The heartache's name might be terrorism, an evil plot of many, or the heartache might spring from a single deranged mind at work in a movie theater, or in an elementary school. The heartache might claim thousands of innocent lives or it might claim dozens or it might claim two, but, no matter the particulars, here we were once more on Monday, America, doing what we do:
Dealing with it.
Shaking heads and wiping tears.
Dealing with it.
One hand covering our mouths in shock, the other making a fist in outrage.
Dealing with it.
Trying to make sense of what is senseless.
This time it revolved around sports, ostensibly, although, of course, it didn't. The Boston Marathon was the target, but the real target was an American institution. The real target was our shared peace of mind, our sense of security.
The Boston Bruins postponed Monday night's home game out of respect for the tragedy's victims. Locally, Dolphins stadium officials postponed an announcement about a soccer tournament. This story wasn't about sports, though, any more than Newtown was about schools. This is part of the American story now and will continue to be.
It is about vigilance, and resolve. It is about getting back up, always.
The heartache might be orchestrated and come from continents away. It might be random and come from up the street. The blood runs the same.
This time, two bombs exploded near the finish line, probably sounding for just an instant like the fireworks that might celebrate something. But this awful noise killed at least three people and injured many more. This awful noise severed limbs, according to the terrible reports.
People screamed. Blood stained the pavement. We saw footage of people screaming and running.
We saw first responders going to work.
Patricia Soden, 51, of Hollywood, Fla., had finished the race just before the first explosion. She and her husband Bert, who also competed, are both OK.
"All of a sudden there was this horrendous explosion. My heart stopped," she told The Miami Herald. "Terrifying."
Race organizers had set up a medical tent to treat the usual marathon stuff. Fatigue. Dehydration. There were water bottles on ice and sliced oranges in bowls.
That medical tent would be needed Monday in the most unimaginable, horrible way.
Two other unexploded bombs were found nearby. An incident five miles away at Boston's JFK Library was reported.
There were obvious suspicions of terrorism, of what could turn out to be the biggest attempt at mass killings on U.S. soil since 9/11.
We have seen this before. Felt this before.
It happened to be Boston this time. It could have been our town. The thing about terrorism is that no matter where it happens, it feels like our town, doesn't it? Viscerally? Our hearts go out like it was.
If adversity tests and toughens a man or a woman, then it must work collectively on a country.
Well, America keeps getting stronger, folks.
They keep trying to knock us down. We keep getting back up, our eyes a little sharper and our hide a little harder, but hopefully not our hearts, though.
A marathon this time! Can you imagine?
This was our oldest such race, in our most historic city. This was Patriots' Day. Some 25,000 runners were competing, lined up at the start and thinking of nothing more than maybe setting a personal-best time, or even just finishing the race at all.
A marathon might be the most intensely personal challenge of any sport.
Is a body really made to run 26.2 miles? To some, it is an almost spiritual calling. Bigger than just running.
You want to say the finish line of a marathon is just about the last place you would expect such a thing as this to occur, but you stop yourself. Because where should you expect such a horrible thing? During a Batman movie? In a skyscraper office building? At an elementary school? Anywhere ?
Monday's Boston Marathon had begun with 26 seconds of silence in honor of the Sandy Hook Elementary victims.
The 26-mile marker, near the finish line where the bombs blew, had been decorated with the city seal of Newton, Conn.
To expect the unspeakable anywhere is insane, an affront to civilization.
To expect it anywhere to the degree we fear it anywhere, any time, means we have conceded something precious and irreplaceable.
So we do what we do.
We mourn the latest innocent victims who might have been us.
We damn the latest coward killers.
And then we get back up, somehow just a little bit stronger.
We deal with it.
Greg Cote is a columnist for the Miami Herald.