CAMP SHELBY, MISS. - When he goes to Iraq, Rick Miller, a medic with the Pennsylvania National Guard, hopes to wield a tongue depressor, not a rifle.

But he faces a stark reality: The enemy targets medics and other medical personnel.

"They figure once you lose your medical asset, more guys die," Miller said. So he's taking precautions.

The Columbia resident said he might not wear the Red Cross armband traditionally worn by medics in the field, for fear it will make him a target. He might carry a smaller medical bag, issued by the military, so as not to be identified as easily.

And though he doesn't fire howitzers or kick in doors like an infantryman, he's glad he has been trained to fire his rifle proficiently.

In previous wars, medics were generally not targeted by the enemy. They were noncombative, rushing to the aid of a fallen comrade instead of attacking.

But killing the medic has become a strategy in Iraq, said Miller, 40, a paramedic for a Mount Joy ambulance service. He doesn't want to take chances, even while treating patients at a makeshift clinic, so the rifle will be handy.

"It's a different kind of combat -- the battlefield is the whole country," Miller said. "There are no defined lines. There's a chance you could be a target."

Miller and other medical staff will go to Iraq as part of the Pennsylvania National Guard's 56th Stryker Brigade. More than 4,000 Guard members from the state will go, the largest combat deployment of Pennsylvania National Guard soldiers since World War II.

The brigade has trained at Camp Shelby, a sprawling Army facility in southern Mississippi, since September. It will train through November and leave for the Middle East in January.

The Stryker Brigade's medics and nurses, members of the 328th Brigade Support Battalion based in Lancaster, might see patients suffering from traumatic war injuries. But a majority of those who seek treatment will likely be suffering from ankle sprains, back pain or rashes, Miller said. Medical personnel also will provide dental treatment.

It's possible a patient could turn out to be an armed insurgent, but Miller isn't afraid to go to Iraq.

"I want to go now, actually," he said, standing in a flat cinder-block building at Camp Shelby that serves as a clinic for the soldiers who are training.

Behind small curtains are sick beds -- green cots with tall legs. Computers track patients' visits, but old-fashioned bedside manner still is part of the treatment.

Lt. Keith Holdren, a physician's assistant from Allentown with a master's degree from a medical college, was eager to rejoin the Guard after Sept. 11, 2001. Though he insists he's focused on treating the U.S. soldiers and the Iraqi police, military and civilians that medical personnel will see -- in their clinic and in the field -- he is aware of the danger.

He has a rifle and knows how to use it.

"In an environment like that, it's something you hope you don't need -- but it's nice to have," said Holdren, 42. "Things have changed. I think you have to be prepared for that. We're classified as 'non-combative,' but we can still take a defensive posture in protecting our patients."

JIM LEWIS: 255-8479 or jlewis@patriot-news.com