TIM MAK, OKSANA OSTAPCHUK, AND J.P. CHAN
Michael has never met me, and likely never will.
But I’ve met him.
I first see him, unconscious, in the back of a speeding ambulance, rushing west along the highway towards Dnipro, a hub for the wounded. Even if he were awake, the 50 year old would not be able to see me: his eyes are covered with bandages.
Two medics work on Michael as the ambulance speeds towards Dnipro.
His body is covered by the marks of violence: his left leg has been amputated. His left forehead and eye have trauma from an explosion.
He’s been pumped full of blood that is not his own, in order to save his life, along with a cocktail of drugs meant to improve his chances of survival: tranexamic acid to help with blood clotting; morphine and fentanyl to help with pain; and a long list of others.
The back of the ambulance is thick with the feeling of concentration, the air empty of sound except for the engine and machines working to keep this man alive. His bed, equipped with stabilizers to reduce movement on the highway, stays steady as equipment showing vital signs works ceaselessly. One medic sits near Michael’s head, the other, closer to his feet.
I’m embedded with MOAS, an NGO that began its work in Ukraine after the full-scale invasion. Since Feb. 2022, they’ve evacuated some 30,000 patients from the frontlines, focusing on only the most difficult cases – serious head trauma, stomach eviscerations, limb amputations, strokes. The drivers often spend 18 hours a day on the road, back and forth, back and forth.
30,000 is just a number. Here is one real person, in front of me, clinging on to life. His personal trauma, and the grating mental trauma his medics go through as they treat patient after patient, is a reminder of the cascading and cumulative effects of the war as we approach the two-year mark.
A moving ambulance creates a different relationship between medic and patient. It’s far more intimate, far more personal – and leaves a deeper mark on the psyche.
Yevhenii Solod, who works on the ambulance for MOAS, notes that in a hospital setting you’d rarely spend more than an hour at a time with a patient. But in an ambulance, you spend far more time with them, ensuring they are stable for the duration of the trip.
“For hours, their life is in our hands,” he said. “You cannot allow yourself to lose focus, even for a minute… mentally, it drains a lot.”
MOAS medics stand in front of one of the ambulances.
The relationship is mostly unspoken. Because MOAS focuses on the most critical cases, the vast majority of patients are unconscious – on a breathing apparatus, for example; unconscious or otherwise unresponsive. They meet their patients, who will never meet them.
“My dialogue is usually with the machines here… checking their vitals and keeping them alive,” Solod said. “I tried to stay away from feeling too empathetic… [this work requires you] to be a bit cold-blooded inside to do the job efficiently.”
He remembers a doctor who was once his boss that gave him this advice: you need to show patients love and compassion, but you need to develop a layer of control beneath it, so that you don't take the medical outcomes too close to the heart.
“I still have some gunpowder left,” Solod said, referring to his energy levels. “I know that [soldiers on the front lines] are going through much worse times. And we cannot survive without them.”
MOAS medics are on standby constantly. At their headquarters near the frontlines, in a town they’ve asked me to conceal for security reasons, we await orders for the next evacuation. Once nightfall comes about, we are locked in place and cannot leave – there are serious concerns that saboteurs or overhead imagery might detect their location if we move around after dark.
A MOAS driver behind the wheel.
Then comes the waiting. The doctors have a joke: when the journalists are here, it gets quiet. Days with overcast or foggy weather tend to be quieter, as drones are less useful and the artillery duels slow down.
When a patient needs evacuation, it happens in an instant.
“There is no time for exhaustion. You obviously feel it. But the situation that the boys are in – obviously this motivates you a lot,” said Artem Bildii, a MOAS team leader who organizes and coordinates evacuation teams. “We are going to continue grinding, continuing doing it. And I believe victory is going to be ours.”
The last I saw of Michael, from a screenshot of a video that I took of him being admitted to a hospital.
We don’t know what happened to Michael. After a ride from the MOAS headquarters to a hospital in Dnipro, he disappeared into the Ukrainian medical system. His wounds were extremely serious, but survivable, due to the quick work of soldiers and medics around him.
We do know what happens when the wounds are too severe, or if the combat situation makes it too difficult for timely evacuation. Medics know all too well what happens in that situation, which is why a certain level of cold-heartedness is needed.
In a town in Donbas I was passing through while reporting this story, I saw the ultimate consequences of the war – that death happens even when every medical intervention is performed perfectly and evacuation is swift.
A monument at the side of the road: “Pain will not cease in centuries...”
On the side of the road, I saw a large wall covered with photograph portraits of the local fallen, the soldiers who medics could not save.
“Pain will not cease in centuries. Heroes do not die. Glory to the heroes!” read the monument.
On that foggy, misty day, a woman approached, and tenderly wiped the moisture off the image of a man on the wall, pausing to kiss the photo – a ritual borne out of grief.
It’s a pain that does not forget, as Aeschylus put it, falling drop by drop upon the heart.
She left, and I wondered just how many Ukrainians feel that same pain today. This is what these medics fight, grind, and grit their teeth to stand against.
As I walked away, I turned back one more time to see her returning to the wall, hoping for one more solitary moment with the photo of someone she had clearly loved.
Her pain had still not ceased.
No comments:
Post a Comment