The doctor sutured the scalp as Burns trained a flashlight on it and held a temporary breathing tube in the other hand. He and five other doctors worked shoulder to shoulder, their arms, legs and heads tangled around a nest of tubes, cables and medical equipment. Dozens of other doctors and nurses struggled to save other patients, wading through ankle-high piles of torn-off bandages.
Some died, but others survived.
And Youssef? Once the boy was stabilized, he was flown to Baghdad for treatment.
Later, Burns would try to check on the boy whose life he helped save, using a computer that tracks patients. For six weeks, Youssef's name appeared. Then suddenly one day, it was gone. Burns heard rumors the boy had gone home; he would never know for sure.
But on that February day when he fought for Youssef's life, the North Dakota doctor had a final duty.
He walked a mile to a base morgue to establish the cause of death for two Iraqi civilians killed in the blast and two U.S. soldiers.
He signed the paperwork, then ended his 19-hour day with an e-mail to his wife, Becky. He feared she'd hear news of the bombing and worry. "I am fine," he wrote. "Disregard news reports."
As it turned out, she hadn't seen the news at all.
At Walter Reed, a new reality was setting in for Sgt. J.R. Salzman, recovering after the loss of his lower right arm.
He'd thought he would get a prosthetic arm, rebound quickly and be just fine. But after several surgeries -- including the amputation of his left ring finger -- it was becoming clear: This wasn't a two-week recovery. It would be months, even years.
Salzman, who had been the go-to guy when a Humvee needed fixing in Iraq, now had to learn how to do the most rudimentary things: Zip a jacket. Brush his teeth. Write with his left hand.
He was haunted by nightmares. Sometimes he dreamed he saw the flash of an IED explosion. Other times, he woke screaming that his arm was gone, begging for a tourniquet.
The methadone and Lyrica he took for nerve pain left him dizzy, confused, drowsy. He had trouble remembering appointments.
Even proud moments turned into ordeals.
When Salzman was invited to the president's State of the Union address, it took 20 minutes and help from his wife, Josie, just to put on his dress uniform. It was his first trip outside Walter Reed; he didn't like leaving his safe haven.
As they listened to the speech, which was interrupted several times by applause, J.R. couldn't clap. Josie felt like crying, and applauded loudly on his behalf.
Josie was insistent that J.R. talk with a therapist. She didn't want to put it off. Her husband, an athlete, a champion log roller, had lost his right hand. He needed to talk with someone about it.
When they finally arranged to meet together with a therapist, it did not go well.
Josie thought J.R. wasn't being honest, that he said he was eating and sleeping well, when he was having nightmares and living on pudding snacks.
Tensions mounted. He threatened to send her home. He thought she expected him to be the same person with whom she had fallen in love, and he wasn't.
But as the months passed, Josie stayed and J.R. improved. He learned to write left-handed, to dress himself, even to fly fish with a prosthetic arm.
His sadness, though, lingered. He found himself remembering small details about the hand he lost, down to the scars he had from carpentry work. He'd think about that day when his wedding ring was snipped off by bolt cutters at the Green Zone Hospital in Baghdad.
Salzman knew others had worse injuries. He wanted to be positive, but sometimes it was hard.
"I think having given two years of my life and my right arm is more than enough for my country," he wrote in his blog. "Now I want to get back to my private life, and learn how to live again all over."
As spring approached, Sgt. John Kriesel prepared to take his first steps on prosthetic legs.
He wanted to walk earlier, but he had to heal from back surgery needed so he could bear weight on his legs. His spine, sacrum and pelvis had to be fused.
Kriesel had prepared for months, watching other amputees being fitted with prosthetic legs. His left leg -- which was amputated above the knee -- was replaced with an aluminum limb that bends like a real leg; a computer chip inside senses if he's going to fall and lock ups to prevent it.
His artificial right leg -- shorter because his leg was amputated six inches below the knee -- has a carbon-fiber foot with a high-tech shock absorber.
On March 12, 2007, Kriesel donned a stars-and-stripes T-shirt and red shorts, wheeled into the therapy room, grabbed the parallel bars and stood.
At first, he felt as if he was on stilts.
But he was thrilled to look at people at eye level and kiss his wife, Katie, standing up. He walked back and forth, heel to toe, heel to toe, to perfect his form.
A doctor had warned Katie that because John's spine was fused, he'd lose mobility in his lower back and would waddle. His gait, though, was smooth.
Kriesel worked up a sweat but was reluctant to quit. Only when therapists started switching off the lights at the other side of the room did he stop. They locked up his prosthetic legs so he didn't try to practice when no one else was around.
Five days later, Kriesel graduated to a walker.
Two weeks later, he had two canes.
At the end of April, Dr. Joe Burns headed home.
When the plane refueled in New Jersey, some soldiers kissed the American soil. For Burns, the smell of humidity and the sight of greenery almost made him giddy.
After a debriefing in Texas, he flew to North Dakota on April 25, his 26th wedding anniversary. When the plane pulled up to the gate at Fargo, Burns' daughters, Anna and Sarah, waited, along with his wife, Becky.
His gift to Becky, purchased in Kuwait, was a brass Aladdin's lamp, the kind you rub to make a wish.
His own wish had already come true.
Shortly before midnight, Burns arrived home. Within minutes, Becky was asleep. A teacher, she had to be at school the next day.
But Burns was wired.
He wanted to savor the comfort of his own bed, the closeness of his family, the quiet he had desperately missed. And the peace.
Finally, he fell asleep.
To be continued.