SAN ANTONIO — The five badly burned soldiers arrived around 11 p.m., sedated and swathed in bandages from head to foot — the screech of the plane's wheels on the tarmac and waiting ambulances marking the end of a 7,500-mile journey.

Dr. Kevin Chung waited inside Brooke Army Medical Center as the ambulance convoy zipped through its gates. He knew the soldiers were coming in from Germany, after being evacuated from Iraq.

Now Chung and some 30 doctors, nurses and others took over.

They cut open the men's bandages and, using diagrams of the human body, mapped the soldiers' burns — shading in red for third-degree, blue for second-degree — to plan for surgery.

They called the soldiers' families. They needed permission to operate. Quickly.

The men had been injured days earlier when a roadside bomb turned their Bradley fighting vehicle into an inferno. One man who had escaped ran back to help a trapped comrade.

"This one's the hero," Chung said, as the first stretcher rolled in. "They're all heroes," a nurse replied.

Chung did a bronchoscopy to check the "hero's" lungs. He threaded a fiber-optic scope into the tube connecting the soldier to a ventilator. Tarlike soot deposits appeared on a video monitor. To Chung, it looked as if someone had smoked 100 packs of cigarettes in 10 minutes.

The others' lungs were worse.

'YOU HAVE TO BELIEVE'

Brooke's burn center — the only one of its kind for the nation's military — has its own rhythms and rituals.

The center's 40 beds are tucked in a fourth-floor wing of the hospital at Fort Sam Houston. In the halls and on the walls, there are constant reminders of the war — the scarred young men, the clocks set to Iraq and Afghanistan time.

Doctors operate in 90-degree heat, sometimes six at once working on a soldier; nurses, in boots, masks and long gowns, sweat as they scrub down patients in steaming showers; families congregate, longing for the day loved ones will emerge from the cocoon of bandages.

In another era, another war, many patients probably would never have made it this far.

But troops today have better body armor, fast evacuation from the battlefield to war zone hospitals, then state-of-the-art treatment in Germany and the United States.

Brooke has special teams that fly to Landstuhl Regional Medical Center in Germany to bring home the most severe cases on a C-17 transport, sometimes handling emergencies in midair.

Once patients arrive at Brooke, skin grafts are usually done within 24 hours to stave off infection, the major cause of death.

"The faster you get the burn off the patient, the better off you're going to do," says Dr. David Barillo, chief of the flight evacuation team.

There is a steady flow of wounded from Iraq and Afghanistan — more than 570 thus far, of which about 6 percent have died.

Many survivors, however, are permanently scarred. Some also suffer from blast-related wounds, such as head injuries or fractures. Others can't walk, cut their food or tie their shoes.

"We now have an entirely new population of burn survivors ... with oftentimes lifelong and life-changing injuries," says Dr. Evan Renz, a Brooke surgeon.

"You have to believe that you're doing the best thing for the patient by helping them survive," Renz says. "You have to believe that in the end, when all is said and done, they will be glad they made it through."

GRIM STATISTICS

Chung woke from a quick nap on his office couch the morning after the five badly burned soldiers arrived, and walked down the hall to check on them. All were stable. But the news quickly turned grim.

One soldier went into shock. His heart, lungs and kidneys failed. He died without regaining consciousness.

With burns, Chung says, patients can rally, then suddenly take a turn for the worse — all the while dealing with excruciating pain.

"I can't think of a more devastating injury," he says. "In the most tragic instances a lot of us say to ourselves ... sometimes life is worse than death."

Of the five burn patients, one was transferred out of intensive care. The "hero" was rebounding, too. Then an infection set in — and he died.

Within three weeks, four of the five were gone.

MERLIN GERMAN'S STORY

Chung always reminds himself of the most critically burned patient he helped treat who survived. That would be Sgt. Merlin German. German's survival is a story of numbers: