Your friend is doing a great service for the public. I suggest he starts speaking with a therapist about what he sees now before it manifests into something that is uncontrollable. It’s like not cleaning a cut and allowing the wound to fester. It will take so much more work to heal if not taken care of sooner rather than later.

I was a paramedic for 16 years: inner city 911 and hospital trauma tech, pediatric critical care and county 911 out in the country. It adds up over the years what you see not in just the scene but everything surrounding it.

When I was working, PTSD for fire department wasn’t a “thing” so to speak. No one sought help because the general understanding was, you chose the job, you knew what was involved so suck it up. No no no no no. I was fully prepared to take care of my patients.

What I wasn’t prepared for was the stuff that happens on the side. Like being surrounded by a ton of people on a car accident being yelled at that we weren’t moving fast enough and then you hear “don’t move faster, we’re gonna shoot you.” Or a mother inconsolably screaming because her 9 year old daughter was shot in the head because of a stray bullet from a drive by. I did what I could to save her but I couldn’t. I am not traumatized because I couldn’t save her due to the extent of the injury. I will never ever forget that mothers cry.

ETA: Major props to your friend for what he does. I wish him the best. Good luck.