LANDSTUHL, Germany — After almost 20 years helping the wounded as a reservist, Capt. Rogelio Alonzo has developed a tolerance for seeing gruesome injuries.

But even his defenses break down sometimes, and he’s overcome with sympathy.

“I hate seeing the amputees,” said Alonzo, a nurse practitioner from Fullerton, Calif. “I sometimes have to turn away.”

Alonzo is one of 291 reservists from the 349th General Hospital in Los Angeles who has worked the past year at Landstuhl Regional Medical Center. Most will return home later this month, making way for 254 reservists who arrived Friday from the 328th General Hospital in Salt Lake City.

Reservists provide key relief in the hospital, fulfilling services from bedside care to cooking. They help ease the hospital’s workload that comes from serving almost 22,000 wounded soldiers from Iraq and Afghanistan since the war on terrorism began in 2001.

“I can’t say we’re doing most of the work, but we’re doing a lot of it,” said Col. Joanne Slyter, a dietician with the 349th reserve unit who volunteered to stay an extra year.

During busy times, the hospital sometimes resembles a scene out of the television show “M*A*S*H,” Slyter said, as gurneys carrying wounded soldiers roll by in every direction and doctors dart in and out of surgery.

The hospital reserve units are made up of mostly nurses, who come from a variety of backgrounds and sometimes are years removed from bedside care, said Alonzo, assistant head nurse for the hospital’s medical and surgical ward.

Nurses from large metropolitan hospitals often have little trouble adjusting to the volume of patients and gravity of the injuries that Landstuhl handles daily, Alonzo said. But others find themselves in an environment that is difficult to prepare for, he said.

Alonzo recalls holding the hand of an Army staff sergeant in his 40s who lost sight in both eyes after a makeshift bomb exploded near him in Baghdad last year.

“There is nothing you can say to make him feel better,” Alonzo said. “Sometimes just being there and letting them know that you’re there for them is the best thing.”

In an unusual case, doctors examined a young Marine who had fallen out of a building and could not move his legs. Tests showed he was not paralyzed but suffered from a “conversion disorder,” a psychiatric condition that can inhibit motor movement after someone experiences a stressful event, Alonzo said.

“I’ve seen it all,” Alonzo said.

The soldier did eventually regain the use of his legs.

Maj. Angela Muzzy, a nurse with the 349th reserve unit who works in the hospital’s intensive care unit, delivers the same basic message to her patients, no matter if they appear coherent or not, she said.

She tells them: “You’re safe. You’re out of Iraq. You’re in an American hospital. We’re contacting your family,” she said.

And when she is not helping soldiers deal with severe injures, she concentrates on dealing with the carnage she sees by praying, traveling on her days off and talking with people trained to help nurses with job-related stress.

“And I spend a lot of money at the PX [post exchange],” Muzzy said with a smile.

Recurring images of burn victims and amputees still remain for Muzzy, a professor of nursing at the University of Arizona. But that was a price she was willing to pay for the “most honorable nursing job I’ve ever had,” she said.

To prepare for work in the intensive care unit, Lt. Col. Robert Savage, of the 328th reserve unit, said he communicated by e-mail with nurses working there now.

Savage, a staff nurse at a small hospital outside of Boston, said he expects the young men will remind him of his boys, who are 16, 20 and 22 years old.

“We’re going to see a lot of trauma — young fellas in bad situations,” Savage said. “I’m sure I’ll think of them when I see these young faces.”

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