Many are familiar with the discomfiting runaway streetcar exercise, but police officers may find themselves exposed to a real life version of it, producing compounded trauma, guilt, second-guessing, and moral injury.  Even worse, they may become inured to the demands of their jobs and consequences of their actions by repeated exposure.  Further, resistance to evaluation is high, for if you are diagnosed as being on the trauma spectrum you could lose your livelihood.  For as much trauma as our first responders are exposed to, it is increasingly tragic that research and services are severely lacking to address their emotional injuries.  No one gives you a helicopter ride to the trauma center for emotional trauma, even though we have research that supports the benefit of immediate intervention.  Leaving people to their own devices post-trauma can be a death sentence.  Getting back on the horse after you have been thrown off is one thing.  Getting back on after you have been trampled by it is quite another.