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ROBERT SIEGEL, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

AUDIE CORNISH, host:

And I'm Audie Cornish.

Post-traumatic stress syndrome, or PTSD, is a condition closely associated with the battlefield. But Michael Ferrara developed PTSD without going to war: He spent three decades living and saving lives in Aspen, Colorado, as a search-and-rescue man. After several years, horrific images from those rescues started playing over and over in his mind.

Therapy brought him back, and he joins us from Aspen Public Radio to talk about his case. Also joining us is writer Hampton Sides, who writes about Ferrara and the other rescuers who have had to cope with their own post-traumatic stress, and that article appears in the January edition of Outside magazine. Welcome, Michael Ferrara.

Mr. MICHAEL FERRARA (Former Rescue Worker): Hello.

CORNISH: And Hampton Sides, who joins us from Santa Fe.

Mr. HAMPTON SIDES (Writer, Outside Magazine): Hi, it's good to be here.

CORNISH: Michael, give us a description of what triggered your PTSD.

Mr. FERRARA: You know, it's really hard to pinpoint an event or time. For 30 years, I've been a ski patrolman, cop, paramedic, firefighter, and little by little, it just started to build, and then one day, the slideshow that was all these events started running in my head. And I couldn't control it.

CORNISH: Can you give a sense of what are the kinds of things you were seeing?

Mr. FERRARA: Oh my, yes, an eviscerated man from an automobile crash; burned, dismembered bodies; and climbers who had fallen 2,000 feet. It's really hard to come up on the body of a good friend, and, you know...

CORNISH: And that happened to you at one point.

Mr. FERRARA: It's happened to me a number of - numerous times. The last one was a very close friend of mine in December of '08 who had been killed in an avalanche. I was at bottom at that point.

CORNISH: How did you handle it?

Mr. FERRARA: I isolated. I didnt leave the house. And I had begun using Percocet that had been prescribed for physical ailments for my emotional trauma.

CORNISH: Now Hampton, Michael's not alone in this experience. And you write about this idea that civilian PTSD among first responders, like fire, police and mountain-rescue people, is there any way to do that job without encountering this?

Mr. SIDES: Well, it's only recently become apparent that PTSD is rampant in the community of first responders. And I think maybe the last community that has come to recognize this has been these mountain communities who, you know, these people who essentially get to do what they love to do, and yet they come across this trauma. And they see these horrible things, often people that they know.

There's also the - kind of he-man quality to this. These guys, most of them, and Michael included is - I mean, he is a tough dude. He's a macho guy. And he is. And he wouldn't tell you that, but these guys don't like to recognize when they're hurting.

CORNISH: Michael, describe some of the therapies you did in order to heal yourself.

Mr. FERRARA: First of all, I didn't heal myself. I had a lot of professional help. Part of the things we did was got me to focus -instead of - there's a saying, I don't know how many people I've saved, I only remember the ones I've lost - to start looking at the saves I had.

CORNISH: Hampton, with more and more focus in the medical community on PTSD on soldiers, what does that mean for wider use of these kinds of therapies for civilians?

Mr. SIDES: Well, I think it's going to become much more widespread. Part of it is just educating people. And the paramedics and the ski patrollers, after an incident on the mountain, will have these debriefing sessions, where they will talk a little bit about it, and that's usually all they do.

But now, I think more and more people are beginning to recognize, you know, the first symptoms, things that you can do preventively, and I think that now, you know, with the lead that the Veterans Administration has given us in terms of dealing with and talking about this condition, now it's okay for first responders and all other situations to come forward and try to deal with it before it becomes acute, like it did in Michael's case.

Mr. FERRARA: This is Michael. I had a very interesting case a number of years ago: a young man riding his motorcycle on a mountain road hit by an 18-wheeler. He was conscious when I got there, begging me not to let him die. He died on me, in my arms.

And I talked to a psychologist afterwards, and she said: How are you doing? I said: Oh, I'm fine. She goes: Why would you be fine? You've just had a man beg for his life, die in your arms. Why would you be fine after that?

And we have to recognize that having this stuff mess with your head is not abnormal. You're not supposed to see stuff like this. And what we need to do is break through the culture by someone like myself stepping up and saying: Hey, it happened to me. And I'm going to ask you: Are you okay?

CORNISH: Michael Ferrara, thank you so much for talking with me.

Mr. FERRARA: Thanks for having us here.

CORNISH: And Hampton Sides, thank you.

Mr. SIDES: Good to be here.

CORNISH: The article on rescue workers and PTSD is in the January issue of Outside magazine.

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