He's flying. Twisting through the air like a man flung from a trapeze. The sky envelops him. It's so bright.

There's no time to wonder why. Bryant Jacobs feels his body slam against the ground. He's flailing. Tumbling over and over.

He comes to rest on his stomach. He tries to breathe. The air is hot and black with smoke and dust.

He strains his neck back, lifts his head and tries to push himself up. That's when he notices the top of his left index finger is gone. A bone protrudes from a mess of dirty, bloody tissue.

He wonders, for a moment, where the rest of it went.

"Jacobs!"

The sound of his name breaks through the ringing in his ears.

Sgt. Ming Chu is suddenly at his side. Chu flips him onto his back and puts pressure on his wounds. His stomach. His chest. His hand. Both legs — shredded in the blast.

Specialist Carlos Muniz sees everything from the gunner's perch of his Humvee, two trucks back.

A tremendous boom. A huge black cloud. A wave of dirt and metal and smoke. He cowers in the turret while hell passes over him.

As the dust settles, the driver of Muniz's truck, Chris Harry, creeps the Humvee forward. Two soldiers are lying in the dirt.

Muniz instantly knows who they are.

Jacobs, to the right, is on his back. Sergeant Chu is leaning over him, rolling out a tourniquet, covered in blood.

To the left, his long and slender frame curled up like a child hugging a stuffed animal, is David Mahlenbrock.

The two soldiers had been sitting side by side in the bed of their Humvee.

No one is by Mahlenbrock's side, but Muniz cannot go to him — the gunner stays with the truck. That is how they have trained. He tightens his hands around his rifle, locking himself to his post.

Chu runs back to get another medical kit.

"Now," Muniz remembers thinking. "Now he will help Mahlenbrock."

But Chu goes back to the right.

"Why's nobody helping Mahlenbrock?" Muniz calls after Chu. "How come nobody's helping him?"

Chu stops and turns. He looks up at Muniz and shakes his head.

They call for a helicopter, then decide not to wait. The soldiers grab handfuls of Jacobs' tattered uniform and lift him into the flatbed of Muniz's truck.

At last Muniz can do something to help. He cradles Jacobs in his lap. He hugs his head and talks to him and tries not to look down at the younger soldier's mangled flesh.

He doesn't tell the 24-year-old how bad things look. He doesn't tell him that Mahlenbrock's tattered body is in the shattered truck they're dragging back to Kirkuk Air Base in northern Iraq.

Jacobs begins to drift asleep.

Muniz tries nudging him. He tries yelling at him. He even tries startling him. Repeating a joke they've been telling each other — in the crude way soldiers joke in war — Muniz tells Jacobs that his penis has come off, and that he has it in his hand, and that he is going to do bad things with it.

Jacobs stirs, slightly.

Muniz slaps him. It feels good, for some reason, to slap him.

Jacobs' eyes pop open, then slowly close.

Muniz slaps him again.

"You gotta stay awake."

"I'm so tired."

"You gotta stay awake."

Muniz keeps talking. To Jacobs, the words are unintelligible.

The helicopter meets the convoy halfway to Kirkuk. Jacobs is yanked from the Humvee. His leg tumbles, dangling from the stretcher.

He screams. Like a big breaking wave back on Honolulu, where he trained with the Army's 65th Engineer Battalion, the pain slams into him and washes over his body.

He passes out.

Then, for a fleeting moment, he's back. There are doctors standing over him with bloodied hands.

For three weeks, that's all he'll remember.

It's late in the evening on Dec. 3, 2004, when Sherry Scheiding gets the call at her sailboat, where she lives with her husband in the San Leandro Marina in San Francisco Bay.

A man who identifies himself as Mr. Rice tells Scheiding her son has been wounded. He's not expected to live.

Sometimes, Rice says, mortally wounded soldiers make it to Landstuhl Army Regional Medical Center in Germany before they pass.

Perhaps she can get there before her son dies. Perhaps she'll have the chance to say goodbye.

The top of his thigh is splayed open just below his groin.

The skin of his lower leg is split along the calf. Blood and fat and muscle gush from the wounds. Gravel, dirt and shiny flecks of shrapnel, embedded in the crimson muscle tissue, glitter under the surgical lights at the U.S. military hospital in Kirkuk on the afternoon of Dec. 3, 2004.

For soldiers in Iraq and Afghanistan, the rate of amputations is double what it was in Vietnam — mostly because combat medics and military field surgeons have gotten better at saving soldiers with severe injuries to their arms and legs.

But military doctors are also saving more limbs — even those as damaged as Jacobs' right leg.

Surgeons always try "to err on the side of limb salvage," says Major Benjamin Potter, an orthopedic specialist at Walter Reed National Military Medical Center who served in Afghanistan's volatile Helmand Province in the summer and fall of 2011.

So long as "a patient isn't trying to die on you on the table," Potter says, combat surgeons will do what they can to "really preserve all treatment options" — even if it's likely a patient will have to have an amputation when he or she arrives at a stateside medical center.

Jacobs' right leg isn't moving. With all the shrapnel and nerve damage, his medical records note, it's certainly possible it will need to be removed.

Over the next three days, as he's moved from Kirkuk to Kuwait to Landstuhl, then into the cavernous cargo bay of a C-17 Globemaster for a perilous nine-hour flight over the north Atlantic Ocean, a relay of care teams watches for signs of infection and clotting that might force an emergency amputation.

But right now, whether he keeps the leg is secondary. Jacobs' caregivers are focused on keeping him alive. And for the moment they're succeeding.

Scheiding gets another call. Don't go to Germany, she's told. Come to Walter Reed — but don't get your hopes up.

Jacobs arrives at Walter Reed Army Medical Center in Bethesda, Maryland, on Dec. 6.

It's a week shy of the one-year anniversary of the capture of Saddam Hussein by U.S. forces in Iraq. A records technician classifies his wounds with the code "E998," meaning the injuries occurred "after cessation of hostilities."

Doctors use tweezers to remove metal shards and gravel flecks as small as grains of sand, and pliers for bomb and Humvee fragments the size of fingernails. They extract hundreds of shrapnel pieces from Jacobs' stomach, back, buttocks, legs, hand and the back of his head.

They pull his intestines away from his body, cut away the ravaged tissue and rechannel what remains to a colostomy bag. They clean and stitch his left index finger at the proximal joint.

It's clear that his right leg could be a years-long work in progress. The surgeons drive screws into his shattered femur. They graft healthy veins onto areas left in tattered strings. They cut away the ragged flesh, binding together the cleanly cut ends with layers of sutures.

It's unclear to what end. Most of the nerve endings past his knee have been blown away.

That gives Jacobs' care team pause. There's no right or wrong answer, they tell his mother, but amputation might help him live a more active life. When not at her son's bedside Scheiding pores through research on nerve damage, looking for answers.

Forty miles south of where Jacobs is being treated, scientists at Johns Hopkins University are exploring the possibility of transplanting stem cells to promote nerve regeneration in damaged arms and legs. Lab tests on mice look promising.

Wanting to preserve all possible outcomes for her son, Scheiding tells his doctors that she doesn't support an amputation.

A decade later, it's still hard for her to talk about.

"It was 50-50," she says. "As a parent, making that kind of decision, there weren't any right answers."

Jacobs comes to believe he slept through his first days at Walter Reed. His medical records, however, indicate he is awake in fits and starts, "anxious at times, and suspicious of everyone."

He fights nightmares and hallucinations. He trashes his hospital room. A doctor signs an order to strap him into his bed.

When he becomes more conscious and calm, nearly a month has passed. He is tangled under a web of tubes and wires, pinned by casts and steel rods in a critical-care unit.

His mother and stepfather are there.

The first thing Jacobs can remember with any clarity is eating breakfast. On the hospital tray before him are waffles and sausage. "You're going to throw that up," Stephen Scheiding warns.

Jacobs eats it anyway. Then he vomits it into a bedpan.

Thirty-nine surgeries come and go in three months.

Surgeons slice thin layers of healthy skin and graft it on areas that are badly damaged. When some grafts fail to take, they rip off the dead skin and start again.

They fight streptococcus, E. coli, and Bacteroides fragilis.

They battle Jacobs' pain with inexact artillery. Among other drugs, he is given acetaminophen, oxycodone, tiagabine, warfarin, ranitidine, nortriptyline, enoxaparin and methadone.

Six months after his arrival, he's permitted his first trip home.

At the Salt Lake International Airport, his plane is greeted by airport police and firefighters, lights and sirens blazing. It's a hero's welcome. At a TGI Friday's restaurant in Sandy the next day, the waitstaff pushes three, then four, then five tables together to accommodate his gathering friends and family. His grandmother has made T-shirts for the occasion. Black with white lettering across the back, they read: "In honor of Spc. Bryant Jacobs."

He rolls cautiously into the restaurant, piloting his wheelchair around a party of a half-dozen women in red hats. He asks for a Dr Pepper and picks up a menu.

"So, what now?" someone asks.

Jacobs stares out the restaurant window.

"Well, if there is one thing I want to do," he says, looking out at Salt Lake City's dominating mountain skyline, "it's to get on my snowboard and ride."

It is early June 2005. The Wasatch Range has just shed its powder-white veil. Utah's resorts won't be open again until November.

Five months. Somehow, battered and mangled as he knows he is, it seems like enough time.