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Survivors of gun violence often suffer with physical and emotional pain years after

More than 300 Americans are shot every single day. That’s according to the national organization, Everytown for Gun Safety. Many survive their initial injury. But the physical and emotional trauma does not end when they’re discharged from the hospital. 

It was supposed to be an ordinary Saturday morning at a Tucson Safeway in January 2011. Pam Simon was preparing for a Congress on Your Corner meeting.

Her boss, former Congresswoman Gabby Giffords would be talking to members of the public.

"Gabby arrived, ran across the parking lot wearing black and red and I had black and red on," she recalled. "We always laughed about how we accidentally ended up with the same colors. I gave her a quick hug and she said, ‘let’s get going.’"

Soon after, Simon says a figure came between her and Giffords.

"And the next thing I knew I was on the ground. I did have an image of Gabby's feet flying into the air," she said.

In less than 30 seconds, a gunman carrying a 9 mm killed six people and injured 13, including Giffords and Simon. 

Going down the line

Mary Reed was also there along with her husband and two children. 

"And I caught a ricochet shot in my left arm," she said.

She remembers the gunman going down the line, shooting at close range. When he got to Reed, "He stood behind me, saw that I was covering my child and tried to shoot her through me and grazed my right arm trying to shoot at her head," said Reed.

Reed spun around so she could look the shooter in the eye. He lowered his gun from her head and shot her a third time. A single round entered her spine.

"The bullet sits inside a nerve bundle that comes out of your spine that controls your bowels, bladder and right leg."

Although not paralyzed, Reed has been living with chronic pain ever since. 

Simon’s gun injury has mostly healed, but she suffers in other ways. "I would say the mental injury has been much more difficult for me than the physical."

Simon was diagnosed with PTSD. And it’s something she deals with to this day. "Sometimes you don't even know the trigger," she explained. "But all of a sudden, you're planning your escape route again."

Survivors feel abandoned

Last year, a study in the Annals of Internal Medicine looked at the long-term outcomes for gun violence survivors over the course of a year. It was one of the first, large-scale studies to do so. 

"The people that do survive have at least 40% increase in pain diagnosis … 50% increase in psychiatric disorders. And that can be depression could be post-traumatic stress disorder, and 85% increase in substance use disorder," said Dr. Sue Bornstein, the chair of the Board of Regents for the American College of Physicians, which has called firearm injury a public health issue for the last 30 years. 

Despite that, care for survivors beyond the acute phase is limited.

"Unfortunately, they do sometimes feel abandoned, I think the evidence shows that they feel abandoned after they're discharged from the hospital," she said.

That’s changing in some places, says Bornstein, because the reality is, gun violence is on the rise and there’s a need for more coordinated care afterwards.

Life after gun violence

Dr. Kyndra Simmons is the director of frontline training and technical assistance at the Health Alliance for Violence Intervention, known as HAVI. The alliance currently works with 50 hospitals across the United States to create and build out hospital violence intervention programs. 

The goal is to better support survivors after they leave the hospital. 

"That's the biggest piece," said Simmons, "how do you heal from the injury? Because what we have to talk [about], especially with survivors of gunshot victims, [is that] sometimes their body is not going to be the same."

And sometimes those are really difficult conversations, she says. Simmons thinks back to a time when she encountered a woman who was shot in late adolescence. 

"Later on it was determined that she was unable to have children. Just from the extent of her injuries, and these are some of the things that come about, because sometimes all of the bullets can't be removed."

And what happened to that woman is just one example of those lasting consequences. Colin Goddard was shot in the 2007 Virginia Tech massacre. He’s now suffering from lead poisoning because of bullet fragments still in his body.

"My son was picking flesh out of my daughter's long hair because everyone was shot in this tiny confined space so close together." — Mary Reed

The forgotten victims

But it's not just the injured who struggle, there are the uninjured like Mary Reed’s children.

Reed was the last to be transported to the hospital. As she waited, her children used rags to try to stem the bleeding. She remembers her then 13-year-old son, with his one free hand, reaching over to touch his sister's head.

"My son was picking flesh out of my daughter's long hair because everyone was shot in this tiny confined space so close together."

It was then she knew they would never be the same. More than a decade has gone by and her now adult children still wrestle with the horror of that day.  

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KJZZ senior field correspondent Kathy Ritchie has 20 years of experience reporting and writing stories for national and local media outlets — nearly a decade of it has been spent in public media.