ENG“Cause of death? Heroism”: The notes of the Ukrainian military medic

Bloody Stretcher. Anesthesiologist’s Notes

Which emotion do I feel most often? Rage. Towards the enemy, towards my colleagues who don’t work hard enough, to the military who sometimes screw up. But most of all – to myself. I just light up a cigarette in a spare minute, lower my eyelids – and then my endless series of memories starts.

***

A fighter with a head injury. Both pupils dilated, no pulse. He needs resuscitation, but the defibrillator and ventilator are on the second floor, in the operating room. I’m losing precious seconds. Shit, it’s my bad: I should have set up the shock room on the first floor. I intubate him and head up to the operating room. There’s a civilian EMT next to me and I’m showing him how to pump the guy. In parallel, I’m setting up a PICC line and infusing adrenaline. The civilian surgeon has started moaning right next to me.

“Doc, look at this hole in his head. I suggest that we end it. He doesn’t stand a chance.”

“Biiiitch, I’m the trauma doctor here. I’m the one who decides when reanimation starts and when it ends. We’ll try for the full 30 minutes, just like we’re supposed to. And if anybody doesn’t like it, he can get the hell out of the trauma room.” We got a heartbeat after 36 minutes. Unfortunately, the injury was severe and we couldn’t save him.

***

A five-year-old boy was carried in. Barely conscious, face distorted with pain. He wasn’t screaming. I could see that he was trying, but didn’t even have the strength to cry.

I can palpate a shard to the left of his navel, which means internal bleeding. I set up two peripheral IVS and sedate him with morphine. He’s seriously injured, but stable. What next? I don’t have pediatric intubation tubes. I’d never put in a central line for a kid… My brain is feverishly recalling my lectures in pediatrics, I can even hear the catchphrase of my lecturer at Luhansk Medical University: “if it works, don’t touch it”.

I grab the phone:

“Hello, Ivanna Olehivna, I was a student of yours. I need some advice…”

The boy survived.

***

I’ve been at war for so long. Most of my adult life. For me it started in 2014, but I only joined the battle myself in 2015. I haven’t worked in the hospital during all these endless years. I was also with a battalion: I asked for it, but it wasn’t easy. One time after a night battle the fighter Poltava came up to me.

“Listen, I got hit a little yesterday, can you please have a look? Just don’t tell the commander. He’ll kill me.”

I found three superficial shrapnel injuries on him and prepared my instruments. I put on my gloves and mask, took hold of the tweezers and step up to him. And all of a sudden he faints. What?! Yesterday, his “nest” took five direct strikes. His machine gun never stopped despite the shelling.

“Sania, what’s happening?! I never expected white coat syndrome from you!”

***

Occasionally medics from the other defense units in the sector would come visit. Katia was a pretty woman with long black hair carefully hidden under her helmet. To me, thin girls in body armor look like children wearing their parents’ clothes.

This time, she was pale and almost lifeless: she took off her helmet and flak jacket and slumped into a chair.

“We’ve lost two scouts, one is [dead]. The other was taken prisoner.”

“Why do you think he was taken prisoner?” I asked and handed her a mug of coffee.

“Before he died the 200 pressed the radio button, so we actually heard the other guy being taken prisoner.”

She was clutching the mug and staring in a way that burned me. After several days, they brought the body of the fighter who had been taken captive. Only half of his body, to be precise. They never found the rest.

***

The hospital walls started shaking and the window panes were trying to jump out of their frames. A wild roar ended in a powerful explosion. As we waited for the next incoming shell, we took the civilians with the children to the bombshelter. We called the senior doctor, and told him a body was coming.

“The police will be here soon. We have to go to the morgue to examine a body, will you join me?”

“Yes, sure.”

In med school, there was a phrase in Latin above the entrance to the autopsy department: Here the dead teach the living. That’s why I was doing my best to examine and carefully study every fallen warrior.

On the autopsy table, we saw a body with a pilot’s helmet. The smell of burnt hair.Rigor mortis had fixed his right hand next to his left shoulder. The fingers of his left hand were contorted. The skin was burned on his entire body - not a single living inch. Through the helmet goggles, I could see dull eyes and an open, twisted mouth. A phone charger is sticking out of his burnt pocket.

“Doc, I need to state the reason of death in my report, what caused his death?”

The senior examiner was silent, he was carefully examining the body. I decided to make an assumption:

“Burns, maybe? I can’t see any other injuries.”

He remained silent for several seconds more:

“They told me that the first pilot ejected right away. This guy stayed in the jet while it was falling. He was still trying to control the jet. When a jet is on fire, the fire catches the cockpit and instantly burns off all of the oxygen. So there’s nothing to breathe.”

“You mean, he was burning alive in that fucking cockpit, but tried to guide the jet away from the city?!”

“I can’t be sure. I think so.”

“I’m not getting it. Even if he had fallen here, would it really cause so much damage? Was it worth his life?”

“There could have been bombs in the plane and jets also use a special fuel. If he had fallen on us, the consequences would have been catastrophic.”

I silently filled out out the protocol. Can I fill in the cause of death as “heroism?”