Tucson, Arizona (CNN) — U.S. Rep. Gabrielle Giffords remained in critical condition Tuesday after she was shot in the head on Saturday at the rampage at her meet-and-greet event, but she is breathing on her own and doctors have backed off on some sedation.
“I’m happy to say she’s holding her own,” said Dr. Michael Lemole Jr., chief of neurosurgery at University Medical Center. “Her status is the same as it was yesterday. She’s still following simple commands.”
Lemole said she’s generating her own breaths.
“The only reason we keep that breathing tube in is to protect her airway so that she doesn’t have complications like pneumonia,” he told reporters.
Lemole said he’s encouraged by the fact that she’s “done so well” with an injury where survival and recovery are “abysmal.”
“This is where we constantly say it’s week to week, month to month. I know everyone wants new results every day but as long as we don’t backslide and as long as she holds her own, that’s good. That keeps us hopeful.”
“We have to play this according to her timeline, not ours,” he said.
Lemole said “she has no right to look this good and she does.”
“We’re hopeful, but I do want to underscore the seriousness of this injury and the fact that we all have to be extremely patient.”
Six of the victims in the Saturday shooting remain at University Medical Center, Chief of Emergency Medicine Peter Rhee said. Along with Giffords, three people are in serious condition and two are in fair condition.
Jared Lee Loughner, 22, who authorities say shot up a gathering held by Giffords outside a supermarket, has been anecdotally regarded as very troubled and perhaps mentally unbalanced because of his ramblings spotted on the internet and the way he has been described by acquaintances.
The shooting has sparked horror across the United States and generated much partisan talk about vitriolic political discourse in American life and what Loughner’s motivations are.
U.S. District Judge Raner C. Collins has ruled that all magistrate and district judges in the District of Arizona’s Tucson Division must recuse themselves.
The ruling, dated Monday, cited the need to “avoid the appearance of impropriety, and because a judge has a duty to disqualify him or herself if his or her impartiality could be reasonably questioned, whether or not such impartiality exists.”
Experts said Tuesday the alleged shooter in the massacre may have difficulty making the case for a successful insanity plea.
Paul Callan, a criminal defense attorney and a former prosecutor, and Jeff Gardere, a clinical and forensic psychologist, told CNN’s “American Morning” on Tuesday they have doubts that an insanity plea would stand.
With the “amount of planning that went into this assassination,” Callan believes “it’s highly unlikely he will meet the legal insanity defense threshold.”
“It’s very hard to prove insanity at trial,” Callan said. “You really have to prove that your mental illness is so severe that you don’t even understand that you’re committing a criminal act. And it’s almost impossible to prove that.”
Gardere emphasized that “premeditation will work against him in this one as far as getting an insanity plea.”
Judy Clarke, Loughner’s defense attorney, has not broached this issue.
Court documents released Sunday show that investigators found a letter from Giffords in a safe at the house where Loughner lived with his parents, thanking him for attending a 2007 event, similar to Saturday’s meet-and-greet.
“Also recovered in the safe was an envelope with handwriting on the envelope stating ‘I planned ahead,’ and ‘my assassination’ and the name ‘Giffords,’ along with what appears to be Loughner’s signature,” the affidavit states.
A law enforcement official said Loughner asked Giffords a question at the 2007 event and was unhappy with her response.
“He never let it go,” the source said. “It kept festering.”
Loughner bought the Glock semiautomatic pistol used in the shooting back in November. He didn’t fit any of the “prohibited possessor” categories that would have prevented the purchase and passed an instant federal background check. He tried to buy ammunition at a Walmart store, abruptly left and made the purchase elsewhere.
Later Tuesday, mourners will gather at a memorial Mass for the victims. The Mass will be held at 7 p.m. MT at St. Odilia Church in Tucson — where 9-year-old shooting victim Christina Green had her First Communion a year ago.
“Right now it is important as a community to pull together and to reach out in care and concern to all who have been affected by this tragedy,” Bishop Gerald Kicanas wrote Monday in a letter to the Roman Catholic Diocese of Tucson.
The Arizona State Legislature in Phoenix was expected to pass legislation Tuesday that will bar protesters at funerals from getting within 300 feet of services, a spokesman for the state Senate said.
The action, according to House Republican spokesman Daniel Scarpinato, is in direct response to a controversial church’s announcement that it will picket the girl’s funeral.
Westboro Baptist Church of Topeka, Kansas, has made its name by staging protests at funerals of people who died of AIDS, gay people, soldiers and even civil rights leader Coretta Scott King.
As for Loughner, he appeared in a Phoenix federal courtroom Monday to formally hear the charges against him — including two counts of murder, two counts of attempted murder and one count of attempting to kill a member of Congress.
Randy Loughner, the suspect’s father, asked a neighbor to tell reporters camped outside the family’s Tucson home Monday that he would eventually make a public statement.
“Right now he can’t talk. He can’t get out three words without crying,” neighbor Wayne Smith told CNN affiliate KGUN.
Smith said the family had called him Monday and asked for help bringing in the mail at their home. Smith said Randy and Amy Loughner were devastated, but did not know why their son allegedly shot 20 people Saturday.
“They have no idea,” Smith told CNN affiliate KVOA. “They’re as blind on it as we are.”