Early in 1918, Hemingway responded to a Red Cross recruitment effort in Kansas City and signed on to become an ambulance driver in Italy.[13] He left New York in May and arrived in Paris as the city was under bombardment from German artillery.[14] By June, he was at the Italian Front. It was probably around this time that he first met John Dos Passos, with whom he had a rocky relationship for decades.[15] On his first day in Milan, he was sent to the scene of a munitions factory explosion, where rescuers retrieved the shredded remains of female workers. He described the incident in his non-fiction book Death in the Afternoon: "I remember that after we searched quite thoroughly for the complete dead we collected fragments".[16] A few days later, he was stationed at Fossalta di Piave.
On July 8, he was seriously wounded by mortar fire, having just returned from the canteen bringing chocolate and cigarettes for the men at the front line.[16] Despite his wounds, Hemingway assisted Italian soldiers to safety, for which he received the Italian Silver Medal of Bravery.[17][note 2] Still only 18, Hemingway said of the incident: "When you go to war as a boy you have a great illusion of immortality. Other people get killed; not you ... Then when you are badly wounded the first time you lose that illusion and you know it can happen to you."[18] He sustained severe shrapnel wounds to both legs, underwent an immediate operation at a distribution center, and spent five days at a field hospital before he was transferred for recuperation to the Red Cross hospital in Milan.[19] He spent six months at the hospital, where he met and formed a strong friendship with "Chink" Dorman-Smith that lasted for decades and shared a room with future American foreign service officer, ambassador, and author Henry Serrano Villard.[20]
While recuperating, he fell in love, for the first time, with Agnes von Kurowsky, a Red Cross nurse seven years his senior. By the time of his release and return to the United States in January 1919, Agnes and Hemingway had decided to marry within a few months in America. However, in March, she wrote that she had become engaged to an Italian officer. Biographer Jeffrey Meyers states that Hemingway was devastated by Agnes' rejection, and in future relationships, he followed a pattern of abandoning a wife before she abandoned him.