Before he returned to active duty last year, Army Reserve Maj. Donald W. Robinson was a civilian trauma surgeon at Cooper Hospital in Camden, N.J., a city so violent it's known as the "murder capital" of America.

Nothing Robinson saw in Camden, however, came close to the horrors he and his surgical teams with the 86th Combat Support Hospital faced in Baghdad, from December 2004 through July.

"I expected to see a lot of penetrating trauma because those were the reports coming out of Iraq," Robinson said in a phone interview from his current assignment at Fort Benning, Ga. "When I got there, I was taken aback. This was penetrating trauma to the nth degree. It was massive. The tissue destruction was like nothing I'd ever seen before."

Robinson, 43, said he hasn't talked with surgeons from the Vietnam War, but he has read about the injuries they treated. He believes the wounds being suffered daily in Iraq, mostly from large improvised explosive devices, are unlike anything seen before in a war.

"It's just hard to explain the amount of destruction with an IED," Robinson said. "Imagine shards of metal going everywhere. ... Add the percussion from the blast. Then put someone inside a Bradley Fighting Vehicle and add fire to it, and burning flesh. A person inhales and (suffers) inhalation injury .... They didn't have that in Vietnam, not all that together."

Major Gen. George Weightman, who oversees Army medical training, said medical personnel in Iraq are at high risk for post-traumatic stress disorder.

"We refer to that as compassion fatigue," Weightman said. "How many really banged-up, mangled bodies can you take care of before, all of a sudden, you just get numb or can't handle it anymore?"

Robinson was assigned to Ibn Sina Hospital, a modern facility originally built for Saddam Hussein's army. On his first day, he walked into the emergency room at 9 a.m. as five trauma patients were arriving. It was his first experience with IED victims.

"In all honesty, it just looked like destruction," said Robinson. "Blood everywhere. People were screaming. It was chaos."

Robinson, chief of surgical and critical care for the 86th, and a doctor who was showing him around each took a patient into surgery.

"That day seemed like it never ended because, after that, another patient came in and then another and another. The next thing I knew, it was 12 o'clock at night. ... I went to sleep on the floor. ... Woke up the next morning about 6 o'clock and it was the same thing, and just kept going."

He operated on almost 400 patients over the next seven months. When a patient died, Robinson said, "I wished I could have called that person's mom or dad to say, 'You know, I'm the one who took care of your son, and I want you to know that we did everything possible to save his life.' "

Before rejoining the Army, Robinson knew his pay would fall by a third and that Iraq would be dangerous. So why do it?

"Simple," Robinson said. "I think I can save lives. If it was my son over there, I would want me taking care of him. That's the bottom line."