Sen. Tim Johnson Out of Intensive Care

In this Aug. 26, 2005, file photo, Sen. Tim Johnson, D-S.D., is pictured in Arlington, Va. after the Defense Base Closure and Realignment (BRAC) voted to keep open South Dakota's Ellsworth Air Force Base. Johnson's condition has been upgraded from critical to fair, four weeks after he was hospitalized for a brain hemorrhage, his office said Tuesday. (AP Photo/Charles Dharapak, File) (Charles Dharapak - AP)

WASHINGTON -- Sen. Tim Johnson has been transferred out of intensive care and has said some words, his doctor said Thursday, nearly a month after the South Dakota Democrat suffered a brain hemorrhage.

An MRI on Wednesday showed the speech centers in the senator's brain were spared injury in the initial hemorrhage Dec. 13, said Johnson's neurosurgeon, Dr. Vivek Deshmukh.

"This is confirmed by the fact that he is following commands and has started to say words," Deshmukh said in a statement released by Johnson's office.

Johnson will be participating in "aggressive therapy" in the inpatient rehabilitation unit at George Washington University Hospital, the statement said.

Johnson's doctors have said that when he arrived at the hospital, he was feeling weakness on his right side, and that condition will require physical therapy.

The senator has responded correctly when asked his name, Fisher said, though there is not much sound coming out of his mouth because of a tracheotomy tube still in his throat.

"It is clear that he understands that people are introducing themselves, he is looking at name badges to try and associate it with the person, he is saying words and responding to commands," she said. "It's clear the electricity is on and the system is humming."

The progress is slow, Fisher said, but he is improving.

"The fact that Tim is beginning to use words is remarkable as is his strength and determination," said his wife, Barb Johnson, in the statement. "He even maintains his sense of humor when I share e-mails about his grandsons' adventures."

On Tuesday the senator's condition was upgraded from critical to fair, and his doctors said he no longer needed a ventilator to help him breathe. He is being weaned off the tracheotomy tube that remains in his neck, his office said Thursday.

His office has said that his recovery is expected to take several months.

Johnson was diagnosed with the arteriovenous malformation, a condition, often present from birth, that causes arteries and veins to grow abnormally large, become tangled and sometimes burst. He was rushed to the hospital after becoming disoriented on a phone call with reporters, and he underwent emergency surgery hours later.

His long-term prognosis is unclear. Doctors have said he is steadily improving and has been responsive to his family and physicians, following commands, squeezing his wife's hand and understanding speech. He needed the ventilator to assist with his breathing after fluid developed in his lungs as a consequence of his initial hemorrhage, his doctors said.

In cases like Johnson's, doctors often depend on the patient's ability to answer questions to assess any cognitive damage caused by the hemorrhage.

Johnson's sudden illness raised questions about the Democrats' one-vote majority in the upcoming Senate session. South Dakota's Republican governor, Mike Rounds, would appoint a replacement if Johnson's seat were vacated by his death or resignation.

A Republican appointee would create a 50-50 tie and allow the GOP to gain Senate control because of Vice President Dick Cheney's tie-breaking vote.