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After the shock in Tucson, there's the pain of healing
Beyond the six killed and 13 wounded in shooting rampage, a community is trying to cope.

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 settling in as victims of last weekend's shooting spree -- and their tightknit 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 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 Tucson itself, a picturesque desert community of sun-bronzed university students, retirees and artists that prides itself on being open-minded but is now identified with a heinous crime.

"I happened to get hit by bullets, and all of you, especially those who were there, you got wounded too," Giffords aide Pam Simon, 63, who was shot twice in the Jan. 8 rampage said 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 as a whole, 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 accused gunman Jared L. 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 that crowd at the congresswoman's public event outside a supermarket may never be fully answered.

"This was a combat situation that hit people not prepared for combat," said Dr. Paul W. Ragan, a Vanderbilt University psychiatry professor and 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 a magazine from his 9 mm Glock handgun 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 Sunday was upgraded to serious condition, from critical, after a successful procedure to remove her from a ventilator.

Many of the 12 other people who were wounded have undergone multiple surgeries and face months, possibly years, of therapy -- likely both physical and psychological.

Survivors recognize that 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."

Steven R. Siegel of the Denver District Attorney's Office has seen the long-term fallout after helping people following the country's most horrific crimes -- from the 1995 Oklahoma City bombing to the 2007 Virginia Tech shooting rampage.

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 shooting massacre in 1999, all youth beds at mental health facilities across Colorado were filled. Many were teenagers 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 Center for the Study and Prevention of Violence at the University of Colorado at Boulder.

Doctors say that some of the victims could experience a near-constant mental replaying of the attack outside the Safeway supermarket that left six dead. They may develop irrational fears, worrying obsessively that the accused gunman could escape and harm them again. A few might find they can't even drive past any Safeway.

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 neighbors 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 the funeral service of 9-year-old Christina Taylor Green, the youngest shooting victim: "Forever Young, Christina. Never Forget. 9/1 1/0 1 -- 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 YMCA swim team 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 also has had bad dreams.

There is a long journey of healing ahead.

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