It’s been four years since a mentally disturbed man drew out a gun and fired on former Democratic Rep. Gabrielle Giffords at an Arizona Safeway, nearly killing her, and now she is visiting with President Barack Obama.

Giffords and retired astronaut Mark Kelly, her husband, spoke with Obama privately at Central High School in Phoenix on the fourth anniversary of the shooting for a few minutes before Obama was set to talk about his plan to get Americans into home ownership, according to an Arizona Republic report.

A main point in the conversation was about work being done to stop gun violence, according to a spokesman for Americans for Responsible Solutions, which the couple founded to fight for gun control on the second anniversary of her attack. Giffords and Kelly told Obama that congressional action on gun violence would be essential moving forward.

Obama opened his remarks describing the meeting on a day that he described as “tough” for folks in the region. Although Giffords survived, six people died and 13 others were wounded in the attack.

Obama said that Giffords looked “wonderful” and had the same energy as before, further calling her a “hero.”

To commemorate the anniversary, some of the survivors of the attack and relatives gathered for a memorial service Thursday morning in Tucson on the lawn of the University of Arizona Medical Center. The crowd observed a moment of silence after a bell rang to mark the time of the attack.

Giffords said on her Twitter feed that she would like to thank her former colleagues for the moment of silence and that she was “thinking of you all today.”

Nineteen people were shot in the Jan. 8, 2011 attack during a constituent meeting Giffords held in a supermarket parking lot in Casas Adobes, Arizona, near Tucson. Six people died, including a district court chief judge, one of Giffords’ staffers, and a nine-year-old girl.

Giffords had been holding a meeting called “Congress on Your Corner” at a Safeway store when Jared Lee Loughner walked up and shot her in the head with a pistol before firing at other people. Giffords wounds at the time were considered “critical” after being shot at point-blank range, and her recovery since then has been long and slow.

Loughner, 22, was arrested at the scene. He had been obsessed with Giffords, and had been suspended by his college for disruptive behavior, releasing videos on YouTube in where he appeared increasingly unhinged, ranting about various issues. Court filings includes notes in which Loughner allegedly said he planned to kill Giffords.

He refused to say anything to authorities, and was determined by a judge to be incompetent to stand trial in January 2012, being diagnosed with paranoid schizophrenia. He eventually pleaded guilty to 19 counts and was sentenced to life in prison in November 2012.

The shooting caused a national discussion of the harsh political rhetoric in the United States, with some suggesting that the charged atmosphere could have been part of what prompted Loughner to attack Giffords. Sarah Palin in particular was criticized for using gun metaphors often and for images on her website where various districts were “targeted” with crosshairs.