The wail of an ambulance signaled the start of what one doctor at the small village clinic called the "gush."
The first of a flood of wounded were two Libyan rebel fighters whose legs had been mangled in a blast and one of the clinic's own medics, who staggered in with a gunshot wound in the back that streaked red across his white coat.
As rebels push Moammar Gadhafi's forces back to the edges of the frontline city of Misrata, the fighting is turning rural medical centers in villages like this one into battlefield clinics. Their staff, more accustomed to distributing medicine and handling minor outpatient cases, are now performing trauma surgery.
"I'm a dermatologist," said Dr. Mohammed al-Tawil, who dashed about the clinic's hall trying to register Friday's incoming patients on his clipboard. "But now we've all become emergency medics."
The clinic sits in Zawiyat al-Mahjoub, a sandy village of wheat fields and date palms to the east of Misrata, the only major rebel foothold in western Libya.
The fighting has transformed the clinic. Huge concrete pipes have been stacked outside its front windows to protect from blasts. Its staff now includes three surgeons, five doctors, two intensive care specialists and about 20 nurses. All are volunteers, al-Tawil said. They consider running the clinic a national duty.
Friday's rush began around noon, after government tanks fired on about 50 rebel fighters south of the village, said 31-year-old Abdullah Shiguman, who helped bring in the injured. Government forces then approached in pickup trucks and opened fire with large caliber anti-aircraft guns.
Clinic staff had barely clipped the clothes from the first three patients and begun disinfecting their wounds when more sirens and screaming were heard outside.
A pair of rebel fighters rushed in the door, carrying an injured colleague in a blood-soaked shirt. Others followed, including one dripping blood from his head and leaving a red trail down the hall. Nurses rushed over with mops.
"Where is everyone? We need to get him in here!" a bearded rebel yelled at the door. Medics raced out to bring in more patients, putting as many as three in each room.
Most of the fighters live nearby and some know the staff.
In one room, a nurse in a white coat and pink headscarf sat weeping near the body of a dead fighter.
In the next room, a fighter lay unconscious on a bed, the twisted remains of his legs wrapped in a blanket. Six medics gathered to do CPR, one in a bloodstained smock standing on a short stool to pump his chest.
Back in the hallway, a rebel entered carrying a large bundle of remains wrapped in a green blanket.
"That's just parts," al-Tawil said, shaking his head.
Another bundle followed.
"No, no, no, no!" the men's friends wailed, waving their arms, hugging each other and jumping up and down in shock as the medics quickly opened and closed the bundles.
Four of the day's 10 injured were loaded into ambulances for transfer to Misrata's central hospital. The six dead were laid out on the tile floor in the morgue.
Nurses rinsed the blood from the stretchers and floors, and less than 90 minutes after the rush began, the clinic was quiet enough for all to hear the blunt booms of explosions not far in the distance.