The survivor guilt settled in moments after he saw all the bodies. Later came the fear of walking Yonge Street again.
He grew hyper-aware of sounds and people around him, looking for anything out of place. And driving his company’s white van became a struggle.
“For the longest time I was worried about my brakes,” said Dion Fitzgerald. “If I saw someone crossing at a crosswalk, I would brake like a block away.”
The 43-year-old father was one of many Torontonians whose lives were changed forever that sunny afternoon on April 23, 2018.
It was 1:27 p.m. when Fitzgerald signed out of Eva’s Satellite, where he worked with about 30 troubled teens and young adults. He was walking down Yonge Street in north Toronto to get lunch when he saw the first body.
He immediately worried that it was one of the young people he worked with, but as he got closer Fitzgerald realized it was an older man on the ground, one he didn’t recognize.
“He was already gone,” he said.
Soon, police arrived at the scene and witnesses described seeing the man get hit by a white Ryder van, which also struck and killed several others.
“I need to check on my 30 young people, to see if they were hurt,” Fitzgerald recalls thinking, as most of them were without parents.
As he continued to search for familiar faces, Fitzgerald came across body after body – some of them dead, some of them grievously injured.
“There was a lot of blood. One woman’s legs were mangled. I had never seen flesh torn apart like that,” he said in a recent interview, choking up. “At this point for me, I’m really seeing a lot of death, a lot of people who were going about their day and unnecessarily died or were injured.”
As Fitzgerald would later hear on the news, 10 people had been killed in the van attack, and 16 others wounded. Alek Minassian, now 26, was charged in the attack and faces a lengthy murder trial that is scheduled for next year.
It was only later, once Fitzgerald was back at the shelter and scouring the news for information on the incident, that the guilt settled in. He learned of other witnesses who stayed with the injured, saying they didn’t want them to be alone.
WATCH: Survivor recounts horror of deadly Toronto van attack
“What really hit me was I didn’t stay with anybody,” Fitzgerald said. “I kept moving.”
In the weeks and months that followed, he questioned his actions. He tried to process his emotions through painting, but found he couldn’t finish his piece.
“It was too difficult,” he said.
Exposure to a traumatic event can affect people over the short term, disrupting their sleep or causing them to avoid certain areas, said Francoise Mathieu, a psychotherapist in Kingston, Ont., who specializes in secondary trauma.
It can be particularly difficult when the event is in the spotlight because that brings daily reminders, Mathieu said.
WATCH: Toronto first responders on coping after the van attack
And when the effects are intense and last longer than a month, that person may meet the criteria for post-traumatic stress disorder, she said.
While research on secondary trauma began in the late 90s, it has taken a long time for the phenomenon to be widely recognized, she said. The fifth and most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, which defines and classifies mental disorders, was the first to include secondary trauma, she said.
“It used to be that in order to develop PTSD you had to have experienced the trauma yourself but we’re now recognizing that that’s not always the case,” she said.
The first anniversary of a loss or disaster is particularly meaningful, but can also cause certain feelings to resurface in survivors, witnesses and others who are struggling, Mathieu said.
For them, it may be better to honour the milestone without re-exposing themselves to media about the incident, she said. Support systems are also important in helping people deal with trauma, she said.
Among those who have begun researching the nascent field of secondary trauma is one of the witnesses of last year’s attack.
Tiffany Jefkins was out for a picnic with her 10-month-old daughter and two others at Mel Lastman Square when she heard a loud bang coming from Yonge Street. She saw a white van strike four pedestrians.
She strapped her daughter into the stroller, put her friend in charge and ran for the street to put her first-aid training to use.
The first wounded person she saw was bleeding profusely from the abdomen but someone else was already stanching the flow, so Jefkins turned her attention to another injured person. That woman had no pulse and wasn’t breathing, so Jefkins started administering CPR.
She then asked someone else to take over and went to check on the others, instructing stunned bystanders to lend a hand as she carried on. Three of the people she helped died, and Jefkins said she doesn’t know what happened to the fourth.
Now Jefkins, who is doing her doctoral research at the University of Toronto on secondary trauma, says she’ll interview those who’ve witnessed traumatic events, from mass casualty events to cardiac arrests, to see how they are doing and to identify gaps in care.
“How can you ask these people to help if they’re going to come away with potential post-traumatic stress-like symptoms?” Jefkins said. “If we know what happened to them, we can give them appropriate help.”
Shortly after the attack, a counsellor visited the youth shelter where Fitzgerald worked to help staff and the community process what had happened.
The counsellor told Fitzgerald he had done his job that day in trying to care for his group – but Fitzgerald said it took a long time for him to believe that. Fitzgerald also spoke to his doctor and a mentor, which helped, he said. He’s open to seeing a professional to discuss his mental health, thinking there could be some symptoms of PTSD.
It took him a week before he could set foot on Yonge Street again. His first stop: the small memorial for the man he had seen on the ground, the first victim he’d encountered.
In green marker on a nearby pole he read the words: “Here died the greatest man to ever walk the earth. I love you grandpa.”
That got to Fitzgerald, being a new grandfather. Yet returning to Yonge Street helped him in his healing process.
Now he makes a point to walk that stretch regularly, he said.
“There’s some guilt still lurking, but I do know I was doing my job,” Fitzgerald said. “Nobody else in that mess at that time would have been looking for those young people. It was me that had to do that to ensure they were safe.”
— With files from Paola Loriggio.