On Rosemarie Melanson's 153rd night in the hospital, she starts to vomit and can't stop. She pulls her knees to her chest, closes her eyes and coughs bits of strawberry banana smoothie into a plastic bin her husband, Steve, holds for her.
Stephanie, their eldest daughter, stands beside the bed, her gaze fixed on the wall. She'd brought the smoothie for Rosemarie, thinking it would be a treat. But her mother has been unable to keep down food since she was shot in the upper body at a country music festival on the Las Vegas Strip more than five months ago.
When the heaving subsides, Stephanie offers a whisper: "I'm sorry, Mom."
"No," Rosemarie replies. "You don't have to be sorry. My stomach does that sometimes."
Tears glisten on Stephanie's cheeks. Steve catches her eye from across the bed and mouths, "It's OK."
But it isn't OK, Stephanie says later. None of them have been OK since October 1, when the family was caught in the crosshairs of the deadliest mass shooting in modern American history. Rosemarie, 54, has been hospitalised for all but two days since - her excruciating recovery a testament to the all-consuming devastation a single high-velocity bullet can cause.
As Rosemarie recovers from multiple surgeries to repair the wounds to her lungs, liver and spleen and awaits a final procedure to treat her damaged stomach, the family has watched in horror as other defenseless people have endured mass shootings. Again and again - at a Texas church, in a small California town, at a Florida high school - the same type of gun, the same type of bullets. Dozens have died, and many others have been left like Rosemarie.
Picturing those shattered lives, knowing how difficult it will be to pick up the pieces, has convinced many of the Melansons - some of them gun owners and supporters of gun rights - that something needs to be done about gun violence. Parkland, Fla., with all those students killed, was a grim exclamation point.
"People have no idea," Steve says, stepping out of the hospital room to get a cup of coffee from the cafeteria. "They don't know what it looks like."
When he returns to Rosemarie, she is sobbing. He tries to calm her by rubbing her back, but then she starts to vomit, again. This time she brings up blood. A nurse administers anti-nausea medication while Steve holds his wife, helpless.
This is what it means to survive.
Rosemarie was one of the first people struck when a gunman armed with 23 weapons - many of them semiautomatic, military-style rifles - opened fire from a hotel room at the Mandalay Bay Resort and Casino, across the street and 32 stories above the Las Vegas Strip.
Seeing Stephanie and her sister Paige screaming over their mother's collapsed body, a retired Los Angeles firefighter, Don Matthews, crawled over. He persuaded the younger women to flee, then plugged Rosemarie's wound until she could be loaded into a truck and rushed to Sunrise Medical Center.
That's where the Melansons found her, 11 hours later. "She looked bad. Terrible bad," Steve recalled. Rosemarie's face was bruised and swollen, her abdomen still open from surgery.
The bullet hit her chest and traveled diagonally downward across her torso, piercing her diaphragm, liver, stomach, and other organs. Though the bullet was small, the speed at which it traveled meant it slammed into her with tremendous force, producing a shock wave that obliterated surrounding tissue.
"The bullets have a blast effect," said Matthew Johnson, a trauma surgeon who operated on Rosemarie. Johnson said her injury severity score, a 54 out of 75, was among the highest of the dozens of patients he treated from the Las Vegas massacre.
Rosemarie underwent nine surgeries in the three weeks after the shooting, and she spent nearly two months on life support while her organs healed.
But the woman who emerged from heavy sedation in November was not the same sunny, self-possessed person around whom the whole family once revolved.
A debilitating nausea set in. She has vomited almost every day since, and for months, doctors could not explain why. In February, after a short-lived attempt to bring her home ended with Steve taking her to the emergency room in an ambulance, the condition was diagnosed: Rosemarie has gastroparesis, meaning her damaged stomach muscles cannot push food through her system. She will need yet another surgery to treat the condition as well as to remove her gallbladder, which is infected.
The doctors must wait for her old injuries to heal before they can operate. But on Friday, her stomach wound reopened and became infected - another setback. So Rosemarie must remain at a rehab facility, dependent on an intravenous nutrient solution for sustenance and a daily dose of Ativan to keep her crushing anxiety at bay.
She slumps in her hospital bed, not making eye contact with visitors, their presence making her uneasy. But she cries when people leave, dreading being left alone. Loud noises and bright lights distress her, so Rosemarie often has the door to her room closed and the blinds drawn. Even the tiny Christmas tree that Stephanie bought to celebrate Rosemarie's favorite holiday was too much.
"I'm overwhelmed," she told her daughter.
Steve has learned to recognize his wife's shifting moods, the way her expression goes blank just before the anxiety sets in. "What are you thinking about?" he asks. "Why are you crying?"
"I don't know," she tells him. "I can't explain it."
He believes in those moments that she is dwelling on the shooting, which she remembers in vivid detail. One of the first questions Rosemarie asked after her breathing tube was removed was, "How many people were killed?"
Not knowing what else to tell her, Steve told the truth: 58.
They both began to cry.
"But you're not one of them," he added. "You're still here."
In the face of their ongoing tragedy, the Melansons continually say they are grateful. Grateful to Matthews, grateful to the doctors, grateful to God, who they believe must have a plan to make sense out of all this suffering. Grateful for the good days, when they recognize glimmers of the Rosemarie they know, like when she waved her arms, conducting as her family sang on her birthday on Oct. 26.
At a recent physical therapy session, Rosemarie's sister Dottie and their 89-year-old mother, Mary Rose, cheered as she walked 30 feet without help.
"I saw the determination in her eyes," Dottie said afterward. "That's Rosemarie. She's the strongest person I know."
But the exertion takes a toll. That night, Rosemarie was awake until 3am, vomiting and crying.
Steve, who has slept on an uncomfortable black recliner in his wife's hospital room nearly every night since the shooting, stays up with her. He strokes her hair and tries to quell his own fears. Will this ever end?
He has barely fallen asleep when his alarm buzzes to wake him for work. Steve wishes he could remain with his wife, but his job as a graffiti technician for the city provides the health insurance that has covered the vast majority of Rosemarie's medical bills. He kisses her on the forehead and says, "I love you," as he always does before leaving.
Steve's workdays are spent driving around Las Vegas, removing messes from local buildings and lampposts, trying not to feel guilty about abandoning his wife at the hospital. His phone buzzes with updates from Rosemarie's other visitors: She's walking. She's in pain. She wants to know when he's coming back.
Sometimes his route takes him past a spray-painted mural on Westcliff Drive. The wall of 58 graffiti hearts, an impromptu memorial, had been reported to Steve's office a few days after the shooting. His colleagues declined to remove it. When he can, Steve pulls over and reads each of the slain victims' names.
Left behind, Rosemarie is frustrated with the slow pace of her recovery. She picks at her flimsy hospital blankets and feels the walls of her room closing in.
"Can you believe it's been almost six months?" she asks Dottie one afternoon. "And look where I am. I'm still in a hospital bed."
None of them knew how difficult it would be to move on from such an injury. The persisting horror of it has collapsed time; often, it feels as if not a day has passed since the family found her in an intensive care unit the morning after the shooting.
One thing that has changed: In the days after Rosemarie was shot, Steve expressed scepticism that any law could have prevented the massacre. A small part of him feared such violence was inevitable; the price of life in America.
But then Texas happened, 26 dead and 20 injured in a small-town church. And then Parkland, 17 dead and 17 injured in a suburban high school. And that price felt like too much to bear.
"Maybe there should be more control," Steve says. "I hate to see people suffer like Rosemarie has suffered. . . . People are tired. Not just me. Everybody is tired of all the mass shootings."
Even Dottie - a self-proclaimed "strong Second Amendment person" who keeps three rifles, a revolver and two handguns at her Pennsylvania home for protection - thinks it has to be made more difficult to get high-powered weapons like the ones used in recent massacres.
She and Steve are sitting at the Melansons' home, watching the news, when the subject of the Parkland shooting comes up.
"Those kids." Dottie shakes her head. Thinking about it makes her angry. She raises her voice: "This guy should never have been able to get a military gun with military bullets."
"And unfortunately, Rosemarie caught one of those military bullets," too, Steve adds.
On Rosemarie's 156th day in the hospital, Steve is hopeful as he walks through the building's glass doors. He has the next three days off work, so he won't have to leave his wife alone.
"This is my home until Monday," he says.
In the cafeteria, the staff wave him over and coax him into eating some of the food they brought for their lunch. "How's your wife doing, honey?" they ask.
"Oh, you know. About the same."
When Steve gets back to Rosemarie's room, she's crying again. She asks where he went, her voice high and scared.
Five months in, and he's still not used to hearing that terror in her voice. He's also still not sure how to soothe it. There's so much left to fear: the daily uncertainty about what will make her sick, the looming prospect of another invasive surgery. Rosemarie's doctors say she'll make it through just fine, but she's so weak. Steve knows she worries about becoming the 59th heart on the Westcliff Drive wall.
He kneels beside the bed and reaches his arms around her.
"It's OK," he says, cradling her. "Shhh. I'm here; it's OK."