But there’s actually some ambivalence about the parade’s absence in Kansas City. The celebration of the Chiefs’ win last year ended with a mass shooting that killed one person and injured at least 24 more. 

I’ve been talking to the survivors since then with my colleague Peggy Lowe at KCUR for a series we call “The Injured.” They’ve told us all about their lives since the shooting: about being left off the official list of victims, about doctors leaving bullets in their bodies, about the financial hardship of surviving, about the mental toll on the children who were shot, and about their efforts to restore a sense of safety in a society where gun violence is rampant. 

This week we published one last story about what therapists call the “thawing” of survivors. Many people who experience trauma emotionally freeze as a coping mechanism. But with time, that freeze melts, and the intensity of what happened to them can be suddenly overpowering. 

“Trauma pulls us into the past,” Gary Behrman told me. He’s a therapist who worked with witnesses of the 9/11 attacks in New York. 

Sights, smells, sounds, tastes, and touches can all trigger flashbacks that shut down the brain like an overloaded circuit breaker. The survivors in Kansas City told us about being triggered by loud noises, large crowds, and seeing police officers who remind them of the first responders at the shooting. 

And the shooting happened at a cultural institution, Union Station, so many survivors found themselves back there unexpectedly. Kids had field trips to a science center inside. Follow-up doctor visits were often on nearby Hospital Hill. An October dinner organized for survivors was less than a mile away, prompting one young survivor to decline the invitation. 

One survivor told me about a date she went on in December in downtown Kansas City. She doesn’t know the city well — she lives in Leavenworth, Kansas — so she was shocked to look up and see the intersection where a bullet ripped through her leg. 

“Oh f—,” she told her date, fighting tears and a panic attack until the station was out of view. 

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“Oh, c…”, dijo Tavis, desconcertando a su cita.

Tavis vive a 35 millas de distancia, en Leavenworth, Kansas, y todavía no había vuelto a Union Station, donde ocurrió el tiroteo masivo. Sintió ganas de llorar. O tal vez fue un ataque de pánico. Levantó un dedo para indicarle a su cita que necesitaba un momento. Fue entonces cuando él entendió lo que estaba pasando.

“Oh, ni siquiera me di cuenta”, dijo, y siguió conduciendo en silencio.

Tavis contuvo las lágrimas hasta que la estación desapareció de su vista.

“Ok…”, dijo en voz alta, mientras pensaba para sí misma, “bien. Ataque de pánico, primera cita”.

Un año después del tiroteo del 14 de febrero que mató a una persona e hirió al menos a 24, los sobrevivientes y sus familias todavía están conmocionados.

Las relaciones se han tensionado. Los padres están preocupados por sus hijos. El generoso apoyo financiero y los buenos deseos que recibieron en los primeros días ya se han agotado. Y tienen sentimientos encontrados sobre el equipo al que siguen vitoreando: mientras los Chiefs avanzaban hacia otro Super Bowl, muchos se preguntaban por qué su amado equipo parecía ni haber advertido lo que todos estaban pasando.

“No puedo creer que los Chiefs no hayan hecho nada por nosotros”, dijo Jacob Gooch Sr., quien recibió un disparo en el pie. El equipo, la fundación de la familia propietaria y la Liga Nacional de Fútbol Americano (NFL) donaron un total de $200.000 a un fondo para sobrevivientes, pero Gooch dijo que nadie de la organización se acercó a su familia, tres de los cuales recibieron disparos.

Lo que les está sucediendo a estas familias no es nada inusual. Muchos sobrevivientes se “paralizan” emocionalmente como un mecanismo de afrontamiento para evitar sentir por completo el trauma que sufrieron. Pero, con el tiempo, experimentan lo que los terapeutas llaman “descongelamiento”, y la intensidad de lo que sucedió puede volver a dominarlos de repente como le pasó a Tavis.

“El trauma nos lleva al pasado”, dijo Gary Behrman, terapeuta que publicó un modelo de intervención en crisis basado en su trabajo con testigos de los ataques del 11 de septiembre en Nueva York.

Las imágenes, los olores, los sonidos, los sabores y el tacto pueden desencadenar flashbacks que apagan el cerebro como un disyuntor sobrecargado. Es una respuesta de supervivencia, el cerebro es un amigo, dijo Behrman.

La clave para la recuperación es ayudar a los sobrevivientes a encontrar formas saludables de manejar esos desencadenantes, cuando estén listos.

Los sobrevivientes se “descongelan” a su propio ritmo. Recuperar el control después de un evento potencialmente mortal es un proceso que puede llevar semanas, meses o años.

Puede ser fácil sentirse olvidado cuando la vida continúa alrededor. Mientras los fanáticos se juntaban en torno a los Chiefs esta temporada, a los sobrevivientes les resultó difícil ver los juegos. Los Chiefs perdieron ante los Philadelphia Eagles en el Super Bowl del domingo 9 de febrero. Philadelphia celebra su propio desfile el viernes 14, exactamente un año después del tiroteo.

“Es una lástima porque todos los demás siguieron adelante”, dijo Jason Barton.

Barton le practicó resucitación a un hombre que ahora cree que era uno de los presuntos tiradores, su esposa encontró un proyectil de bala en su mochila y su hijastra se quemó con las chispas de una bala que rebotó.

“Si hubiéramos estado al otro lado de ese lugar”, dijo. “No nos habría afectado”.

Viaje de regreso a Union Station

Tavis no es la única sobreviviente que se encontró sin querer en Union Station un año después del tiroteo.

Los niños hicieron excursiones a Science City, ubicado dentro de la estación. Las visitas médicas de seguimiento se realizaban a menudo en vecino Hospital Hill. Una cena de octubre organizada para sobrevivientes por un grupo religioso local estaba a menos de una milla de distancia: una joven sobreviviente rechazó la invitación.

Tavis había planeado regresar a Union Station como parte de su proceso de curación. Pensó que iría cuando se cumpliera un año para tener un momento a solas y sentir las emociones que la invadieran.

Tal vez Dios le estaba mostrando que estaba lista al colocarla allí inesperadamente, le dijo su terapeuta. Tal vez. Pero ella no se sentía lista en ese momento. Quiso ver a un terapeuta justo después del tiroteo. Pero no buscó uno hasta julio, después que la United Way local distribuyera la asistencia financiera a los sobrevivientes y aliviara la tensión económica de meses de trabajo perdido y facturas médicas.

Tavis y su pareja en ese momento habían sacado una tarjeta de crédito adicional para cubrir los gastos mientras esperaban la ayuda prometida.

Después de dos meses de visitas, su terapeuta comenzó a preparar a Tavis para la desensibilización y reprocesamiento del movimiento ocular, una técnica para ayudar a los sobrevivientes de traumas. Ahora, sesión por medio, revisa una hoja de recuerdos del desfile, visualizándolos y reprocesándolos uno por uno.

Está nerviosa porque se acerca el año de aniversario. Es el día de San Valentín y le preocupa que sea deprimente.

Decidió invitar a Gooch, su ex pareja, a que la acompañara a Union Station ese día. Con todo lo que han pasado, él entiende. Estaban en el desfile junto con su hijo y los dos hijos mayores de Jacob. Gooch Sr. y su hijo mayor, Jacob Gooch Jr., recibieron disparos.

El trauma cambia quiénes somos

Gooch Sr. no ha trabajado desde el desfile. Su trabajo requería estar de pie durante turnos de 10 horas cuatro días a la semana, pero no pudo caminar durante meses después de que una bala le destrozara un hueso del pie y se le volviera a fusionar lentamente.

Esperaba volver a trabajar en julio, pero su pie no sanó correctamente y tuvo que operarse en agosto, a lo que siguieron semanas de recuperación.

La cobertura por discapacidad se agotó, al igual que su seguro médico a través del trabajo. Su empleador mantuvo su trabajo durante un tiempo antes de despedirlo en agosto. Ha buscado otros empleos en Leavenworth y sus alrededores: producción, agencias de personal, reparación de automóviles. No ha conseguido nada.

“Todos hemos pasado por problemas, no solo yo”, dijo Gooch Sr. “Me dispararon en el pie y no he trabajado durante un año. Hay gente que ha pasado por cosas mucho peores durante el último año”.

Ahora se siente bien al caminar y puede correr distancias cortas sin dolor. Pero no sabe si alguna vez volverá a jugar al fútbol americano, un pilar de su vida desde que tiene memoria. Jugó como safety para los Kansas City Reapers, un equipo semi profesional, y, antes del desfile, el jugador de 38 años estaba considerando que la de 2024 fuera su última temporada como jugador.

“Me han robado mucho más que el fútbol americano en este último año. Como si me hubieran robado toda mi vida”, dijo Gooch Sr. “Realmente odio esa parte”.

Y esas emociones son dolorosamente reales. El trauma amenaza nuestras creencias sobre nosotros mismos, dijo el terapeuta Behrman. Cada persona carga su propia historia a un evento traumático, una identidad diferente que corre el riesgo de ser destrozada. El trabajo de sanación que viene después a menudo implica dar vuelta la página, y construir algo nuevo.

Recientemente, Gooch Sr. comenzó a ir a una nueva iglesia, dirigida por el esposo de alguien con quien cantó en un coro cuando era niño. En un servicio dominical de este mes, el pastor habló sobre encontrar un camino cuando uno está perdido.

“Estoy buscando el camino. Estoy en el campo ahora mismo”, dijo Gooch Sr. en su casa más tarde esa noche.

“Obviamente estoy en un camino, pero no sé hacia dónde voy”.

“Hice lo mejor que pude”

Todos los días antes de que Jason Barton se vaya a trabajar, le pregunta a su esposa, Bridget, si debería quedarse en casa con ella.

Ella ha dicho que sí lo suficiente como para que se le acabara el tiempo libre remunerado. Jason, que ha sobrevivido al cáncer y a un ataque cardíaco, tuvo que tomarse una licencia sin goce de sueldo en enero cuando un caso grave de gripe lo llevó al hospital. Eso es amor verdadero, dijo Bridget con lágrimas en los ojos, sentada con Jason y su hija de 14 años, Gabriella, en su casa en Osawatomie, Kansas.

Bridget se ha conectado con la madre de otra niña herida en el tiroteo. Han intercambiado mensajes de texto y de voz durante todo el año. Bridget dijo que es bueno tener a alguien con quien hablar que entienda. Tienen la esperanza de reunir a las niñas para que también construyan una conexión.

Con excepción de ir a terapia una vez por semana, Bridget ya no sale mucho de casa. Puede sentirse como una prisión, dijo, pero tiene demasiado miedo de salir. “Es mi propio infierno interno”, dijo. No deja de pensar en esa bala que se alojó en su mochila. ¿Qué hubiera pasado si hubiera estado parada de otra manera? ¿Qué hubiera pasado si se hubieran ido 10 segundos antes? ¿Las cosas serían diferentes?

Una nota adhesiva en su cocina le recuerda: “Estoy a salvo. Gabriella está a salvo. Hice lo mejor que pude”.

Siente mucha culpa. Por Jason quedándose en casa. Por no salir de casa, ni siquiera para ver a sus nietos. Por querer que la familia fuera al desfile en primer lugar. Al mismo tiempo, sabe que de alguna manera prosperó en el caos después del tiroteo, haciéndose cargo de su hija, hablando con la policía. Todo es confuso.

La familia ha sobrellevado el trauma de manera diferente.

En los seis meses posteriores al desfile, Jason vio reality shows que lo mantenían distraído: 23 temporadas de “Deadliest Catch” y 21 temporadas de “Gold Rush”, incluidos los spin-offs, según calculó.

Últimamente ha mantenido su mente ocupada con un nuevo pasatiempo: construir modelos de autos y aviones. Acaba de terminar un Shelby Mustang negro de 1968, y lo próximo es un avión F4U-4 Corsair que Bridget le regaló.

Gabriella pudo regresar a Union Station para una excursión escolar a Science City, pero se sobresaltó cuando vio a un grupo de policías dentro de la estación. Su madre veía en dónde estaba por el celular, y le envió mensajes de texto durante todo el día.

Después del desfile, Gabriella comenzó a practicar boxeo, luego se pasó a la lucha libre. Le había ido bien, incluso se sentía empoderada. Pero dejó de ir, y Bridget cree que se debe en parte a la emoción del aniversario: el primero siempre es el más difícil, dijo su terapeuta. Gabriella insistió en que la lucha libre la estaba agotando.

Como no les dispararon, la familia no se benefició de los recursos disponibles para otros sobrevivientes. Entienden que otras familias se están recuperando de heridas de bala o incluso están de luto por una muerte.

Aun así, sería bueno que se reconociera de alguna manera su trauma emocional. Sus nombres han estado en las noticias. Uno pensaría que los Chiefs al menos habrían enviado una carta.

Jason dijo: “Lamentamos que esto te haya pasado”.

Jason le propuso matrimonio a Bridget en un partido de los Chiefs. Ahora, ver los partidos por televisión desencadena recuerdos.

“Quiero volver a ser parte del Reino de los Chiefs”, dijo Bridget, “pero no puedo. Y ese es un sentimiento enorme y muy solitario”.

“Hay una palabra llamada ‘resiliencia’”

Una noche del pasado octubre, los sobrevivientes se reunieron con sus familias en un restaurante mexicano en el centro de Kansas City.

Algunos vinieron vestidos con sus mejores galas, otros con camisetas rojas de fútbol americano. De todas las edades, desde niños pequeños hasta personas de 70 y tantos años, algunos de Missouri, algunos de Kansas. Algunos hablaban solo español, algunos solo inglés. La mayoría de las dos docenas de personas nunca se habían visto antes. Pero mientras hablaban, descubrieron que el tiroteo que los une también les dio un lenguaje común.

Dos niños pequeños se dieron cuenta de que habían lanzado una pelota de fútbol durante el jubileo antes de que estallara la violencia. Una mujer de unos 70 años llamada Sarai Holguín recordó haberlos visto jugar en ese cálido día de febrero. Después de una bendición y una cena, Holguín, que recibió un disparo en la rodilla y ha sido sometida a cuatro cirugías, se puso de pie para dirigirse a la sala.

“Fui la primera víctima que llevaron a la carpa médica”, dijo en español, sus palabras traducidas por un familiar de otro sobreviviente. Ella vio todo, explicó, mientras, uno por uno, más sobrevivientes eran trasladados a la carpa para recibir tratamiento, incluida Lisa López-Galván, una madre de 43 años que fue asesinada ese día.

Sin embargo, en esa tragedia, Holguín vio la belleza de la gente que se ayuda entre sí.

“Esto nos mostró que la humanidad todavía está viva, que el amor todavía está vivo. Hay una palabra que se llama ‘resiliencia’”, dijo Holguín. Mientras el traductor se esforzaba por entender la última palabra, la gente del público la captó y la gritó: “Resiliencia”.

“Esta palabra nos ayuda a superar los problemas que enfrentamos”, dijo Holguín. “Para tratar de dejar atrás el momento trágico que todos vivimos y seguir adelante, debemos recordar los momentos hermosos”.

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Emily Tavis was on a first date in December when she looked up and realized they were driving past the downtown Kansas City, Missouri, intersection where a bullet ripped through her leg at last year’s Super Bowl victory parade.

“Oh f—,” Tavis said, bewildering her date.

She lives 35 miles away in Leavenworth, Kansas, and hadn’t yet returned to Union Station, where the mass shooting happened. She felt like crying. Or maybe it was a panic attack. She held up a finger signaling to her date that she needed a moment. That’s when it hit him, too.

“Oh crap, I didn’t even realize,” he said, and kept driving in silence.

Tavis sucked in her tears until the station was out of view.

“So anyway,” she said aloud, while thinking to herself, “way to go. Panic attack, first date.”

A year after the Feb. 14 shooting that killed one and injured at least 24 people, the survivors and their families are still reeling. Relationships have strained. Parents are anxious about their children. The generous financial support and well wishes that poured through in early days have now dried up. And they’re ambivalent about the team they all root for; as the Chiefs moved on to another Super Bowl, many wondered why their beloved team hasn’t acknowledged what they have all been going through.

“I can’t believe the Chiefs didn’t do anything for us,” said Jacob Gooch Sr., who was shot in the foot. The team, the owner family’s foundation, and the National Football League gave a combined $200,000 to a fund for survivors, but Gooch said no one from the organization reached out to his family, three members of whom were shot.

What’s happening to these families is far from unusual. Many survivors emotionally freeze as a coping mechanism to avoid fully feeling the trauma they suffered. But with time, survivors experience what therapists call “thawing,” and the intensity of what happened can suddenly overpower them like it did Tavis.

“Trauma pulls us into the past,” said Gary Behrman, a therapist who published a model of crisis intervention based on his work with witnesses of the 9/11 attacks in New York.

Sights, smells, sounds, tastes, and touches can all trigger flashbacks that shut down the brain like an overloaded circuit breaker. It’s a survival response, Behrman said; the brain is a friend.

The key to recovery is to help survivors find healthy ways to manage those triggers — when they are ready.

Survivors thaw at their own pace. Regaining control after a life-threatening event is a process that can take weeks, months, or years.

It can be hard not to feel forgotten when life carries on around them. As fans rallied around the Chiefs this season, survivors found it hard to watch the games. The Chiefs lost to the Philadelphia Eagles in Sunday’s Super Bowl. Philadelphia will hold its own parade on Friday, exactly one year after the shooting.

“It sucks because everybody else went on,” Jason Barton said. He performed CPR on a man he now thinks was one of the alleged shooters, his wife found a bullet slug in her backpack, and his stepdaughter was burned by sparks from a ricocheted bullet.

“If we were on the other side of that place, we would too,” he said. “It wouldn’t have affected us.”

A Trip Back to Union Station

Tavis isn’t the only survivor to have found herself unintentionally back at Union Station in the year since the shooting. Kids had field trips to Science City, located inside the station. Follow-up doctor visits were often on nearby Hospital Hill. An October dinner organized for survivors by a local faith-based group was less than a mile away, prompting one young survivor to decline the invitation.

Tavis had planned to return to Union Station as part of her healing process. She thought she would go on the one-year mark to have a moment alone to feel whatever emotions swept over her there.

Maybe God was showing her she was ready by placing her back there unexpectedly, her therapist told her. Maybe. But she didn’t feel ready in that moment.

Tavis wanted to see a therapist right after the shooting. But she didn’t seek one out until July, after the local United Way distributed financial assistance to survivors and relieved the months-long financial strain of lost work and medical bills incurred by many. Tavis and her partner at the time had taken out an extra credit card to cover expenses while they waited for the promised help.

After two months of visits, her therapist started prepping Tavis for eye movement desensitization and reprocessing, a technique to help trauma survivors. She now spends every other session making her way through a spreadsheet of memories from the parade, visualizing and reprocessing them one by one.

She’s nervous as the one-year mark approaches. It’s on Valentine’s Day, and she worries it’ll be depressing.

She decided to invite Gooch, her former partner, to come to Union Station with her that day. Despite everything, he’s the one who understands. They were at the parade together with their son and Jacob’s two older kids. Both Gooch Sr. and his older son, Jacob Gooch Jr., were also shot.

Trauma Changes Who We Are

Gooch Sr. hasn’t worked since the parade. His job required standing for 10-hour shifts four days a week, but he couldn’t walk for months after a bullet shattered a bone in his foot and it slowly fused back together. He hoped to go back to work in July. But his foot didn’t heal correctly and he had surgery in August, followed by weeks of recovery.

His short-term disability ran out, as did his health insurance through work. His employer held his job for a while before releasing him in August. He’s applied for other jobs in and around Leavenworth: production, staffing agencies, auto repair. Nothing’s come through.

“We’ve all gone through problems, not just me,” Gooch Sr. said. “I got shot in my foot and haven’t worked for a year. There are people that have been through much worse stuff over the past year.”

He feels good walking now and can run short distances without pain. But he doesn’t know if he’ll ever play football again, a mainstay of his life since he can remember. He played safety for the semiprofessional Kansas City Reapers and, before the parade, the 38-year-old was considering making the 2024 season his last as a player.

“A lot more than football has been stolen from me in this last year. Like my whole life has been stolen from me,” Gooch Sr. said. “I really hate that part of it.”

And those emotions are painfully real. Trauma threatens our beliefs about ourselves, said Behrman, the therapist. Every person brings their own history to a traumatic event, a different identity that risks being shattered. The healing work that comes later often involves letting go and building something new.

Recently Gooch Sr. started going to a new church, led by the husband of someone he sang with in a children’s choir growing up. At a Sunday service this month, the pastor spoke about finding a path when you’re lost.

“I’m looking for the path. I’m in the grass right now,” Gooch Sr. said at his home later that evening.

“I’m obviously on a path, but I don’t know where I’m headed.”

‘I Did the Best I Could’

Every day before Jason Barton goes to work, he asks his wife, Bridget, if he should stay home with her.

She’s said yes enough that he’s out of paid time off. Jason, who’s survived cancer and a heart attack, had to take unpaid leave in January when a bad case of the flu put him in the hospital. That’s real love, Bridget said with tearful eyes, sitting with Jason and her 14-year-old daughter, Gabriella, in their home in Osawatomie, Kansas.

Bridget has connected with the mother of another girl injured in the shooting. They’ve exchanged texts and voicemails throughout the year. It’s nice to have someone to talk to who gets it, Bridget said. They’re hoping to get the girls together to build a connection as well.

Except for a trip to therapy once a week, Bridget doesn’t leave the house much anymore. It can feel like a prison, she said, but she’s too scared to leave. “It’s my own internal hell,” she said. She keeps thinking about that bullet slug that lodged in her backpack. What if she’d been standing differently? What if they’d left 10 seconds earlier? Would things be different?

A Post-it note in her kitchen reminds her: “I’m safe. Gabriella is safe. I did the best I could.”

She carries a lot of guilt. About Jason staying home. About not leaving the house, even to see her grandkids. About wanting the family to go to the parade in the first place. At the same time, she knows she kind of thrived in the chaos after the shooting, taking charge of her daughter, talking to the police. It’s confusing.

The family has carried the trauma differently. In the six months after the parade, Jason watched reality TV shows that kept him out of his head — 23 seasons of “Deadliest Catch” and 21 seasons of “Gold Rush,” including spinoffs, he estimated. Lately he’s kept his mind occupied with a new hobby: building model cars and planes. He just finished a black 1968 Shelby Mustang, and next is an F4U-4 Corsair plane that Bridget got him.

Gabriella was unfazed about returning to Union Station for a class field trip to Science City, but she was startled when she saw a group of police officers inside the station. Her mom watched her location on her phone and texted her all day.

Gabriella took up boxing after the parade, then switched to wrestling. It had been going well, even felt empowering. But she’s stopped going, and Bridget thinks it’s partly due to the emotion of the anniversary — the first is always the hardest, her therapist said. Gabriella insisted that wrestling was just exhausting her.

Because they weren’t shot, the family didn’t benefit from resources available to other survivors. They understand that other families are recovering from bullet wounds or even mourning a death.

Still, it would be nice to have some acknowledgment of their emotional trauma. Their names have been in the news. You’d think the Chiefs would have at least sent a letter saying, “We’re sorry this happened to you,” Jason said.

Jason proposed to Bridget at a Chiefs game. Now watching games on TV triggers flashbacks.

“I want to be a part of Chiefs Kingdom again,” Bridget said, “but I just can’t. And that is a huge, really lonely feeling.”

‘There Is a Word Called “Resilience”’

One evening last October, survivors gathered with their families at a Mexican restaurant in downtown Kansas City.

Some came dressed in their Sunday best, some in red football jerseys. All ages, toddlers to 70-somethings, some from Missouri, some from Kansas. Some spoke only Spanish, some only English. Most of the two dozen people had never met before. But as they talked, they discovered the shooting that binds them also gave them a common language.

Two young boys realized they’d tossed a football during the jubilation before the violence erupted. A woman in her early 70s named Sarai Holguin remembered watching them play on that warm February day. After a blessing and dinner, Holguin, who was shot in the knee and has had four surgeries, stood to address the room.

“I was the first victim taken to the medical tent,” she said in Spanish, her words translated by a relative of another survivor. She saw everything, she explained, as, one by one, more survivors were brought to the tent for treatment, including Lisa Lopez-Galvan, a 43-year-old mother who was killed that day.

Yet in that tragedy, Holguin saw the beauty of people helping one another.

“This showed us that humanity is still alive, that love is still alive. There is a word called ‘resilience,’” Holguin said, the translator stumbling to understand the last word, as people in the audience caught it and shouted it out. “Resilience.”

“This word helps us overcome the problems we face,” Holguin said. “To try to put the tragic moment we all lived behind us and move on, we must remember the beautiful moments.”

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That seeming contradiction is slated to come to a head this year. People on polar sides of the abortion debate are preparing to fight over how far the protection for abortion extends, and the final say will likely come from the seven-person state Supreme Court. With the arrival of new Chief Justice Cory Swanson, who ran as a judicial conservative for the nonpartisan seat and was sworn in Jan. 6, the court now leans more conservative than before the election.

A similar dynamic is at play elsewhere. Abortion rights supporters prevailed on ballot measures in seven of the 10 states where abortion was up for a vote in November. But even with new voter-approved constitutional protections, courts will have to untangle a web of existing state laws on abortion and square them with any new ones legislators approve. The new makeup of supreme courts in several states indicates that the results of the legal fights to come aren’t clear-cut.

Activists have been working to reshape high courts, which in recent years have become the final arbiters of a patchwork of laws regulating abortions. That’s because the 2022 U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturned federal abortion protections, leaving rulemaking to the states.

Since then, the politics of state supreme court elections have been “supercharged” as fights around abortion shifted to states’ top courts, according to Douglas Keith, a senior counsel at the nonpartisan Brennan Center for Justice.

“Because we’re human, you can’t scrub these races of any political connotations at all,” said former Montana Supreme Court Justice Jim Nelson. “But it’s getting worse.”

The wave of abortion litigation in state courts has spawned some of the most expensive state supreme court races in history, including more than $42 million spent on the nonpartisan 2023 Supreme Court race in Wisconsin, where abortion access was among the issues facing the court. Janet Protasiewicz won the seat, flipping the balance of the court to a liberal majority.

In many states, judicial elections are nonpartisan but political parties and ideological groups still lobby for candidates. In 2024, abortion surfaced as a top issue in these races.

In Michigan, spending by non-candidate groups alone topped $7.6 million for the two open seats on the state Supreme Court. The Michigan races are officially labeled as nonpartisan, although candidates are nominated by political parties.

An ad for the two candidates backed by Democrats cautioned that “the Michigan state Supreme Court can still take abortion rights away” even after voters added abortion protections to the state constitution in 2022. The ad continued, “Kyra Harris Bolden and Kimberly Thomas are the only Supreme Court candidates who will protect access to abortion.” Both won their races.

Abortion opponent Kelsey Pritchard, director of state public affairs for Susan B. Anthony Pro-Life America, decried the influence of abortion politics on state court elections. “Pro-abortion activists know they cannot win through the legislatures, so they have turned to state courts to override state laws,” Pritchard said.

Some abortion opponents now support changes to the way state supreme courts are selected.

In Missouri, where voters passed a constitutional amendment in November to protect abortion access, the new leader of the state Senate, Cindy O’Laughlin, a Republican, has proposed switching to nonpartisan elections from the state’s current model, in which the governor appoints a judge from a list of three finalists selected by a nonpartisan commission. Although Republicans have held the governor’s mansion since 2017, she pointed to the Missouri Supreme Court’s 4-3 ruling in September that allowed the abortion amendment to remain on the ballot and said courts “have undermined legislative efforts to protect life.”

In a case widely expected to reach the Missouri Supreme Court, the state’s Planned Parenthood clinics are trying to use the passage of the new amendment to strike down Missouri’s abortion restrictions, including a near-total ban. O’Laughlin said her proposal, which would need approval from the legislature and voters, was unlikely to influence that current litigation but would affect future cases.

“A judiciary accountable to the people would provide a fairer venue for addressing legal challenges to pro-life laws,” she said.

Nonpartisan judicial elections can buck broader electoral trends. In Michigan, for example, voters elected both Supreme Court candidates nominated by Democrats last year even as Donald Trump won the state and Republicans regained control of the state House.

In Kentucky’s nonpartisan race, Judge Pamela Goodwine, who was endorsed by Democratic Gov. Andy Beshear, outperformed her opponent even in counties that went for Trump, who won the state. She’ll be serving on the bench as a woman’s challenge to the state’s two abortion bans makes its way through state courts.

Partisan judicial elections, however, tend to track with other partisan election results, according to Keith of the Brennan Center. So some state legislatures have sought to turn nonpartisan state supreme court elections into fully partisan affairs.

In Ohio, Republicans have won every state Supreme Court seat since lawmakers passed a bill in 2021 requiring party affiliation to appear on the ballot for those races. That includes three seats up for grabs in November that solidified the Republican majority on the court from 4-3 to 6-1.

“These justices who got elected in 2024 have been pretty open about being anti-abortion,” said Jessie Hill, an attorney with the American Civil Liberties Union of Ohio, who has been litigating a challenge to Ohio’s abortion restrictions since voters added protections to the state constitution in 2023.

Until the recent ballot measure vote in Montana, the only obstacle blocking Republican-passed abortion restrictions from taking effect had been a 25-year-old decision that determined Montana’s right to privacy extends to abortion.

Nelson, the former justice who was the lead author of the decision, said the court has since gradually leaned more conservative. He noted the state’s other incoming justice, Katherine Bidegaray, was backed by abortion rights advocates.

“The dynamic of the court is going to change,” Nelson said after the election. “But the chief justice has one vote, just like everybody else.”

Swanson, Montana’s new chief justice, had said throughout his campaign that he’ll make decisions case by case. He also rebuked his opponent, Jerry Lynch, for saying he’d respect the court’s ruling that protected abortion. Swanson called such statements a signal to liberal groups.

At least eight cases are pending in Montana courts challenging state laws to restrict abortion access. Martha Fuller, president and CEO of Planned Parenthood Advocates of Montana, said that the new constitutional language, which takes effect in July, could further strengthen those cases but that the court’s election outcome leaves room for uncertainty.

The state’s two outgoing justices had past ties to the Democratic Party. Fuller said they also consistently supported abortion as a right to privacy. “One of those folks is replaced by somebody who we don’t know will uphold that,” she said. “There will be this period where we’re trying to see where the different justices fall on these issues.”

Those cases likely won’t end the abortion debate in Montana.

As of the legislative session’s start in early January, Republican lawmakers, who have for years called the state Supreme Court liberal, had already proposed eight bills regarding abortion and dozens of others aimed at reshaping judicial power. Among them is a bill to make judicial elections partisan.

Montana Sen. Daniel Emrich, a Republican who requested a bill titled “Prohibit dismembering of person and provide definition of human,” said it’s too early to know which restrictions anti-abortion lawmakers will push hardest.

Ultimately, he said, any new proposed restrictions and the implications of the constitutional amendment will likely land in front of the state Supreme Court.

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Her mother, Maggi Wettstein, remembered fearing it could be a yeast or urinary tract infection, something they had been dealing with during potty training. The urgent care centers around them were closed for the night, so around 10:30 p.m. she decided to take Ryan to the emergency room at Carle Health.

The Medical Procedure

The ER wasn’t very busy when they arrived at 10:48 p.m., Wettstein recalled. Medical records indicate they checked in and she explained Ryan’s symptoms, including an intermittent fever. The toddler was triaged and given a nasal swab test to check for covid-19 and influenza A and B.

Wettstein said they sat down and waited to be called. And they waited.

As Wettstein watched Ryan in the waiting room’s play area, she noticed her daughter had stopped crying.

In fact, she seemed fine.

So Wettstein decided to drive them home. Ryan had preschool the next day, and she figured there was no point keeping her awake for who knew how much longer and getting stuck with a big ER bill.

There was no one at the check-in desk to inform that they were leaving, Wettstein said, so they just headed home to go to bed.

Ryan went to her preschool the next day, and Wettstein said they forgot all about the ER trip for eight months.

Then the bill came.

The Final Bill

$445 for the combined covid and flu test — from an ER visit in which the patient never made it beyond the waiting room.

The Billing Problem: A Healthy Hospital Markup and Standard Insurance Rules

Even though Ryan and her mother left without seeing a doctor, the family ended up owing $298.15 after an insurance discount.

At first, Wettstein said, she couldn’t recall Ryan being tested at all. It wasn’t until she received the bill and requested her daughter’s medical records that she learned the results. (Ryan tested negative for covid and both types of flu.)

While Wettstein said the bill isn’t going to break the bank, it seemed high to her, considering Walgreens sells an at-home covid and flu combination test for $30 and can do higher-quality PCR testing for $145.

Under the public health emergency declared in 2020 for the covid pandemic, insurance companies were required to pay for covid tests without copayments or cost sharing for patients.

That requirement ended when the emergency declaration expired in May 2023. Now, it is often patients who foot the bill — and ER bills are notoriously high.

“That’s a pretty healthy markup the hospital is making on it,” Loren Adler, associate director of the Brookings Institution Center on Health Policy, told KFF Health News when contacted about Ryan’s case.

The rates the insurance companies negotiate with hospitals for various procedures are often based on multipliers of what Medicare pays, Adler said.

Lab tests are one of the few areas in which insurance companies can often pay less than Medicare, he said — the exception being when the test is performed by the hospital laboratory, which is often what happens during ER visits.

Medicare pays $142.63 for the joint test that Ryan received, but the family is on the hook for more than twice that amount, and the initial hospital charge was over three times as much.

The hospital is “utilizing their market power to make as much money as possible, and the insurance companies are not all that good at pushing back,” Adler said. A markup of a few hundred dollars is a drop in the bucket for big insurers. But for the patients who get unexpected bills, it can be a big burden.

Brittany Simon, a public relations manager for Carle Health, did not respond to specific questions but said in a statement, “We follow policies that support the safety and wellbeing of our patients, which includes the initial triage of symptomatic patients to the Emergency Department.”

While Ryan’s family would not have had to pay for a covid test during the public health emergency, it was the family’s insurer, Cigna, that did not have to pay this time, since the family had not yet met a $3,000 yearly deductible.

A Cigna representative did not respond to requests for comment.

The Resolution

Wettstein said she knew she could just pay the bill and be done with it, “but the fact that I never saw a provider, and the fact that it was just for a covid test, is mind-blowing to me.”

She contacted the hospital’s billing department to make sure the bill was correct. She explained what happened and said the hospital representative was also surprised by the size of the bill and sent it up for further review.

“‘Don’t pay this until you hear from me,’” Wettstein remembered being told.

Soon, though, she received a letter from the hospital explaining that the charge was correct and supported by documentation.

Wettstein thought she was avoiding any charges by taking Ryan home without being seen. Instead, she got a bill “that they have verified that I have to pay.”

“Like I said, it’s mind-blowing to me.”

The Takeaway

ERs are among the most expensive options for care in the nation’s health system, and the meter can start running as soon as you check in — even if you check out before receiving care.

If your issue isn’t life-threatening, consider an urgent care facility, which is often cheaper (and look for posted notices to confirm whether it’s actually an urgent care clinic). The urgent care centers near Ryan’s home were closed that evening, but some facilities stay open late or around the clock.

In some ways, Wettstein was lucky. KFF Health News’ “Bill of the Month” has received tips from other patients who left an ER after a long wait without seeing a doctor — and got slapped with a facility fee of over $1,000.

Making the decision about where to go is tough, especially in a stressful situation — such as when the patient is too young to communicate what’s wrong. Trying to figure out what’s going on physically with a 3-year-old can feel impossible.

If you decide to leave an ER without treatment, don’t just walk out. Tell the triage nurse you’re leaving. You might get lucky and avoid some charges.

Wettstein won’t think twice about taking Ryan to the pediatrician or an urgent care center the next time she’s ailing. But, Wettstein said, after getting this bill, “I’m not going to create a habit out of going to the emergency room.”

Bill of the Month is a crowdsourced investigation by KFF Health News and The Washington Post’s Well+Being that dissects and explains medical bills. Since 2018, this series has helped many patients and readers get their medical bills reduced, and it has been cited in statehouses, at the U.S. Capitol, and at the White House. Do you have a confusing or outrageous medical bill you want to share? Tell us about it!

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But when Alison Dreith, director of strategic partnerships at the Midwest Access Coalition abortion fund, which has helped people from Missouri and 27 other states get abortions, was asked before the results came in how her organization was preparing for logistic changes, she simply said: “We’re not.”

That’s because actual access to abortion in the country remains largely unchanged despite Tuesday’s results. The web of preexisting state laws on abortions could remain in place while they are contested in court, a process that could take months or longer.

States that passed abortion rights amendments in 2022 and 2023 offer a view into the lengthy legal road ahead for abortion policies to take effect. It took nine months after Ohio voters added abortion protections to their state’s constitution for a judge to strike down the state’s 24-hour waiting period for abortions. And some of Michigan’s abortion restrictions, including its 24-hour waiting period, were suspended only in June, 19 months after Michigan voters approved their state’s abortion rights amendment.

Missouri has an extensive set of such rules. Legal abortions had almost ceased even before the state’s ban was triggered by the Dobbs decision. Over three decades, state lawmakers passed restrictions on abortion providers that made it increasingly difficult to operate there. By 2018, only one clinic was providing abortions in the state, a Planned Parenthood affiliate in St. Louis. Anticipating further tightened restrictions, it opened a large facility 20 miles away in Illinois in 2019.

The laws that reduced the number of recorded abortions in the state from 5,772 in 2011 to 150 in 2021 remain on the books, despite the newly passed amendment protecting abortion rights. The state’s two Planned Parenthood affiliates filed a lawsuit Wednesday challenging those laws and requesting a preliminary injunction blocking their enforcement so the groups may resume abortion services in the state when the amendment goes into effect Dec. 5.

The state’s Republican-dominated legislature has attempted to ignore previous voter-passed amendments. After Missouri voters added Medicaid expansion to the state’s constitution in 2020, the state legislature refused to fund the program until a judge ordered the state to start accepting applications, prompting significant delays in enrollment. The state’s presumptive House speaker, Republican Jon Patterson, has said the legislature must respect the outcome of the Nov. 5 ballot measure vote, while others have pledged to bring the issue to voters again.

Abortion services often get talked about like a light switch, according to Kimya Forouzan, principal state policy adviser at the Guttmacher Institute, a nonprofit that supports abortion rights. But the infrastructure needed to provide abortions is not so easy to turn on and off.

North Dakota’s abortion ban was repealed by the courts in September, for example, but the lone provider of abortions in the state before the ban took effect has no plans to return, having moved operations a five-minute drive away to Minnesota.

Check out my full article here.

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Colorado, Maryland, Montana, and New York — states where abortions are already permitted at least until fetal viability — all will add abortion protections to their state constitutions. Nevada voters also favored protections and can enshrine them by passing the measure again in the next general election.

Florida and South Dakota voters, meanwhile, did not pass abortion rights amendments, and Nebraska voters essentially affirmed the state’s existing ban on abortions after the first trimester, while rejecting a measure that would have protected abortions later into pregnancy.

The biggest changes came in Arizona, where, in 2022, abortion was banned after 15 weeks, and in Missouri, which has had a near-total ban. Voters in those states approved constitutional amendments to protect abortion rights through fetal viability, opening the door to overturning those states’ restrictions and increasing access to abortion services.

But when Alison Dreith, director of strategic partnerships at the Midwest Access Coalition abortion fund, which has helped people from Missouri and 27 other states get abortions, was asked before the results came in how her organization was preparing for logistical changes, she said simply: “We’re not.”

That’s because actual access to abortion in the country remains largely unchanged, despite the Nov. 5 results. The web of preexisting state laws on abortions will likely remain in place while they are contested in court, a process that could take months or even years.

Dreith said she doesn’t think many voters understood all that before heading to the polls. “It might not get them the results that they want, especially immediately,” Dreith said.

Further complicating these state results: The election wins of Donald Trump as president-elect and Republicans in the U.S. Senate, giving their party control, have raised the question of whether a national abortion ban will be on the table. Republicans had demurred on the campaign trail. Such a law would take time to enact, too.

The abortion landscape changed dramatically when the U.S. Supreme Court overturned federal abortion protections with its 2022 decision in Dobbs v. Jackson Women’s Health Organization. That left abortion rules up to the states, prompting 14 to enact bans with few exceptions and several others to limit access.

The ruling also led to a raft of ballot measures: Voters in 16 states have now weighed in on abortion-related ballot measures. Thirteen have favored access to abortions in some way. And while the Florida amendment to protect abortion access failed to meet the necessary 60% threshold to pass, it did receive a majority of the vote.

Abortion opponents such as Susan B. Anthony Pro-Life America praised the votes rejecting amendments in Florida and South Dakota and lamented the amendments that passed in states, such as Missouri, with restrictive abortion rules and bans.

“We mourn the lives that will be lost,” Sue Liebel, its director of state affairs, wrote in a statement. “The disappointing results are a reminder that human rights battles are not won overnight.”

States that passed abortion rights amendments in 2022 and 2023 offer a view into the lengthy legal road ahead for abortion policies to take effect. It took nine months after Ohio voters added abortion protections to their state’s constitution for a judge to strike down the state’s 24-hour waiting period for abortions. And some of Michigan’s abortion restrictions, including its own 24-hour waiting period, were suspended only in June, 19 months after Michigan voters approved their state’s abortion rights amendment.

Missouri has an extensive set of such rules. Legal abortions had almost ceased even before the state’s ban was triggered by the Dobbs decision. Over three decades, state lawmakers passed a series of restrictions on abortion providers that made it increasingly difficult to operate there. By 2018, only one clinic was providing abortions in the state, a Planned Parenthood affiliate in St. Louis. Anticipating further tightened restrictions, it opened a large facility 20 miles away in Illinois in 2019.

Those laws that reduced the number of recorded abortions in the state from 5,772 in 2011 down to 150 in 2021 remain on the books, despite the newly passed amendment protecting abortion rights.

Abortion services often get talked about like a light switch, according to Kimya Forouzan, principal state policy adviser at the Guttmacher Institute, a nonprofit that supports abortion rights. But the infrastructure needed to provide abortions is not so easy to turn on and off.

North Dakota’s abortion ban was repealed by the courts in September, for example, but the lone provider of abortions in the state before the ban took effect has no plans to return, having moved operations a five-minute drive away to Minnesota.

And even when clinics quickly ramp up services, the legal wrangling over abortion rules can lead to policy whiplash, with patients caught in the middle.

Georgia’s law banning most abortions after about six weeks spent years in the courts after it passed in 2019. During two brief stretches after the Dobbs decision, once in 2022 and again in 2024, court rulings meant that clinics in the state could provide abortions up to 22 weeks of pregnancy.

Demand for abortion surged during those times, and clinics were able to resume offering services quickly. But when state courts later said the ban should be enforced, those windows slammed shut. During the 2022 period, some patients scheduled for abortions were left sitting in waiting rooms, according to Megan Cohen, medical director of Planned Parenthood Southeast.

The various abortion rights amendments that passed Nov. 5 could also face challenges.

In Missouri, the state’s Republican-dominated legislature has attempted to ignore voter-passed amendments before. After Missouri voters added Medicaid expansion to the state’s constitution in 2020, the state legislature refused to fund the program until a judge ordered the state to start accepting applications, prompting significant delays in enrollment.

The state’s presumptive House speaker, Republican Jon Patterson, has said the legislature must respect the outcome of the Nov. 5 ballot measure vote, while others have pledged to bring the issue to voters again.

In the meantime, Dreith of the Midwest Access Coalition said people seeking abortions in the Midwest will do what they often do in the region for everything from groceries to health care: drive.

“We expect that the resources we need are not in our communities,” Dreith said, “and I think that’s been helpful to us in this crisis.”

KFF Health News’ Renuka Rayasam and Sam Whitehead in Georgia and Arielle Zionts in South Dakota contributed to this report.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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La joven de 20 años y su familia estaban a solo cuatro cuadras de Union Station, en medio de una multitud de fanáticos de los Chiefs que, con camisetas rojas, caminaban hacia la multitudinaria concentración después del desfile en ese cálido Día de San Valentín.

La bala, disparada por unos adolescentes que se peleaban en la calle, lanzó el cuerpo de Cabrera hacia adelante.

Ella tomó a su madre por el hombro y, en pánico, sin decirle una sola palabra, con sus grandes ojos marrones le señaló la pierna que sangraba. Cuando Cabrera estaba siendo atendida en una ambulancia escuchó los informes que resonaban en la radio de la policía.

“Mi madre intentaba subir conmigo a la ambulancia”, contó Cabrera. “Recuerdo que se lo impidieron, le dijeron algo así como: ‘No puedes subir. Puede que haya otras víctimas que tengamos que recoger’”.

El tiroteo que hirió a Cabrera ocurrió minutos antes del que acaparó los grandes titulares ese día y forma parte de los cientos de disparos de armas de fuego que, cada año, hieren o matan a residentes del área de Kansas City.

Esa incesante oleada de violencia con armas de fuego —desde incidentes puntuales hasta tiroteos masivos— ha terminado aniquilando la sensación de seguridad de quienes sobreviven.

Mientras las víctimas y sus familias intentan superar la experiencia y seguir adelante, las referencias a los hechos de violencia armada son inevitables en los medios de comunicación, en sus comunidades y en su propia vida cotidiana.

“Miro a la gente de otra manera”, afirma James Lemons, que también recibió un disparo en el muslo durante el desfile. Ahora, cuando está rodeado de desconocidos, no puede evitar preguntarse si alguno tendrá un arma y si sus hijos están a salvo.

La nueva temporada de la NFL se inauguró aquí con un minuto de silencio por Lisa López-Galván, la única persona asesinada en el desfile del Super Bowl.

Kansas City ha registrado al menos 124 homicidios este año. La policía local afirma que ha habido otras 476 “víctimas heridas con armas de fuego”, es decir, personas que recibieron disparos y sobrevivieron. Y hasta mediados de septiembre habían ocurrido por lo menos 50 tiroteos en escuelas de todo el país.

Toda esta situación está dejando huellas colectivas.

Quienes han sobrevivido a situaciones de este tipo sufren ataques de pánico, tienen una mayor sensación de peligro en grandes aglomeraciones y padecen una profunda ansiedad ante la posibilidad de que irrumpa la violencia en cualquier lugar de Kansas City.

Cada sobreviviente de un tiroteo responde de manera diferente a la violencia armada e incluso a la amenaza de que surja, explicó LJ Punch, cirujano traumatólogo y el fundador de la Bullet Related Injury Clinic en St. Louis.

Para algunos, haber sido baleados significa que siempre se mantendrán alerta, tal vez incluso armados. Otros prefieren alejarse de las armas de fuego para siempre.

“¿Pero qué es lo que todos tienen en común? Que esas personas quieren desesperadamente sentirse seguras”, afirma Punch.

El intento de Cabrera por entender lo que le sucedió la impulsó a colaborar con un legislador local frustrado que busca cambiar las leyes sobre armas, algo que parece casi imposible, ya que la legislación del estado de Missouri prácticamente prohíbe cualquier restricción local sobre armas de fuego.

Enterarse de otros tiroteos por teléfono

En la mente de Cabrera,el 14 de febrero es una película en cámara lenta, que avanza fotograma por fotograma. Y la banda sonora es su propia voz, que habla y habla. Ve a un grupo de adolescentes revoltosos, que corren alrededor de ella y de su familia. Luego, dos estallidos: ¿son fuegos artificiales? Otro estallido. Finalmente, un cuarto.

“Creo que fue entonces cuando entré en shock y agarré a mi madre”, recordó Cabrera. “No le dije nada. Simplemente la miré y sentí  los ojos muy abiertos. Recuerdo que le hice una especie de señal con los ojos para que me mirara la pierna”.

Cabrera cayó al suelo y otros aficionados corrieron a socorrerla, llamaron al 911 y empezaron a cortarle las calzas. Cuatro hombres se quitaron el cinturón para hacerle un torniquete. Recordó que en ese momento pensó que, si perdía el conocimiento, podría morir. Así que habló y habló sin parar. O eso creía.

Uno de los rescatistas le contó más tarde que en realidad ella no dijo ni una sola palabra, ni siquiera cuando él le preguntó cuántos dedos tenía levantados.

“Me dijo que yo tenía los ojos enormes, como naranjas, y que todo lo que hice fue mirar hacia arriba y hacia abajo cuatro veces, porque él tenía cuatro dedos levantados”, dijo Cabrera.

Cabrera recuerda que después la sacaron del servicio de urgencias de University Health para hacerles sitio a otras 12 personas que habían llegado desde el tiroteo que había ocurrido en la manifestación. Ocho de esas personas tenían heridas de bala. En ese momento miró las redes sociales en su teléfono: ¿había otro tiroteo? Era increíble. Finalmente, sus padres la encontraron. Pasó siete días en el hospital.

Cabrera agradece estar viva. Pero ahora se siente inquieta cuando se cruza con grupos de adolescentes insultando y jugando, o cuando ve camisetas rojas de los Chiefs. Oír cuatro estallidos seguidos —algo habitual en su barrio del noreste de Kansas City— hace que a Cabrera se le oprima el pecho y sepa que está por tener un ataque de pánico.

“En mi mente, lo sucedido se repite una y otra vez”, dijo.

¿Una creciente sensación de amenaza?

Aunque el cirujano general de EE.UU. declaró en junio que la violencia con armas de fuego es una crisis de salud pública, en Missouri casi cualquier intento de regular el uso de armas es un fracaso político.

De hecho, hubo una ley estatal de 2021  —firmada en la misma armería de Kansas City donde se compró una de las armas utilizadas en el tiroteo del desfile— que tenía como objetivo prohibir que la policía local aplicara las leyes federales sobre armas de fuego.

Esa ley fue anulada por un tribunal federal de apelaciones en agosto.

Missouri no tiene restricciones respecto de la edad para el uso y la posesión de armas, aunque la ley federal prohíbe en gran medida que los menores lleven pistolas.

Las encuestas realizadas entre los votantes de Missouri muestran su apoyo a que se exijan certificados de antecedentes y se establezcan límites de edad para la compra de armas, pero también revelan que casi la mitad de los encuestados está en contra de que los condados y las ciudades tengan facultades para aprobar sus propias normas sobre armas.

En una comparación por cantidad de habitantes, Kansas City, Missouri, se encuentra entre los lugares más violentos de la nación. En esta ciudad de 510.000 habitantes, entre 2014 y 2023 se produjeron al menos 2.175 tiroteos, que dejaron 1.275 muertos y 1.624 heridos.

Mientras que el año pasado las tasas de homicidio cayeron en más de un centenar de ciudades de todo el país, Kansas City vivió el año más mortífero jamás registrado.

Punch, del Bullet Related Injury Clinic, comparó la violencia con armas de fuego con un brote de una enfermedad que no se enfrenta y se propaga. Según Punch, la postura permisiva del estado hacia las armas de fuego podría agravar la situación en Kansas City, aunque no haya sido el origen del problema.

“Entonces, ¿está pasando algo? ¿La gente se siente cada vez más amenazada?”, se preguntó Punch.

Jason Barton, que creció en Kansas City, está familiarizado con ese tipo de violencia. Ahora, que vive en Osawatomie, Kansas, consideró detenidamente si debía llevar su propia pistola al desfile del Super Bowl como una forma de proteger a su familia.

Al final decidió no hacerlo, suponiendo que si ocurría algo y sacaba un arma, lo detendrían o le dispararían.

Barton reaccionó rápidamente ante el tiroteo, que se produjo justo delante de él y de su familia. Su mujer encontró una bala en su mochila. Su hijastra sufrió quemaduras en las piernas por las chispas de un rebote de bala.

A pesar de que sus peores temores se hicieron realidad, Barton opina que no llevar su arma ese día fue la decisión correcta.

“No es necesario llevar armas a lugares como ése”, afirmó.

Una peligrosa escopeta calibre 12

Los tiroteos masivos pueden deteriorar gravemente la sensación de seguridad de los sobrevivientes, según Heather Martin, ella misma sobreviviente del tiroteo en la secundaria Columbine en 1999.

Martin es cofundadora de The Rebels Project, una organización que brinda apoyo entre pares a quienes han sobrevivido a experiencias traumáticas masivas.

“En los años posteriores al evento es muy común que se intente encontrar la manera de volver a sentirse seguro”, explicó Martin.

James Lemons siempre había sentido recelo de volver a Kansas City, donde había crecido. Incluso llevó su pistola al desfile, pero, a instancias de su esposa, la dejó en el auto. Tenía a su hija de 5 años sobre los hombros cuando una bala le atravesó la parte posterior del muslo. Él impidió que se golpeara contra el suelo cuando caía.

¿Qué iba a hacer realmente con una pistola?

Y, sin embargo, no puede evitar preguntarse “qué hubiera pasado si…”. No puede quitarse de encima la sensación de que no protegió a su familia. Cuando sueña con el desfile, al despertarse, cuenta: “simplemente empiezo a llorar”.

Sabe que aún no lo ha procesado, pero no sabe cómo empezar a hacerlo. Ha puesto toda su energía en la seguridad de su familia.

Este verano compraron dos bulldogs americanos, por lo que ahora hay tres en casa, uno para cada niño. Lemons los describe como “tener un arma sin tener un arma”.

“Tengo un calibre 12 con dientes”, bromea Lemons, “un protector grande y suave”.

La mayoría de las noches sólo logra dormir unas horas de corrido porque se despierta para ver cómo están los niños. Por lo general, suele echarse en el sofá porque es más cómodo para su pierna, que aún se está curando. También porque lo ayuda a evitar las nerviosas patadas de su hija de 5 años, que se acuesta con sus padres desde el desfile.

Estar en el sofá también le asegura que sería él quien interceptara a cualquier intruso que irrumpiera en la casa.

Emily Tavis, que recibió un disparo en la pierna, encontró consuelo en su iglesia y en el terapeuta de una congregación hermana.

Pero el domingo por la mañana después del tiroteo en el mitín de Donald Trump, en julio, el sermón del predicador giró en torno a la violencia armada, y eso desató el pánico en su interior.

“Me sentí tan abrumada que me fui al baño”, dijo Tavis, “y me quedé allí durante el resto del sermón”. Ahora, incluso duda de  ir a la iglesia.

Tavis se ha mudado recientemente a una nueva casa en Leavenworth, Kansas, que le alquiló a una amiga.

El marido de la amiga le advirtió que si Tavis iba a estar sola necesitaba un arma para protegerse. Ella le contestó que no podía lidiar con armas de fuego en ese momento.

“Y él le dijo: ‘OK, bueno, toma esto’. Y sacó un machete gigante”, recuerda Tavis riendo.

“Así que ahora tengo un machete”.

En busca de algo bueno

Cabrera, la joven que no podía hablar después de que la hirieron, intenta ahora utilizar su voz en la lucha contra la violencia armada.

Manny Abarca, legislador del condado de Jackson, Missouri, vive calle abajo. Una tarde fue a visitarla. Los padres de Cabrera tomaron la palabra; ella es tímida por naturaleza. Pero entonces él se volvió hacia ella y le preguntó directamente a Cabrera qué quería.

“Sólo quiero algo de justicia para mi caso”, dijo, “o que pase algo bueno”.

Antes del desfile, a la joven le habían ofrecido un puesto en la fábrica donde trabajaba su hermana, pero no pudo tomarlo porque su pierna aún estaba curándose. Así que Abarca le ofreció una pasantía y la ayudó a establecer una Oficina de Prevención de la Violencia Armada en el condado de Jackson, un plan que presentó en julio en respuesta a los tiroteos del desfile.

Abarca participó en el desfile de la victoria de los Chiefs con su hija Camila, de 5 años. Estaban en Union Station cuando se produjeron los disparos, y se acurrucaron en un baño de la planta baja.

“Solo dije: ‘Oye, ya sabes, solo mantén la calma. Solo estate quieta. Vamos a averiguar qué está pasando. Algo ha sucedido,’”, contó Abarca. “Y ella me contestó: ‘Esto es un simulacro.’ Y, oye, eso me desgarró el corazón por dentro, porque pensé que hacía alusión a su entrenamiento en la escuela”.

Finalmente salieron temblando pero a salvo, sólo para enterarse de que López-Galván había muerto. Abarca conocía a la popular DJ tejana, una madre de 43 años, a través de la unida comunidad hispana de la zona.

Abarca ha aprovechado la conmoción de este tiempo tenso tras los tiroteos del desfile del Super Bowl para trabajar en medidas contra la violencia, a pesar de que conoce las severas limitaciones que impone la ley estatal.

En junio, la asamblea legislativa del condado de Jackson aprobó una norma que da fuerza local a una ley federal contra la violencia doméstica que permite a los jueces retirar las armas de fuego a los delincuentes.

Pero Abarca no ha podido conseguir que se apruebe la creación de una oficina para la violencia armada, y los funcionarios del condado han rechazado considerar otra medida que establecería límites de edad para comprar o poseer armas, temiendo una demanda del fiscal general del estado, que es bastante agresivo.

Sin embargo, contrató a Cabrera, explicó, porque es bilingüe y quiere su ayuda como sobreviviente.

En cierto sentido, este trabajo hace que Cabrera se sienta más fuerte en su lucha por salir adelante tras el tiroteo. Aún así, la percepción de seguridad de su familia se ha hecho añicos, y nadie tiene pensado ir a los partidos o a un potencial desfile por ganar el Super Bowl en el futuro.

“Nunca esperamos que fuera a ocurrir algo así”, afirma. “Y por eso creo que ahora vamos a ser más precavidos y quizá nos limitemos a ver el desfile por la tele”.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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KANSAS CITY, Mo. — Twenty-four minutes before the mass shooting at the Kansas City Chiefs Super Bowl victory parade in February left one person dead and at least 24 people injured, Jenipher Cabrera felt a bullet pierce the back of her right thigh.

The 20-year-old and her family were just four blocks from Union Station, in a river of red-shirted Chiefs fans walking toward the massive rally after the parade that warm Valentine’s Day. The bullet — fired by teen boys fighting in the street — thrust Cabrera forward.

She grabbed her mom by the shoulder and signaled in panic to her bleeding leg with her large brown eyes, not saying a word. Cabrera was being treated in an ambulance when she heard reports blasting from the police radio.

“My mom was trying to get on the ambulance,” Cabrera said. “I remember them saying, like, ‘You can’t get on. There might be other victims that we need to pick up.’”

Cabrera’s shooting happened before the one that garnered the big headlines that day and is one of hundreds that kill or injure Kansas City-area residents each year. That endless drumbeat of gun violence — from one-off incidents to mass shootings — has shattered the sense of safety for those who survive. As victims and their families try to move forward, reminders of gun violence are inescapable in the media, in their communities, in their daily lives.

“I look at people differently,” said James Lemons, who was shot in the thigh at the rally. Now when he’s around strangers he can’t help but wonder if they have a gun and if his kids are safe.

The new NFL season opened here with a moment of silence for Lisa Lopez-Galvan, the only person killed at the parade. Kansas City has recorded at least 136 homicides this year. Local police say there have been an additional 527 “bullet-to-skin victims” — people who were shot and survived. And there were at least 50 school shootings nationwide by mid-September.

Collectively it is all taking a toll.

Survivors suffer panic attacks and feel a heightened sense of danger in crowds and deep anxieties about the threat of violence anywhere in Kansas City.

Every shooting survivor responds in their own way to gun violence and even the threat of it, according to LJ Punch, a trauma surgeon by training and founder of the Bullet Related Injury Clinic in St. Louis.

For some, getting shot ensures they will always be on guard, perhaps even armed. Others want nothing to do with guns ever again.

“But what’s the common ground? That people desperately want to be safe,” Punch said.

Cabrera’s search to make meaning out of what happened has led her to work with a frustrated local lawmaker seeking new gun laws — something akin to impossible given Missouri state law, which prohibits nearly any local restrictions on firearms.

Learning of Other Shootings on the Phone

Feb. 14 is a movie in Cabrera’s mind, in slow motion, frame by frame, and the soundtrack is her voice, talking and talking. She sees a group of rowdy teenage boys running around her and her family. Then two pops — fireworks? Another pop. Finally, a fourth.

“I think that’s where the shock kicked in, and I grabbed my mom,” Cabrera remembered. “I didn’t say anything to her. I just, like, looked at her, and I had, like, my eyes were widened, and I kind of signaled with my eyes to look down at my leg.”

Cabrera fell and other fans rushed to her rescue, calling 911, and began cutting off her leggings. Four men instantly pulled off their belts when asked for a tourniquet. She remembers thinking that if she lost consciousness, she could die. So she talked and talked. Or so she thought.

One of her rescuers later said she actually didn’t say a word even when he asked how many fingers he was holding up.

“He told me [that] my eyes were huge, like oranges, and that all I was basically doing was, like, looking up and down four times since he had four fingers up,” Cabrera said.

Cabrera remembers being moved out of the emergency room at University Health to make room for 12 people who came in from the shooting at the rally, including eight with gunshot wounds. She checked social media on her phone — another shooting? Unreal. Finally her parents found her. She spent seven days in the hospital.

Cabrera is grateful to be alive. But she is triggered now when she sees groups of teenage boys cursing and playing, or when she sees red Chiefs shirts. Hearing four pops in a row — a regular occurrence in her northeast Kansas City neighborhood — makes Cabrera’s chest swell and she braces for a panic attack.

“It runs over and over and over and over in my mind,” she said.

‘An Increasing Sense of Threat?’

The U.S. surgeon general declared gun violence a public health crisis in June, but nearly any new regulation on guns is a political nonstarter in Missouri. In fact, a 2021 state law — signed at the Kansas City-area gun store where one of the weapons used in the parade shooting was purchased — would have barred local police from enforcing federal gun laws. The law was struck down by a federal appeals court in August.

Missouri has no age restrictions on gun use and possession, although federal law largely prohibits juveniles from carrying handguns.

Polling of Missouri voters shows support for requiring background checks and instituting age restrictions for gun purchases, but also nearly half were opposed to allowing counties and cities to pass their own gun rules.

Per capita, Kansas City, Missouri, is among the more violent places in the nation. From 2014 to 2023, there were at least 2,175 shootings in this city of 510,000, leaving 1,275 people dead and 1,624 injured. And while murder rates fell in more than 100 cities across the country last year, Kansas City recorded its deadliest year on record.

Shared with permission from The Trace.

Punch, of the Bullet Related Injury Clinic, likened the violence to a disease outbreak that goes unaddressed and spreads. The state’s permissive posture toward guns might supercharge the reality in Kansas City, Punch said, but it didn’t start it.

“So is there something going on? Is there an increasing sense of threat?” Punch asked.

Jason Barton was familiar with that violence growing up in Kansas City. Now settled in Osawatomie, Kansas, he thought long and hard about bringing his own gun for protection when he drove his family to the Super Bowl parade.

Ultimately he decided against it, surmising that if something happened and he pulled out a gun, he would be arrested or shot.

Barton responded quickly to the shooting, which happened right in front of him and his family. His wife found a bullet in her backpack. His stepdaughter’s legs were burned by sparks from a bullet ricochet.

Despite his worst fears coming true, Barton said not bringing his gun that day was the right decision.

“Guns don’t need to be brought into places like that,” he said.

‘A 12-Gauge With Teeth’

Mass shootings can derail survivors’ sense of safety, according to Heather Martin, a survivor of the Columbine High School shooting in 1999 and co-founder of The Rebels Project, which provides peer support to survivors of mass trauma.

“Trying to find a way to feel safe again is very common,” Martin said, “in the years following it.”

James Lemons had always felt trepidation about returning to Kansas City, where he grew up. He even brought his gun with him to the parade but left it in the car at the urging of his wife. His 5-year-old daughter was on his shoulders when a bullet entered the back of his thigh. He shielded her from the ground as he fell. What was he realistically going to do with a gun?

And yet he can’t help but wonder “what if.” He can’t shake the feeling that he failed to protect his family. Waking up from dreams about the parade, “I just start crying,” he said. He knows he hasn’t processed it yet but he doesn’t know how to start. He has focused on his family’s safety.

They got two American bulldogs this summer, making three total in the house now — one for each kid. Lemons described them as “like having a gun without having a gun.”

“I’ve got a 12-gauge with teeth,” Lemons joked, “just a big, softy protector.”

Most nights he sleeps only a few hours at a time before waking up to check on the kids. Usually he’s on the couch. It’s more comfortable for his leg that is still healing, and it helps him avoid the restless kicks of his 5-year-old, who has slept with her parents since the parade.

It also ensures he’ll be the one to intercept an intruder who breaks into the house.

Emily Tavis, who was shot through the leg, found solace at her church and from a sister congregation’s in-house therapist.

But then, the Sunday morning after the Donald Trump rally shooting in July, the preacher’s sermon turned to gun violence — triggering panic inside her.

“And it just, like, overwhelmed me so much, where I just went to the bathroom,” Tavis said, “and I just stayed in the bathroom for the rest of the sermon.” Now even attending church gives her pause.

Tavis recently moved into a new house in Leavenworth, Kansas, that she is renting from a friend. The friend’s husband cautioned that if Tavis was going to be alone she needed a gun for protection. She told him she just can’t deal with guns right now.

“And he’s like, ‘OK, well, take this.’ And he pulls out this giant machete,” Tavis recalled, laughing.

“So I have a machete now.”

A Search for Something Good

Cabrera, the young woman who couldn’t speak after being shot, is now trying to use her voice in the fight against gun violence.

Manny Abarca, a Jackson County, Missouri, legislator, lives down the street. One evening, he came to visit. Cabrera’s parents did most of the talking; she’s shy by nature. But then he turned and asked her directly: What did she want?

“I just want, like, some justice for my case,” she said, “or something good to happen.”

Before the parade, Cabrera was offered a factory job where her sister worked, but she hadn’t started because her leg was still healing. So Abarca offered her an internship, helping him establish a Jackson County Office of Gun Violence Prevention, a plan he introduced in July in response to the parade shootings.

Abarca was in the Chiefs victory parade with his 5-year-old daughter, Camila. They were in Union Station when shots were fired — and they huddled in a downstairs bathroom.

“I just said, ‘Hey, you know, just be calm. Just be quiet. Let’s just find out what’s going on. Something’s happened,’” Abarca said. “And then she said, ‘This is a drill.’ And hey, it tore everything out of me, because I was like, she’s referring to her training” at school.

They emerged shaken but safe, only to learn that Lopez-Galvan had died. Abarca knew the 43-year-old mother and popular Tejano DJ through the area’s tight-knit Hispanic community.

Abarca has taken advantage of this heated time after the Super Bowl parade shootings to work on anti-violence measures, despite knowing the severe limitations posed by state law.

In June, the Jackson County Legislature passed a measure that gives local teeth to a federal domestic violence law that allows judges to remove firearms from offenders.

While Abarca was able to get a gun violence office approved, county officials vetoed another measure that would establish age limits for purchasing or possessing firearms, fearing a lawsuit from a combative state attorney general. He hired Cabrera, he said, because she is bilingual and he wants her help as a survivor.

In a sense, the work makes Cabrera feel stronger in her fight to move forward from the shooting. Still, her family’s perception of safety has been shattered, and no one will be attending games or a possible Super Bowl victory parade anytime soon.

“We just never expected something like that to happen,” she said. “And so I think we’re gonna be more cautious now and maybe just watch it through TV.”

[Update: This article was revised at 5 p.m. ET on Nov. 14, 2024, to reflect news developments.]

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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This story can be republished for free (details).