On the night of the February 24, 2022, Maxim was in the operating theatre of a private hospital in Kyiv. In the evening before that day, they had seen Putin announcing the start of a “special military operation”, but nobody in their hospital really understood what it meant for them. Then, they had to take a patient to theatre for an emergency surgery, so they had little time to dwell on Putin’s plans – they had a job to do.
The window in their operating theatre was facing one of Kyiv’s main roads. At about 4 a.m. Maxim looked out of that window, and saw a traffic jam, a complete standstill of hundreds of cars. That is the first image of the war that he remembers – a traffic jam at 4 a.m. seen from an operating theatre.
Later, when it was getting lighter Maxim went out for a smoke in front of the hospital. He remembers low clouds over the city – it was going to be another lousy February day. Then, something loud flew over his head, and exploded at a distance. Then, a large formation of attack helicopters flew very low over the Dnipro River. The chopping sound of rotating blades was very similar to machine gun fire, especially heard from such a short distance. It was the sounds made by that missile, and those helicopters that brought the war to the doorsteps of Kyiv’s inhabitants, including Maxim, and changed their lives in an instant.
Initially, there was panic – nobody in the hospital received any instructions as to what to do next, so everybody did what they thought was best under the circumstances. Maxim drove to one of the city’s general hospitals, which was his main place of work. A thirty-minute drive on a good day, it then took him 5 hours to get there. It seemed that everyone was trying to get their families out of the city. While standing in that hellish traffic, Maxim was looking at the faces of people through the windows of the cars around him – many looked scared, lost, broken; a lot of children were crying. That traffic jam in the centre of Kyiv was another strong image of the first day of war that he vividly remembers.
At his main place of work things were moving at a very fast pace. All the medical personnel who stayed in the hospital on the 24th of February did so on their own accord. The hospital’s administration did not force anybody to stay – those who wanted to leave the city were not prevented from doing so. The hospital’s Medical Director, who is a surgeon stayed, supporting the staff in any way he could. He was scrubbing for particularly complicated emergency operations himself, inspiring others, leading from the front. Without doubt, many of the doctors and nurses stayed in the hospital because of his inspirational leadership.
All elective surgery was cancelled. They were all prepared to admit wounded soldiers, but initially there were not any. Russians did move close to Kyiv, in fact street fights were taking place on the outskirts on the first day of the war, but there were hospitals closer to the hotspots, which were just about managing to deal with the numbers of casualties.
It changed on February 26, two days after the war had started. A column of Russian troops broke through Ukrainian defences near “Beresteyska” underground station, just 2 kilometres from Maxim’s hospital, and 5 kilometres from the centre of the city. That column was destroyed, burned down to the ground by Ukrainians mostly using Soviet-era RPGs. Maxim remembers his first admissions – euphoric Ukrainian soldiers with badly burned hands and necks. They had been firing those Soviet-era RPGs at the Russian column in quick succession – firing, and re-loading them non-stop, and not noticing that the tubes had been getting overheated. Adrenaline levels off the charts had made them totally insensitive to pain. Maxim remembers those soldiers well – “a thousand-yard stares” on their dirty faces, the stories they were telling him going under, and waking up after their surgeries, when the residual levels of anaesthetic drugs removed all their inhibitions. It was his first ever face-to-face encounter with war, and it affected him deeply. There were about ten Ukrainian soldiers who came in on that day, and they all had burned hands and necks in addition to other wounds. There were no Russians left to treat then…
Smoking remains of the Russian military column near “Berestyvka” underground station on February 26. (Courtesy: http://www.golos.com.ua/rus/article/356588)
http://www.golos.com.ua/rus/article/356588
They have never acted as a battlefield hospital since then. Russians were pushed out of Kyiv soon after that episode, and their hospital became a tertiary centre admitting wounded military personnel for definitive treatment and rehabilitation of their injuries, after they had received damage-control surgery, and primary stabilisation in field hospitals situated closer to the frontlines. Like all their colleagues working in civilian hospitals, Maxim and his colleagues had to learn about treatment of battlefield injuries very quickly. Initially, there was no logistics, or triage, so they had to deal with horrendous injuries in soldiers, who were being transferred from peripheral hospitals, where things had not been done properly, or even missed. Seeing those injuries were taking its toll on the hospital staff, who had had no previous exposure to blast and explosion trauma, especially on those working in theatres, and particularly young women, many of whom had already moved to the West, having taken their children with them. They quickly started rotating staff between theatres, so that they did not get exposed to seeing the same types of injuries, particularly those requiring major surgery.
At the beginning of the war, the hospital was reasonably well equipped, but lacked medical equipment and disposables specific to treatment of military trauma. Those were later supplied by various volunteer organisations who managed to raise the money, and source everything that was required in record time.
There was also an issue of air raids, which intensified significantly as Russians were withdrawing from the city in the first week of the war. The initial instruction from the hospital’s management was for all the staff to head down to the basement once the air raid sirens would have gone off. However, there was no instruction that specified what to do with patients who were being anaesthetised and operated on at that time. So, when air raid sirens did go off when a patient was being anaesthetised, people simply chose to stay with them risking their own lives doing so. Men working in theatres, and intensive care units made a collective decision to stay with patients, while women headed to the basement. Many of those women had children living in the hospital with them, so nobody raised any objections to that decision. That was the arrangement in the first couple of weeks when they did not have portable breathing machines in theatres and could not leave anaesthetised patients on their own. Eventually, they managed to get those portable ventilators through humanitarian aid channels, and started taking unconscious patients down to the hospital’s basement during air raids with them
Everyone treated air raid sirens seriously at the beginning of the war. They heard Russian missiles flying overhead; one of them was once shot down above their hospital by the Ukrainian air defences – luckily, its fragments fell elsewhere. Eventually, bombings became less frequent, and people started ignoring sirens. As with everything else complacency kicks in…until it is shattered by a disaster!
Life under siege
The hospital went into a virtual lockdown on the first day of the war. People who were there on Day 1 ended up living there for two months. In the first couple of weeks, nobody was allowed in the streets of Kyiv, and all the shops were closed. Maxim had a friend, a manager at a supermarket, who arranged delivery of food to the hospital through volunteers, who were escorted by the Police. In about one week, the food in the supermarket ran out. People lived of whatever they had managed to bring with them from their homes on the first day of the war. The hospital’s canteen had some food supplies, which was shared among the staff. Then, after two weeks it became clear that Russians pulled out of the city (or, were pushed out, to be exact), and it was safe to come out of the total lockdown, at least during the daytime. President Zelensky issued an executive order for the small businesses to re-open to support the economy, and to feed people. Then, the staff were able to make short trips to shops, and their homes. Maxim remembers popping out to his flat for 10-15 minutes every 3 days, or so. It was good to visit his home, even for a short while. It felt like some sort of normalization, a modest step towards peaceful life.
Sourcing, delivering, and unloading of drinking water supplies for everybody in the hospital was a communal effort.
The hospital has begun treating civilian patients, and elective surgery has resumed too. Now, they are doing a fair amount of military trauma, as well as their normal “civilian” work. Wounded military personnel are kept mixed with civilians on the wards. That decision had been made early on as creating a separate “military wing” was seen as giving Russians a potentially easy target for their missile strikes.
Maxim specifically mentions the spirit of camaraderie, selflessness, and self-organization that was prevalent during the two months that the staff had to live in the hospital. People were truly taking care of each other, putting the needs of their colleagues before their own. They were all a part of the team in the truest sense of that often misused, and abused word. He has seen a glimpse of what humanity is meant to be like. During COVID pandemic, he had thought that this might have finally happened, but it had not – fundamentally, everyone had continued to be there for themselves. This time, during the war everyone was there for each other. This is the main thing that has kept Maxim going, waking up and looking forward to facing another day. He does not want to let his comrades down; he wants to be worthy of them. They are all here to get The Job done, and this realization of a communal goal in the face of a grave danger has changed people to the better, bringing the best out of every individual.
Also, he feels that he owes it to the soldiers that he treats, who have made the ultimate sacrifice for him. He must do his job the best way that he can at the place where he is right now. He feels that he can do more as a doctor treating the wounded, rather than a soldier fighting at the frontline. He has had no military training, or experience, and feels that he is doing a much better job trying to mend the broken bodies of those, who have done it for him.
Those two motivating factors – paying his debt to the wounded soldiers and trying not to let his colleagues down inspire Maxim to be the best at what he does every day, and are the source of inspiration that get him through the daily horrors of war.
He is worried about his parents. They live close to the Belorussian border in a family house that had been built by his father, a retired Army officer. Russians constantly threaten to invade from Belarus, building up significant numbers of troops and military hardware on the Belorussian side. They have been using Belarussian territory to launch their jets, and rockets towards Ukraine, but have so far withheld sending a significant military assault force across the border. Ukrainians have been preparing too, building fortifications, and mining the fields on their side of the border. Some of those minefields are very close to Maxim parents’ house… Maxim has been telling them to move, to get out of the danger zone, but his father’s response has been the same:
“I will not move anywhere. It is my land, and I will fight for it if it comes down to it. Your mom is free to go, but she did not want to either the last time I have asked her.”
And those conversations, although worrying, and upsetting to Maxim are also a source of an inspiration for him to continue fighting his very personal war the best way he can, where he is right now.
Maxim at work now – things are getting better!