The first thing Maj. Dawn Garcia noticed when she came back from Iraq was the quiet.

  Gone was the throbbing drone of the medevac helicopters in Baghdad that signaled the round-the-clock arrival of more dying and wounded.

"At first, it was weird not to hear the choppers. I'd wake up and it would be silent," says the Army nurse of 15 years.

Then she knew she was home.

Like the approximately 2,000 Army nurses who have deployed to Iraq and Afghanistan, Maj. Garcia has found that the transition from a war zone to stateside normalcy is a complicated thing.

Unlike the battlefield soldiers they patch up, combat nurses have less time to readjust to their normal work routines – three half-days of training compared with two weeks for soldiers. This follows a week of decompression in Iraq. Nurses can take a 30-day leave, but most don't.

"It's always amazing to me," says Lt. Col. John Orendorff, chief of security, plans and operations at Brooke Army Medical Center. "I'll see them in their desert fatigues at the airport, then a few days later, I'll see them in hospital whites in the cafeteria."

When she first arrived at the 31st Combat Support Hospital, in the heart of downtown Baghdad's Green Zone, Maj. Garcia thought it would be a relatively safe place. After all, the Green Zone was a no-combat zone by definition.

But during her yearlong tour as head nurse, the hospital located in a clinic built by Saddam Hussein for his family was a favorite target for terrorist rockets.

Daily, medical staff was inundated with a seemingly unending string of burned and broken young soldiers. Nearly 12,000 soldiers have been wounded since the war started in March 2001.

"It was strange," she says, "being in an environment where people were trying to kill you."

The calmer pace

Maj. Garcia is learning the calmer pace of being a nurse recruiter for Brooke. And she is re-acquainting herself with her husband, Joe, and their two daughters, ages 10 and 7.

The transition is going well, she says. Even superbly. Two months after her return, she and her family went to Disney World.

But Maj. Garcia says some of her thoughts remain fixed on Iraq. The 31st was the primary destination for wounded GIs, civilian contract workers, U.S. government employees and Iraqi police and residents caught up in the daily wave of terrorist attacks. About 100 soldiers a week were treated and shipped out to Germany for transit to a stateside hospital.

"We all learned very quickly," Maj. Garcia says. "It's the kind of work we've trained for. But ... I didn't expect the significant number of casualties we encountered in even that first week. These were the wounds that nightmares are made of."

Extensive burns. Ruined limbs. Muscles ripped by bullets. As soon as one patient moved out of a bed, another moved in.

Sometimes, Maj. Garcia says, nurses simply held the hands of the dying, whispering comforting words.

They learned that the high-energy military weapons cause more damage to bones and flesh than the stabbings and gunshots seen in emergency rooms back home.

Maj. Garcia says it was not uncommon for her to pause and wash the blood of others from her arms.

She remembers a young soldier brought in one night, his body shredded in the explosion of a roadside bomb. The nurses had to turn him every 15 minutes so he could breathe. His wounds looked like a shark had ravaged him.

Medical teams worked on him feverishly. They replaced his blood volume twice. They performed surgery right on the intensive-care unit.

"Then, his heart stopped. And we couldn't get him back," Maj. Garcia says.

"Everyone cried. And then we went back to work."

Seven days a week

As head nurse, Maj. Garcia worked seven days a week, tending to her patients and mothering the nurses and medics under her command.

She left the hospital only occasionally for the half-mile walk to the gym. During off hours, she sat around with friends, watching movies on DVD.

They laughed together, she says. And they cried.

One night, a rocket-propelled grenade, or RPG, struck behind the hospital where Maj. Garcia slept.

"We didn't always move on the booms," she says. "You got to learn which ones were serious."

Maj. Garcia's older daughter had heard about suicide attacks that killed 10 people in the Green Zone and asked her mom about it during one of their weekly phone calls.

"I told her it wasn't anywhere near me and I was safe," Maj. Garcia says.

"Now, at home, the question comes up if I'm going back. Her answer, 'Maybe.' "

Different rhythms

On the second floor at Brooke, 1st Lt. Paul Hodge, 32, checks on cardiac patients undergoing monitoring in the subdued quiet of the telemetry lab. A little over three months ago, he was a nurse at the 31st, tending to the war wounded.

The workload in a combat hospital carries its own rhythms. The medical staff daily found themselves at the balancing point between life and death. It's a responsibility that is keenly felt, Lt. Hodge says, and not easily gauged by stateside experience.

"Stateside, you know you're working in a safe environment," he says. "There, it's burns, traumatic amputations, gunshots and blast injuries. And they keep coming."

One of the hardest parts of being away was missing the birth of his first child, Levi, who arrived in February 2004. Friends and family stepped in to help his wife, Elizabeth, and the couple kept in constant contact.

"We made it work," he says.

While in-country, Lt. Hodge kept his emotional bearings through the support of his colleagues.

"We worked with each other and looked out for each other," he says. "You can't be a loner in a place like Iraq."

Back home, Lt. Hodge says he's had little difficulty making the transition to stateside life.

"If I feel symptoms of stress, I know I have the support system around me. And if there's something wrong, Elizabeth will be the first one to drag my butt in to get help," he says. "But really, having Levi means we have to see life as it is.

"When I got back, he always wanted to be comforted by mom," Lt. Hodge says. "But slowly, it changes. He laughs at me now, and reaches out to me. And that makes me feel good."

Getting lives back

Maj. Garcia's duties as a nurse recruiter are much calmer and quieter than her turn as a combat nurse.

"Right after I got home, thunder and lightning would wake me. That's past," she says. "My husband and I understand each other better, and our relationship is better than before."

But she acknowledges that they are still working on getting their lives back after a year of following decidedly different tracks.

"My husband and my daughters now have different memories from mine. There is a year gone from our lives," she says. "There are still some issues to work on. We have to remember to talk to each other about stuff." She looks down at the framed photograph of her family and smiles.

"Kids have a way of dragging you out of yourself and back into life," she says. Maj. Garcia still feels the tug of war – that sense of caring for others in a far away and dangerous place. Both the injured and her nurses, who called her "Mom."

"I was responsible for them. I'm not involved in patient care right now. And some days, that's really hard on me," Maj. Garcia says. "Here, the clock hits 5:30 and you go home. Over there, you never go home."