. Most don鈥檛 survive it.鈥
About four years ago, to help more people with these challenges, Kruse and Giffords started a nonprofit called , located at 1011 N. Craycroft Road, Suite 301.
Early last week, Andy Ortiz, Christina Thomas and Rona Howard gathered there, with Kruse, for a group therapy session. Each of these 蜜柚直播ans developed aphasia after a stroke, and each have unique challenges when it comes to language and communication.
That鈥檚 typical, Kruse says. Aphasia is different for everyone, and some find it easier to speak than to read or write, while others are the opposite. Sometimes, people mistakenly think people with aphasia have a cognitive challenge, or that they have been drinking or using drugs.
鈥淭he thing that鈥檚 really important to know is that it does not impact cognition,鈥 Kruse said.
What it does impact is a person鈥檚 ability to connect with others, and can lend itself strongly to social isolation and loneliness.
Support groups are critical for this reason, Kruse said. It鈥檚 vital for people with aphasia to come together and work on things without feeling pressure.
鈥淧eople want to do things so quickly,鈥 Kruse said of the public in general, 鈥渆specially talking.鈥
Yet while aphasia is very challenging, Kruse said people at her center share a lot of laughs and discuss many things: dating, finding new purpose in doing volunteer work, work woes.
During therapy, Kruse is constantly writing down what people say and then showing it back to the group. She does this for a number of reasons: some members have impaired auditory comprehension and it helps to have the spoken word paired with the written word.
Another reason, she said, is to help people follow a train of thought, and recall where the conversation is at if they lose their place. Lastly, it serves as a way to maintain a record of what was shared. That way, a group member can point to a word and resume the conversation if they鈥檝e lost their place.
During the height of the COVID-19 pandemic, Kruse started doing virtual programming with these methods, and just resumed in-person sessions a few months back. Those virtual programs have also kept going, with members tuning in from all over the country.

Speech-Language Pathologist Fabi Hirsch Kruse, left, works with former Congresswoman Gabrielle Giffords during a speech therapy session at Giffords鈥 home in 蜜柚直播.
鈥楬ad to give that up鈥
During last week鈥檚 session, Thomas shared how she鈥檇 like to visit her daughter in Germany but the stroke has left her nervous about flying, even though her neurologist said it鈥檚 fine. In a few months, it will have been four years.
Thomas was initially told she would never walk or talk again, but she鈥檚 proven that was wrong. Still, some things are no longer within grasp.
鈥淔or 30 years, I was an accountant and now I can鈥檛,鈥 she said, clearly but slowly. 鈥淚t鈥檚 hard. I had to give that up.鈥
While Thomas communicates clearly at times during the session, other times she pauses for a long spell, and sometimes the words didn鈥檛 come to her at all.
Among the hardest words for many people with aphasia to say are functors, the little words we say over and over again including pronouns, prepositions and conjunctions.
Ortiz, who had a stroke two years ago, finds it most challenging to comprehend what鈥檚 being said, especially if people are in a rush. One example: ordering in a restaurant. Questions from wait staff can be overwhelming, he said.
鈥榃e make it work鈥
When Howard had her stroke six years ago, she was 43 and running her own cleaning business.
She had to shut it down.
Howard uses an app called on her phone to talk, and uses pre-programmed messages or writes new ones herself. In a recent Facebook post, she shared what it鈥檚 been like to be a mother with aphasia raising a teenager.
鈥淢y daughter knows that when I鈥檓 typing something she sits down next to me and patiently waits for me to finish,鈥 she wrote. 鈥淲e talk about everything until I鈥檓 sure she understands me. Sometimes we are both exhausted but we make it work.鈥
Howard wrote that she can sometimes hear her daughter making her own doctor鈥檚 appointment 鈥渂ecause I can鈥檛 talk on the phone.鈥
鈥淪he is 18 years old now and just graduated high school,鈥 she said. 鈥淎phasia just brought us closer. We have our own special language.鈥
Photo galleries of the mass shooting in 蜜柚直播 on Jan. 8, 2011
The January 8th Memorial is nestled along the west side of the historic Pima County Courthouse, where almost an acre of gardens and paths surr…
Six people died and 13 were injured by gunfire when a gunman opened fire outside the Safeway store at Ina and Oracle roads north of 蜜柚直播 on …
Six people died and 13 were injured when a gunman opened fire outside the Safeway store at Ina and Oracle roads on Jan. 8, 2011.聽
Photo coverage of events and developments on the day after the shooting of Rep. Giffords and the deaths of six people.
Photo coverage of events and developments surrounding the shooting of Rep. Giffords and the deaths of six people.
"Mass for the Healing of Our Community, Remembrance of Those Who Have Died, and for the Consolation of All Victims and Their Families" at St. …
President and First Lady Obama visit 蜜柚直播 Wednesday, January 12, 2011 for a memorial service "Together We Thrive: 蜜柚直播 and America" to hon…
The funeral of Christina Taylor Green was held Thursday, January 13, 2011 at St. Elizabeth Ann Seton Catholic Church. Green was killed in the …
Images from the three large memorials for the victims of the January 8th, 2011, shooting.
Front pages of different newspapers' coverage of the mass shooting in 蜜柚直播 on Jan.8, 2011, that left six people dead and more than a dozen wounded.
Contact reporter Patty Machelor at 806-7754 or