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Those who loved him say Yvon Ricard died twice. Once, when he witnessed the carnage of the Lac-Mégantic rail disaster. And ultimately, when he could no longer endure the memory of it.

On that summer night in 2013, when a ghost train barrelled down the tracks on its cataclysmic course in small-town Quebec, Mr. Ricard was able to escape with his life.

He survived the worst rail disaster in modern Canadian history. But he could not survive its aftermath.

“I won the lottery of life,” he once confided to a good friend, Joël Bujold. “But some days, I wonder if it wasn’t a poisoned gift.”

The night of the tragedy, Mr. Ricard had just finished playing a set at the Musi-Café nightspot and gone outside for a cigarette. That’s when he saw the runaway train approaching, its sheer force so powerful that the ground felt like a floor of shaking marbles.

Mr. Ricard got away. The musician he’d just shared the stage with, the man he described as a brother, stayed inside for a beer and never came out. Neither did many customers who had been singing and listening to Mr. Ricard’s music just minutes before.

Mr. Ricard was among the lucky ones, or so it seemed. Last August, more than two years after the oil-laden train derailed and exploded, 44-year-old Mr. Ricard took his own life. His name does not figure among the 47 victims of the Lac-Mégantic disaster, but those who knew him say that on July 6, 2013, his life derailed too. He was haunted by the loss of his musical partner, Guy Bolduc, and many others he knew who perished that night.

“To me, my brother died at the same time as his friend Guy,” Mr. Ricard’s sister, Brigitte, said in an interview. “Even if he survived two years, what was left behind in his head was just fire and incredible images that made living intolerable.”

Mr. Ricard’s torment, as told by his friends and family, parts the curtain on the private psychological toll of the catastrophe. Despite the passage of time, 67 per cent of people in Lac-Mégantic still report moderate-to-severe signs of post-traumatic stress disorder according to a study released by Quebec public-health officials in February. Many describe mental aftershocks they never anticipated.

Daniel Gendron, next to the last wagon pulled from perimeter and left next to the by-pass road. (Michel Huneault for The Globe and Mail)

“It’s only afterwards that you realize you could have lost your life,” said Daniel Gendron, a paramedic who was among the first on the scene. Unable to sleep more than three hours at a time after the events, irritable and anxious, he was diagnosed in the fall of 2014 with severe depression and went on a 10-month work leave. He still avoids loud music and violence on TV. “What we lived through, it was worse than war. Because we didn’t expect it.”

René Simard, a schoolteacher who escaped from the same terrace of the Musi-Café as Mr. Ricard, returned to work last fall after a prolonged absence. He is now on medication for the first time in his life – antidepressants – and sleeps on his sofa so he can be near his front door, just seven steps away.

“For a while, I was a zombie,” he says in his living room, where a pillow and blanket are neatly folded on the couch. “I’m no longer the René I was before. That René died.”

René Simard, in the hallway where he curates and presents the art work of his students at Polyvalente Montignac.

The sheer impact of what everyone in town refers to as “La tragédie” is inescapable. To this day, questions about the accident still haunt Lac-Mégantic. The recent revelation that something as simple as a 10-second safety procedure, the setting of an ignored brake, could have averted the catastrophe is just one example of the painful answers the town still seeks. Other scars are more literal: The town’s core, including a once-vibrant main street that recalled a charming New England village, has vanished; dozens of buildings were ruined in the disaster and 37 were demolished due to contamination. In their place is an expanse of emptiness that resembles a vast airport runway. It is twice the area of the former World Trade Center site in New York.

Few residents have been spared from grieving. In sheer scale, the death toll of 47 in the town of 5,900 represents the equivalent loss of 48,200 people in metropolitan Toronto.

Mr. Ricard knew many people who would die that night at the Musi-Café. He was a long-time regular there, as well as at other venues across small-town Quebec, his showmanship and musical skills drawing appreciative crowds over the years. Mr. Ricard was a strapping six-footer who could warm up audiences with his joking banter and the persona of what his sister called a big-hearted clown. A versatile chansonnier who picked up the guitar when he was 18, he was comfortable performing everything from Francis Cabrel to Metallica to Quebec crooner Michel Louvain. On the night of the disaster, he and Mr. Bolduc had the crowd at the Musi-Café on their feet, dancing.

His fate diverged from his partner’s because he smoked. After the pair’s set ended after 1 a.m., Mr. Ricard went outside to have a cigarette. That’s when he saw the train hurtling down the tracks at 105 kilometres an hour.

He fled as electrical wires fell overhead, his ears ringing with the sound of crushing metal behind him, his body oppressed by the heat.

Once out of danger, he wanted to turn around, but the furnace-like heat pushed him back. He searched frantically for his wife, Ève, before finding her. Mr. Ricard finally took refuge at the home of a friend, Sébastien Audet, who answered his door to find Mr. Ricard’s face covered in soot.

“He was just shaken,” Mr. Audet recalled. “He didn’t realize the scale of what had happened yet. It happened so fast. He was on adrenalin. I think it was only after that he realized that he escaped death.”

Reality began to sink in. In a wrenching TV interview three days later, Mr. Ricard’s shock spilled out from him. His face twisted in pain, covering his eyes with his hands, he seemed distressed by the fragile line between life and death.

“I happened to be outside. I had that chance. [Guy Bolduc] didn’t have that chance,” he told the interviewer. “There are so many circumstances, when you think about it – it could have been me.” Had the duo’s set gone on “30 or 40 seconds longer,” he said, many more would have died that night.

Mr. Ricard, a father of two young girls who lived in Quebec City, earned his living through his music, and he resumed his touring. In each venue, fans approached him to ask him about the night of the disaster, forcing him to revisit it over and over. “He said, ‘People are always asking me the same questions. I don’t want to be mean,’” he confided to his friend, Mr. Bujold. “He told it thousands of time. ‘Yes, it was hell.’”

His friends started to notice he was having trouble coping. A beer put down too abruptly on a table made him jump. He sought professional help but kept having nightmares and flashbacks – of explosions, of balls of fire; he took medication to calm his nerves, Mr. Bujold said. But he couldn’t escape the reel of the disaster that played in a loop in his head.

“I talked it over with a doctor, but it’s in my head. I saw it all explode.” he told Mr. Bujold, who added: “He lived with the remorse of the death of his friends.”

Mr. Audet also saw a change in his friend. “He wasn’t the same man. I don’t know if it was anger, if it was fear. But there was this deep sadness deep inside him. He had lost his joie de vivre.”

On Aug. 15 last year, Mr. Ricard was back in the Lac-Mégantic area performing at a private party outside of town. Chatting to the guests at the cottage on Lac Saint-François, he mentioned being in therapy. “He spoke openly that it was hard,” said the party’s host, Jonathan Grondin. “He said that the images kept coming back in his head in Lac-Mégantic. And that he lost his buddy.”

His family asked for donations to suicide-prevention in his obituary. At his funeral, his sister Brigitte said everyone thought her brother was lucky to have survived the rail disaster, but all he got was a “reprieve.” Her brother, she told mourners, had been “crushed by that train.”

The accident left psychological scars on the town too. Many of the 47 victims were young. The recent public-health report found a rise in alcohol consumption among a sixth of the population of Lac-Mégantic, and twice the rates of anxiety compared with the region. People report symptoms of sleep disruptions and recurring memories. Around town, people say they feel a tightening in their gut at the sound of a train whistle, a wailing siren, or the sight of fire.

Céline Larin, a public-health co-ordinator for psychological aid in Lac-Mégantic, says authorities have seen no rise in suicide since the derailment of the train, operated by Montreal, Maine & Atlantic. However, she describes a “heaviness” and “moroseness” that has settled over the town. Some survivors have been afflicted by feelings of guilt – guilt that they didn’t do enough to help others that night, or even that they weren’t there at all. “It’s the imposter syndrome: Why him, not me?” she said.

The persistence of symptoms of post-traumatic stress disorder in Lac-Mégantic, nearly three years after the disaster, is not unique, although the rates are alarmingly high. In New York, responders to the World Trade Center disaster – workers who took part in rescue, recovery and clean-up at the site – are still being monitored for their physical and mental health.

“After 15 years, we still see individuals,” said Dr. Fatih Ozbay, medical director of the World Trade Center Mental Health Program at Mount Sinai in New York. While up to 80 per cent of people may suffer “transient” reactions such as sleep problems or increased anxiety after traumatic incidents, most people see the symptoms go away; a subset of sufferers develop full-out post-traumatic stress disorder.

“Those are individuals whose fear reactions do not go away, they’re not extinguished,” he said.

“People should be informed that these residual symptoms are more common than some may think,” Dr. Ozbay said in an interview.

Testimonials are beginning to emerge that paint a picture of the horror that night. Mr. Gendron, the ambulance driver, recalls that the noise of escaping pressure from the damaged tankers was so loud, he had to shout to be heard at his home, which was almost one kilometre away from the crash site. As he rushed out of his house to the scene of the derailment, he first checked the temperature on the thermometer hanging outside the kitchen window – it was 45 degrees Celsius.

Mr. Simard, the schoolteacher, recalls that as he ran for his life from the conflagration, he looked back and saw the silhouettes of people engulfed by flames. He felt as though he was being pushed by a wave of heat. “I was afraid of melting, like a candle,” he said.

Lac-Mégantic today is a town struggling to be reborn. There are signs of renewal. A new commercial street, Papineau, is lined with shops and cafés, and 60 per cent of the land in the former disaster zone has been earmarked for development projects, from a spa to a hotel complex to housing.

Owner Yannick Gagné has reopened the Musi-Café in a new location on Papineau street, the ‘new’downtown strip.

A new Musi-Café reopened more than a year ago after a $2-million investment, and on one recent weeknight it was buzzing with locals and out-of-towners; musical acts are booked on weekends. Owner Yannick Gagné, who had left the old Musi-Café just 40 minutes before the train derailment, was busy behind the bar, saying he wanted the name Musi-Café to be synonymous not with death but with resilience.

“I don’t want people to see us as whiners. We need take ourselves in hand and rebuild,” he says. “The Musi-Café had to come back. I didn’t want to seem like someone who gave up.”

But Mr. Gagné is not turning his back on the past. A wall inside the bar has been converted to a memorial to the 2013 disaster. One display case features a beer glass and cocktail shaker recovered from the ruins, both charred to the colour of coal.

The centerpiece of the memorial wall is a large painting donated by Mr. Ricard’s sister. It shows Mr. Bolduc and Mr. Ricard jamming side-by-side on their guitars, as they were the last night of Guy’s life, and the first night of the ending of Yvon’s.

Brigitte Ricard said she wanted to paint the pair together to remember them as they were. She agreed to speak about her brother to make sure people don’t forget him, or what the train disaster did to him.

“I wanted to pay homage to these two people, who both lost their lives,” Ms. Ricard said. In the painting the pair appear absorbed in their music together, unaware of what awaits.