Jared Lee Loughner appears different than he did 15 months ago. His brown hair shaved short, his face fuller, his countenance capable of a smile.

His voice is dull, flat but purposeful, as if it's difficult to form the words. He is obviously medicated but alert, able to concentrate and follow conversation and court proceedings.

Fifteen months ago Loughner was judged mentally incompetent to stand trial for killing six people and injuring 13 others. He was unkempt and rocked back and forth before making an incoherent outburst and being whisked away by marshals.

On Tuesday, that had changed. After months of medication for schizophrenia and psychosis, classes explaining the court system, and therapy that includes two prison jobs, Loughner is now competent to stand trial, and to change his plea. And that is what, thankfully, he did.

Loughner pleaded guilty to 19 counts in U.S. District Court. Seven charges carry a life sentence, to be served consecutively. The other charges, including attempted murder, add decades to the sentence.

Jared Lee Loughner will die in prison.

Saying any ending is the best in a situation like this has the uncomfortable weight of inaccuracy, if for no other reason than this terrible thing should never have happened.

Given that the alternative is a lengthy, painful and public trial requiring the testimony of the many victims, the plea agreement, which ensures Loughner will never be free, is the only conclusion that offers any modicum of justice.

The courtroom was silent Tuesday as U.S. marshals brought Loughner from a side door to the nearby defense table. In the few steps to his chair, he scanned the courtroom. His family, clustered on a wooden bench in the back row, stood slightly and craned to see him.

Judge Larry A. Burns read each charge, explained each right and potential trial defense that Loughner was agreeing to give up. He responded "I do have an understanding" and "Yes, I understand."

Burns read the last two pages of the plea agreement aloud - the statement, written in the first person, of Loughner's crimes on Jan. 8, 2011. How he planned to assassinate Rep. Gabrielle Giffords, how he purposefully shot the others gathered to meet with the congresswoman.

"I shot them because they were participating in Congress on Your Corner," said Burns, reading from the agreement that carried Loughner's initials on each page and signature on the last. Burns asked Loughner if he understood the statements and that he was admitting to serious crimes that carry life sentences.

Loughner said yes. Burns accepted the plea agreement and set sentencing for Nov. 15. And then, in the legal sense, the matter will come to a close.

If only it could truly be that tidy.

Psychologist Christina Pietz, who works at the federal prison hospital facility in Springfield, Mo., where Loughner is held, testified that, to the best of her knowledge and based on an exhaustive review of records and interviews, she was the first to diagnose Loughner as having a psychotic illness, in his case, paranoid schizophrenia.

The prison psychologist was the first to put a name on the blatantly severe psychotic mental illness raging in a young man who had, for months, been spinning out of control.

In 2005, after breaking up with his girlfriend and the death of a friend's father, he voluntarily saw a psychologist for depression. He went back to the same person in 2006 after he was caught drunk at high school. He was prescribed an antidepressant, but there was no evidence in the records that he had taken the drug.

What happened to Loughner - how he seemed average until about age 16 - is, unfortunately, not unusual in cases where serious mental illness unfolds over time. It is not uncommon for psychotic mental illness to manifest first in young adults.

Pietz testified that in high school Loughner began to have auditory hallucinations - hearing voices - and, at one point, asked his parents if they heard voices, too.

His friends thought he might kill himself, and his parents, who answered written questions from Pietz, stated they had the same fears. His behavior became increasingly odd, nonsensical, eccentric.

His friends and classmates became fearful of him, which, Pietz said, isn't uncommon when a person begins to show symptoms of mental illness. He grew alienated and ostracized at the very time he most needed help and intervention.

Loughner needed someone to step in and get him help - and if he refused, as he probably would have, to use what the law affords and seek an involuntary intervention. He had made videos shortly before Jan. 8 stating he wanted to assassinate someone.

The signs were blazing. But it took the murder of six people, and the injury of 13 more, for Loughner's psychosis to finally be diagnosed.

Pietz said Loughner has said he wishes he'd gotten medication sooner. "The thoughts, I'm tormented by them," he told her.

And, because no one acted in time, Loughner was left to torment his victims and a community trying to find answers.

Arizona Daily Star