Collective trauma in a town destroyed

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By Stephanie O’Neill, Kaiser Health News

One of the final memories Carol Holcomb has of her pine-shaded neighborhood was the morning sun that reflected red and gold on her trees last Nov. 8. That day, she said, promised to be a beautiful one in the Butte County town of Paradise.

So she was surprised to hear what sounded like raindrops tapping her roof a short time later. Holcomb, 56, stepped outside to investigate and saw a chunk of pine bark floating down from the sky.

“It was about 3 inches by 2 inches,” she said. “And it was smoking.”

It was her first glimpse of the approaching wildfire that would become the deadliest and most destructive in California history — one she continues to relive in debilitating nightmares and flashbacks.

The Camp Fire virtually incinerated Paradise, a town of 27,000. It killed 85 people in the region — many of them elderly. Most died in their homesothers while fleeing in their cars or trying to flee on foot.

For thousands of residents, the terror of sitting in traffic jams as the wildfire bore down left emotional scars. “Everyone who experienced this went through trauma,” said Linnea Duncan, a licensed clinical social worker who fled the fast-moving firestorm from her home in Magalia, a community just north of Paradise.

In the commotion of evacuating Paradise, Carol Holcomb lost a backpack containing her mother’s Bible, her grandfather’s Purple Heart medal and photographs of them. But, thanks to a good samaritan, she recovered the family treasures.Michelle Camy for Kaiser Health News

Dr. Sandro Galea, dean of Boston University’s School of Public Health, said: “We would expect to find a high burden of post-traumatic stress disorder and depression.”

Galea, a leading researcher in the field of mass trauma and disaster, said the consequences for individuals can vary depending on factors such as the intensity of their experience, the type of support available to them after the disaster and whether the community comes together in the recovery and rebuilding process.

For Holcomb, it took nearly three hours to escape Paradise as smoke from burning houses, cars and brush turned day to night and cut visibility to mere feet. Barely able to see the road, she got behind a large truck — its tail lights her guide. As she watched the flames devour nearly everything around her, she could hear residential propane tanks exploding like steel-encased kernels of popcorn.

“You could hear, ‘Boom, boom, boom,’” she said.

Just as she got out of the flames, her truck caught fire. Holcomb pulled onto the median of the highway and jumped out in time to save herself and her cat. A man she didn’t know told her to get into his truck and together they made it to safety. In the commotion, she left a backpack next to her burning truck. It contained treasures: her mother’s Bible, her grandfather’s Purple Heart medal from World War I and photographs of both of them.

Diagnosis: PTSD

Nightmares and flashbacks in the immediate aftermath of a disaster are normal, said Barbara Rothbaum, director of a trauma and anxiety recovery program at Emory University School of Medicine. So too are irritability, anger, hyper-vigilance and problems with sleep and concentration. But when these symptoms persist for at least a month, the diagnosis can be post-traumatic stress disorder, or PTSD. First acknowledged by America’s mental health community in 1980, it’s the one mental health disorder predicated on exposure to traumatic events.

For most people, Rothbaum said, the psychological distress will fade. But for others, especially those who avoid thinking, speaking or writing about the event, symptoms may stick around for years, affecting their relationships, their work and their ability to heal.