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As the chief trauma surgeon at Kyiv’s military hospital, Petro Nikitin has his hands deep in the churning war hundreds of kilometers away.
The 59-year-old doctor’s work to repair the bodies of some seriously wounded soldiers was very impressive.
“I just operate,” said Nikitin, during a break in the operation.
“I don’t do anything in my life now, I don’t see my children, who have been evacuated, I don’t see my wife, who has been evacuated, I live alone, and only treat the wounded.”
While Ukraine’s military has not given casualty figures, some Western sources estimate that more than 100,000 Ukrainian soldiers have been killed or wounded since Russia invaded the country nearly 15 months ago.
Fighting has been fierce in recent weeks around the eastern city of Bakhmut – the scene of the longest and bloodiest battle, where Ukrainian forces have recently retaken more territory from Russian forces.
More fighting, more damage
A major Ukrainian counteroffensive is expected in a few weeks, with more people expected to face the operating table at the Nikitin hospital, which, like other Ukrainian military hospitals, is understaffed as doctors are drawn to field hospitals.
The Associated Press agreed not to identify the Kyiv hospital for security reasons.
On February 25, 2022, a day after the Russian army attacked, Nikitin posted a photo on Facebook showing him listening to an Israeli specialist treating a gunshot wound.
Surgeons from all over the world have agreed to participate in online training on combat-related injuries, which Nikitin is quickly doing as president of the Ukrainian branch of the international association of trauma specialists.
“Each of us had relevant experience before the invasion, but not in that volume,” Nikitin said. “The high number of traumas is new to us.”
Gunshot wounds turned out to be rare.
“I don’t even remember the last time I took a bullet,” the surgeon said.
Many types of injuries
But they are familiar with various traumatic injuries: explosive weapons such as land mines, artillery shells and grenades often injure many parts of the body at the same time.
“We receive people with broken legs, chest, stomach and arms at the same time,” said Nikitin. “In such a case, we have to decide what part of the injury should be our priority.”
The military hospital is one of several in Kiev. As a top-level trauma center, it receives the most complex cases, usually involving patients who are stabilized at the front and spend time in field hospitals before being transferred to the capital.
“We don’t do first aid here. We don’t save lives. That’s what the medics do,” he said. “What we’re going to do is return these people to a normal life.”
Dealing with wounds that cause damage to soft tissue, bones and structures that connect nerves and tendons is the most difficult for the surgical team, Nikitin said.
Sometimes he was forced to amputate a soldier’s arm or leg, which “from a moral point of view” would have been a disturbing decision, he said.
“It’s emotionally difficult not only for the patient, but for the surgeon.”
Long days, every day
Nikitin usually arrives at the hospital at 7:45 and stays until the work is done, sometimes not leaving until 11 at night.
His wife and children fled Ukraine in March 2022 as Russian forces closed in on Kyiv. He accompanied his family to the border, and returned to the city.
As the Russian and Ukrainian armies prepare for a possible spring offensive, their schedules have eased to about three operations a day.
Most of the patients treated were recently wounded during the fighting for Bakhmut and elsewhere in Donetsk province, or in Chernihiv and Sumy provinces in northern Ukraine, where they are routinely evacuated.
The young soldier Nikitin operated on recently was Mykyta, a native of Bakhmut who was wounded in the lower leg while fighting for his hometown and celebrated his 20th birthday shortly after the operation. AP withholds last name in accordance with military guidelines.
His last memory of Bakhmut conjures a “terrible” image in his mind, the young soldier said.
“This is the city I grew up in, and it’s broken,” he said from his hospital bed. “City on fire.”
Compared to the massive trauma some patients experience, Mykyta’s injuries don’t seem severe, but he could still lose his lower leg, Nikitin said.
Attempts to remove the skin from the wound were unsuccessful, and doctors tried again.
Nikitin felt optimistic after the surgery, but said it will take three weeks to know if the latest skin graft is working.
“If that doesn’t work, the next step is amputation,” he said.
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