Pain sets in for Arizona shooting victims
Tucson - The harrowing first week is over. Now as the national focus drifts away and a quietness returns to this laid-back college city, the profound pain is setting in as victims of last weekend's shooting spree - and their tight-knit community - enter the toughest part of their healing process.
There are the parents who lost their 9-year-old daughter. A wife who will live with the haunting memory of her husband's dying moments, filled with her loving whispers after he used his body to shield her from the bullets. A 20-year-old intern for US Rep. Gabrielle Giffords stamped with the mental images of holding her to his chest and trying to stop the bleeding after a bullet passed through her head.
And then there's the city of Tucson, a picturesque desert community of sun-bronzed university students, retirees and artists that prides itself on being open-minded but is now linked to a heinous crime in which six people were killed and 13 others wounded.
"I happened to get hit by bullets and all of you, especially those who were there, you got wounded too," said Giffords' aide Pam Simon, 63, who was shot twice, as she met with survivors, witnesses and community members.
The months to come will determine the lasting impact of those wounds, not only for the residents of Tucson but the country itself, which has spent a week reflecting on whether a divisive political atmosphere, angry rhetoric or loose gun laws might have intersected with a dangerously mentally ill young man in Tucson.
And what of suspected gunman Jared Loughner's parents, who have remained secluded in their modest home, issuing only a brief statement expressing sorrow? Questions as to why he fired on the crowd that January 8 morning may never be fully answered.
"This was a combat situation that hit people not prepared for combat," said Dr Paul Ragan, a Vanderbilt University expert on gunshot victims. "There really is this profound assault on one's own sense of certainty in life and safety."
Survivors have found a sense of peace from the community's overwhelming support, rolling their wheelchairs past the cards, candles, and flowers blanketing the hospital lawn.
They also are consoled by the moments of human goodness - the heroic feat of the men who tackled the gunman, the woman who grabbed his empty magazine and the strangers who scampered under the hail of gunfire to help the wounded.
Most uplifting has been the remarkable recovery so far of Giffords, who opened her eyes, grabbed her husband's arm and appeared to try to hug him on Wednesday night after President Barack Obama visited her hospital room.
Many of the 13 wounded survivors have undergone multiple surgeries and face months, possibly years, of physical therapy.
Survivors recognise the body often heals more quickly than the mind.
"The wounds in our heart are a lot, lot deeper," Simon said. "They aren't going to heal in a long time."
Long-term fall out
Jenny Douglas, the daughter of Giffords' aide Ron Barber, 65, who was shot three times, said her father "remembers it all, very clearly".
Mavy Stoddard, 75, who was shot in the leg three times, also remembers. Her husband, Dorwin, 76, dove to the ground and covered her when the shooting started. She talked to him for 10 minutes, while he breathed heavily after being shot in the head. Then his breathing stopped. The two grade school sweethearts had lost contact and then found each other again after both retired in Tucson, falling in love.
Steve Siegel, of the Denver District Attorney's office, has seen the long-term fallout after helping people in the aftermath of some of the country's most horrific crimes - from the 1995 Oklahoma City bombing to the 2007 Virginia Tech shootings.
Some have been unable to function, losing jobs, turning to alcohol and drugs, even attempting suicide. Every time a tragedy occurs somewhere it can trigger their traumatic feelings - an actual chemical response in their bodies.
Trauma, he says, acts like a stone dropped in water, rippling out far beyond the crime scene: Within 48 hours of the Columbine high school massacre, all youth beds at mental health facilities across Colorado were filled. Many were teens shaken by the news clips of the chaos.
More than two years later, about 600 people were still seeking help to cope, said Bill Woodward of the Centre for the Study and Prevention of Violence at the University of Colorado at Boulder.
Disturbing turn of events
Doctors say some of the victims could experience a near-constant mental replaying of the attack outside the Safeway supermarket. They may develop irrational fears, worrying obsessively that Loughner could escape and harm them again. A few might find they can't even drive past any Safeway.
When Bill Hileman went to see his wife Susan in the hospital after the shooting he found her in a morphine-induced haze, screaming out: "Christina! Christina! Let's get out of here. Let's get out of here."'
Susan Hileman, 58, was holding the hand of her neighbour, 9-year-old Christina Taylor Green, the youngest of those killed, as they waited to see Giffords when the shooting erupted.
In a disturbing turn of events involving another shooting victim, J Eric Fuller, 63, was arrested on Saturday after allegedly making threatening comments at an ABC News forum to which he'd been invited.
Authorities said Fuller, a military veteran, would be "involuntarily committed" for mental health evaluation after confronting a local official of the conservative tea party movement with the words, "You're dead."
A team of psychiatrists and social workers is working to counsel the patients and their families.
"We've got to bring them back as a whole human being," said the victims' chief trauma doctor, Dr Peter Rhee, who has treated soldiers in Iraq and Afghanistan.
Countless others may need the help, too: There are those who escaped the gunfire unscathed, the police officers and emergency crews who witnessed the carnage, the Safeway workers, the neighbours and friends of both the victims and the assailant, and the community as a whole.
Vicky Dotson, 38, watched her 11-year-old daughter, Emmalee, place pebbles on the ground to leave a message outside Christina's funeral service: "Forever Young, Christina. Never Forget. 9/11/01-1/8/11" and wondered how to explain it all.
"You kind of wait for them to ask questions, if they have questions. They obviously know it's a bad thing," she said. "Beware of your surroundings, that's one of the first things I told her."
Emmalee swam with Christina on the swim team at a YMCA community centre but did not know her well. Still, her death has affected her in unexpected ways.
"I've just been scared going out and it's just been sad," said Emmalee, adding that she's also had bad dreams.
Christina's father, John Green, told the Boston Globe that some of his daughter's organs had been donated to a Boston area girl, news that "really lifted" the family's spirits.
There are many keys to solace and recovery, experts say.
"In a lot of ways you don't really know what the overall impact is for a very long time," said the University of Colorado's Woodward. "You don't know what the impact was on the community as a whole."
The same is true of the political process, he said. "How many people are still going to be wanting to go to political events? What kind of security is there going to be there?"
So far officeholders and constituents outside Arizona appear to be emboldened by the tragedy. Less than a week after the shooting at Giffords' public "Congress on Your Corner" meet-and-greet, similar gatherings across the country resumed under greater police presence, drawing large crowds.
Democratic Representative Shelley Berkley called her Las Vegas office's open house a stand against violence, noting America's political climate is at a crossroads.
"The reality is, we haven't been behaving very well as leaders of our nation," Berkley told The Associated Press. "I hope this is a turning point."
Obama, at Wednesday night's memorial service in Tucson, implored a divided America to honour the victims by becoming a better country.
That may be easier said than done, as even the memorial where Obama spoke produced controversy, with some conservatives insisting it appeared to be an event scripted by the White House. Obama spokesperson Robert Gibbs denied that, and the University of Arizona said it had done the planning.
Political scientist Dan Shea says ideological blogs, cable news, radio shows and other mediums are wrapping voters in a "partisan cocoon". That's not going away, but he is optimistic lessons will be learned from the shooting.
"I think people will be watching elected officials more closely," said Shea, of the Centre for Political Participation at Allegheny College in Meadville, Pennsylvania. "I think it will hold them accountable for their rhetoric and that we'll celebrate those who are passionate but also respectful in their discourse and punish those who cross the line."
There is a long journey of healing ahead.