In Times of War

For the past four years, I have worked as the Head of Pathology at the National Institute of Surgery and Transplantation in Kyiv, Ukraine – the country’s main center for pancreatobiliary and hepatic pathology. Alongside this, I also run a medical Instagram account (@pathology_ua) to teach people about pathology and the work we do in the lab.

But, like everyone else in Ukraine, my life and work changed the day Vladimir Putin started the invasion of my country. On the first day of war, I still went into work, but only for half a day. Everyone was in shock. For the next seven to eight days, we all stayed at home and some of us moved to western regions of Ukraine. In the second week of war, we resumed our routine practice while preparing the hospital to take in wounded people. Fortunately, because there were only a few routine patients, we had the capacity to help some of our medical colleagues here in Kyiv who have difficulties with histology.

There has been quite serious trouble between Russia and Ukraine since 2014, but the invasion was a sudden escalation. Before the invasion, I did not believe that it was possible – and our healthcare system had no contingency plans in case war broke out. The day before was a normal workday; it was only after the war started that Ukraine’s healthcare system made hasty preparations to receive wounded soldiers and civilians. I know there are other municipal hospitals already dealing with wounded people. Since the invasion started, I have become skilled in tissue block embedding, digging trenches, and recognizing different rocket systems by sound alone. Just a few months ago, I would never have imagined myself doing the latter two – but now, they have become a part of my new normal.

With war comes new sensations and experiences. During the first week, my family and I hid in the underground parking of our house during air raids and slept in the car. We then began to go out into the common corridor on our floor to follow the “two load-bearing walls” rule, which could save us from the consequences of a rocket hitting the house. Not long after that, we put a bed in the common corridor and I even worked there at the microscope for several evenings. For the first two weeks, it was not clear what would happen next or how – I had to calculate our food supply and plan to refuel the car. There was a shortage of bread and cigarettes in stores for several weeks, so it was a joyful moment when I found a bread shop not far from my house. After attempts to break into Kyiv by enemy detachments at the very beginning of the war, the city turned into one big checkpoint – checking documents, car trunks, and more – but all residents understood it was necessary to prioritize our safety above everything else.

As far as I’m aware, pathologists in Kyiv were not reassigned to other duties within the Ukrainian health system; however, I cannot speak for cities and towns closer to the enemy border that are under siege. We started with about two weeks of delays for pathology reports and are now down to only a five-day delay, with some biopsies even reported within one working day. The most pressing challenge we pathologists are facing right now is the departure of many employees to Western Ukraine. For the first few weeks, there were no technicians in my lab, so doctors were trying to do everything from grossing to block embedding. On the second week of the war, I even drove about 200 tissue blocks to another hospital where they had enough lab technicians to cut them for us. Now, one of our technicians has come back to work for a few days each week, so our workload is a little better.

Outside of work, my first terrible glimpse of war was a battle with an enemy detachment only three kilometers from my house. They were going to break through the main transport artery of the city and I heard it all happening from my window. When everything calmed down, messages began to appear that the enemy squad had been eliminated. It was then that I had my first thought that not everything may be so bad. The second terrible moment was a missile attack on the Kyiv TV tower, located only 1.5 km from my house. Kyiv has suffered minimally compared with cities such as Mariupol, Kharkiv, Chernigiv, and many other smaller cities located closer to Russian borders. Nevertheless, we lived for almost a month in anticipation of the complete encirclement and siege of the city. Thanks to our Armed Forces of Ukraine, this did not happen and, as of 31 March, 2022, the enemy has been forced to retreat.

Putin’s attack on Ukraine has united all Ukrainians – we have never been such a united nation as we are now. For this, we can thank him. After the war began, I started to cover military events on my medical Instagram page, and I want to say thank you to all the pathologists who wrote words of support from all over the world, including Russia. I was offered help with moving to another country, finding a job, and financial assistance. It was very touching.

To support pathologists in Ukraine from outside the country, donating to official charity foundations for Ukrainian people or the army would help tremendously. If you can, target some of your help to pathologists by making it easier for those who are moving west to Poland, Czechia, or Germany to find jobs.It turns out that, even in Europe, no one can always be calm – and war is not just a scary story from the past. It is here and it is now. The whole world is fighting Russian aggression. To my colleagues and those outside Ukraine, I say help us to separate the civilized world from the darkness.