Why the Pentagon has turned on the makers of 'Baghdad ER'

This Sunday, subscribers to the American cable channel Home Box Office will be treated to a film about the Iraq war unlike any other. Almost at the start, you see a medical orderly carrying a human arm, amputated above the elbow, which he puts into a red plastic bag.

Welcome to Baghdad ER, the unvarnished, unexpurgated truth of what war is really like.

This has been quite a month for films and pictures about 9/11 and the war in Iraq that sprung from it. On Tuesday, the Pentagon finally released video images from a closed circuit camera of American Airlines Flight 77 as it smashed into the Pentagon. The pictures rekindled memories of that terrible September Day, but they were oddly unmoving - largely because the aircraft was barely distinguishable, just a greyish-white blur in one frame, followed by a flash and an orange fireball in the next.

Far more upsetting was United 93, about the United Airlines jet which crashed into a Pennsylvania field after passengers rose up against the hijackers. The critically acclaimed film was numbing in its account of banal everyday life transformed into a nightmare, whose horrific ending everybody knew in advance. Even so, it was only a film - a faithful but ultimately fictional re-creation of events, not the event itself. But Baghdad ER is for real; for some maybe too real.

That perhaps was why Donald Rumsfeld, and Gordon England, the Deputy Defence Secretary, as well as Lieutenant-General Kevin Kiley, the army's surgeon general, and General Pete Schoomaker, the army chief of staff, weren't there at the preview on Monday, at the auditorium of the National Museum of Natural History in Washington.

Baghdad ER (the ER stands for emergency room) is the work of the Emmy-winning filmmakers Jon Alpert and Matthew O'Neill, who spent two months in mid-2005 at the 86th Combat Support Hospital in Baghdad's Green Zone, the main front line medical facility for the US army in Iraq. This is where wounded soldiers are first taken when their vehicle has been blown up by an IED, an Improvised Explosive Device also known as a roadside bomb, or when a suicide bomber has done his worst. It shows the daily lives of the doctors, chaplains nurses and orderlies who work in this place of suffering.

Barring the odd technically blurred face of an appallingly injured soldier it flinches from nothing, be it pools of blood and guts on the floor, shattered limbs, and men in the last instants of the life. It is unsettling enough to go to the Walter Reed Army Hospital - as I did with my wife to visit a cousin of hers who lost both legs in July 2004 when his Humvee was hit by a 155mm mortar round at Samarra in the Sunni Triangle. But Walter Reed is 5,000 miles from the war's front line, where wounded soldiers go to recover, and learn to re-use their mutilated bodies.

In Baghdad ER you are spared nothing. In one harrowing scene a chaplain comforts a dying marine. "We don't want you to go, We want you to fight," he says. "But if you can't, it's OK to go. It's OK to go. But we'll be right with you. If you get better, or if you go." For the doctors, coping with the conveyor belt of dreadful wounds is a separate ordeal. Major Merritt Pember, one of the surgeons shown in the film, spoke of his emotions to the magazine US News and World Report.

Was there a worst day, he was asked. The days "all kind of blended together" he replied. "I was there six months, and it never once rained. You see the same injuries come in the door every day. One day, I did four or five amputations; that was the worst. You know that you have to do the amputation because you can't repair it, but it's not feel-good surgery. It gets old." Another doctor, asked what he wanted for the Fourth of July, answers simply "not to have another dead soldier". Each evening Major Pember and his colleagues tried to find some kind of relaxation from the exhausting, endlessly depressing work by going up on to the roof of the hospital to smoke a cigar.

Above all, Baghdad ER breaks a taboo. Insofar as possible, the Bush administration has kept this war as quiet and as sanitised as possible. The victims that have been shown have mostly been Iraqis, not Americans.

Occasionally that has not been possible - such when the corpses of the four security company workers were dragged from their blazing car and strung up from a bridge in Fallujah in 2004. But The military transport aircraft are not shown on television as they return with their sad cargo of coffins to Dover Air Force Base in Delaware. Nor are the dead soldiers' funerals - none of which has been attended by President Bush.

Sometimes the President has talked of "sacrifice". But for ordinary Americans who do not have friends or family who have done a tour in Iraq, this has been a war virtually without sacrifice (unless of course you attribute the rise in petrol prices to the conflict).

Mr Bush stresses constantly that America is at war, and maybe so for decades to come. But for all the bumper stickers proclaiming "Support Our Troops", this has been a war unlike any other. Wars usually demand belt tightening, tax increases or some other form of deprivation, however modest, for the citizenry. In the "war on terror", like other wars, military spending has soared. But the last few years have been a festival of tax cuts - at least for the better off - despite record deficits. "Spend, spend, spend," might have been the official advice on how the home front should comport itself in this proclaimed time of national testing.

Baghdad ER disposes with the illusion of normality as brutally as an IED.

As recently as March, an HBO executive said this week, a retired general who saw an early screening told him that the film "captured the soul of the US army". That soul may be more brittle than it first seemed.

If the military is now distancing itself from a venture it once enthusiastically embraced, one reason is concern of the impact it might have on soldiers who served in Iraq, and on the families whose who are still there, or about to go. This week, 'Baghdad ER' will be shown separately at 22 military bases. In a memo a few days ago to army medical staff, General Kiley warned that it showed "the ravages and anguish of war". Those who saw it "may experience many emotions ... If they have been stationed in Iraq, they may re-experience symptoms of post-traumatic stress, such as flashbacks or nightmares."

But some suspect another motive: a fear by the Pentagon that the documentary will undermine public support for the war. If so, its civilian bosses truly are as out of touch with reality as their critics say they are. That support is already crumbling. Seven retired generals have even called in public for the resignation of Mr Rumsfeld. A poll yesterday in The Washington Post showed that only 40 per cent of Americans now believe that going to war was right; 59 per cent reckon the invasion was a mistake.

Mr Bush's own approval rating has tumbled to an all-time low of barely 30 per cent - on a par with public opinion of his handling of the war. Asked to explain the other day, Karl Rove, fêted strategist for the President in happier times, acknowledged "Iraq looms over everything". If America had a parliamentary system, not a Presidential one, the odds are it would have been under new leadership by now.

Compared to the war in Vietnam, with which it increasingly is compared, US losses in Iraq have been comparatively light - as of yesterday 2,444 confirmed dead in slightly more than three years, compared with 58,000 during the eight years of Vietnam war. In part this is a triumph of the battlefield medicine on display in Baghdad ER. An unprecedented near-90 per cent of wounded soldiers survive. But these latter now number 18,000 - many of them with lost limbs and other terrible injuries from which they would have once certainly have died. Unless one of the names belongs to your family or to a family you know, the carnage slips by almost unnoticed - a bleak daily procession of statistics reflecting a distant reality about which you prefer not to dwell.

Only the bloodiest incidents now make the front pages of newspapers or the evening network news. Thus Baghdad ER will deliver an almighty jolt to those who see it, either on Sunday or when it is repeated on Memorial Day, when the US remembers those who fought in all its wars. The film is not pro-American or anti-American, least of all an act of leftwing sedition. It is anti-war only in the sense that any depiction of the ghastliness of combat is anti-war.

Alpert himself calls it "a very patriotic film", that showed the true consequences of war which ordinary Americans had before had little opportunity to see. "It shows the heroism of the soldiers, and you can't understand the heroism of the doctors and soldiers unless you see the horror they face every day."

And for one mother at least, it brought closure. Paula Zwillinger's 21-year-old son, Lance Corporal Robert Mininger, was the marine who died, and who has seen the film.

"To actually be at my son's bedside with him when he came in through his injuries, during his final moments, that truly is a gift that not every parent gets, especially when your son is deployed overseas," she has said.

The film, she acknowledged in a CNN interview, was very graphic. "But this is the truth. This is what our children are facing every, every day. It's very important for the American public to really know what we're doing over there," no matter what their view about the war.