"There are two priorities. The first is to save lives, so you want to make sure he's stable," Rooney said. "Then from an extremities standpoint, you try to salvage everything you can."
In the case of Little, the doctors decided to remove the lower part of his remaining leg.
Rooney, a West Point graduate, sees cases like Little's day after day. Even coming from a family of surgeons and specializing in traumatic spinal injuries back home in Texas doesn't shield him from the effects of what he witnesses every day.
"One of the frustrating things is that you know as a physician a lot of times you're used to succeeding," he said. "Here a lot of the time what they hand you is a patient that's been devastated. There's no win. You lose and you lose and you lose and you're just not used to losing. It just sucks."
Like everyone who works at the hospital, Rooney finds ways to cope.
"Exercise. So a lot of us exercise. A lot sleep. Some people eat, some people don't sleep very well. There are probably a lot of people on antidepressants. You know if they didn't have 'general order No. 1' which is 'no alcohol,' there probably would be a lot of drinking," Rooney said.
When White has a free moment, he checks on the patients who have come through Rooney's emergency room. The young scorpion bite victim is now in intensive care, but with anti-venom administered White was hopeful they would see a turn around in her condition during the next few hours.
White also checked in on Little who was now out of surgery, but still not awake. He would remain in the clinic for only a few hours more. The goal was to get patients stabilized and moved out as quickly as possible to U.S. medical facilities in Germany, and eventually the United States, to continue their treatment.
Little's commander, Lt. Col. Mark Weinerth, and a few fellow soldiers also arrived to check on his condition. They approached the bed cautiously and quietly pinned a Purple Heart medal to Little's pillow. A chaplain offered a brief prayer.
"We bless this soldier," he said. "We thank you father for his family back home. Continue to be with this soldier, continue to bless him. In His holy name we pray. Amen."
Weinerth asked the nurse how the medics did treating Little in the field.
"They did a great job," White assured him. "They did everything perfect. They saved his life."
Weinerth was also thankful for the work done by the staff at the hospital. "You guys are incredible up here."
White returned the praise.
"You guys have the hard job," he said. "You are out there every day. Not us."
But even in this Green Zone hospital, there have been sustained attacks and personal losses. In July White and the staff tried in vain to save fellow nurse Maria Ortiz, who had walked out of the hospital just as mortars began to fall. Ortiz, who was supposed to be married when she returned from Iraq, was the first army nurse killed by hostile fire since Vietnam.
"Anyone who has ever taken care of someone who they were close to, someone they've worked with, and they've actually had to then work on them — it's a different ball game. Totally different ball game," White said. "Even though you attempt to focus on injuries like you do on 8,000 other cases you've done, when it's somebody you know, that you really know, and you know they're counting on you to save them, you know it's a different ball game."