General Mark Milley greets former military members and their families at a memorial ceremony for U.S. military members who lost their lives in a Sadr City, Iraq, battle 10 years ago, at Fort Hood on April 5, 2014, in Killeen, Tex. (Jahi Chikwendiu/The Washington Post)

The woman, who moments earlier had been forcing a smile for the visiting general and the congressmen, burst into tears. Her brother, a young private first class, lay in a hospital bed a few feet away, one of the victims of last week’s mass shooting at Fort Hood.

He was conscious and healing but unable to talk because of a breathing tube.

Lt. Gen. Mark A. Milley wrapped his arms around the woman and tried to console her in the hallway outside the hospital room. “I’ve been in a lot of combat zones,” he said. “I’ve seen a lot of wounded and injured soldiers. He’s going to be okay.”

Milley had returned to Fort Hood late last month, after a one-year tour of Afghanistan and a short leave. Eleven days later, Spec. Ivan Lopez opened fire on troops in his transportation unit and a surrounding two-block area, killing three soldiers and wounding 16 before he took his own life. As Milley visited the hospital Saturday, he was still wearing his Afghanistan combat boots, which had his blood type and the last four digits of his Social Security number written in marker on the ankle.

For more than a decade, Milley had been making similar visits to hospitals in Iraq and Afghanistan to check in on his wounded troops and offer words of encouragement. “Battlefield circulation” was what his staff was calling this day, which included hospital visits and a trip with two Texas congressmen to the crime scene. It was the same phrase that Army commanders, including Milley, routinely used in Afghanistan and Iraq to describe a day spent moving around those war zones.

The sister of the wounded private told Milley that she was a single mom and part-time college student who was taking time off from a $10-an-hour job to be at her brother’s bedside. Money was tight, and she wasn’t sure how much longer she could stay before she would have to head home to Nevada. Milley took her cellphone number and promised to put her in contact with people at Fort Hood and groups in Killeen that could offer help.

“Your brother is a tough soldier,” Milley said. “He’s got a strong family. He will get back on his feet. He will make it.”

To spend a day with Milley in the wake of Wednesday’s shooting is to see how much Fort Hood, the Army and its commanders have been altered by more than a dozen years of war. More than 550 troops from Fort Hood have died in Iraq and Afghanistan since the Sept. 11, 2001, terrorist attacks, and thousands more from the massive Army post have been wounded, though the pace of deployments and casualties has slowed considerably in the past year.

Milley has logged about five years of combat time in Afghanistan and Iraq. On the granite memorial outside the 1st Cavalry Division headquarters at Fort Hood are the names of 28 soldiers who died under his command in western Baghdad in 2004 and 2005 when the insurgency in Iraq was still gathering strength. He is quick to note that his experience during America’s longest stretch of continuous war is not remarkable and probably is not even unusual. “You’ve got a whole crop of generals now who were battalion and brigade commanders at the beginning of this thing,” he said. “This has been our profession in life.”

On this day, Milley’s profession had him walking through the open door into another hospital room, where a young soldier was sitting in a chair by her bedside. She looked scared, uncertain and exhausted. Milley bent down on one knee so she would not have to look up at him. “How are you feeling?” he asked.

She replied in what was barely a whisper. The general held her hand and gently gripped her wrist. Not long ago, talk of post-traumatic stress disorder or other mental wounds suffered in combat was taboo in the Army. On this day, it was something a general discussed with a wounded soldier by her hospital bed.

“You’re going to have challenges getting the images out of your head,” he quietly told her. “You have a mom here. You have a family in uniform. Remember, you’ve got help if you need it.”

Milley rose to his feet and turned to the two congressmen, who were standing behind him in the small room. Now he was talking to them, though his message was mostly intended for the wounded soldier. “She’s as tough as nails,” Milley said, his voice loud and suddenly gruff. “She’s an American soldier. She’s going to get some rest, and she’s going to be okay.”

Some of the wounded were sitting up in their hospital beds. Their legs were still pale and jaundiced, but the color was returning to their faces. Milley marched into the room of a former Special Forces soldier who had been shot in the neck during the rampage and was unable to speak. His shoulders were badly bruised. “You don’t have to talk,” the general said. “I can read your mind. You look a hell of a lot better than you did the other day.”

The soldier had a children’s alphabet puzzle on his lap and touched the letters to spell out his reply. “It is because I am SF,” he tapped. Milley tore his own Special Forces tab off of his uniform and handed it to the soldier to stick on his white hospital gown. It was a trade. “You owe me your tab when you’re done with that one,” the general said.

In another hospital room, the congressmen talked with an Army officer who had been shot in the stomach. He had dialed 911 with one hand while applying pressure to his wound with the other. Before he went into surgery, he scribbled a note to his commander that now hung above his hospital bed. “Sir, how’s everyone doing? Let everyone [know] I am doing good and we’ll all get through this as a family-team.”

Outside the hospital, the congressmen spoke with a television camera crew.

“Well, we’ve met with American heroes today,” said Rep. John Carter (R). “I don’t know where we find these people.”

Rep. Roger Williams (R) added: “Everyone is doing much better. We expect full recoveries.”

Milley avoided the cameras. Instead, he pulled aside a company commander from Fort Hood whose 80-soldier unit had suffered two dead and three wounded in the shooting. At a massive post such as Fort Hood, it’s impossible for the commanding general to know more than a fraction of his soldiers. Milley had met this officer only a couple of days earlier, in the aftermath of the tragedy. As they spoke, the general scanned the officer’s uniform and noticed his 82nd Airborne Division combat patch — a sign that he must have fought with the infantry unit in Afghanistan or Iraq, or both. “Make sure your soldiers get help. Get them counseling,” Milley said. “No survivor’s guilt. You’ve been in combat, so you know. It’s the same drill here.”

The day ended with Milley back at his office in Fort Hood. The hospital visits were similar to those that he and his fellow generals had been making in war zones for a dozen years, he said. Of course, there were no family members overseas.

“The nature of the wounds is different, too,” he said. In Iraq and Afghanistan, he mostly saw blast wounds, which tore off limbs and left bodies badly mangled and burned. Bullets entered the body cleanly and then tumbled and tore up the insides.

But otherwise the time spent with the wounded was almost exactly the same: The same words of encouragement. The same simple gestures intended to show kindness, compassion and care. Even some of the same doctors, who had honed their skills treating combat trauma overseas.

“Same as in Bagram, same as in Kandahar, same as in Baghdad,” he said, with one big difference. “In combat, you expect it. You don’t expect it back in the U.S. on this scale.”