I’ve personally been lucky enough to be able to process most (all, maybe?) of the traumatic events I’ve been exposed to, but I’ve known others who have not. I’ve seen a decent amount of blood in my time, and held more than a few folks hands as they died. But not a lot. And I’ve been lucky to be able to help them, most of the time, which helps.

I’ve seen folks go suddenly catatonic in high stress environments (and nearly die because of it), suddenly switch from friendly to literally attacking someone (in one case choking their spouse until they passed out - their legal situation got very unpleasant after that) due to a conversational trigger, and have seen someone’s eyes go ‘black’ in a screaming rage due to a combination of environmental factors that didn’t make much sense, reaction wise.

PTSD is a common thread here, but only about half of them were diagnosed with it that I’m aware of.

Each of them I remember showed significant physical signs of distress when it was happening, such as uncharacteristic pupil dilations, extreme body tension, breathing irregularities, distant stares or seeing ‘through’ what is there, etc.

I’ve been lucky to do a lot of meditation and mindfulness in the past, and when I’ve felt the physical reactions and related cascades, have been able to process what was happening in a way.. I could make use of? Understand without being hijacked by it? Feel without ‘being’ it? Guide to a more useful place?

Not sure how else to describe.

The full body pulsing heartbeat, the choking/crushing feeling in the chest, the need to fight right now, the overpowering rage that can happen, the near blindness from the tunnel vision, the punch in the gut. It’s different, depending, but it shares common themes.

Not sure if that helps?

Personally, one that stuck with me for years (but definitely was not the worst I’ve seen) was when I was first on the scene to a multi car accident. It was a three car pileup, and the last vehicle was a disabled person transport van. The first vehicle had stopped to make a left hand turn across oncoming traffic when I watched the van driver plow into the back of the middle car, which then got pushed into the car turning left.

The van driver didn’t even tap their brakes, and they were going almost exactly 55mph at impact. I distinctly remember the explosion of glass and the rear end lifting up like in a movie.

It was a 4 lane, undivided highway. I happened to be the car directly behind the van, and was going to make that same left turn as the vehicle they plowed into.

The driver had two passengers - a middle aged woman who wasn’t wearing a seatbelt in the front passenger seat who got almost scalped by the windshield and had some kind of closed head trauma, and a disabled woman in a wheelchair in back.

The impact was so severe, the woman in back broke several ribs and ripped the anchors for her wheelchair out of the van frame, partially impacting the back of the passenger seat and driver seat. She ended up turned partially.

The driver had an airbag and had been wearing her seatbelt and walked away uninjured.

I managed to come to a safe stop, call 911, stop traffic and get additional assistance from one of the other motorists, and started triage so when the EMTs arrived, they knew who to transport and why. I did initially fall for the (classic) ‘pay attention to loud one’ at first, but was able to snap out of it when the EMT who arrived started to do the same thing, and I was able to grab him and point him to the closed head trauma patient who was not able to form whole words anymore, and was being too quiet, and needed immediate transport or would likely die.

This was before I had my EMT certification, and I was running off old Boy Scout first aid training.

It was not a feeling that I was in control, though I was definitely more in control than any of the approximately 80ish people around me, until the county Sheriff showed up and took over the scene.

I don’t think I was able to actually calm down until the next day. I had no one to talk to at the time, I lived alone and only a couple hundred yards away.

For years afterwards, if I heard car tires screech, I could feel my muscles tense, my brain switch into emergency mode, my heart rate to shoot up, and everything start flooding back. I had disruptive thoughts about it, etc.

I still distinctly remember the way the passenger was acting and the distinctive halo of blood on the windshield where her head impacted, and the screaming of the disabled (but relatively ok) passenger in the back.

But if they can scream, they’re doing pretty good compared to the ones who can’t.

Good news is, I didn’t have to black tag anyone, and there were no kids. Also, the later training I got turned it into more useful and directed action, and therapy and meditation helped me process it over the years. It doesn’t bother me particularly anymore, and I haven’t felt anything like a Trauma cascade from it in at least 15 years.

It happened… 20 years and a handful of months ago.

I’ve run across some nastier ones and have processed those too. But I don’t think you want me to talk about those.