An intern, left, and office manager take the reins in Giffords's Tucson office. | Will Seberger for POLITICO 'What would Gabby want?'

TUCSON, Ariz. — On Monday, when Rep. Gabrielle Giffords’s breakfast was delivered to her Houston hospital room, she asked for something else: toast.

It might not seem like much, but one month after a failed assassin fired a bullet into her brain, such seemingly small milestones in her long recovery have helped sustain Giffords’s inner circle — family, friends and aides — as they cope with last month’s Tucson massacre by sharing in her progress and continuing to serve her constituents. Giffords is now eating three meals a day — as her husband, Mark Kelly, announced Tuesday on Facebook — and as she did Monday, speaking is the latest sign of progress.


Over the past month, her aides have been forced into one of the worst crisis management tests ever faced by a congressional office.

It’s hard to imagine any small staff dealing with such a sprawling, massive and sustained ordeal — and the staffers have done it in the absence of their leader and three of their colleagues, one of whom was killed and two of whom have not returned to work since being shot. (See: Intern gets back to work in Arizona)

Even the outpouring of support can be a logistical nightmare: Giffords’s district office has logged nearly 20,000 contacts in the month since the rampage.

They deal with these challenges by answering the oft-repeated question: “What would Gabby want?”

At the center of the entire Giffords operation is her 30-year-old chief of staff, Pia Carusone, who has been running Giffords’s Tucson and Washington offices from spartan side rooms at Houston’s TIRR Memorial Hermann hospital with her BlackBerry, a Mac computer and a tiny, 3-by-5-inch reporter’s notebook containing four weeks’ worth of daily to-do lists. She cadged the notebook from an FBI agent in Arizona when she realized she needed to keep track of all her tasks. (See: Recovering, Giffords speaks)

It travels with her, as do a black-and-white lapel ribbon and three bracelets — a white one bearing the date of the shootings; a blue one with a heart symbol, a peace sign and the name “Gabby”; and a red one that keeps her curls under control when it’s not clinging to her wrist.

Carusone was at home in Washington on Jan. 8 when an aide called to tell her there had been a shooting. A second aide confirmed that Gabe Zimmerman, Giffords’s outreach director, had been killed and that the congresswoman had been shot in the head. Carusone called Kelly and packed a bag with all the wrong clothes — save for the black suit she would wear to three funerals.

“All I thought was, I might be going to a funeral,” she said in an interview with POLITICO in Houston on Monday. She’s been buying clothes as necessary ever since, having spent just five hours at home in Washington since the shootings.

She contacted the White House, a handful of congressional colleagues and the House sergeant-at-arms. Within minutes, her phone was flooded with so many calls that she couldn’t dial out. (See: Echoes of Tucson on the House floor)

Before she got to Tucson, she had to push back on erroneous reports that Giffords was dead. Carusone had just spoken with Giffords’s mother when the news broke. It wasn’t true.

“This is inaccurate. She is in surgery,” she wrote in an e-mail message that she copied, pasted and sent to members of the media.

After landing in Tucson, Carusone began coordinating with hospital officials, law enforcement officers, doctors flown in to consult with the surgical team, a grief counselor for the staff and incoming family and friends — and helped handle an endless string of media requests. A special e-mail address set up to handle press inquiries related to the shootings received more than 900 messages in one day. Carusone’s gotten calls from Katie Couric, Diane Sawyer and Oprah Winfrey’s “people,” to name a few.

Her colleagues say her background — she’s run campaigns, worked as a spokeswoman and managed Giffords’s staff — helped prepare her to step up when all hell broke loose.

“I can’t imagine doing it without her having that experience,” Giffords spokesman C.J. Karamargin said.

The logistical triage was so intense that volunteers from other government offices began helping Carusone and Karamargin.

“She’s dealing with this by pushing forward,” said C.R. Wooters, Rep. Chris Van Hollen’s chief of staff and a friend of Carusone’s. “Pia and the Giffords team represent what’s best about this business. They are smart, aggressive and fiercely loyal to their boss and the needs of her constituents.”

What’s most remarkable about Carusone’s uncommon resolve and dedication to service is how common those traits are in Giffords’s world.

Zimmerman, for example, shared Giffords's passion for public service, his colleagues say, setting the example for how to close cases for constituents who needed help navigating a bureaucracy.

"He was everything you could want in a supervisor, friend, and congressional staffer. Kind, smart, thoughtful, thorough and so many more wonderful attributes. A beautiful man," said Amanda Sapir, a case worker in Giffords’ office. "We all continue a deep commitment to helping people in his honor and to fulfill the Congresswoman’s charge to care for one another and help as many of her constituents as possible."

By the morning of Jan. 10, the district office in a small complex here was open for business.

“Of course,” office manager Joni Jones said in an interview in a district office conference room Tuesday, “Gabby would want us to open.”

At a time when they were mourning their own friend and worried about their boss, Giffords’s aides began receiving constituents and well-wishers. They set up a system to keep track of all the gifts they received from around the world — stacks of handmade blankets, paintings and other items are in a closet in the district office — and the folks who just sent their best regards.

“She attracts people who really care, and then, after that, you learn that in Gabrielle Giffords’s office, constituent service is No. 1,” said Jones, a “50-something” who volunteered for Giffords’s 2006 campaign after being “Gabbified” when she heard the candidate speak at an event.

"Gabby loves and treats her staff like family. She attracts those who believe they can make a difference in people’s lives,” Kelly said in a statement provided to POLITICO. “Her staff is a reflection of who Gabby is and her dedication to Southern Arizona and to the people she serves.”

One of her interns, college student Daniel Hernandez, became a national hero by cradling his boss, applying pressure to her head wound and working to keep her conscious until help arrived.

Last week, another intern was on the front end of a relay team that helped get a constituent out of Egypt as protesters and pro-government forces clashed in the streets.

After failing to get help from Arizona’s two senators, Alice Callison called Giffords’s office for help shortly after 4 p.m. on Jan. 31 because she was concerned that her daughter could be trapped in Cairo without food, water or a way to get to the airport.

Callison said she first thought that her call “might not be important enough” to break through, given everything else the Giffords office was dealing with. But she called anyway because Giffords is her congresswoman. “I live in her district,” she said in an interview.

Holly “came in and said it looks like we have an emergency,” Sapir said of the intern.

Sapir called Callison and collected information on 24-year-old Andrea Richardson, whose efforts to get out of Egypt were complicated by injuries she had sustained in an earlier bus accident. Then Sapir called the State Department’s special task force on Egypt to alert the administration to the situation, following up immediately with a written request for help. Before midnight, Sapir heard back from State. “They had called her and assured her they would do their best to make sure she was safe,” she told POLITICO. “She was out first thing in the morning. ... It was just an ideal collaboration of everyone doing their job at the highest level.”

Carusone is now shuttling between Tucson and Houston, where she and Kelly are staying in a guest house because it’s closer to the hospital than Kelly’s place.

She’s getting closer to eight hours of sleep a night now — double the amount she was sleeping. The demands are still overwhelming. In short order Monday, she fielded a call from Rep. Jeff Flake (R-Ariz.), did an interview with a local television station and hopped on a conference call for Giffords’s Solar Hot Team, a consortium of stakeholders in advancing solar energy efforts, standing in for her boss.

“If anyone can get through this, she will,” Carusone told the participants.

Giffords’s aides said they know the congresswoman would be proud of the work they’re doing on her behalf and that each bit of good news on her recovery is uplifting.

Kelly delivered some of it in his Facebook post Tuesday: “The doctors say she is recovering at lightning speed considering her injury, but they aren’t kidding when they say this is a marathon process. There are encouraging signs every day, though. Gabby’s appetite is back and — even though it’s hospital food — she’s enjoying three meals a day,” he wrote.

Carusone was eating lunch at a Mexican restaurant in Houston on Monday when her BlackBerry rang and “NASA” popped up on its screen.

“It’s Mark,” she said as she took the call.

Kelly was taking a moment out from his first day back at work as a space shuttle commander to get a midday update on his wife’s rehabilitation.

Carusone delivered the latest progress report: Gabby asked for toast. Small but significant.

She told POLITICO later that Giffords’s daily successes are an inspiration for everyone around her.

“This whole thing would be a lot harder to manage personally and emotionally if she weren’t progressing as fast as she is,” she said.