LOOKING BACK over his nearly 30 years as a highly decorated first responder in Colorado's Roaring Fork Valley, Michael Ferrara has trouble pinpointing the exact moment when his life began to unravel. His ordeal arrived not all at once but in a long spool of assaults on his soul and psyche. A plausible starting point, though, might be March 29, 2001, and a nightmare that occurred at the airport in Aspen.
One fine warm day this past August, Ferrara and I decided to walk over to the site. His six-year-old mountain-rescue dog, a German shepherd named Lhotse, led the way. Ferrara wore sweats and trail-running shoes. His skin was ruddy from the sun, his graying strawberry-blond hair cropped short. We stopped outside the Aspen airport's fence, which is designed, among other things, to keep herds of elk off the tarmac. Ferrara squinted through the sun as a Learjet taxied and then shot into the sky.
"I'm OK with this," he assured me. "I've learned to recount without reliving—it's part of the therapy."
The weather was snowy and cold on that evening nearly ten years ago. One minute past seven o'clock, a Gulfstream III came in on an instrument approach. Fifteen friends from Los Angeles, most of them in their late twenties, had chartered the jet for a few days of spring skiing to celebrate a buddy's birthday. Something went wrong on the final descent. The pilot apparently couldn't see the runway. A wing tip caught the ground, the plane flipped, and the tail segment broke off. Then the plane exploded into flames.
Ferrara, who at the time was both a Pitkin County sheriff's deputy and an assistant coroner, was among the first to arrive. Over the years, he had worked on a half-dozen small-engine-plane crashes in the mountains around Aspen. In other jobs as a paramedic, ski patroller, high-angle rescuer, and avalanche specialist, he'd often dealt with blood and trauma and heartache. Among scores of incidents, he was first on the scene when the late senator Robert Kennedy's son Michael Kennedy, 39, fatally struck a tree while skiing in Aspen in 1997. Ferrara was steeped in the stoic culture of the first responder, and instinctively knew how to take charge in chaotic situations. But he wasn't prepared for this.
In the swirl of the dome lights, through the flickering of a dozen fires, Ferrara drank in the surreal horror of the crash. The first charred and bloodied body he came upon was still buckled to his seat, his cell phone ringing in his pocket. Then, out of the corner of his eye, Ferrara saw something jammed into the elk fence: a hunk of flesh, dripping with serous fluid. Ferrara spent that terrible evening with fellow officers, assembling body parts into plastic bags. It was one of the worst tragedies in Aspen's recent history. All 18 people, including the crew, were killed. Ferrara got home at four in the morning, smelling like jet fuel. He stripped out of his gore-smeared clothes and left them in the front yard.
As he told me all this, he blinked and blinked, as though waiting for tears that wouldn't come. "The thing is," he said, "I drive by here every day. It's a reminder. A trigger. People jet here all year long to have fun in this playground. Nobody comes to Aspen thinking something like that is going to happen. They look at these beautiful mountains and see paradise. I look at these same mountains—and sometimes I see another side."
FERRARA, WHO HAS long been known around town as Mongo, is a genuine Aspen character. His nickname comes from the burly villain in Mel Brooks's Blazing Saddles—played by football star Alex Karras—who knocks out a horse with a single punch and deadpans the famous line "Mongo only pawn in game of life." Mongo landed in Aspen in 1979, after passing on law school in Buffalo, New York, near his rural hometown of Williamsville. He was 29, and in those early days he became known as a hard-charging, hard-partying, slightly outrageous but extremely competent tough guy who liked to live on the edge.
Comments
Excellent article.Thank you Outside Magazine for stepping out of stigma to air this information. We have thousands of first responders and returning military struggling with PTSD. They are not going crazy and there are plenty of us willing to go the extra mile to help them feel better. We are losing too many to suicide. We have a Crisis Team that covers First Responders on the Western Slope. Michael we would love to have you on our team. Your experience and 'scars' can continue to help others.
Flag ThisYes "IT" eats you! PTSD is a bitch: images come and go at all the wrong times. Teach one of us to relax like an accountant or a school techer does not work. An excellent article, I THANK YOU from my whole heart as a former and ret NYPD officer and a Combat vet, memory loss from RPG and IED's and all of the dead bodies. I have hope for us all who help others!!!
Flag ThisThank you for your comments and support. I am getting daily emails from people wanting to share. Not just first responders but relief workers, victims of trauma and mountain guides. I am trying to get back to all of them. I'm a better rescuer than letter writer. Not everyone has been so supportive. I knew that if I stepped into the spotlight there would be those who would be unkind. The letters and emails make me realize that it's worthit. I have to remember to get forgiveness give forg
Flag This"Rock on" Mike. Every "Bad One" is like peeling a layer of skin off an onion. Sooner or later there isn't much left. The first one isn't any different than the 50th. Thanks for your candor and your countless years of service. Think of all the good you have done and will continue to do. Bill Mead NREMT-P Patrol Director Cannon Mountain Franconia, NH
Flag ThisThanks to Mike Ferrara and to Hampton Sides for a collaboration that resulted in a great and informative article. We at the National Center for PTSD were delighted when Hampton asked to interview our Executive Director, Dr Matt Friedman, who is quoted extensively. For those who suffer this condition, whether Vets, responders, or others, it's helpful to know about our website: www.ptsd.va.gov Yes, there are lots of websites with info on PTSD, but ours has excellent PTSD info all in one place.
Flag ThisThanks Mike, I am an EMT and a Ski Patroller. I've had some that haunt me. I am fortunate enough to have a job with health care - specifically mental health benefits. Like many, I have dealt with many issues unrelated to emergency response and have had to seek help. Like many, I used alcohol to self medicate and learned that its not much help at all. Actually exacerbates the problem, which for me presents as depression. Its an issue worth talking about. Thank you for doing just that!
Flag ThisMichael, DO NOT go to the Western Slope, or you WOULD think of committing suicide with the nonsense that goes on, and the egomaniacs out here trying to battle for control of services. Living in Mesa County, I know Sheila is ironically one to stay away from...
Flag ThisThanks for sharing your expereince. From being on the Western Slope however, I am sad to say there isn't much in the form of help, and would be leary of those who claim they can "fix it."
Flag ThisThanks so much for everyone's comments and concerns regarding the real pain of PTSD, flashbacks, and negative intrusive thoughts. Many people find a technique called 'grounding' helpful. It helps you separate from panic/pain/distress. The goal is to focus on the outside real world: pick up an item and look at real details (weight, materials, texture); count the number of doors and windows in the room you are in; name all the sports teams you can. This is from "Seeking Safety."
Flag ThisThis excellent article should go a long way to dispelling the myth that a person gets PTSD because he or she is somehow weak. Nothing is farther from the truth. Once a person has gone into a freeze (a brain mechanism governed by our lower "animal" brains) it primes one for PTSD. Being in the freeze is not something one has control over and it can last for a second or hours. Fortunately, there are evolving models of treatment that don't take years to deal with the flashbacks.
Flag ThisThe following is old now, appeared in various regional news sources and was published in Mountain Freak Magazine. It is sort of poetry, an expression of one Mountain Rescue person's grief and recovery back before PTSD was openly discussed: Click the link and page down to "Orange", you'll see what I mean. http://www.trsar.org/sar_newsletter/2004/sept04.htm There are short-edited versions circulating, they are not worth reading. This is the closest I found to the original first seen in 1996
Flag ThisMongo I am an ex-Snowmass Patroller and Basalt EMT that grew up in the RF Valley emulating Eis and others. I now live in Alaska, ironically cross country skiing daily. Please contact me at: strohmeyer@hotmail.com. Thanks.
Flag ThisI call myself a "feral" physician, having left a 20 year career as a family physician in 2007. I left after a suicide attempt. I recognize the PTSD aspects of my attempt, got therapy, and feel whole now. I was appalled at the reaction of my state board of medicine-- shut up and get back in line-- to that dark time in my life. I learned that an entire industry supports keeping physicians quiet about this epidemic by shaming the victims. I honor you for your work, keeping first responders sane.
Flag ThisMike, I've worked in EMS & did a bit of S&R during my work with a Sierra Nevada camp, and became aware of my need to make room for the experiences this work brought to my life. I learned that other first responders who did not suffer any ill-effects from witnessing trauma were not in it for the people they were rescuing, but had less-than-noble motives. People want you there for them because you care, and you're on firm ground in ignoring the idiots. Thank you, sincerely, for your service.
Flag ThisMike, I was a "501" for MRA in the late 80's and early 90's, but there is no reason you should remember me. My 1st mission was a body recovery, as were most of them. I retired from MRA when the "slide shows" started for me, using the excuse at the time of being newly married. The images usually stay in their proper compartment now, hope they do so for you. Thanks for publizing the issue for first responders, it is well past time. Contact me if you ever care to: James@JamesAngevine.com
Flag ThisPTSD susceptibility seems to vary greatly. I have seen entire trainee classes give up the SAR game when their first mission was a body recovery. Some people last years, 100's or 1000's of missions. Others can't get past a few years. Some can take more than others. But all can take more if they talk about it, if they have an outlet for grief and stress. Old timers could help a lot but too many think everyone needs to be stoney like them. They forget years of newbies lost to bad attitudes. Sad.
Flag ThisMichael and others, Thanks for illuminating this important issue, Michael. It's real. EMDR is an A rated treatment for PTSD. Please visit www.emdr.com to read more about it. It can help you cut through this and get back to yourself very quickly especially when compared to other therapies. I'm also happy to talk with you to help you find the best EMDR therapist in your area. www.juliestowasser.com My best to you, Julie
Flag Thisas a nurse of 15 years I found i had hit a wall when i could never seem to do enough to honor my memories of those I had helped or wished to have helped better. . . or could not have helped in any case.
Flag ThisI heard about this article on NPR and couldn't wait to read it: Hampton Sides and an in-depth article on a fascinating topic is an irresistible combination. It's so valuable to have this view from the inside. I often wonder how first responders (and front-lines military) can possible deal with what they encounter, and the answer is that they really can't without suppressing their humanity. That doesn't work for long. Thank you so much for this.
Flag ThisGreat article; EMDR was so helpful to me five years ago in the aftermath of the death of my daughter, who was 17. I had horrific flashbacks of her floating face-down in the bathtub, of my CPR efforts and other awful visions. I've been a ski patroller since 1970, EMT and CPR instructor for decades and thought on one level that all this volunteer work prepped me for the day when my victim would be my beloved daughter. Then the guilt and horrible visions became relentless. Best to all, Steve
Flag ThisGreat Article that will I share with social workers, therapist, first responders and the like. There can never be too much information on this subject that has been traditionally been focused on the military. First responders first began to be highlighted after the 911 attacks.There are many great therapeutic models used to treat PTSD.The main concern would be to make certain that the practitioner is trained and qualified to treat trauma. Robin Sparer LCSW-C, LICSW
Flag ThisGreat Article that will I share with social workers, therapist, first responders and the like. There can never be too much information on this subject that has been traditionally been focused on the military. First responders first began to be highlighted after the 911 attacks.There are many great therapeutic models used to treat PTSD.The main concern would be to make certain that the practitioner is trained and qualified to treat trauma. Robin Sparer LCSW-C, LICSW
Flag ThisThanks for the great article. I always knew I would get it. It was only a matter of time. I have even joked about it years ago before anyone really knew what it was. I have been a working Paramedic for nearly 30 years and I am on my second tour in Afghanistan as a Flightmedic doing Medevac missions. People are always asking questions about this type of call or that. Funny I seen to have had some type of experience with most. I can recall with vivid detail because of the "Slide Show" in my head.
Flag ThisI have PTSD and it came on pretty suddenly after 39 years. Workers Comp Colo denied my claim but my employer went to bat for me and Comp agreed to pay for treatment for several months, even though they denied the claim. I'm getting better pretty quick but I don't know how I would have fared without good treatment. My psychologist says, we're humans, not robots; and we have strong feelings which can help us in our work. Unexpressed it can just build up as in a pressure vessel and later burst.
Flag ThisOne thing that must change is the attitude about PTSD from Work Comp insurers. They don't consider horrible calls "abnormal" for our work so we're supposed to just suck it up and not get help at Work Comp's expense. This is an opportunity for the state legislatures to hold insurer's to the fire and force Work Comp carriers to accept these claims. I don't see this problem going away as the first EMS/SAR workers of my generation get ready to retire.
Flag ThisI'm a CA Psychotherapist (had PTSD myself years ago) but I'm writing this from Northern Ireland tonight...loads of PTSD over here. I specialise in what I call "duty iinduced" PTSD. I've been treating Cops, Paramedics, Firefighters & Soldiers since 1995 (btw EMDR kicks clinical ass...in a good way). Mike, I really endorse your efforts to put together peer support long before the ice starts to crack beneath one's feet. I'm popping a check in the Post to you tomorrow. Without a herd we perish.
Flag ThisMike, thank you for having the courage to share your story, how you got to that "place" and how you continue to work hard to get back. I worked as a Paramedic for 23 years and can recall many "slide shows" from those years. Something that has always bothered me in the world of EMS & First Responders is the school of thought that we need CISD and grief counseling after an MCI or possibly a "bad call", usually involving a kid But what about the cumulative effects of dealing with death & dying?
Flag Thiscontinue: Seeing pain, loss, death, destruction, the blood & guts of the innocent & guilty, it has to have an effect. As a Flight Paramedic based at a Level I trauma center in Washington, DC during the height of the "knife & gun club" drug wars, we staffed the trauma bays as well as flew. At the end of a particularly "routine" night shift, we realized we had zipped 8 kids (between the age of 16-22) into body bags. Some came in dead, others were pronounced after valiant resuscitation attempts.
Flag ThisPart 3, read from bottom up. And that was just one shift. We did that night after night, year after year. The military surgeons used to do their trauma training at our hospital in the 80's & 90's. It's not just a Tucson or Columbine type event that stays with you. So, again, thank you for being a voice, Mike. Thank you for speaking out & bringing attention to this very important subject. There are a lot of First Responders out there who have a lot to gain from your courage & experienc
Flag ThisI can relate to everything Mike has shared. By age 35 I had 18 years in EMS and Emergency Medicine, my "burn out" occurred 4 years after completing residency. I can assure you that the "consequences" for a doc with this problem represents a significant barrier to getting help. I know many more EMS/ER folks are suffering in silence. Thank you for your courage. I hope to be of service. Let me know how I can help.
Flag ThisI can relate to everything in Mike's story. Thank you for your courage. By age 35 I had 18 years in EMS and ER finally reaching attending physician at a Level 1 Trauma Center. My "burn out" happened within 4 years of finishing residency. I made it through with a new life. There are many more EMS/ER folks suffering in silence because the "consequences" for admitting the need for help are severe and life altering on their own. It's critical that first responders know there's a solution.
Flag ThisGreat article which I will secretely share with a few chosen collegues. Thank you for stepping up and being the champion for us all. Good luck and God bless on your Alaska adventure.
Flag ThisGREAT ARTICLE! I have been a paramedic for 34 years. People always tell me that they couldn't do my job and I just tell them that "you get used to it, it doesn't bother you."...until this article. I broke down and cried. I feel his stress and pain yet refuse to think that it is also me. I didn't know about the "habits" which surround our profession just to deal with life. I too have rock climbed, raced motoercycles (still do at age 58), go to the wilderness and crave adventure.
Flag ThisI have attributed my lasting in this profession due to my constant need for adrenaline. I have been a whitewater guide and instructor for 35 years. Every so often i need a break (burn out?) from the job and just go off and do adventures that seem to calm me. I too have found that I am always preferring endorphines to adrenaline more as time passes. The repetitive thery was unknown to me but I have been doing it all along...I just didn't know it.
Flag ThisI have attributed my lasting in this profession due to my constant need for adrenaline. I have been a whitewater guide and instructor for 35 years. Every so often i need a break (burn out?) from the job and just go off and do adventures that seem to calm me. I too have found that I am always preferring endorphines to adrenaline more as time passes. The repetitive thery was unknown to me but I have been doing it all along...I just didn't know it.
Flag ThisI have over 27,000 miles of canoeing under my belt, 2 completed Appalachian Trail thru hikes and 1,000 miles of the PCT....and never knew why. Thank you Mike, you have changed my life!
Flag ThisPart 1 -- I agree with all below that this is an excellent article, and the realization that PTSD affects more than soldiers is long overdue. However, I must say that I am disappointed that the article focuses on -- and stops at -- first responders. There is no question that first responders encounter horrible, terrifying scenes. But what happens to those broken victims after they are rescued by the first responders? They become patients.
Flag ThisPart 2 -- The ER doctors are then handed the horror by the first responders (see the comments by Dr. Evenhouse, above). And after the few minutes to hours spent in the ER, the horror is handed off to surgeons, intensive care doctors, hospitalists and nurses. It is a great disservice to those in the medical field who must also deal with this horror to focus only on first responders, and ignore others in the chain of care.
Flag ThisPart 3 --I have suctioned blood from the mouths of dying teenagers all night long. I have cared for children dying of a retinal tumor whose parents picked at it daily, over the course of months. I have performed compressions with a baby's heart sitting in my hand-- the chest cracked wide open -- after heart surgery. I have cared for weeks for a teenager who was dying, his toes rotting, but his parents refused to let him go. It is time to recognize the potential for PTSD in all care providers.
Flag ThisI work for the VA as a psychiatric nurse, and teach a 2-hr session on PTSD to members of the Montana Law Enforcement Acadmey. An excellent resource is the American Academy of Experts in Traumatic Stress, aaets.org. Read http://www.aaets.org/article87.htm, http://www.aaets.org/article199.htm, http://www.aaets.org/article168.htm. First responders, police/firefighters, ER and other health care professionals involved in treating folka with PTSD all have an increased risk of developing PTSD.
Flag ThisYes... & don't 4get the teachers, social workers, direct care workers, & clinicians (like ME) who also go through & see too much stuff. Get HELL for advocating, but then what??? Many of the people that i work with have dual diagnoses - mental health & mental retardation, they don't have a voice. If u really care... PTSD u r left with after many years of battling an uncaring sysytem.
Flag ThisAfter being an Army nurse in Vietnam, I found myself crying over nothing 8 years later. PTSD didn't exist even for the VA at that time. Through the years of ups and downs, I've somehow managed to continue being a nurse but kept my grief to myself. I still carry shame over not being tougher than I am. I applaud Michael Ferrara's strength and openess in bringing his own journey of grief to the forefront and saying even tough guys cry. After all,Michael means He who is like God.You're in my prayers
Flag ThisSides I think you have written an important piece that will ultimately help many in the medical profession on all levels.I think that the details of Cory Brettman's death were unnecessary - you have opened up an emotional can of worms for his friends and family - you should have read your article and given this some thought - I am crying as I write this...
Flag ThisMicheal, Me too, Let me know if you need help or just want to talk. Can't wait to here about your AK trip. John
Flag ThisExcellent article! To watch Outside Television's coverage of Michael Ferrara's story, check out my report on The Buzz: http://www.outsidetelevision.com/shows/buzz/episode-7
Flag ThisI battled this for years when my little boy died in my arms. I never got help and it almost killed me. I was a criminal trial lawyer dealing with tragedy every day. PTSD is real.
Flag ThisWOW....this was an amzaing article....I do not even know this man, but he is my hero! There were times I cried and times I thought, "how can one man be so amazing!" I am a Psych Nurse so I know about PTSD and it amazes me that he took so much before he actually developed PTSD!!! AN AMAZING HERO!!!
Flag ThisWOW....this was an amzaing article....I do not even know this man, but he is my hero! There were times I cried and times I thought, "how can one man be so amazing!" I am a Psych Nurse so I know about PTSD and it amazes me that he took so much before he actually developed PTSD!!! AN AMAZING HERO!!!
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