Before taking off for the first time to strike at the bastions of Islamic State militants, Lieutenant Robert Smith eats a light breakfast of an egg sandwich and some fruit with a coffee.

Then his routine as a pilot aboard the USS Dwight D. Eisenhower begins with a briefing for flight, donning his flight suit and polished leather boots and ascending to the flight deck before climbing into the cockpit.

Smith - his name has been changed to protect him and his family from reprisal - is lanky at 1.80 metres with pale skin and a thin moustache. He insists he is not nervous.

"We are extremely well prepared. I know exactly what's expecting me," he says as he takes off for the first time on this mission early in July.

The nuclear-powered aircraft carrier, measuring more than 300 metres in length and carrying almost 50 jet fighters, has been cruising off the Syrian coast since the end of June, launching sorties to attack targets in Syria and Iraq.

The smell of fuel hangs over the flight deck from where the jets are launched by catapult, taking them from a standing start to 250 kilometres per hour in two seconds. Their engines are at full power before the cables restraining the jets are released.

"It's like a roller-coaster ride," Smith says.

The "Mighty Ike" has a central role in the US military strategy that was discussed at the NATO summit in Warsaw on Friday and Saturday.

It relieved the USS Truman in mid-June, and is operating from the Mediterranean rather than the Persian Gulf to speed up the handover, as the commanding officer, Rear Admiral Jesse Wilson, explains.

When the first jets took off, fighting was still raging around Fallujah in western Iraq, but since then Iraqi government forces with air support from the international coalition, have retaken the city.

The US-led bombing campaign over Syria and Iraq has been conducted for almost two years, helping to drive the extremists from large areas. Ramadi and Fallujah in Iraq and large areas in Syria along the Turkish border have been seized from their control.

But an end to the fighting is not in sight. Islamic State continues to control Mosul in northern Iraq, where a lengthy and bloody struggle looms.

Kurdish forces have for weeks been trying with US help to take the strategically significant city of Manbij in Syria's Aleppo Governorate, making only slow progress. Suicide bombers have taken a heavy toll on the Kurdish forces.

The routine on the Eisenhower is little affected. Every time a jet is launched, the 5,500 men and women aboard can hear and feel it, the furniture vibrating in the cabins and the pictures on the walls shaking.

Wilson, a powerfully built man with a firm voice, stops talking for a few seconds as a jet takes off. "I've got one of the best jobs in the world," he says. "I've got a great crew of brave women and men."

The crew members say they enjoy life aboard the floating city, despite the grinding routine and cramped conditions. Most of them rarely see daylight, and many live in cabins sleeping 90 in bunks stacked three high.

No privacy, little in the way of leisure activities and no alcohol. "Life here is hard," says weapons officer Mathew Rechkemmer. "We get few breaks and we're almost always working."

The pilots are the only ones aboard to experience combat first hand. Smith spends seven hours in the air. He has a snack to eat and must urinate into a bag. But the pilots talk about their work as though they were doing a normal job.

Not a single US pilot has lost his life in this campaign against Islamic State, although they are well aware of the fate of Jordanian pilot Muath Al-Kasasbeh, who was burned alive after falling into the hands of the extremists on December 24, 2014.

Smith says they never forget the fact that they can be killed at any time. "It's always in our mind, but we have learned to live with it."

The pilots are reluctant to talk about their feelings, about the possibility that they are killing innocent people as well as their targets.

"We always try to ensure that we hit the right people," Smith says, expressing confidence in those who select the targets.

Five years of training has turned them into professionals. Smith says he feels no emotion as he fires his missiles, only concentration on the job in hand. "War is serious," he says.

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