Mykola Horbatiuk, a 27 year-old from Kyiv, was in the second year of his residency as a neurosurgeon in Germany, when Russia launched its all-out attack on his homeland.
He and his immediate network of friends and acquaintances immediately took up relief efforts.
“At first, we started doing volunteer work, raising money and organizing the delivery of humanitarian aid to Ukraine through various charities.”
But after the first month of the war, donations started to dry up, and Mykola realized that if he really wanted to help his country he needed to return home to contribute to the war effort as a doctor.
“I just couldn’t keep living there, in Germany, going out and having a laugh and a drink with friends while people were suffering in Ukraine.”
So he applied for a position at Mechnikov Hospital in the eastern Ukrainian city of Dnipro, which sees many of the worst casualties from the fighting along the front lines in the nearby Donbas region.
“They were more than happy to take me,” he says.
But instead of a salary, the surgeon in training received a small room and free meals on the grounds of the sprawling medical facility, where he has been working since early May.
He starts his day making the rounds of the patients, then there’s usually a meeting or two, and it’s off to the operation room.
“There are few planned operations, as in peace time, but you still get the occasional surgery that cannot be put off, such as an advanced brain tumor.”
Most of the patients he sees, about 70%, are soldiers with serious wounds from the front. He and his colleagues at the hospital never know how many to expect.
“It’s very irregular, day and night. Sometimes we get a single soldier in an ambulance, and sometimes 12 or 15 casualties delivered in a big bus that’s been converted into a hospital transport.”
The main challenge for the hospital’s highly-trained staff is to prioritize the most serious cases.
“You have to keep a cool head in the face of what amounts to a never-ending emergency situation.”
The second challenge is speed, Mykola explains: “If you have started an operation, you have to wrap it fast and move on to the next.”
The workload is demanding, the pace is grueling and the shifts are long – 36 hours straight, 24 of which Mykola is on his feet.
So how do you relax, recharge? I ask. “I don’t. My phone is always turned on. I am always on call.”
But the biggest challenge, at least emotionally, is facing the countless victims of Russian artillery fire after their operations.
“We recently had a young man with a stomach wound who’d also lost both legs. He was in a state of deep, clinical depression and would lie in his bed silent and motionless, just staring at the wall.”
But not every case is the same, Mykola underlines, in what amounts to a tribute to both the stamina and patriotism of the Ukrainian soldiers fighting for their country.
“There was another guy who had a head injury and underwent three days of operations. He recovered amazingly fast and immediately asked to return to the front, to his ‘brothers in arms’. He was lucky, of course, but there have been others like him.”
Bullet wounds are rare among his patients, Mykola says. It’s almost always shrapnel wounds that he sees, pieces of shells and rockets lodged deep into their victims or that tear right through them.
“We get the worst of the worst, disfigured faces, amputations – horrible things to behold.”
Most arrive at Mechnikov Hospital in a medically induced coma or under artificial respiration.
“Then you meet their relatives – their wives, their parents, the mother and father of someone who is much younger than you. It’s an emotionally draining experience.”
And the more you learn about the patient, the harder it is. Sometimes the patient has no one, his parents are, for example, under Russian occupation and cannot be contacted by the Ukrainian military.
“Some of the people whom I have met here are so strong, people ready to give their lives at a moment’s notice – to protect people like me.”
It is, in fact, Mykola’s first hand witnessing of the sacrifices made by rank and file Ukrainian soldiers that keeps him going under such conditions – that and the support of his colleagues at Mechnikov Hospital.
“I am grateful to the doctors here who have helped me to learn so much. I couldn’t get this kind of experience anywhere else. And it is experience that is so badly needed in Ukraine today.”
As for the future, the challenges will not end with the war, as the country will have hundreds if not thousands of permanently injured young men to care for.
“Some will bounce back. Others, for example, who lose their eyes or limbs, may never have an opportunity to support themselves or start a family.”
It was Mykola’s family that gave him the motivational foundations to face the challenges that he is now experiencing.
“My grandfather was a dissident in the Soviet Union and was persecuted by the KGB. So I have never had any illusions about what to expect from Russia.”
And as the war drags on well into its fourth month, and many, especially abroad, lose interest or begin to question Ukraine’s cause, Mykola maintains a simple truth in mind.
“We, here in Ukraine, are not threatening anyone. The Russians are attacking us, civilians as well as soldiers. They understand perfectly well what they are doing. They have lost their humanity.”
Mykola considers himself among the lucky ones. He didn’t even have to give up his residency in Germany, where the authorities have renewed his visa.
But for now, he mans a different front line, one very different from the smoke and fire of battle.
“There is no drama here, just pain, physical and psychological pain for the wounded and their families.”
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