The terror of being trapped by thick black smoke and an encroaching wall of fire still evokes raw emotions in Slave Lake resident Pat MacKay, nearly a year after a devastating wildfire in the northern Alberta town.

"We were just standing there in the middle of the street watching my place going up and her place behind us," MacKay said, her voice trembling as she recounted how she and her daughter-in-law watched their homes burn the evening of May 15, 2011.

"And then all of a sudden, we saw these two headlights going through the thick black smoke, and I just flailed my hands and I put my hands on the trunk of the car ... I don't think we cared how many were in that car. We were getting in that car and we were getting out of there."

MacKay was one of thousands of residents who fled Slave Lake that night as a massive wildfire fanned by 100 km/h winds swept through the town. Miraculously, no one died. RCMP later determined the fire, which destroyed 374 properties, was deliberately set. The investigation continues but no charges have been laid.

MacKay and her daughter-in-law made it to safety, but she is still traumatized by the memories of that night and racked by guilt for not moving her vehicle to the driveway of her home. Instead, it was stuck behind an automatic garage door that was left inoperable when the power went out.

Today, MacKay has a difficult time looking at photos of her old home, and struggles with thoughts of what might have happened.

"It's something that stays with you for a very long time, knowing that you just got out with your life," she said.

Town lost 5 of 13 doctors

Slave Lake is now a hive of activity. The town has issued permits to rebuild about half the destroyed properties and neighbourhoods that were reduced to rubble are coming back to life.

While many people are trying to move on with their lives, others have decided to leave. For-sale signs dot some of the vacant lots.

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Dr. Philip Immelman is working long hours as he and his colleagues make up for the departure of five of the town's 13 doctors. (CBC)

The town lost five of its 13 doctors after the fire, leaving the remaining physicians to work long days while trying to deal with their own losses.

Dr. Philip Immelman was one of the doctors who stayed behind and helped reopen the Slave Lake Hospital. He now admits he thought about returning to his native South Africa, but decided to stay out of loyalty to his colleagues and the residents of Slave Lake.

"I have made a commitment to the community that I will continue serving as long as I'm capable," he said

Immelman, who lost his own home in the fire, believes many people still haven't come to grips with the toll that takes.

"Basically, we all carry on and slowly start getting our lives together," Immelman said. "But emotionally, I don't think any of us really realize what it means."

Smell of smoke triggers anxiety

The passage of time has made a difference to Yolande Klyne. As she gazed last year at the street where her home used to be, Klyne wondered if her life would ever return to normal.

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Yolande Klyne says she becomes anxious when she smells wood burning in a stove or a campfire. (CBC)

Now her family is checking out their newly-rebuilt home. 

"It does get back to normal," she said. "It takes a lot of time but things will be okay again and I only hope that for the people that are trying to sell and moving away that one day maybe they'll come back to the community."

Despite the new start, Klyne still grapples with anxious thoughts.

"If you are out and about and you smell someone's wood stove burning or if someone's got a campfire going,  it brings back some memories. That smell of smoke," she said.

"If it is a particularly windy day, that anxiety rises a little bit."

The smell of burning grass also triggers anxiety for MacKay, who has since been diagnosed with post-traumatic stress disorder. Even something like the darkness of a cloudy day takes her back to the moment she was surrounded by smoke. 

"I start getting that closed-in feeling," she said. "I know it's clouds. I know it's not smoke, but it's just that feeling that's there."

MacKay says she needs to leave Slave Lake. She plans to rebuild her home and then put it up for sale.

"My desire to stay here is just not here in my heart. My heart is just not here. It's just not. I can't explain it."

With files from the CBC's Briar Stewart