The Most Dangerous Place in Iraq

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U.S and Iraqi soldiers crouch on a road during a street battle as insurgent gunfire echoes around them, earlier this year in Ramadi, al-Anbar Province.

There wasn't much blood on the last casualty of the day in Ramadi, the capital of al-Anbar Province. The bandages on the face of the American soldier who arrived at the U.S. field hospital in the area around midnight Dec. 6 were only a little red as medics crowded around him at the operating table. Navy Commander Carlos Brown, the chief surgeon at Camp Ramadi, peered at the bullet wound in the soldier's lower face as his team quickly cut clothes off the man and readied surgical equipment. "Stop," Brown said suddenly. All hands fell away from the table, and everyone grew silent. "He's dead."

Gaining Control in Ramadi

AUDIO: U.S. forces have made some advances in the struggle to clear insurgents from this city. But the death toll shows that they still have a long way to go

The emergency room remained quiet for a moment, but outside a wail of grief went up from one of the soldiers who had rushed their comrade from a nighttime battle in Ramadi to the base hospital. "Jesus f---ing Christ!" the soldier yelled, falling to his knees. A second later several soldiers and Marines from Camp Ramadi were also kneeling with their arms around him as he cried. They stayed on the ground for a while, huddled together in the swirl of dust kicked up by the vehicles that had come throughout the day bearing other American and Iraqi casualties from violence in Ramadi.

Across Iraq that day, 11 American servicemen died in one of the deadliest 24-hour periods for U.S. troops in the country this year. Four of the dead appeared in Brown's hospital in the heart of Anbar Province, where U.S. troops are killed in greater numbers than anywhere else in Iraq. Since June, the U.S. effort to quell sectarian violence in Baghdad has drawn thousands of troops to the country's capital, where the world's attention remains largely focused. But outside of Baghdad, U.S. forces are suffering the heaviest death toll these days as they continue to wage a grim, uncertain struggle to defeat insurgents in the predominately Sunni province of Anbar. Tallies of the war dead from August to November show that more than two-thirds of the U.S. casualties in Iraq were outside Baghdad, with four in 10 of those deaths occurring in Anbar Province. Much of the killing happens in Ramadi, where insurgents and fighters from al-Qaeda in Iraq attack Marines, U.S. soldiers and Iraqi security forces almost daily.

Usually the U.S. casualties in Ramadi come in twos and threes during lightning insurgent strikes like the one Marines faced Dec. 4 in the downtown area. Hundreds of Marines and a handful of Navy medics hole up every day inside several newly established police stations in central Ramadi. In the latest push to gain control of the city, U.S. forces man what amount to a string of inner-city garrisons across town, offering training and support to small groups of Iraqi police who warily walk the surrounding streets. The patrols rarely venture far. The blocks around the compounds are flush with insurgents who watch the movements of Iraqi security forces and U.S. troops, waiting to attack at unpredictable moments.

Eleven days had passed without a major assault on one such station in central Ramadi when suddenly a mortar slammed into a door leading to an outside toilet. The yells rose even before the sound of the massive blast faded. An Iraqi policeman dangling a bloody arm yowled in Arabic as he ambled down a corridor away from the smoke and dust of the explosion. Worried shouts and the barking of orders surrounded one of the American wounded as he lay on his back in the same hall, bleeding heavily. Another wounded American sat stunned with blood flowing from his mouth and gashes on his head and neck. Outside, a Navy medic lay dead from shrapnel wounds. And on the roof of an adjacent building, a Marine was dead after getting shot in the face in gunfire that came with the mortar. About half an hour later, the dead and the wounded were brought to Brown, who says at times he struggles with his emotions when treating fellow servicemen and -women.

"I've found myself choked up with tears in my eyes," says Brown, a native of Texas who worked in an emergency room in Los Angeles as part of his military training. "And I've seen that on multiple people on my team."

Camp Ramdi's morgue sits a short distance away from Brown's hospital. On nights when dead U.S. servicemen and women lay inside, troops gather in darkness outside the doors in formation for what they call a "heroes' ceremony." The dead, wrapped in black body bags, are carried from the morgue, past rows of troops standing at attention, and loaded into ambulances. The troops then follow the ambulances in silence as they drive slowly to a nearby helicopter pad. There the bodies are placed onto lumbering Chinook helipcopters and begin a long journey from Ramadi to the places where they may finally rest.