The Military Surgeon at the Front: Stories From Ukraine's Endless War

Dr. Olena Marchenko has been treating war wounds in eastern Ukraine for four years. Here is what she has seen, what it has cost her, and why she keeps going.

Dr. Olena Marchenko performed 847 surgeries in 2025. She knows the number precisely because she logs every operation in a notebook she carries in the pocket of her surgical scrubs — not because she is required to, but because she made a decision early in the war that every patient would be counted, recorded, and remembered, regardless of whether they survived.

Marchenko, 41, is a trauma surgeon who has been working in military field hospitals in eastern Ukraine since March 2022. She trained at Kyiv Medical University and spent the first decade of her career in civilian trauma surgery — road accidents, industrial injuries, the ordinary catastrophes of peacetime. Nothing in that decade prepared her for what she encountered when she volunteered for military medical service six weeks after Russia's full-scale invasion began.

'The injuries are different,' she says, speaking through a translator in a quiet moment between procedures. 'In civilian trauma, you see damage from impact — bones broken, organs bruised. In war trauma, you see what high-velocity projectiles do to tissue. You see blast injuries. You learn things about the human body that you would never learn in peacetime and that you would have preferred never to know.'

In four years of working in conditions of near-continuous operational stress — performing surgery in facilities that have themselves been subject to missile attack, working 18-hour shifts when casualty volumes peak, training Ukrainian medical students in techniques that were classified research two years ago and are now daily operational necessity — Marchenko has developed a specific form of pragmatic resilience that is different from the emotional detachment that trauma medicine can produce.

'I am not detached,' she says carefully. 'I count every patient. But I cannot let the weight of each one prevent me from being useful to the next one. That is the moral arithmetic that surgeons at war learn to live with. I do not know whether it is healthy. I know it is necessary.'