by Kevin Taylor & r & & r & & lt;span class= "dropcap " & N & lt;/span & o more Sim-Man practice for Staff Sgt. Loretta Myers; the next chest she pounds on will be heaving and bloody. No more run-of-the-mill heart attacks and car wrecks for Sgt. 1st Class Michael Fields; the next trauma injuries he sees will involve shrapnel and bullets.

Myers and Fields, despite the military titles, are healers first of all -- civilians, medical workers. Myers is a cheerful 26-year-old licensed practical nurse from Bonners Ferry who lives in Spokane Valley and works in Coeur d'Alene. Fields, 43, is a Spokane Valley firefighter and EMT.

They and roughly 20 other medical workers from Spokane are bound for a year or maybe more in Afghanistan to staff a battlefield surgery as members of the Army Reserve's 396th Combat Support Hospital.

On television, this is MASH. In real life, it's vastly different.

"You see trauma in the states, but over there it's a lot more concentrated. You are seeing battle injuries -- amputated limbs, bullet wounds from head to toe," says Lt. Col. Cheryl Brown, Iraq War veteran and commander of the Spokane detachment of the 396th. (Most of the unit is based in Vancouver, Washington.) "I've seen gross pictures for years. But pictures... you don't hear the person yelling, you don't smell the blood, you don't feel your own adrenaline rush and your body tingling because these are all new sights and sounds for you."

Brown is active-duty military, and when she took over command of the medical unit at the Joe E. Mann Reserve Center in Hillyard about a year ago, she stepped up reality training with the Sim-Man mannequins, increased the tempo at drills and shared all the ugly, corny and horrifying stories from all the deployed nurses and medics she could find.

Most important, Brown stressed that as reservists with skills in critical demand, it wasn't if they'd be deployed, but when.

In fact, this is the third deployment in less than four years for the 396th. Myers and Fields are each on their second mobilization in three years, even though the military has a stated policy of tapping reserve and National Guard soldiers only every five years.

The reality of the so-called Global War on Terror has the all-volunteer military strained beyond its limits. Reservists with valuable skills -- doctors, nurses, anesthetists and surgical techs -- are being leaned upon heavily.

"We can say we've mobilized nearly everyone who is a credentialed reservist -- whether it's a nurse or other type of medical provider -- in the Northwest," says Col. Dwight Thompson, hospital commander of the 396th CSH. "There was a point in 2003 where we had actually mobilized every single registered nurse in the Northwest. Every single one had been touched."

Sixty percent of his soldiers volunteered for the Afghanistan deployment, Thompson says. "I think what's saving the Army Reserve medical units is the patriotism and the willingness of the [soldiers] to volunteer to go again."

"I did not volunteer for this mission. I was deployed," says Fields, speaking very clearly during a telephone interview on Dec. 14 from Camp Atterbury, Indiana. Fields spoke as Thompson, an officer in charge of trainers, and a lieutenant from the camp's public affairs office were all listening to the interview.

Far from unpatriotic, Fields was clearly noting the strain of constant deployment on civilian soldiers. He and his wife, also a reservist, were deployed for two years (2003-05) performing medical duties from Fort Lewis to Fort Drum, New York. His wife, now pregnant with their first child, is just coming off a second deployment as he is beginning his tour of a year -- and maybe longer, the Army is saying -- to Afghanistan.

Fields has especially valuable skills. "My job is the senior NCO of the operating room. I am in charge of the OR surgical team," that will treat U.S. and NATO soldiers as well as Afghanis and even insurgents. "The problem is we are running out of senior leaders. You can only send the same sergeants over so many times," he says.

"I could retire. People ask me, 'Why do you go over there? Why do you stay in?' It can't always be the other guy. Sometimes it has to be you," he says.

In a second conversation after Fields gave up the telephone, Thompson acknowledged a trend of reservists leaving either at 20-year retirement time or the 8-year reenlistment point. "We've had folks get out who went over once and weren't sure their families or their practices could take it again," Thompson says. "This is a tremendous sacrifice."

Thompson himself is headed to Afghanistan with this detachment of 50 soldiers from the 396th -- which includes nearly 20 from Spokane. (Exact numbers were not revealed.)

& lt;span class= "dropcap " & T & lt;/span & hompson, Myers and Fields spoke from Camp Atterbury, where the soldiers are receiving intense battlefield training. They could be in Afghanistan in weeks.

"They just road-marched out here today. Tonight they are going to get attacked by 107-mm rockets slamming into their FOB [forward operating base]," says Lt. Colonel Thomas McKevitt, who delivered newspapers in Spokane as a kid and who now commands a battalion of First Army trainers at Camp Atterbury.

The military has sprawling forts where thousands of outbound soldiers at a time play war games, just as in the old Beetle Bailey cartoons. At Atterbury, McKevitt says, "We do the IBUs... the itty-bitty units: medical units, dental units, postal, finance."

He had a script cooked up that had the medical soldiers mount a patrol to try and find the rocket launchers. "They won't, though, because we want to rocket them again tomorrow night and then have them launch an artillery counterattack that will cause civilian casualties," McKevitt says. "We want to do a mass casualty exercise, and we will try and sneak insurgents with explosive vests into the civilians coming for aid. If the civilians are not segregated and searched correctly, we will be able to infiltrate and detonate explosive devices in the medical facility."

In 2003, mortar rounds tore into a surgical tent in Balad, Iraq, wounding 14 of the 20 soldiers from the 396th who were working inside.

The drills are drawn from battlefield realities in Afghanistan and, in a change from just a couple of years ago, the battalion of OCTs (observer-controller-trainers) has members deployed in Afghanistan who communicate shifting tactics and counterstrikes back to McKevitt every few days.

The soldier training can be intense for civilian healers who normally don't carry heavy weapons to work. But there's an upside, too.

"That was really fun when I shot the .50-cal.," Myers says.

Typical small-arms fire can sound like the crackle of fireworks, but when someone lights up the .50-caliber machine gun, its deep, authoritative report is heard as much in the stomach as in the ears.

"It was awesome," the 5-foot-2 Myers exclaims. "I was going to send my brother -- he's a big hunter -- a picture of me with .50-caliber rounds across my shoulder. Ha!"

Fields, who has been with the 396th since 1988, says, "We are getting excellent training. We did medic training in Pennsylvania and worked for almost two weeks at Kings County Hospital in Brooklyn. It was fabulous: multiple gunshot wounds, trauma stabbings -- everything we'll see when we get over there."

Myers notes the sacrifice of fellow soldiers who are leaving new spouses or young children behind. She herself joined the reserves little more than five years ago after graduating from nursing school. "I guess I wanted something more, and I always wanted to be in the military. I was already a nurse and wanted to take care of soldiers," she says.

Brown, the detachment commander back in Spokane, says she toughened up the drills for this unit: She wants them to be prepared emotionally when helicopters start arriving with their payloads of bloody young men.

From her own experiences in Iraq, she described the intensity of stabilizing wounds, plugging holes and dealing with shattered bones... and then -- poof -- the patient is gone to another base or to Germany or to Walter Reed.

"Your shift ends... but the story doesn't," Brown says. She recalled her first day in nursing school when the instructor asked 80 young students what they wanted to be remembered for.

"A lot of people said research or some literature they would write. I said I don't care if anybody remembers my face or my name as long as they know when they needed someone, a person was there," Brown says.

The soldiers in Iraq and Afghanistan, she says, deserve good medical care. "I want them to know we have their backs."

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