Introduction:

Since then, Alex has been feeling down and low. He frequently experiences intrusive flashbacks of the wildfire response. These flashbacks are mostly triggered by the sound of sirens, the smell of smoke, or even the sight of fire-related news stories. Sometimes Alex experiences intrusive memories unexpectedly with no known triggers. A recurrent intrusive memory for him is the sound of Samir screaming out agony and the little girl crying, while Alex was standing at the door of the room feeling helpless. Alex experiences persistent guilt and self-blame. He questions whether he could have done more to save his best friend and the little girl. He always ruminates about the parents who lost their little daughter wondering if they blame him too for the death of their daughter. During the rescue of the family, Alex describes feeling numb and dissociated as if he was watching himself from outside of his body. He felt a sense of duty and responsibility to protect the community, but he was also gripped by fear and anxiety. He cannot understand why his anxiety was so high at that time; he feels he was a bad firefighter and a weak man. The relentless fire, thick smoke, and the constant threat to his life left him in a constant state of high alert. Because of his worry, he is constantly checking the stove at his home and the electricity to make sure a fire does not start at home. He describes worrying about something bad happening to his family. When he is out, he frequently calls his wife and daughter at home to make sure they are fine and safe. His wife understands where his worries come from but Alex avoids discussing the traumatic experience and refuses to visit the area affected by the wildfire. Alex has difficulty sleeping and often experiences nightmares related to the traumatic event. He startles easily, is often irritable, and has trouble concentrating. He has started to drink alcohol excessively as a way to numb his distress and improve his sleep. He avoids social gatherings and has become increasingly isolated colleagues thinking that they would blame him for Samir and the little girl’s death.