The Army division known as the Screaming Eagles, formed ahead of the 1944 Allied invasion of Normandy, has lost 104 men this year - or about 1 in 5 American deaths in Afghanistan. That is close to a toll of 105 divisional deaths in Iraq during a 2005-2006 deployment that was its deadliest year in combat since Vietnam.
The 20,000-strong division from Fort Campbell has been fighting in two of Afghanistan's most violent regions, the south and the east, since it began deploying in February under President Barack Obama's plan to roll back the Taliban with more troops. It is the first time the 101st has deployed in its entirety since Gen. David Petraeus led the division during the invasion of Iraq in 2003.
Few are as directly involved in dealing with each soldier's death as Kimberley McKenzie, the chief of Fort Campbell's casualty assistance center.
Among the first to be notified after a combat death, McKenzie and her nine staffers ensure families are informed quickly, helping them over the ensuing weeks and months to navigate a maze of paperwork and decisions.
"We can get the calls at 2 o'clock in the morning, and that happens seven days a week," she said.
In her office, signs of the somber work are everywhere. Electronic bugles - which now replace live renditions of taps at many military funerals - are lined up in cases. A folded American flag, ready to be presented to a wife or a mother, sits on a desk. Wooden ceremonial display cases for a soldier's awards and decorations are stored atop filing cabinets. A large whiteboard on one wall displays the names of dozens of soldiers who have died this year.
McKenzie, 46, has been doing this job at Fort Campbell on the Tennessee-Kentucky state line since the 1990s, through the Desert Storm and Desert Shield operations against Iraq in 1990 and 1991 to the current wars in Afghanistan and Iraq.
"I have been here so long, which can be a blessing and a curse because you know so many of the soldiers," she said.
After the initial call, her team hurries to find a soldier's family. From the moment the death of a soldier is confirmed with the Department of the Army, regulations give them just four hours to notify the primary next of kin.
Often it's a nationwide search for parents or spouses who are far from Fort Campbell. A family may have moved and not told the Army, listed information may be incorrect or the soldier may be estranged from relatives. Too often, she says, a family member is listed as "address unknown."
She relies on counterparts at other military installations nationwide for help.
The notification process is highly regulated. Word must be delivered in person. Scripts are memorized and read exactly, because there's no room for error when giving the saddest news to a soldier's family. Even a simple typo or an incorrect rank is disrespectful, she says.
"At that moment we have either gained their trust, or we have lost it forever," she said. "They need to be able to trust us from the time we knock at the door until they don't need our assistance anymore."
Once family is notified, her staff helps arrange for relatives to meet the body at Dover Air Force Base in Delaware. The military is responsible for preparing the body, securing a casket and transporting the remains for the funeral. Within about seven to 10 days after the death, the family visits Fort Campbell to be briefed on what is afforded survivors, including benefits, life insurance payments, social security and health insurance.
Her staff is also responsible for noncombat deaths, such as auto accidents or illness and sometimes suicides or homicides.
She has learned to set aside her own pain over the loss of so many young men and women. Her focus, she said, is on supporting the widows and parents and children.
"We have a job to do for those families and we owe it to them and the commander," McKenzie said.
Still, she says she cannot ignore the large numbers of soldiers who have died and the sorrow she bottles up sometimes spills over. On average, 11 Fort Campbell soldiers have died each month in combat since March.
"At the end of the month, it's almost sickening to me as a person," she said.
This month the division lost six soldiers in a building leveled by an explosives-packed vehicle at a southern Afghanistan base. In November, six other soldiers were shot and killed by a gunman from the Afghan Border Police during a training mission in eastern Afghanistan.
Maj. Gen. Francis "Frank" Wiercinski, the senior commander at the post during the division's deployment, said at a news conference this month that everyone at Fort Campbell feels the loss of each soldier.
"One hurts. Everybody knows one. The level of grief that goes through everybody is incredible," he said.
These days combat deaths don't always make front pages, although the Kentucky governor orders flags to half-staff on the days of soldiers' funerals. But McKenzie says she refuses to believe there's any lack of respect and honor for the fallen soldiers outside Fort Campbell's gates.
"That one loss of a soldier is like a nerve center, or a spider web," she said. "It's not restricted to Fort Campbell and our community. It reaches so many lives and impacts them."
Within months, thousands of soldiers from the 101st will begin returning to Fort Campbell to be greeted with cheers and hugs and McKenzie will feel some sense of comfort.
But that relief is tempered by the knowledge that soldiers from other units have taken the place of those Screaming Eagles in the combat zone.
An internal White House review of war strategy released this month showed that the addition of 30,000 U.S. troops this year has halted Taliban momentum in many parts of Afghanistan, but tough combat is expected to continue for years.
"Until they are all home, whenever that happens, there's always going to be someone in harm's way," she said.