Bullet holes at petrol stations, solitary tanks and charred buildings were among the starkest reminders of a war that had not ended when three US surgeons crossed over from Poland’s border into Ukraine to perform lifesaving surgery on victims of war.
Kirtishri Mishra, 34, Laura Bukavina, 38, and Shubham Gupta, 40, from University Hospitals Cleveland Medical Centre, took a 16-hour flight to the Polish border village of Medyka on 13 October before crossing over the border by foot into Ukraine.
From there, they drove to Urosvit Hospital in western Ukraine’s Lviv to treat patients at the facility – that journey took over 24 hours.
The doctors then embarked on another six-hour car journey to the Ukrainian capital Kyiv to treat wounded soldiers and civilians at a military hospital.
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“The journey for the most part never really felt unsafe, but there was always an undertone that things were not normal,” Dr Mishra, who works as a reconstructive urologist, said.
“What was crazy for us is we would be driving along the motorway, and we would pull up at a petrol station and see bullet marks there from warfare that had taken place in that area.
“Some of those things were major reminders of what had happened there, so that was a very sobering experience.”
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The doctors at Lviv Railway Clinical Hospital
From 7am to 8pm, the surgeons’ rigorous schedule would see them treat Ukrainian soldiers and civilians who had suffered physical trauma, including those with landmine injuries and gunshot wounds.
“We were on the go the whole time, and we didn’t really have a chance to process what was happening,” Dr Mishra said.
“Having said that, doing it with people who I know and who I consider to be my friends helped alleviate a lot of the stress.”
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Dr Bukavina in the operating theatre in Ukraine
During their time in Lviv, Dr Mishra described meeting one doctor whose friends had died in Russian bombing in the east of the country and whose parents had chosen to remain close to the Russian border.
“His spirits were still high. Maybe in this moment, they are just doing what they need to survive and to protect their country,” Dr Mishra added.
Sharing her experience, Dr Bukavina, an urological oncologist who was born in Ukraine and emigrated to the US when she was 11, said what struck her was the spirit of the patients she treated.
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Dr Mishra performing a urethroplasty
Reflecting on one 19-year-old patient, who had undergone 13 surgeries and was living with a kidney bag to help drain his urine, she said: “Looking at someone who has a good six decades of life minimum left and who is in great physical shape and who doesn’t even have a family yet, someone who is still a child and staying in hospital for seven months enduring this – it was difficult.
“I think the closer you are in age to your patients, or the closer the patients are to the age of your children, there is a certain level of projection that takes place.
“You think: ‘If I was a mother, how would I feel if my child was here for the last year suffering?’
“And there is nothing you can do. These mothers, they have no one to reach out to or call.
“They’ve travelled all over Ukraine and they’ve tried to reach their relatives overseas and just ask for opinions and actions. Then, to have someone come in and fix this – they take it as such a gift.”
Dr Bukavina went on to describe how she and her colleagues had not anticipated the level of tissue destruction they saw when they first arrived to the country.
She said: “The trauma that we saw there was very different from the trauma in the US. What we see from motor vehicle accidents is nothing compared to what you see there. Trauma from explosions is very different.”
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Dr Gupta performing surgery and teaching the local urologists in Ukraine
With air raid sirens now a part of everyday life for Ukrainians, the doctors described one moment when they heard an alert as they operated on a patient.
“Everyone’s phones went off, but the doctors there just ignored it and kept going,” Dr Bukavina added.
“A month before we came they had sandbags on the windows to protect them from blast injuries – however the sandbags were removed before we came.”
“I think the people there are just going through the motions,” Dr Mishra said.
“Going through these experiences may not materialise into something until years later. I experienced it for a short period, but living in that I can imagine changes people in ways that we may not know until later.”
Nearly two years into Vladimir Putin’s invasion, which has seen thousands killed or wounded, Dr Bukavina described the scenes emerging from the war as “heartbreaking”, adding there was “hurt on both sides”.
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The surgeons at the military hospital in Kyiv
“On a personal note, it’s heartbreaking because there are a lot of people on both sides – the Ukrainian and Russian – who are hurt,” Dr Bukavina said.
“There are a lot of Russians who don’t want this war, but they’re completely silenced by their government.”
Dr Gupta, who spent a few years in the contested state of Kashmir between India and Pakistan as a child, said ultimately it was always “the people on the ground that suffer”.
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Recalling going to school and being sent back home due to bomb threats, he said there was a physical and psychological trauma that people were left with during times of conflict and out of war “people had to relearn how to love” once more.
He said: “War is not pretty, war is woven into the fabric of human history, but all of us are privileged to grow up in a time when war has typically not been the norm, at least not immediately around us.”
Reflecting on their time in Ukraine, Dr Mishra said what struck him were the “humble” and “amazing” people.
He said: “One of the doctors there talked about how when the initial bombing started he woke up at around 6am and drove his wife and his two-year-old son away from Kyiv through the backstreets and then drove right back and got to work in the hospital.
“I think people see it as a duty, they want to contribute to this cause. This indomitable spirit that they have despite going through all this was just awe-inspiring.
“After witnessing that, you come home, and you hug your wife and your parents a little bit tighter.”
