In August, however, the rate of acute cases jumped to three of four ER patients.
"It was intense," said Lt. Col. Greg Kidwell, who oversees the emergency room at the hospital.
Capt. Neil Taufen, an emergency room physician, said the pace was all the more striking because it came after a quiet stretch.
"July was just dull, and it was like: Everything's going to be all right. And then Najaf fired up, and it was just like nothing had ever changed," said Taufen, of Fort Sill, Okla.
Najaf and the neighboring town of Kufa, about 90 miles south of Baghdad, have been quiet since a peace deal was brokered in late August by Grand Ayatollah Ali Sistani. Last week, an informal cease-fire also took hold in Sadr City, the Shiite slum that is the main stronghold of junior cleric Moqtada Sadr and his Mahdi Army militia, which fought in Najaf.
But U.S. forces continued to clash with Sunni Muslim insurgents and foreign-born fighters west and north of Baghdad. Twenty-six Marines were killed during August in Anbar province, which takes in Fallujah and Ramadi and extends across the western desert to the Syrian border. Insurgents hold sway in both cities and routinely attack U.S. patrols.
"It's always kind of a smoldering fight out there," Kidwell said.
Parts of Baghdad also remain combat zones.
Propped on pillows in a ward of the Baghdad combat hospital Saturday afternoon, Spec. Christopher Riang, 19, wore a zipper of surgical staples up his abdomen after a nasty surprise the night before off the capital's hostile Haifa Street.
"I yelled 'grenade!' and made sure the Iraqi translator took off," he said, describing the overnight ambush that left him with a belly full of steel shards. "Then I took off. I guess I couldn't outrun the grenade."
The interpreter was also injured, as were four other 1st Cavalry soldiers caught in the alley when grenades began raining down.
"Almost everybody took shrapnel," said Capt. Chris Ford, the company commander. Three soldiers were injured lightly enough to return to duty after treatment, as are about 45 percent of U.S. forces wounded in Iraq. Two others needed medical evacuation. The interpreter went home.
"Basically, we had to fight our way out of that alley," Ford said. Bradleys came to help, he said, but most of the patrolling in the largely hostile neighborhood is conducted on foot.
"It's a labyrinth," Ford said. "And it's conducive to their kind of fighting."
More and more often, children are lobbing the grenades, Ford said. Insurgents offer boys of 10 or 12 years old $150 to toss a grenade at a U.S. patrol, the captain said.
"For the longest time, we've had a good relationship with the children," Ford said. "Now this. Who enjoys putting a bead on a kid?
"Nobody. That's why they paid them."