The nominee then must have their story wind through a dozen levels of military and presidential reviews, during which various factors are taken into account to ensure that only the greatest among the many noble sacrifices are selected for the final honors.
Some of it's recipients have gone on to fame, or earned it by their honored actions, including President Teddy Roosevelt, Audie Murphy in World War II, and even 'Buffalo Bill' Hickock.
It's recipients have been called 'unsung soldiers who acted valiantly in a moment of extraordinary pressure'.
Following the 9/11 attacks in 2001, over a million military men and women have served in Afghanistan and Iraq, and the first from this 'War on Terror' to be so honored was Sergeant Paul Smith.
He grew up in Tampa, Florida, enlisted in the Army in 1989, and served in the first Gulf War in 1991. He didn't join up at first out of patriotism, that developed later. At first he wanted just a good-paying job right out of high school, and saw this as his best shot. A career soldier, Smith was serving in Bosnia when the United States was attacked in 2001.
In April of 2003 he had moved on to Iraq, and was serving there as a combat engineer as his unit moved from Kuwait towards Baghdad, seizing a part of the Baghdad Airport on April 3rd, 2003.
The following morning, Paul was part of a team that was constructing a holding cell that would house prisoners of war, when the company came under attack by at least 100 Iraqi soldiers of Saddam Hussein's Special Republican Guard.
