Military medics of Ukraine
Mykhailo Pasichny
Civil surgeon

It started when I woke up from a heavy explosion at 5 a.m., grabbed my phone, and heard Putin’s address. In that moment, everything became clear. To me, he was obviously saying that Russia is coming to kill the Ukrainian nation and culture.

It’s classic fascism: “We are going to establish order at your place — with military help.”

A few months ago, I was reading up on current events in social media and realized we were moving in the direction of war. So, I prepared my exit backpack — it stood nice and ready, and by the end of the day on February 24, I picked up my surgical instruments, drove out to the military hospital in the closed part of the city, and offered my help. The head of the facility knew me very well, and they were happy to have me there.

I was performing surgeries by the next day. The injured kept coming. Generally, I would work on the heavily wounded. I tried to save some people’s lives, others’ limbs, and some just needed hope that they’d get better.

At first, they would bring in only the injured soldiers. Those soldiers would be processed in an observation hall and then moved to one of three places: X-ray, patient rooms, or one of five operating tables.

When a few injured soldiers from the front lines were dropped off at once, everyone available got to work. Up to eight people would work on one soldier. First, you’d have to cut through their clothes (which is not simple, with the frost outside). Then, anesthesiologists would get to work, and then teams of surgeons.

We worked fast to not lose patients, especially at the first stage; they were coming in with low blood pressure, shock pain, and heavy bleeding. Many soldiers came with modern NATO tourniquets (that super-cool tool saved the lives of many Ukrainian soldiers in our hospital). Most of them are highly trained in how to apply those tourniquets — and applied they were, massively. Later, doctors had to sort out where tourniquets were actually needed or not.

I’ve been a surgeon for 38 years. I’ve seen a lot in my career, but so many wounded, and so severely — never. Almost all the injuries were fragmentation wounds, and all of them were different. Bomb explosions, mines, grenades. Embedded, through-and-through, single, and often multiple wounds.

Shelling tore off people’s arms and legs, so we were doing a lot of amputations. If the fragments hit the stomach we did resection, taking out part of the intestines to save a soldier’s life. Sadly, a fragment to a skull meant a bad prognosis.

There were mutilated faces. Missile fragments had turned jaws into a mixture of teeth and bones; sometimes, the fragments went through the neck.

One 20-year-old soldier had part of his larynx torn out. When they brought him in, his head was hanging down, otherwise, he would have choked on his own blood. It was a miracle he made it to the hospital. We intubated him, folded up his larynx, then he was hooked to a tracheostomy tube. And that kiddo made it! Even better, he was walking around later, hugging the medical staff. He couldn’t talk anymore, though; he lost his vocal cords.

There were serious injuries to pelvic organs. Two soldiers were brought in, fists holding pressure on their wounds. Their friends had their arms inside the pelvic wounds, stemming the blood flow. We were able to save those two.

I performed five restorative surgeries on hip and shoulder arteries. In a different situation, patients faced a risk of losing their limbs, but we managed to restore blood flow there.

Every day on the job, the circle around Mariupol tightened. Local hospitals suffered from a crazy number of injured civilians. There was a shortage of medical supplies and helping hands. Civilians kept coming when they heard our military hospital still operated. We opened the gates, let everyone in, walking or driving, and tried our best.

The need among civilians to seek out our hospital was increasing day by day.

I heard, and saw with my own eyes, brutal stories. One young woman, less than 20, was sitting in her room, reading a book. She came to us, her face covered with a shawl. I took it off, and she was missing half a nose, her upper lip, and her teeth. I restored her upper lip and fixed her nasal breathing. Everything else will require a complicated reconstruction process after the war is over.

Another time, two kids were brought in. Fragmentation injuries. An 11-year-old girl died in 20 minutes; we saved the other.

Why did it happen to them? Because they lived in Ukraine.

The war made it clear that Russians didn’t come to fight Ukrainian soldiers, but to bulldoze our land. When it came to Mariupol, all major electrical lines were destroyed first. Next, all of our water supplies were bombed. Finally, all the infrastructure and cellular towers were ruined.

Air bombing by Russian aviation intensified every day. When the city gets hit by a 500 kg bomb, every living thing in a 100-meter radius dies from the impact. All the window frames in the nine-story buildings nearby would be smashed, something would catch fire, and the trees would turn into 3–4-meter stumps. This is the horror of war in the 21st century.

Tanks were pounding from their cannons. The injured people, once in the hospital, told me that tanks were hitting 2–3 kilometers out for the sake of killing as many soldiers and civilians as they could.

One day the rear of the building next to mine was hit. The impact tore a 1.5-meter hole through the ninth floor. The outside wall was simply smashed into the building. Several apartments turned to rubble. The strike split the building in half.

My wife told me a story: She once came out of the hospital and saw a 16-year-old kid, just standing there, shaking. He was walking down the street with his dad when a bomb killed his father. My wife talked to him, comforted the kid the best she could, and went back to work.

Sometime later she came out again. The boy was bent over his father’s body on a stretcher, rubbing his hands together and asking: “What will I say to mom now… ?”

After some time, dead bodies were laying around the city.

On March 8, I happened to be on duty with the hospital chief. By then the number of casualties had increased significantly, so we talked about the first mass graves. We didn’t look for documents to confirm, we just buried people to avoid unsanitary conditions.

By this point, airstrikes were becoming more frequent, and my wife couldn’t go out anymore. The risk of death was too high.

Early in the morning on March 15, three rockets hit our hospital. One exploded in the reception area and heavily injured a soldier. The next night, on the 16th, the artillery style seemed different, and there were fewer hits from our side. That’s why, early the next morning, I decided it was time to leave the hospital.

I drove to pick up my wife, unaware of the ambush Russian soldiers had set up along the road. We noticed them later, as we took the same road to leave the city. Thank God they didn’t seem interested in us. My guess is they were waiting for an attack from our soldiers. We simply got lucky.

I stopped by my mom’s place to say goodbye. She is bedbound, and my sister looks after her.

There were no organized evacuation routes, so we had to get out on our own. To make it past multiple Russian checkpoints on the road to Tokmack, we deleted everything on our cellphones. It helped that I was a Mariupol resident — plus, I’m over 60. People my age get bothered less.