MICHAEL FERRARA HAS trouble pinpointing the exact moment when his life began to unravel. A plausible starting point, though, might be March 29, 2001.

The weather was snowy and cold on that evening nearly 10 years ago. Fifteen friends from Los Angeles, most of them in their late 20s, had chartered a jet for a few days of spring skiing to celebrate a buddy’s birthday. Something went wrong on the final descent into Aspen’s small airport; 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. He had worked on a half-dozen small-engine  plane crashes in the mountains around Aspen. As a paramedic, a ski patroller, a high-angle rescuer, and an avalanche specialist, he’d often dealt with blood and trauma. Among scores of incidents, he was first on the scene when Robert Kennedy’s son Michael Kennedy, 39, fatally struck a tree while skiing in Aspen in 1997. Steeped in the stoic culture of the first responder, Ferrara instinctively took charge in chaotic situations. But he wasn’t prepared for this.

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. All 18 people, including the crew, were killed. Ferrara got home at 4 in the morning, smelling like jet fuel. He stripped out of his gore-smeared clothes and left them in the front yard.

“Nobody comes to Aspen thinking something like that is going to happen,” he says. “They look at these beautiful mountains and see paradise. I look at these same mountains—and sometimes I see another side.”

FERRARA LANDED IN Aspen in 1979 from a small town near Buffalo, N.Y. He was 29, a hard-charging, hard-partying, slightly outrageous but extremely competent tough guy who liked to live on the edge. Ferrara quickly learned the calculus of thrill and risk that abides in this richest, fittest, most overachieving of Alpine towns. He raced motorcycles and skydived and climbed desert spires and ran ultramarathons and skied like a beast. But he also saved lives. In the town’s highly accomplished world of search-and-rescue paramedics, he was one of the very best.

“I’m only half joking when I say that I’d lie there an extra hour to have him come rescue me,” says Doug Rovira, an expedition physician who’s worked with Ferrara.

Ferrara is a handsome guy, a former bodybuilder with bulging biceps, a barrel chest, and a strong, clear voice that gets your attention. He has frosty blue eyes and a chiseled face reminiscent of Clint Eastwood. He’s in terrific shape for a man of 60, yet there are hints of pain in his step, from a life of sports injuries. “If you play the games of the mountains,” he says, “you’re going to get hurt.”

It was the possibility of emotional injury that Ferrara hadn’t counted on. Yet in December of 2008, after months of downward spiraling, he experienced a devastating breakdown and was diagnosed with post-traumatic stress disorder. Fellow Aspen first responders were shocked. PTSD was supposed to happen to soldiers, on jittery battlefields far from home, not in a Xanadu dedicated to strenuous good fun.

There are an estimated 24 million cases of PTSD in the U.S., most of them likely veterans. Over the past decade, however, PTSD has become associated with firefighters, police officers, emergency techs, and other first responders whose jobs expose them to horrific scenes. Alpine first responders are beginning to recognize that dwelling in backcountry beauty does not inoculate one against tragedy. “PTSD is a sneaky player,” says Dean Cardinale, the ski-patrol director at Snowbird. “These stresses do affect us—profoundly.”

AFTER THE 2001 plane crash, Ferrara continued to excel in his high-pressure work. In 2003, Pitkin County awarded him a commendation for bravery for actions above and beyond the call of duty. His reputation as a rock-solid rescuer spread beyond Aspen, and he found himself spending vacations doing what he did at work: going climbing and pulling bodies, alive or dead, from the mountains. In 2005, Ferrara patrolled on Denali with the National Park Service High Rescue Team.

Yet it was taking a toll. Ferrara began to withdraw from friends. He developed a blank stare. He went through several relationships. He started using Percocet, a narcotic painkiller. In the course of the day, he would cry for a few minutes, consumed by an overwhelming sadness referred to by some PTSD sufferers as “flooding.”

At other times, he was overtaken by what he called “the slide show,” a cruel flickering of mental images: an eviscerated body, a father in the ambulance with his critically injured skateboarder son, those charred figures on the runway. He could hear Michael Kennedy’s children saying the Lord’s Prayer around their dying father in a mountain glade. He didn’t just remember the traumas; he relived them. “The pictures were burned into my mind,” Ferrara says. “They were happening right here, right now.”

Search-and-rescue veterans often speak of the particular horror of encountering free-fall victims. “You pick up an arm and it disarticulates, you see eyeballs exploded, you see brain matter in the trees, and the birds are eating everything,” says Marc Beverly, an SAR trainer in Albuquerque. “You’re picking up people’s teeth and putting them in Nalgene bottles. When you experience something like this, it’s with you forever.”

Aspen’s subculture of mountain athletes and first responders is a rarefied and often hypercompetitive world that places a high premium on toughness and takes note of every stumble. “It’s a super-intense town to work in, and the crowd Michael ran with was really charged up,” says Dave Hahn, a world-renowned mountain guide and ski patroller in Taos, N.M. “If you fail, you do it publicly. It’s very difficult to keep your place in the hierarchy.”

People like Ferrara often end up having the most acute problems with PTSD. “The bigger they are, the harder they fall,” says SAR specialist Tim Kovacs of Arizona.

IN 2006, FERRARA quit the sheriff’s department, but he was still working as a ski patroller on Aspen Mountain and as a paramedic at the Aspen Valley Hospital ER—while also volunteering for mountain rescues and recovery operations. He spent two more high-pressure seasons dragging hurt skiers off the mountains, digging corpses out of avalanches, and, at times, making dreadful calls to loved ones.

Then one Sunday evening in 2008, he was working in the emergency room when a fellow paramedic told him, “There’s been an avalanche on Aspen Mountain, in the Mid Country. The patrolmen just found a skier. Michael, it’s Cory.” Cory Brettmann was a beloved figure in Aspen, a veteran ski patroller and family man—and he was Ferrara’s best friend. They’d ice-climbed together, spent time in Alaska together, traveled widely in the spirit of adventure.

Ferrara cried when he heard the news, then met the ski patrol near the 1-A lift at the base of Aspen Mountain. He opened up the litter and pulled back the blankets. Cory still had a tube in his mouth from the paramedic’s resuscitation efforts, and his hair was caked with snow and blood. He’d suffered blunt trauma. Tumbling in a wall of moving snow, he’d pinballed through a stand of trees, breaking a femur and multiple ribs before finally suffocating. Ferrara washed Cory’s face and combed his hair so he’d be presentable to his wife. Then he took his friend to the morgue.

“Any emotional armor I had left, Cory’s death shattered it,” Ferrara says. “I was in a fog of despair. I couldn’t see beauty anymore, only darkness.” He couldn’t sleep, couldn’t think. The slide show played without cease. By this point, Ferrara had begun to seriously abuse Percocet. “All I wanted was to medicate,” he recalls. “I couldn’t go back out there and face the mountain. I just couldn’t do it anymore.”

As his substance abuse worsened, Ferrara burned bridges and frustrated colleagues. When the head of Aspen Mountain Ski Patrol confronted him about his erratic behavior in February 2009, Ferrara confessed to his addiction. Banished from the patrol room, his paramedic license rescinded, he broke down. Then he entered an intensive rehab program and began to consult psychiatrists at the University of Colorado’s Depression Center.

They had no trouble diagnosing him. Fer­rara had many signs of PTSD: the combination of debilitating anxiety and severe depression, withdrawal, emotional flooding, the insomnia, the lack of eye contact, the memories stuck on merciless “play.”

I FIRST MET Ferrara on a misty, cold afternoon last winter. He was 11 months into his therapy. He stroked the soul patch on his chin and spoke with thoughtful detachment. “I’ve got joy again,” he said. “I’m running. I’m climbing. The slide shows have stopped.”

He had been clean for a year. He was taking the antidepressant Zoloft and had sat through many months of cognitive-behavior therapy sessions—sessions designed to “unpack” bad memories and relearn ways to store and think about trauma.

Ferrara has found a restorative power in physical activity that involves a rhythmic, left-right-left-right action. Soldiers diagnosed with PTSD have found that vigorous repetitive-motion exercise such as ice skating and rollerblading can be extremely helpful in keeping symptoms at bay. For many PTSD sufferers, the most helpful sport of all seems to be Nordic skiing. Ferrara has taken to it with a vengeance. Nearly every winter day, Ferrara and his dog hit the trails that twist like capillaries through Aspen’s surrounding mountains.

It was during those long hours of brisk solitude that Ferrara hit upon the idea that’s animated him over the past year: the First Responder Recovery Project. In November, he launched a new website—frsos.com—filled with information about civilian PTSD and links to psychiatrists, therapists, clinics, and hospitals across the country. “We need to create a whole new culture in which civilian first responders can openly talk about it, and we need to make good PTSD treatment as readily available to them as it is to soldiers,” Ferrara says.

To raise awareness for the project, Fer­rara has done a most Ferrara-like, most Aspen-like thing: He’s hatched an ambitious adventure. Starting the second week of March, he plans to ski across Alaska, from the Pacific Ocean to the Arctic, from Valdez to Prudhoe Bay. The 900-mile trek, sponsored by Eddie Bauer First Ascent, should take about 70 days.

What Ferrara will do when he gets back is less clear. To pay his bills, he’s patched together odd jobs. He’s bucked hay on a nearby ranch, assisted at a home for developmentally disabled adults, done a little janitorial work, and served as a fitness trainer at Aspen’s five-star Little Nell hotel. If these jobs seem beneath the dignity of a man of his training and experience, the fact is he’s grateful for the work.

Ferrara knows he has to reinvent himself. He can’t go back to ER work, and the search-and-rescue assignments he does accept will be fewer and farther between. He’s talked about teaching, or touring the country to “spread the gospel” about PTSD. “It’s okay to dial it back,” Ferrara says. “And it’s okay to quit. That’s what I learned. I don’t need the boldest job—I don’t want to be that guy anymore.”


From a longer feature by Hampton Sides that was originally published in Outside. Used with permission. All rights reserved.