TUCSON, Arizona — In the past five years, Gabby Giffords has hiked the Grand Canyon, gone skydiving, raced in a 40-mile bike ride and founded an advocacy group that helped persuade President Barack Obama to take executive action on gun control.
That's while recovering from a gunshot wound that nearly killed her, learning to speak again and rehabilitating.
Friday marks the anniversary of the 2011 shooting at a Tucson constituent event that left six dead and 13 injured, including the former U.S. congresswoman, the target of the attack.
The city observed the day with an annual bell ringing at two locations, including Banner University Medical Center, where many of the victims were treated. Tucson Mayor Jonathan Rothschild rang a bell 19 times, once for each victim, at the city's central fire station.
Giffords was shot in the head during the attack. She has a language disorder known as aphasia and speaks in short phrases or words. The right side of her body is largely paralyzed.
The shooter, Jared Loughner, pleaded guilty to 19 federal charges and was sentenced to life without parole.
"It's been a long, hard haul, but I'm getting better," Giffords said in an email this week. "I wake up every day grateful that I have a second chance at life and a second chance at service."
Giffords and husband Mark Kelly, a retired astronaut, founded Americans for Responsible Solutions, a political action committee that calls for stricter gun regulations.
The couple had their hearts set on 2013 legislation that would have required background checks on all gun sales. But the bill failed, and Kelly and Giffords searched for an alternative, deciding presidential executive action was the next best option.
Kelly said he encouraged Obama to act, and the staff at Americans for Responsible Solutions worked with the White House on the plans for a year.
The president's action was aimed at narrowing the loophole that exempts gun sales from background checks if the seller isn't a federally registered dealer. It implements guidance specifying that even those who sell just a few weapons at gun shows, flea markets or online can be deemed dealers and required to conduct checks on prospective buyers.
Critics say the plan won't make a significant dent in unregulated sales and that Obama should have let Congress handle the issue instead of taking action himself.
Kelly said Americans for Responsible Solutions will take up the cause during the upcoming election season by advocating for candidates who support tougher gun regulations.
At their Tucson home, Giffords is merry, smiling as she plays with her service dog, Nelson, who likes to eat napkins but can also fetch a tissue box at the sound of a sneeze.
Giffords and Kelly were home for the holidays, but they spend a large part of their time traveling for their political action committee. In between, Giffords goes on bike rides — she spent the first half of last year strenuously training for a race — and continues speech therapy about three times a week.
She likes to watch TV and most recently binge-watched the Netflix hit documentary series "Making a Murderer."
"When I met her, she could say some words but certainly struggled," said therapist Fabi Hirsch. "So she has just made tremendous progress, and I attribute at lot of that to the fact that she works constantly on improving her communication skills."
Giffords has full cognitive ability, but communicating is an ongoing challenge.
At times, Kelly has to guess what she's trying to say with one word. Other times Giffords can form several sentences, but not without extensive practice.
When she's traveling, Giffords works with Hirsch online. She does speech exercises using her iPad in her spare time.
Giffords said one of her biggest feats was riding the 40-mile portion of the El Tour de Tucson race in late 2015. Giffords and Kelly trained for a large part of the year, even after she took a bad tumble and broke her femur last spring. Giffords rides a retrofitted recumbent bike.
"At the end of the day, I'm optimistic about my recovery and that our country will become safer from gun violence," she said.
This story has been corrected to show the name of the documentary series is "Making a Murderer," not "Marking a Murderer."