Psychologists often find it difficult to help first responders —police, firefighters and emergency medical personnel —overcome emotional scars that arise after witnessing terrible scenes of death and injury. Hurricane Katrina may have increased the complexity of post-traumatic treatment even further.

After the hurricane, emergency personnel had to work endless hours, witness people die in their arms, and stumble over drowned bodies underwater at their feet. But as many of them noted in televised interviews, what made matters far worse was feeling powerless. Trained to save lives, they had to walk past people dying on hot highways because the victims were past the point of no return and time could not be lost in finding others who still had a chance. Some police heard fellow officers’ final cries for help over police radios as they drowned in raging floodwaters. At least two police officers were so distressed at their own helplessness that they committed suicide.

Experts in treating post-traumatic stress disorder (PTSD) say helping individuals cope with such nightmares may be especially hard because, for many, the bedrock on which recovery can be built has also been taken away. Speaking on National Public Radio’s program All Things Considered on September 20, Jeffrey Rouse, a psychiatrist at Tulane University, explained why: “The key things that are important for recovery from trauma are a lot of the psychosocial things, like good family support, continuity of socioeconomic status, your job, all the things in life that we have to buffet us.” For many first responders, their homes were destroyed, family members were injured, and co-workers were missing or thought dead.