Editor’s Note: A professional firefighter with the City of Dupont, Wash., and a reservist with the 446th Aeromedical Evacuation Squadron, Capt. Ed Hrivnak is on active duty in support of Operation Iraqi Freedom. This story is adapted from his journal.

Stand with me on the flightline. The planes are huge, and the noise and number of them is overwhelming. We launch aeromedical evacuation missions every day. It’s impressive to watch and I’m proud to be a part of it. No time off; we work 12 to 16 hours a day.

Today’s mission: down range to the AOR, “the sand box.” The airplane: a C-141C built in the 1960s. The crew: seven reservists. We total 100 years of military experience, 8,300 hours of flight time. Our four medics speak German, Spanish, Japanese.

The pilots: middle-aged reservists who could have retired years ago. Look for gray hair and crow’s feet; they’re the guys who’ll bring you home again.

Our alert was for 0900. But the airfield down range was MOG, “mogged out;” too many planes on the ramp. We finally fly at 2145. We’ve been awake for 12 hours.

We fly 5.5 hours to the airfield. Eat and drink all you can; there’ll be little time when patients arrive. Spread out in the plane so we won’t all get hit by the same ground fire. The plane bulges with cargo and we are sardines up forward.

Get ready for combat entry. Squirm into your Nomex flight suit. Body armor, for flak and bullets. A CamelBak or canteen. Kevlar helmet and goggles. Check your flak vest, survival vest, and 9mm Berretta and ammunition – for defense; we don’t fight in combat. Gas mask on your left hip; better practice putting it on and inspecting the seal. Then the professional gear: the quick-don oxygen mask, checklists, dog tags, Nomex gloves, latex gloves, pocket mask, eye protection, medical kit.

The plane depressurizes to avoid explosive decompression if we’re hit. The loadmasters arm our defenses and peer out the back for missiles and ground fire. The approach is random, steep, and stomach-wrenching, to make us a tougher target. But the airfield is “cold” today; no missiles coming in.

We land, but there’s no room to park, so we wait an hour. Finally the plane opens up, and heat and dust surge in. You’re a bucket of sweat.

Unload. Refuel. Reconfigure the aircraft for patients: 11-7+2. That means 11 litter patients, seven walking wounded, and two attendants. There’s a gunshot wound to the stomach. Foot amputations from a land mine. Open fractures. A head injury. Blast and shrapnel injuries. Some can take care of themselves; some need lots of help. Pain medicine. Antibiotics.

We board them quickly. One litter is broken, so we jury-rig it. I push pain medication to get the GIs comfortable.

The engines howl, and we put everything on again. Ground time: five hours. The loadmasters man the doors with flares until we’re out of missile range.

For eight and a half hours it’s almost nonstop nursing. A leaky chest tube gives me fits; I’m constantly adjusting the suction to keep the patient comfortable. All the wounds are dirty; that requires multiple antibiotics. One GI gets infected anyway and spikes a fever. Another almost passes out from dehydration. We run low on IV tubing, gloves, alcohol wipes.

We talk to the wounded to assess their well-being. The Marine with the belly wound has a Purple Heart next to him. The medal will mean something someday. “Today,” he says, “ all I know is that my stomach hurts and I’m going to spend a long time in the hospital.”

A GI with shrapnel wounds was ambushed. “Mortar fire. Many wounded. Metal flying everywhere. Lucky no one was killed.” The GI with the amputations stares at the litter above. “This sucks,” he mutters. “But I’m lucky to be alive.”

I manage to slam down an MRE and grab a catnap before we land in Germany by night. Our mission took 29 hours. Most of us were up 12 hours before that. Total: 41 hours. We were lucky; the field came under rocket attack after we left.

The mission was one of the most rewarding things I’ve ever done. I trained seven years for the mission I hoped I’d never do. The training paid off. I’m honored to take care of brave Americans of the Marines and Army. Our long duty can’t compare to the sacrifices the GIs on the line are making.

Another mission. Today when we land, the ground crews and medics look rested. No missile attack for a week. Even the patients look relaxed. On the last mission the patients clutched their gas masks; today, many board without them. They have colorful, animated stories of firefights, prisoners, battles, and how they were wounded.

Joe, a Marine, was outflanked by an Iraqi who shot him in the back. He looks at me as he talks, but he isn’t seeing me. He’s reliving every moment of the battle.

A soldier with shrapnel wounds speaks of taking prisoners. “We could advance a lot faster if we could figure out a faster way of getting Iraqi POWs off the battlefield.”

He also talks about how Iraqis mistreated American POWs. His squad vowed to fix bayonets before letting themselves be captured. But, he says, American airpower doesn’t let the Iraqis get that close.

A tank commander tells me how a rocket-propelled grenade glanced off his M-1 tank, and shrapnel struck him in the neck. He’s a first sergeant, a professional, a Gulf War veteran with genuine dedication.

“I need to get back to my boys and take care of business,” he complains. A classic example of the backbone of our military.

This flight is just the beginning of the journey home. Some will return to duty, some will never fully recover. All will carry memories.

I think about the soldiers and Marines who go home to their families mentally and physically different. The 19-year-old who lost most of his feet: what does the future hold for him? And for the critically injured with a long future of VA hospitals and disability?

I stay here and tend the wounded because I want to do all I can to help them. The tank commander told me he couldn’t do my job. But my job is easy compared to leading tanks into battle.

The C-141C is nothing like a hospital. It’s loud, dirty, poorly lit. Sometimes we stack patients four-high in the litter stanchions. You need a headlamp to see the ones on the bottom. We never do wound care on the plane; just pack another dressing on.

Once we’re at altitude, you can feel the tension ease. Combat veterans morph back into kids just out of school. We talk first about combat and how they were wounded, but then about home: seeing girlfriends or wives, holding children again, tasting an ice-cold beer. A pizza. Cookies….

That’s it. One Easter day we brought along frozen pizzas and cookie dough. I walked from patient to patient, asking who’d like a pizza. I got looks of disbelief from men who’d seen nothing but MREs for three months. Then pizza aroma drifted from the on board convection ovens. No more combat veterans; now they were gleeful kids, laughing, joking, munching a foretaste of home and America and forgetting about their wounds. Then we brought out the fresh-baked cookies, hot and dripping with chocolate. Their faces told me, as words cannot, that there’s more to healing the wounds of war than drugs and dressings.

Vibration wears you down. Hydraulic fluid and condensation weep from overhead. There are hot and cold spots. Heaters, vents, and pressurization suck moisture from the air. Think how a patient with a chest tube feels. He has a hard time breathing to begin with.

Think of the young soldier with chunks of his body missing. He’s in pain, he smells, he’s dirty, his bandages leak blood and fluid. Morphine isn’t working, but it’s the strongest stuff I’ve got. I open one bandage and find sand fleas where toes used to be. I ask him to wiggle the toes he has. One side moves fine. What’s left on the other is cold and hard. He looks at me, and his eyes plead, “Tell me I’ll be whole again.”

I act like I’m adjusting something. Tell the truth? Lie? The seconds move slowly. Then I grin and give a thumbs-up. He beams with relief, but I feel broken for lying to him.

I spend the rest of the flight at his side. We finally land and I am spent. I give him more morphine so he can tolerate the ambulance ride.

Days later, I visit him in the hospital. I ask him to wiggle his toes. The bad ones move, ever so slightly. There is always hope. When I look at such patients, I see no glory in war. Some come onto the plane with a thousand-yard stare, some with eyes darting about, maybe looking for an ambush or booby-trap. Some walk with a nervous jitter, some stumble on like zombies. Some have eyes glazed by morphine.