At just 20 years old, Anna Noe has seen much of life and death as she trains to become a Licensed Vocational Nurse (LVN) at the Brooke Army Medical Center.
It was what she expected when she followed her brother, Scott Noe, into the military.
"You have patients who die every day in your arms," she said.
But she has also been present when a baby's head begins to crown as a woman gives birth.
"You see every realm of life and I've had some really great patients," she said.
Noe has seen soldiers her age so badly burned that their entire quality of life is gone.
"You fight every day not to let them pull the plug on themselves," she said. "You aren't only there for the patients, you are there for the families. You shed tears from joy to sorrow and that can become overwhelming even though it is rewarding."
Putting the saddle on her horse Power Stroke and heading into the hills for a ride or a race around barrels in the practice arena is one way Noe lets off steam.
Despite the difficulties she has faced, she never felt unprepared. Her father, David Noe, worked hard to make sure his daughter was strong.
"My dad knows how to yell," she said. "I actually got in trouble once because I told the drill sergeant he couldn't yell half as loud as my dad could."
And push-ups and sit-ups were not a problem to a young woman in good shape.
"For the mental aspects, I trust in Christ. Through Christ anything can happen," she said.
From Army basic, she went on to emergency medical technician training.
The 56 credits she earned toward an equine science degree served her well when the opportunity to go to nursing school arose.
As she trains for a career in military medicine, Noe, who grew up in the Rim Country, is also interested in forensic science.
Re-enlistment and an officer's commission are two choices Anna will have in November.
How they dovetail with her dreams of marriage and children is a determination the young woman has yet to make.
Service to their country was unquestionable for siblings Anna and Scott Noe.
Their father was a Captain in the U.S. Air Force. An uncle and a cousin are Marines.
Scott is serving in Afghanistan as part of a Special Forces team stationed out of Ft. Bragg, Texas.
He spends nine months out of a typical year overseas, locating and defusing bombs, his father said. Scott began his Army career as a Ranger. He served his first tour with the parachute infantry then was selected for Special Forces training.
"The Army taught him Arabic," David Noe said.
"For a guy who did not like high school, Scott is all application now."
With two children in the military, the entire family is in sporadic contact. Anna came home for Christmas this year, but Anna and Scott last saw each other in October 2004.
Despite distance, the family bond is strong.
"We'd do anything for each other," Anna said. "My dad, brother and I are like The Three Musketeers."