It doesn't even have to be one thing, can just be the combined weight. As easily "compassion fatigue" as a big call.

I always thought it odd that people asked what the worst calls I've been on were - like "tell me about an unpleasant experience". But the thing that most people don't consider is that they assume it will be a gnarly trauma call. TBH, for me anyway, when it comes down to it, we're just blood and tissue, and in some ways you can, and have to, just 'disconnect' from that.

The worst calls are the emotionally damaging ones: SA/CSA, elder abuse, domestic violence, tragic accidents, the like. Those add up.

A department in my County has two fulltime therapists on staff.