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Amber Hensley rushed from Thurston High School’s cafeteria to meet her mom in the parking lot. She’d forgotten her orchestra uniform and needed it for a concert that day — May 21, 1998.

As she walked through a breezeway between buildings, the high school junior brushed by her classmate, Kip Kinkel. He was headed into the school. Their eyes met. Hensley smiled. He stared blankly.

“I was like, ‘OK,’” she said. Something seemed off.

A few seconds later, Kinkel pulled a gun from beneath his trench coat and shot two classmates, killing one.

Hensley turned around to see two boys lying on the pavement, shot and bleeding. The shooter headed for the cafeteria where students had gathered for breakfast. She saw the door close behind him.

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Just inside, Joshua Pearson and his friends were gathered at long tables. Kinkel approached Pearson’s best friend and fired another bullet.

“He had walked all the way right up and pretty much stood over Mike (Nickolauson) and shot him in the head,” Pearson recalled of his friend’s murder, “and I was right on the other side of the table.”

Pearson saw one of his friends tackle the shooter and ran to help. They struggled to take his gun. Kinkel fired another shot, which pierced a student’s finger and continued through Pearson’s buttocks and lodged in the wall behind him. Pearson said it felt like he got punched.

Recovering from a gunshot wound would be the easiest part.

Pearson and Hensley narrowly escaped death and witnessed horrific scenes that day in Springfield, Oregon: The shooter killed two students and injured 25 others.

Hensley is unable to erase the memory of being in the breezeway that day. She later recalled to her mother reaching down to help a classmate who had been shot in the head, and seeing “white stuff” — his brain matter — all over.

After the tragedy, Pearson would go on to lean on his “family” of remaining close high school friends who had been in the cafeteria that day. He became closer to other survivors, too.

“There was kind of a bonding thing there,” said Pearson, now 35.

{%ql-The survivor’s guilt killed her for years. %em Charlene Butolph, mother of a Thurston High shooting survivor%}

Hensley, also 35, pushed herself to be social for a time, then kind of “shut down,” as she puts it. She stopped talking to her friends about it and clung to her mother, Charlene Butolph, for support. She lived with her for five years following the shooting.

Butolph said although her daughter worked full time, there were near-daily crises as Hensley struggled with serious depression, which culminated in a hospitalization after she threatened to kill herself.

“The survivor’s guilt killed her for years,” Butolph said.

Both students say they had trouble concentrating during their senior year of high school. Neither likes to talk about the shooting.

The FBI says the frequency of so-called active shooter events — those that require law enforcement response, occur in a crowded area and are not suicides or accidental discharges — has increased in recent years, as have the body counts. The FBI counts 160 such events between 2000 and 2013.

The nonprofit gun control advocacy group Everytown counts 160 shootings in schools alone since 2013. Its data include suicides and accidental discharges.

A wealth of research has established many of the serious physical and psychological conditions that plague adults today — things such as heart disease, diabetes, obesity and depression — could have their foundations in adverse childhood experiences. The more traumatic events a child experiences, the higher the likelihood of health problems, some data show.

Some in the mental health field think it’s time to study whether one-time traumatic events can have similar effects.

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One thing is certain: Understanding how to support the thousands of survivors impacted by school shootings every year will help prevent the trauma from consuming survivors’ lives. Crisis experts say it’s more crucial now than ever that schools, parents and communities are prepared.

“What we have seen is that even more than the trauma itself, it’s the response to the trauma that matters,” said Ashley Winning, a postdoctoral research fellow at Harvard University’s T.H. Chan School of Public Health. “If that is true, then the school and family could have a big effect on whether this will turn into distress and health issues down the road.”

‘Scared to death’

Butolph was due to be married the week following the shooting at Thurston High School. Hensley insisted the wedding go on. But that weekend, Butolph said her daughter begged her and her husband not to leave for their honeymoon, even though it was only scheduled to last the weekend.

“She was like, ‘I don’t want you to leave me, Mom!’” Butolph recalled. “She was scared to death if we left something would happen. We had to teach her that, ‘It’s OK; we’ll come back.’”

The years that followed were filled with near-daily crises as Hensley battled emotional issues stemming from the shooting, Butolph said. She couldn’t turn a corner and run into someone without screaming. She always slept with the door open and never when no one else was home. She was afraid to be alone.

“We were living on the edge for about five years,” Butolph said. “I think I was running on pure adrenaline for five years.”

The school offered free counseling for students after the shooting, but Hensley said it felt impersonal to see a different counselor every time.

“That was kind of hard, just having to meet new people all the time,” she said. “Every day it was a new person.”

Eventually, Hensley said, she stopped seeing counselors altogether. She stopped talking to her friends about the shooting, too. That’s when, she said, she started on a path of self-destruction.

Butolph said her daughter was taking antidepressants but eventually refused to take those as well.

“But without the medication, she was just a basket case,” Butolph said. “She would sit in her room and scratch her arms.”

Shortly thereafter, Butolph said her daughter told a friend she was looking for a gun and was hospitalized at Sacred Heart in Eugene for two weeks.

{%qc-A wealth of data explains how chronic trauma experienced during childhood plays out in adulthood in the form of depression, obesity, heart disease, diabetes, drug use and, ultimately, early death. Less is known, however, about the long-term effect of a one-time traumatic experience, such as a school shooting.%}

These days, a wealth of data explains how chronic trauma experienced during childhood — things like psychological, physical or sexual abuse, neglect, living with household members who were substance abusers, mentally ill or suicidal or having parents who were imprisoned — plays out in adulthood in the form of depression, obesity, heart disease, diabetes, drug use and, ultimately, early death.

Less is known, however, about the long-term effect of a one-time traumatic experience, such as a school shooting.

What is well understood: The adverse childhood experiences students have prior to witnessing a shooting affect how they recover from the trauma, said Dr. Vince Felitti, a clinical professor of medicine at the University of California, San Diego, and a retired internist for Kaiser Permanente in California.

For one, the earlier those adverse experiences occurred in their lives, the more damaging they’ll be, and the more likely they are to worsen one’s recovery from witnessing a shooting, he said.

“If we take, say, 100 or 1,000 people and expose them to the same experience, will there not be significant differences in the way people react?” Felitti said. “The answer is, without question, there will be.”

Winning published a paper in October in the Journal of the American College of Cardiology that found people who experienced trauma in childhood were more likely to experience heart-related diseases, even if they did not experience distress in adulthood.

Although, like Felitti, her research has centered on chronic stress, Winning said she’s concerned about the long-term effects of students who witness school shootings. Given how commonplace such events have become, Winning said, it’s a source of trauma that deserves more attention. “That one time could be just as severe as a more chronic issue,” she said.

That could happen if the individual develops post-traumatic stress disorder or simply thinks about the incident constantly.

“This could be really changing the health of the population by all the exposure,” Winning said. “Witnessing it would likely inflict trauma, but even a few schools over, being so close, those children might experience distress.”

Hensley moved to California in 2004 but has since moved back to her hometown. Today, she works as a dental assistant. She has three kids from previous relationships. She said she doesn’t know if she’ll ever really recover.

One of the first things Hensley did when she got back to Springfield was drive by her old high school. It had been remodeled but still has the memorial wall out front.

“I wanted to see if it was hard for me, and it wasn’t,” she said. “It’s actually kind of nice to see what they did with everything.”

‘I wanted to see the kids alive’

After the shooting at Thurston High School, crisis response expert Cheri Lovre, of Salem, met with a group of students and asked what would make them feel safer in school. Did they want armed police officers? Patrol cars out front?

They shook their heads.

“They said, ‘We want moms in the hallways,’” Lovre said.

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That was the first of a dozen school shootings Lovre, a Bend native, would respond to during the next two decades. She said she’s since come to learn that things like police officers and metal detectors only tend to raise students’ anxiety after such events.

When the school reopened for classes five days after the shooting, parents stood in the hallways — their pockets filled with snacks — welcoming students back. Still more parents lined up to form cordons to block kids from the throng of reporters that swarmed as they got off the buses. There were long pieces of paper on the walls for students to write on. A wall around the property was covered in flowers, candles and teddy bears.

Lovre walked the halls as classes started. She felt a tinge of anger when she started noticing uniformed police officers in the hallways.

“I thought, ‘What happened here? The kids said they didn’t want them. Who asked them to be here?’” she said.

In as diplomatic a manner as she could muster, she walked up to a group of them and asked who sent them.

“One of them said, ‘You know, this is actually my day off. I just came down because I wanted to see the kids alive,’” Lovre recalled.

Often, after a school shooting, the focus tends to be on ensuring the students are tended to. While that’s certainly crucial, Lovre said, if the parents, teachers, law enforcement officers and other adults in their lives aren’t stable enough to take care of them, there’s no way the kids will be stable.

“Kids can only get as well as the adults around them,” she said.

Lovre helps ensure teachers are taken care of after shootings by providing helpers in the classrooms that have “empty desks,” those of students who were killed or wounded. Her team did this at Marysville-Pilchuck High School in Washington after the October 2014 shooting, in which the gunman killed four students before taking his own life.

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Teachers are bound to struggle with how to start — and sometimes how to continue — the first couple of classes after a shooting. Lovre pairs “empty desk” teachers with crisis responders based on their personalities. Lovre used to do this herself, but that was back when shootings involved only one death. As such events grew to include eight or more casualties or wounded, more people had to be brought in.

“We do it in a lovely, graceful way where as much as the teacher is able to do, we have them do,” Lovre said. “We sit in the back of the room, but they know that at any moment we can just stand up and take over and take the focus and guide the conversation.”

When the teacher indicates to the stand-in that he or she is ready to take the reins again, they’re able to, she said.

Robin Gurwitch, a clinical psychologist and faculty member in Duke University Medical Center’s department of psychiatry and behavioral sciences, agrees it’s crucial to stabilize adults so they can support the children. “If the oxygen mask drops, put it on yourself before helping somebody next to you,” she said. “If you are not getting enough oxygen, if you are not getting enough support, then you are not going to be able to best support the others.”

Gurwitch was part of a panel the U.S. Department of Education convened a few years ago to develop a curriculum designed to help school personnel understand the impact of school shootings and reduce their own distress. She thinks schools are getting better at supporting students and staff after shootings.

In some cases, teachers may not be able to return to the school because of the trauma they experienced there, said Sandy Austin, a school counselor who works in the same district as Columbine High School in Colorado, where a pair of shooters killed 12 students and one teacher in 1999.

If that happens, districts should be able to relocate them to another school and consider making other accommodations as well, said Austin, who counseled Columbine students after the shooting there.

A teacher who worked at Columbine during the shooting transferred to Austin’s school afterward. When she started, she asked the principal to warn her ahead of time whenever there was going to be a fire alarm. The alarms were standardized throughout the district, so it would be the same alarm she had heard during the shooting at Columbine.

The principal warned the teacher before two or three fire drills, Austin said. But one day, someone lit a small fire in a restroom, prompting an unplanned fire alarm. “I went to go find that teacher and I said, ‘Are you OK?’” Austin said. “That was the first time that that fire alarm went off since the tragedy and she didn’t know about it. She was just taken back to the day of the tragedy and everything that happened. That can be very traumatic.”

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A safe haven

Kevin Parker was in the cafeteria at Columbine High School when the shooting started. A 25-year-old working for the Christian ministry Young Life at the time, he was having lunch with a Columbine student. Just after the gunshots started at 11:19 a.m., they saw a janitor, who later died, through windows that lined the huge room. He yelled at them, motioning to get down. Everyone in the cafeteria hid below tables.

Once pipe bombs hidden in backpacks the shooters had planted in the cafeteria began exploding, survivors in the room ran toward the school’s front entrance. They stopped momentarily at a park across the street from the school but resumed running when they could still hear gunshots. This time, they ran into a neighborhood, where homeowners — somehow already aware of what was happening — stood in their driveways beckoning students inside.

“Literally, 15 to 50 students would pile into one house and then we just kept running,” said Parker, who is now a Washington state representative. “I was in the last group and then we ran into a house.”

Parker doesn’t remember much about the person — he thinks it was a woman — whose house they waited in for hours until feeling safe enough to come out.

That night, after students left the elementary school where survivors were told to gather and reunite with loved ones, a massive group of students flocked to the one-bedroom condo where Parker and his wife lived, about 1 mile from Columbine. None of it was planned.

That the students wanted to gather at this place didn’t surprise Parker. He and his wife had become well known in the community through Young Life, whose leaders would commonly order food and have it delivered to his condo for the students. What did surprise him, however, was how the students chose to gather: grouped according to where they were — or weren’t — during the school shooting. Those who weren’t at the school during the shooting gathered at his kitchen table. He believes some of them struggled with survivor’s guilt.

{%qr-What they had seen is as much or more than what some people see going to war. %em Kevin Parker, about students who saw the worst carnage at Columbine%}

“At the kitchen table were kids who kind of felt like, ‘Why wasn’t I at the school that day?’” he said.

Those who gathered in the living room had been in various parts of the school, whether it was a classroom or the cafeteria.

Students who had been in the library during the shooting, where most of the killings took place, squeezed together in a loft area.

“What they had seen is as much or more than what some people see going to war,” Parker said.

In the aftermath of shootings, high school students tend to cling to one another for support, Lovre said. That’s different from elementary and middle school students, who tend to cling to their parents or caregivers.

“The older they are, the more we really have to do what will work for them,” she said. “They’re not opposed to having adult support, but it really has to be what’s going to work for them.”

What to expect

Crisis response experts say it’s crucial after school shootings to let survivors and their families know what types of reactions to expect. It’s normal to be jumpy and hypervigilant, for example. It’s normal to have trouble sleeping, feel very sad and be anxious. Some people will withdraw from social contact and others will refuse to be alone. Bullying or hate speech could increase and could appear among kids who’d never engaged in it before. Older kids might engage in risky behaviors such as driving too fast or sexual promiscuity.

Many school shooting survivors report having trouble concentrating afterward. Louisiana State University and University of Missouri researchers used shooting databases, school report cards and standardized testing data to examine high schools’ test scores, enrollment and graduation rates after they experienced shootings, both homicidal and suicidal, using other high schools in the same districts for comparison.

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Their results, which they published in a working paper last May, showed homicidal shootings significantly decrease test scores in math and English among ninth-graders and significantly decrease that grade’s enrollment. The effects were more or less dramatic in accordance with the number of casualties. Suicides did not affect grades or enrollment. Additionally, separate student-level data restricted to California confirmed shootings lowered test results for students who remain enrolled, the researchers found.

Crisis response experts say it’s important teachers are aware of that and go easy on students.

The 2007 shooting at Virginia Tech, in which 33 people including the shooter were killed, happened during the spring semester. Afterward, many professors didn’t require the students to complete their finals, said Susan Silk, a Southfield, Michigan-based crisis response expert who provided counseling for victims after that shooting.

“We helped them to know that they weren’t wimping out,” she said. “We helped the parents to know that this wasn’t an excuse to not study. We helped the teachers know that this is the way this would affect their kids, is that it would be really difficult for them to concentrate and analyze and problem-solve.”

The bad news is those effects won’t go away overnight, Silk said.

“These are going to be unpleasant sensations that you’re going to be experiencing for a while because you were in a very dangerous, very scary situation,” she said. “The good news is that these will go away over time.”

Pearson, the Thurston survivor, was a junior when the shooting took place. He found it very hard to focus for the rest of that school year. “I’m not really sure I even accomplished any schoolwork.”

Luckily, his teachers were understanding. They let him leave class if things got overwhelming, and some even set up tables in the back of the room so he could lie down instead of stand. His injury didn’t allow him to sit.

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Today, Pearson is married and has seven kids, all from previous relationships. He earned an associate degree from a technical college and works as a medical courier, although he said he’d like to be doing something else.

Like Hensley, Pearson said he prefers not to talk or think about the shooting at Thurston High School. He has a keepsake chest full of mementos from the event — get-well cards, teddy bears, newspaper clippings — that he pulls out whenever friends or his kids ask about it.

“It saves me from having to do too much talking,” he said.

On rare occasions, he pulls it out and shuffles through it, just to get a fresh look.

Stirring up old wounds

Austin, the school counselor who works in the same district as Columbine, has worked with kids in a number of difficult situations. At one school she worked at, there were several suicides in a row. After the third one, a big, burly football player sat down across from her in her office.

“He was like the best athlete in school, a very tough kid,” she said. “He started to get tears in his eyes. He said, ‘Ms. Austin, I don’t know any of the three guys. I just don’t know why, but I have tears that are just right here. I’m having a hard time holding it together.’”

Austin and her fellow mental health professionals say it’s important to recognize that after a school shooting, it’s not always the obvious ones — the best friends of those killed or those who were in the same room in which the killings took place — who will need the most help. Sometimes, it’s those who perhaps weren’t at school that day or who didn’t know anyone involved. For them, the incident can stir up the remnants of unresolved trauma that occurred years ago.

“A lot of times adults — teachers, parents, whatever — will say, ‘Well, this particular kid doesn’t need to miss my math class because she didn’t know the person who died,’” said Carol Palmer, a licensed professional counselor and registered nurse in Bend who has taught others about responding to death and psychological trauma.

Rather than say that, it’s important every student who needs to has the opportunity to, say, retreat from class and go to an activity room that’s set up after a traumatic event, she said. There, she said counselors can learn what’s going on with them.

“What you find out is other concerns,” said Palmer, Lovre’s sister. “Other students about whom they’re concerned or maybe that they themselves have felt suicidal or that things at home are very scary.”

Palmer was among the counselors who worked with Bend High School students after 17-year-old Zachary Leyes fatally shot himself in a modular classroom in February 2014. Counselors at the school the following Monday supported about 250 students, she said.

“We go to great lengths to tell people that psychological trauma is something that is palpable, usually curable, but that almost no one gets through it without some professional help,” Palmer said. “So with the Bend High response, we made great effort to let everyone on the staff, all of the students and their parents know that if they were having unsettling experiences as a result of this, that help was available.”

The modular classroom was later torn down and disposed of, Palmer said.

“If there is any one gift in modular classrooms, that’s it,” she said. “You can hook that bugger up to a tractor and drive it to the dump.”

In the case of the football player, Austin implored him to think about any other times he had felt this way or lost anyone. He said he couldn’t think of anything. She told him to think back to when he was a little boy. Had he lost a pet?

That’s when he told her his dog had died when he was 8. He and his dad were burying it in the backyard and when he started crying, his dad had said, ‘Quit crying! Big boys don’t cry. You grab that shovel and help me bury this dog,’ Austin said. Two years later, his parents had divorced, he wasn’t seeing his dad and he went fishing every weekend with his grandfather. When his grandfather died at the end of that summer, he sat next to his mother at the funeral. She was crying.

“He thought, ‘I’ve got to be strong for mom now. I can’t cry,’” Austin said. “That’s when the floodgate opened up. I said, ‘So you’ve never been able to work through that?’ He said, ‘No.’”

{%qc-When I hear about them, it reminds me of the shooting I was in. It makes me feel empathetic and sympathetic towards them because I know what they’re going through. %em Joshua Pearson, following the shooting at Umpqua Community College in Roseburg%}

Even today, both Pearson and Hensley are taken back to that day at Thurston High School when they learn about new shootings. Both have their own ways of protecting themselves against those dark, familiar feelings that always seem to trickle in. Pearson said he avoids the news altogether, while Hensley said she has avoided Facebook all day on Thurston shooting anniversaries.

Neither, however, could avoid news of the Oct. 1, 2015, shooting at Umpqua Community College in Roseburg, a little over an hour south of their former high school. Nine students were fatally shot and nine others injured.

Pearson said the news hit him pretty hard. He thought about going to Roseburg to help out however he could but ultimately wasn’t able to.

“When I hear about them, it reminds me of the shooting I was in,” he said. “It makes me feel empathetic and sympathetic towards them because I know what they’re going through.”

‘Not the new normal’

The day Terri Roberts and her husband buried their son, the last people they expected to see were their Amish neighbors.

Their son, 32-year-old Charlie, had days earlier stormed into a one-room schoolhouse in the Amish community of Nickel Mines in Pennsylvania, sealed the windows and doors, tied up the schoolgirls and, one by one, shot all 10 of them, killing five. He then turned the gun on himself.

Dozens from the Amish community came to the funeral. They lined up to form a crescent shape around the Roberts family to protect them from the swarm of reporters and news cameras waiting from the road. The two people who first came to greet Roberts and her husband were the parents who had lost not one but two daughters at the hands of their son.

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Roberts says the community’s reaction to her son’s horrific crime was extremely healing and gave her hope for the future. “It was hard for people to hold bitterness and hatred inside against our son when the very folks that his crime had been committed against were willing to show forgiveness and love and reach out to us,” she said.

The shooting was in 2006. Today, Roberts — 64 years old and living about 6 miles from Nickel Mines — is battling stage 4 breast cancer. She still regularly visits Rosanna, the youngest of her son’s victims, who remains tube-fed and wheelchair-bound from her injuries.

Finding forgiveness will become increasingly important for communities following such incidents, Roberts said. She believes others should learn from her Amish neighbors.

“Forgiveness is a choice, and it frees us,” she said. “That’s a message I want the world to have. We have a lot of bitterness, hatred, retribution, anger and things that are not moving us forward.”

Silk, the crisis response expert in Michigan who responded to the Virginia Tech shooting, said the way communities respond to shootings can have dramatic impacts on how individuals heal. She saw that in Blacksburg, Virginia, after the shooting at the technical college there.

“It had a very strong identity, a very strong sense of itself,” she said. “I think as with anyone who is a victim of violence, your predisposition — your previous history — has everything to do with how strong you will be in your resilience and your response.”

In Blacksburg, a city of about 43,000, the students, faculty members and administrators knew each other well and were comfortable with one another, which made it easier for them to accept and provide support, Silk said. It’s harder for people to lower their defenses and accept support from strangers when they’re already in distress.

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Roseburg, home to UCC, is half the size of Blacksburg. Silk said the community presumably benefited from a similar level of support across students, school personnel and community members.

Following the shooting on the Virginia Tech campus, Silk saw students gathering on the campus lawn in the warm spring weather hugging and linking arms. Older students tend to seek emotional reassurance from their classmates, she said.

“I think that’s what they needed,” she said. “Very often when something like this happens, people don’t isolate. They want security and comfort from one another.”

She saw her role there, then, as letting people know what reactions to expect. She printed them on fliers and handed them out. She hung them up around the campus. In big, bold text, they said, “Abnormal reactions are a normal reaction to an abnormal situation.”

They warned students they may have trouble sleeping. That it may be hard to concentrate. That they may not want to be alone. That’s an important lesson, she said, because on Monday, they may have been living their lives without any of those symptoms. Then on Tuesday, something catastrophic happens. On Wednesday, they feel terrible.

“But that’s not the new normal,” she said. “That’s a temporary aberration and you will go back to how you were feeling on Monday.” •