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Michael R. Gordon, a Times correspondent, went with the Iraq counterterrorism force to the old city of Mosul, where Islamic State fighters are hemmed in and civilians are trapped.

Perched on a rooftop near the ruins of the Al Nuri Grand Mosque, Lt. Gen. Abdul-Wahab al-Saadi used a rock to sketch out the endgame for Mosul.

The Islamic State was down to perhaps 150 fighters, hemmed in on all sides, defending a bastion that seemed to be shrinking by the day, said the general, a senior commander in Iraq’s counterterrorism service.

On a visit to the old city of Mosul on Wednesday with General Saadi and his men, it was clear that the militants’ resistance was still fierce and often fanatical, even by the Islamic State’s macabre standards.

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Earlier this week, 17 suicide bombers, some of them women, infiltrated the streams of desperate civilians trudging out of the city, which the Islamic State took control of three years ago. When the bombers blew themselves up, they sent a wave of casualties to the trauma centers set up by international humanitarian groups on the edge of the urban battlefield.

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Iraqi counterterrorism forces, with American air support, trying to wrest control of the old city in Mosul from remaining Islamic State fighters. Credit Michael R. Gordon/The New York Times

On Wednesday morning, frantic Iraqi soldiers raced their wounded comrades in battle-scarred Humvees to two of those trauma stations. By the time they arrived, two of them were already dead — one blown apart by a roadside bomb and the other a victim of a sniper shot to the head.

Some Islamic State fighters have been stripping the uniforms off dead Iraqi soldiers and donning them to try to sneak out of the city, Iraqi military officers say. But many of the militants appear to be determined to die and to take as many Iraqi soldiers as they can with them.

More than eight months after the Iraqi forces, supported by American airstrikes and advisers, began to wrest Mosul back from the Islamic State extremists, Prime Minister Haider al-Abadi appears to be poised to announce that the forces have finally retaken all of Iraq’s second-largest city. In Mosul, that victory appears to be tantalizingly close, but not quite at hand.

By April, the offensive had slowed to a crawl. The Iraqis’ decision to open a northern front in early May had re-energized the campaign, though the battle has proved costly for civilians and the military alike.

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Before the battle began last year, the worst-case estimate by United Nations experts was that 750,000 of the city’s population of more than a million would be displaced. As of this week, 920,000 people have left.

As many as 15,000 civilians, the experts fear, may be trapped in a small pocket of the city that Islamic State militants are struggling to defend.

Emptied of much of its population, the old city in western Mosul remains a baking battlefield where parched and defenseless civilians vastly outnumber ruthless extremists, who have their backs against the Tigris River and seemingly nothing to lose.

Much of the combat takes place in the morning before the midday sun sends temperatures soaring to more than 115 degrees. Early Wednesday, I joined General Saadi again as we drove through old city’s battered streets.

Soon the ruins of the mosque came into view: Its 12th-century minaret was severed, and its walls were shattered, but its green dome was somehow intact. The area in front of the ruined mosque had been cleared by the counterterrorism force and was now occupied by their black, armored Humvees equipped with gun turrets.

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The remnants of the minaret of Mosul’s Al Nuri Grand Mosque, which was destroyed last month by Islamic State fighters who took control of the city in 2014. Credit Michael R. Gordon/The New York Times

Disembarking, we climbed over huge slabs of debris clogging up an alleyway. There was a whistling sound and an explosion — supporting American firepower for a street battle that was about 100 yards away.

“Hellfire,” General Saadi said approvingly. “To support my army.”

The best view was from the roof of a large building where the counterterrorism service officers have set up an outpost. As we reached the roof, Iraqi soldiers in nearby positions were trading volleys with Islamic State snipers. More American airstrikes sent plumes of smoke into the sky.

The elite counterterrorism service, known as the CTS, has had to move carefully through the narrow, bombed-out alleyways of Mosul and across exposed rooftops. Its soldiers are now pressing the fight in the center of their enemy’s resistance, flanked by the Iraqi Army and federal police on either side.

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The militants included a large number of foreign fighters: Of the 100 Islamic State extremists that were killed this week, 26 came from outside Iraq, the general said. Russian-speaking foreigners, most likely Chechens, were among the best snipers, he added, though he did not think highly of the Islamic State’s infantry tactics.

Nobody, however, questioned their proficiency in making and using explosives.

“They can’t drive car bombs at us anymore, so they hide bombs in abandoned vehicles or just try to run up to us and blow themselves up,” he said.

The Iraqi military searches civilians as they try to escape the remains of the city. Men who have sought to flee have been told to remove their shirts, and some strip down to their underwear to show that they are not hiding a bomb. Believing that women are less likely to be screened as carefully, the Islamic State has been using female suicide bombers.

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Iraqi forces began their offensive against Islamic State fighters in Mosul last year and have nearly regained control of the entire city. Credit Michael R. Gordon/The New York Times

Three members of a CTS battalion dispatched to Mosul from Basra, in southern Iraq, were killed in the recent suicide attacks, the unit’s commander said.

The fact that some militants have managed to get their hands on Iraqi uniforms means that the CTS has to be especially vigilant. “We know our guys well, and can tell when it’s them,” General Saadi said.

He also insisted that he was not surprised by the recent spate of suicide attacks. Tips from civilians and drones flown by the Iraqi forces, he said, had given him valuable intelligence. Still, all 17 of the recent bombers, he acknowledged, succeeded in blowing themselves up.

At the trauma stations a short drive from the front, it was clear that the Islamic State’s bombs were claiming their share of victims: among them, an Iraqi soldier who was already dead when he arrived Wednesday morning at a triage point run by Global Response Management, a nonprofit organization.

Alex Potter, a nurse at the center, said she could gauge the flow of the battle for Mosul from the casualties that arrived. A surge in gunshot wounds to Iraqi troops was an indication that they were making another push against Islamic State positions. Civilians with limbs and torsos crushed by debris were a sign of airstrikes. Suicide bomb blasts often resulted in severe burns and worse.

The casualties arriving from the bombings in recent days had been “half civilians, half Iraqi military,” said Pete Reed, an emergency medical technician who runs the Global Response Management. “The majority of suicide vest attacks in the past few days have been by females,” he added.

At another nearby trauma center run by the Iraqi Army and CADUS, a humanitarian organization based in Germany, an Iraqi Humvee rushed up, straight from battle in the old city. Anxious Iraqi soldiers unloaded their comrade wrapped in a thick, blood-soaked blanket.

A gaping bullet hole was in the back of the soldier’s head, the work of an Islamic State sniper. The doctors quickly pronounced the soldier dead, and he was lifted into a black body bag. His name and unit were inscribed on a strip of paper that was taped to the outside. A small bag containing his possessions and athletic shoes was placed alongside. He was soon taken away, and a small pool of blood was wiped from the floor.

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