This week 16 Ohio families were informed that their sons had been killed in Iraq, in what for US forces has been one of the deadliest flurries of violence since the invasion more than two years ago. For the 3rd Battalion, 25th Marines, based in the Cleveland suburb of Brook Park, the bad news came thick and fast.
Two men were killed in a gun battle on 28 July, followed by another five on Monday. Then nine members of the battalion were killed on Wednesday along with five other Marines and an interpreter in a roadside bombing.
For the families who have sons and daughters in Iraq there was a desperate struggle to obtain information: they simply wanted to know whether they were alive or dead. Pat Murray told the Columbus Dispatch newspaper that she spent all day trying to obtain information about her son, David Kreuter, who had a new-born son. At the end of the day the Marine Corps informed her that he was dead. "I just had a terrible gut feeling," she said.
By contrast Robert Hoffman was sure his son Justin was fine. "I felt a little guilty not being more worried but there's no point to worrying," he said.
But Mr Hoffman's confidence was misplaced. He was out on his bicycle when his other son called on his mobile phone to tell him there were Marines at the front door. Mr Hoffman, from Delaware, did not really need to be told that his son had been killed. "I guess I already knew."
The number of US troops killed in Iraq stands at about 1,828; the number of Iraqi civilians who have been killed may be 100,000.
Yet for most US citizens, the daily horror of Iraq is only brought home when it strikes close at hand.
Isolde Zierk, an Ohio mother whose son is a member of the battalion, said she was doing her best to support other families. "When my son comes home, I can have my nervous breakdown," she said. "Until then, I'll just keep on doing what I can."
There are already signs that among this military community, the toll is having a political effect.
The parents of 23-year-old L/Cpl Edward Schroeder were talking about plans to attend the funeral of the reservists killed on Monday when the Marines came to their house to inform them their own son had been killed. His mother, Rosemary Palmer, who was opposed to her son joining the Marines, told MSNBC television network that she believed the invasion of Iraq had been "very naïve".
"You don't go to another culture and try to impose yours and expect it to work," she said. "We're not Iraqis. We don't have the same culture. And while I understand that we're a multicultural nation, we don't act like it sometimes. We act like the whole world thinks exactly the way we do."
Edward's father, Paul Schroeder, said he believed the US military operation in Iraq was failing. "The repetitive process has been going on for 27 months, since the active invasion phase ended, 27 months of doing the same thing over and over and over again, with no evidence that it is getting better.
"If there were evidence it was getting better ... these fellows would still be alive after all of this strenuous effort. Then it is time to make a change. Either put the number of troops on the ground that you need to really do the job or get the heck out. We have a saying in the Midwest: piss or get off the pot."
The risk of areas such as northern Ohio being struck hard by the war and suffering multiple casualties has been heightened in Iraq because reserve troops are recruited, train and fight together.
The same situation was not seen in the Vietnam War, which was fought largely by active-duty troops in units drawn from around the nation. Bad news was not concentrated.