Two soldiers lay near each other in the rain, close to death. One man's legs were blown off below the knee. The other had been knocked unconscious and was struggling to breathe.
An IED had blown up in Afghanistan in 2007, in a small village near the Pakistan border. Army medic Chris Torres, who was in the caravan of trucks hit by the device, faced a wrenching choice.
If he helped one soldier first, the other could die. The driver with the missing legs was talking. Torres applied tourniquets to both legs. He never had time to treat the other man.
As friends and colleagues gather Saturday to memorialize Army medic Paul O. Cuzzupe of Seffner, killed Aug. 8 in Afghanistan, his passing illuminates the extraordinary dangers and challenges medics face on the modern battlefield.
IEDs and infiltrators kill more soldiers than identifiable flashes of gunfire. Unlike in wars past, medics today commonly treat civilians, including children and the elderly, who are collateral damage in war.
But some of the hardships never change, like having to decide who will live and who will die. After Torres got back to base that day in 2007, he called his father-in-law.
"He was really upset," said James Bradley, a retired Army medic. "He was questioning whether what he did was right."
A former reconnaissance scout, Bradley remembers riding in an armored personnel carrier in Vietnam — then waking up in a hospital. He suspected medics had saved his life. After the war, he trained to become one.
Now Bradley is a physician's assistant for the Department of Veterans Affairs in New Port Richey and the patriarch of a family of Army medics. A son, Seamus, is currently on his third tour of duty as a medic in Iraq and Afghanistan. Daughter Erin is married to Torres and was a medic herself. Another daughter is also married to a medic.
Bradley told Torres he would have done the same thing that day in Afghanistan.
"The problem is that there is only one of you and two of them," said Bradley, 58. "How do you make that decision? That is where your training comes in."
By all accounts, that training has improved greatly since earlier wars or even the start of operations in Iraq and Afghanistan. Before going to battle, medics today study for 16 weeks and experience 15 days of simulated combat conditions that could rival a Hollywood set — complete with exploding bombs, mock villages, mannequins with simulated injuries.
Years ago, training was a mere five days.
The survival rate of those wounded in battle was less than 70 percent in World War II. In Iraq, it's about 90 percent.
"The number of lives saved . . . has been exponentially, hugely improved," said Dr. David Shapiro, an associate professor of surgery at the University of South Florida, who trains Army medics at Tampa General Hospital.
The field tends to attract the best and the brightest.
Like their compatriots, they take both enemy and friendly fire. Seamus Bradley was in Afghanistan in August 2005 when his unit got into a firefight with rebels.
The battle was almost won when one of the rebels threw a grenade. The explosion blew the leg off an Afghan coalition soldier and sent him rolling down a rocky hillside.
Seamus Bradley ran to treat him. A Blackhawk helicopter arrived and dropped flares to divert heat-seeking missiles. One of the flares burned Bradley's face and melted his latex gloves.
Seamus Bradley spent eight weeks in recovery, and was awarded the Purple Heart and the Army Commendation Medal.
That experience and others like it were tough to shake. Over the years, his mood darkened.
"A lot of it is just knowledge or experience," said Seamus Bradley, now 25 and stationed in Fort Bragg, N.C. "The more you see of the world, the more you come to understand it. It's like being a missionary, people who go out in the world and see the not-so-rosy side of human nature."
His father noticed the change. He had seen it before.
"If you are a combat medic at the tip of the spear, you know things are going to happen and people are going to die," James Bradley said. "And your job is to be right smack in the middle of it.
"It just has a way of hardening you."
The effects resonate more when medics can't save their comrades.
For Chris Torres on that day in Afghanistan, there was no helicopter. Heavy fog had forced the rescue chopper to turn back and doubled the driving time needed to get the two severely injured men to a base.
The unconscious soldier died. The double amputee Torres had treated lived. The choice he had to make three years ago has haunted him ever since.
"It's still tough," said Torres, 28, who trains incoming medics in simulated combat conditions near Fort Sam Houston, Texas. "I just needed a little more time. You think, 'If the weather wasn't so bad, if it wasn't foggy, if it wasn't raining — if, if, if, if, if.' "
Even so, he finds a way to put the experience behind him, as did Cuzzupe, the medic from Tampa who will be laid to rest Saturday.
Just a week before he died, Cuzzupe was given the Army Commendation Medal for trying to save the life of an Afghan child who lost both legs and an arm. The child died.
"It changes you," said Seamus Bradley. "It gives you a respect more than anything else. You just do the best you can, all the time."
Times staff writer Rick Danielson and researcher Shirl Kennedy contributed to this report. Andrew Meacham can be reached at firstname.lastname@example.org or (727) 892-2248.