Mosquito.

Clare Sierra couldn't say it for the longest time. Words with one or two syllables came back, but three or four? She clenches her fist, the frustration still palpable. "Oh! How do I say that?"

Sierra had a stroke nine years ago at 46. She no longer works and uses a wheelchair when she tires of walking. And she watches Rep. Gabrielle Giffords from a unique vantage point.

"I've been following her since that day," Sierra said, referring to Jan. 8, when Giffords was shot in the head in the parking lot of a Tucson, Ariz., grocery store. "I am so pleased with her." But, she adds, "[Giffords] can't speak in the same way."

Sierra is one of about two dozen brain injury and stroke survivors who graciously allowed me to join their recent Tuesday "Coffee Talk" gathering at Park Nicollet Methodist Hospital in St. Louis Park. Though buoyed by Giffords' appearance on Capitol Hill earlier this month, they resist promising too much.

The weekly INSPIRE program, part social hour, part group therapy, is a lifeline for participants. Some say they might not be alive without it.

"How does brain injury change you?" asks coordinator Karen Bjorgan, the group's founder and herself a stroke survivor. One man bursts out laughing. He's had to relearn how to talk. Others chime in. They can no longer walk. Or taste or smell. They see double. They can't remember their children's birthdays. Fatigue is relentless.

Troy Dahnke, 42, has aphasia, which impairs his ability to speak. The father of two young sons, he can no longer work. "My boys are my strength," he says slowly. "My oldest gets it, but my youngest, he was too little to know what I was like before."

Some bristle at well-meaning comments. "You sure are doing well with that wheelchair," one says as an example. Equally hurtful: "But, you look fine."

"It's not that I don't want to seem fine," said Maggie McCann, 58, a hairdresser and nanny. "But people expect things." If she's talking on the phone with someone who is also doing the dishes, for example, "I can't keep my concentration. I want to scream. But I say, 'Wait a minute. Don't crank at people. No one will want to talk to you.'"

Sometimes, friends do pull away. Some marriages shatter. And sometimes, survivors don't want to live, despite devoted families and friends.

Ron Shephard, 60, watched everything crumble after his stroke three years ago: his work in risk-management, his driving and church activities. The worst, he said, was having to be bathed by his grown son.

"I pretty much gave up," said Shephard, who lost more than 100 pounds in his depression. Today, thanks to a loving family and the auxiliary family at INSPIRE, he feels "blessed. I was able to survive." His wife, Mary, he says with amusement, finds him "more humble, easier to approach."

Kim Zismer, 54, found depression "as paralyzing as the physical paralysis of the stroke." While she didn't lose her ability to speak four years ago, "I hated who I had become. I hated my life. I felt that I was useless," said Zismer, a former registered nurse with two grown children.

"I took care of my kids all those years, then it was me, taking, taking, taking. Of course I hope that [Gabrielle] doesn't go through that, but I had a lot of support, and it still happened."

Today, she takes adaptive yoga and golf, rides a recumbent bike and credits her "Christian faith, family and this group as being a huge part of my recovery."

Participant Nick Dennen offers another inspiring tale. At 20, he suffered a traumatic brain injury in a near-fatal 35-foot fall off a cliff into a creek. Now 33, Dennen is married, employed and in the best shape of his life. Still, the soft-spoken author of a book about his recovery, titled "23: Time To Choose," emphasizes that a damaged brain takes years to heal. "And there's no saying you'll ever even get remotely close to being the same person."

That's why this group is so important, said Bjorgan, who had a stroke at age 32, three weeks after giving birth to her daughter. As part of her therapy, she created INSPIRE in 1997. "You have a better recovery if you have support," she said.

"We talk about how to handle anger, what's the best thing that's happened despite living with a brain injury, how do they bring joy into their lives," Bjorgan said. "A lot of times, they share tips that only they know."

Bjorgan, too, is following Giffords. "I pray for her, that's what I do," she said. "She's capable. I hope she has the recovery I did."

Gail Rosenblum • 612-673-7350 gail.rosenblum@startribune.com