SLOVYANSK, Ukraine — The doctors could have left months ago.
Some 70 percent of this hospital’s staff have already fled — leaving Ukraine or heading west to relative safety farther from the front line.
Valentyna and Arkady Glushenko’s children have begged them to do the same — to run, to leave their work behind, “to stay alive.” But even as Russian forces push closer, with positions now just about seven miles from this eastern city, the two doctors are refusing to budge.
“If the general runs away from the hospital, what happens to the army?” Arkady said with a shrug one morning this past week, the near-constant sound of outgoing shelling reverberating just outside his first-floor office window. “I have to help people. It doesn’t matter if they are army or civilians. It doesn’t matter gender, faith or who you are.”
The Glushenkos are among a dwindling number of civilians willing to stay in this enclave in eastern Ukraine, where the threat of a Russian takeover looms ever closer.
Over the past several weeks, Russian forces have made major territorial gains, pushing outgunned Ukrainian soldiers back from key positions and using artillery to destroy infrastructure in small cities and towns along the way.
Street battles are raging in the city of Severodonetsk. Other nearby cities, including Lysychansk and Bakhmut, have come under intense shelling. Russian forces have also set their sights on Slovyansk — a town that pro-Russian forces briefly controlled during their 2014 assault on the Donbas region. At that time, they infiltrated the hospital, eventually using part of it as their base as Ukrainian doctors tried to use the facilities to treat many wounded civilians, Arkady said.
When the soldiers were finally forced out by Ukrainian troops, the building was left in disarray. “The doors were smashed; there was dirt everywhere,” Arkady recalled.
This time around, with the city still in Ukrainian hands, the hospital staff who stayed behind are avoiding thoughts of a worst-case scenario and instead keeping their full focus on the task at hand. “They’re not here right now,” Arkady said of the Russians. “So let’s just not bring it up.”
Arkady, 62, and Valentyna, 58, met at this hospital decades ago. He was an ambitious first-year surgical resident; she was his intuitive operating room nurse. They married in 1984, and she gave birth to a son that same year, and another four years later. Arkady persuaded Valentyna to return to medical school to become a doctor. She focused on gynecology while he worked as a surgeon and cared for their sons. The intensity of the job meant she learned at a young age that she would need to make personal sacrifices for her career.
She said she worked so many shifts that she “didn’t see my kids grow up.”
Eventually, she was promoted to director of the hospital. Arkady became director of surgery.
The couple experienced difficult times in Ukraine’s early days as an independent nation. In the early 1990s, Valentyna recalled, they went some six months without pay. They worked shifts in the hospital while bartering vegetables from their garden for food and supplies.
But they could never have imagined the circumstances they now find themselves in as they treat mainly civilians wounded in Russia’s war on Ukraine — the vast majority injured by shelling. They and the other staff members who opted to stay behind are continuing to treat patients even as they contend with the enormous risk of Russian assault, including its personal consequences.
Dmitry Smirnov, a 27-year-old radiologist working in the hospital, learned through Telegram that his house in the nearby Russian-occupied city of Lyman had been destroyed.
A dwindling number of pregnant people are left in Slovyansk, with many having relocated to safer cities farther from the front line. When one woman delivered a premature baby three weeks ago, there was no neonatal doctor to treat the newborn. Instead, Valentyna found the mother and baby a spot in an ambulance with a badly wounded soldier. The three were transported together to Dnipro, a city about four hours away.
Hospital staff members have had to adjust to the new wartime reality. In the basement of the hospital, they have set up an operating room in the bunker that is prepared to accommodate patients for most major surgeries or childbirth.
With no running water, staff members wash their hands with water from plastic bottles. When the power was cut last week, they rushed to transport many elderly patients to hospitals farther from the front line, fearing they could no longer properly care for them and knowing the need to free up more beds for incoming urgent cases. When a water truck pulled up outside, staff rushed to fill up buckets and other containers.
Still, Arkady said, it beats the conditions in 2014, when they had to collect rainwater.
About 10 miles to the south, in the city of Kramatorsk, the few doctors who stayed behind are coping with similar conditions and a flood of wounded troops.
Mykhailo Skliar started his residency at Hospital No. 3 expecting to slowly hone the basics of trauma medicine by treating household injuries and other more common accidents.
Instead, he was thrown into the role of wartime doctor — treating soldiers grievously wounded in the fighting and civilians caught in the middle, including those with severe wounds from rocket attacks. In April, he responded to the brutal shelling of his city’s train station that killed dozens of people, including children.
“People were lying down in the hallway. A lot of blood was on the floor,” he said. “It was a complete mess. Every staff member was preoccupied with every patient.”
He provides first-response treatment for soldiers wounded on the battlefield before they are transferred to better-equipped facilities in Dnipro. Often, he doesn’t even learn the fate of the people he treats.
On Thursday, he admitted a middle-aged soldier named Roman, who had been shot in his left lung. He required a tube in his chest cavity and was scheduled to be transferred to Dnipro the next day. He breathed shallowly in his bed, his chest covered in bandages. “It’s hard to speak,” he groaned. In the hallway outside his room, bloody fatigues sat in a cardboard box next to a discarded bouquet of flowers.
Later that afternoon, another soldier arrived in an ambulance, his bloody face wrapped in bandages after he was hit with shrapnel.
Skliar’s best friend, Dmitry Oleksyuk, 26, is a fellow trauma resident. The two have lined up their schedules to work together and support each other through the most difficult days. The day of the train station attack, Oleksyuk said, “the first child brought in was a 4-year-old boy whose leg was missing.”
The anguish that comes with treating such cases is a feeling few other people understand.
“We can relate to each other and reveal more to each other,” he said of Skliar.
The war has left Skliar hardly able to recognize the younger, and maybe more innocent, version of himself. “You feel completely different compared to your state before the war,” he said. “I will never see medicine as I saw it before … sometimes you’re a janitor, nurse and doctor all at the same time.”
He feels mixed emotions over the doctors who chose to flee earlier on, he said. Some are living in relative safety while he spends so much time at the hospital treating the wounded that he barely engages with the world outside.
“It feels like life is going on without you,” he said. “You know you’re doing an important job, but you feel like you’re missing out.”
Sometimes, Arkady said, he catches himself thinking “the weather is nice” or “it’s quiet.”
“The next thought is: ‘I hope the war stops,’ ” he said. “But then I realize it’s not going to stop, not today or tomorrow.”
Heidi Levine and Anastacia Galouchka contributed to this report.