FOR FOUR AGONIZING hours, Mark Zea stood outside the Borderline Bar and Grill near Los Angeles, waiting to learn if his youngest daughter, Camille, had survived an assault by a gunman that killed 12 people and left one wounded before the attacker took his own life.
It was after 3 a.m. on Nov. 8 when Camille, 18, used a friend's cellphone to call Zea to let him know she was alive and physically unharmed. Zea, a retired Los Angeles County Sheriff's Department deputy who now teaches medical terminology and police science at a Los Angeles area high school, was relieved, but also worried about Camille's psychological well-being. A couple of days after the mass shooting, Zea took Camille to Palm Springs, California, to unwind. When he suggested they see the movie "Bohemian Rhapsody," to his surprise she said no – she feared being in a crowd. That weekend, Camille was also uneasy at a Veterans Day parade. She told her father that she wasn't too fond of veterans at the moment; the Borderline killer was a Marine veteran.
Things didn't get better for Camille on her first day back at her high school, where she's a senior. She met with a school counselor, who invited Camille into her office to check on her well-being. Camille threw up. "Everything about a public space now gets me so scared. Going to school, I'm constantly watching my back," Camille says. "Going to Starbucks, I'm constantly watching my back. It really has, for now, destroyed my life. I don't feel safe going anywhere, nor do I want to go anywhere."
The consequences of the Borderline attack extend to Camille's father, who constantly worries about Camille's safety. Zea retired from the Sheriff's Department in 2002, after a standoff with a shotgun-wielding man who turned the weapon on himself. Zea was tired of the violence, of having to carry a gun. Now, "I almost feel compelled to carry a gun again," he says.
The Borderline shooting's effects on Camille and her father are a textbook example of how the consequences of gun violence often radiate beyond the immediate victims who are shot and killed or wounded, says Dr. Aaron Wilson, chief medical officer at Sierra Tucson, a residential treatment center in Tucson, Arizona, that treats, trauma, depression and other disorders. For many years, many medical professionals considered trauma to be something experienced by combat veterans, survivors of sexual assault and other individuals who had been directly affected by violence. "We're starting to realize the ripple effect is a lot bigger than we (previously) thought," Wilson says. The effects of such trauma can include anxiety, depression, feelings of sadness, fear of being in public spaces, hyper-vigilance, difficulty concentrating, being easily startled, flashbacks, nightmares and other sleep disturbances, Wilson says. Every person reacts differently to gun violence, he says. Some witnesses, bystanders and survivors of gun violence may experience brief periods of increased stress and anxiety while others go on to develop post-traumatic stress disorder.
It's impossible to quantify how many people who aren't direct victims are psychologically affected by gun violence. There's not much research on the topic, experts say. However, based on the high levels of violence in the U.S., the number may be in the tens of thousands, perhaps higher, Wilson says. "We are beginning to understand how big and far-reaching the ripple effect can be," Wilson says.
In the U.S., about nearly 110,000 people – enough to fill a large football stadium and two major sports or concert arenas – are killed and wounded annually in gun-related incidents, according statistics from the Centers for Disease Control and Prevention's National Center for Health Statistics. More than 38,000 people died of gunfire in 2016, according to the CDC. About two-thirds of those deaths were from suicide. Meanwhile, more than 67,000 people are injured by firearms annually, according to the National Electronic Injury Surveillance System.