“Some of my colleagues were using their cell phones as flashlights”: An interview with a cardiac surgeon about performing open-heart surgery during shelling 

—  Pavlo, you started working at this hospital in 2022, just before what turned out to be the harshest winter in the country’s history. What emotions and challenges did you face back then?

​— Before the full-scale invasion began, I was working at a clinic in Odesa. The move, an operating room that was completely new to me—one I was just starting to get used to—was stressful enough on its own. But with the onset of massive shelling and blackouts, everything changed.

The first thing you keenly feel when the air raid siren sounds is the full realization that neither you nor the patient has anywhere to go. Modern TV shows make it seem as if moving an operating room to a shelter is the easiest thing in the world. But in reality, it’s impossible to move all that complex equipment underground.

Our operating room is located on the top, fifth floor of the hospital. You just stand there, and the only thing on your mind is, “I just hope everything turns out okay.” When we were all on Telegram channels reading warnings that another strike was coming, we’d run through the worst-case scenarios in our heads—in theory. But when you actually experience it in real life—it’s a whole different story.​​

 

 

​​—  Do you remember that first major blackout that caught you at work?​

—  That was at the start of the full-scale war. There was an enemy strike that night. The whole building shook, the glass in the windows rattled, and at that very moment, everything went dark. Everything shut down completely. After those strikes, half the city was without power for about three or four days.  But the scariest part happened right at the moment of the strike, because we were operating in the operating room during the attack.

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—  Performing surgery at the moment of an explosion, when the lights go out, sounds like the plot of a horror movie. What happened in the operating room during those first few minutes?​

—  High-tech devices and the anesthesia machine have built-in backup batteries; they kept us going for the first few minutes while the generator kicked in. It took about a minute, though we were prepared to wait even longer. The generator supplied power to the operating room lamp, but it didn’t happen right away.​​

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—  Were you afraid?​

—  I wouldn’t say we weren’t worried. But there was no panic at all; the stress simply triggered a surge of adrenaline, and everyone knew exactly what to do. I always have a flashlight strapped to my forehead during every surgery, and that’s what saved the day. Some of my colleagues, wanting to help, immediately started using their phones to illuminate the surgical field. Light was our most precious resource at that moment.​​

 

 

—  I suppose this surgery was the most difficult one of your life, wasn’t it? Who exactly were you saving under such extreme conditions?​

—  It was a man in his 60s with ischemic heart disease. The situation turned out to be extremely unusual, because due to the peculiarities of his anatomy, we couldn’t touch the body’s main blood vessel—the aorta—at all. Any careless touch could have been fatal.

So we used a technique that was new to our hospital and very complex—creating a bypass to restore blood flow, but doing so directly on the heart while it was still beating. We took other blood vessels from the patient and connected them together, like a continuous lifeline. Blood was supposed to flow from one vessel, smoothly transition to the second, then to the third, bypassing all the blocked areas.

The surgery lasted nearly four hours. When I realized that our chain was working and the blood was flowing, I was finally able to breathe a deep sigh of relief.

 

 

​​— How did the patient get through the night? After all, there was a total blackout all around us.​

—  That was a challenge in itself. Our intensive care unit is on the first floor, and the operating suite is on the fifth. The elevators powered by the generator weren’t working yet. So we had to leave the patient on the operating table overnight, with staff taking turns staying by his side.

These tables are very narrow; they’re not designed for prolonged rest at all. It was uncomfortable for him, but in the morning, when the city’s power was restored and we moved him down to the ICU, he said it was better that way than any other. After the surgery, the patient returned to his normal life.

 

 

​​— How did patients’ relatives react to the fact that the hospital could lose power at a critical moment? Was there any panic?​

— People understood the situation, and the successful surgeries overshadowed all the horror. But for us, these challenges clearly confirmed that hospitals need complete autonomy. After all, medicine during a blackout isn’t just about a surgeon with a flashlight in the operating room. It also involves the work of the intensive care unit, where infusion pumps must administer medication to patients every second, and their internal batteries aren’t designed to last through prolonged power outages. It also concerns the safety of junior staff caring for patients in the hallways. The issue of uninterrupted power supply has become a matter of survival for us—one that should not depend on the availability of fuel for a generator or the state of the city’s power grid.

 

 

​​— You mentioned systemic solutions and survival. Why can’t conventional diesel generators—which still save businesses and homes—serve as a fully-fledged foundation for your cardiac center’s energy independence?​

— Generators are a good temporary backup, but they have critical drawbacks for medical use. First, there are human and technical factors: a generator requires fuel and constant maintenance, and it might simply fail to start on the first try. Second—and this is the most important aspect of our work—switching to the generator takes time. That very minute I mentioned—in the context of cardiac surgery, where every second counts—can cost a life. Any power surge or delay in powering delicate equipment poses a colossal risk. A hospital’s true energy independence must be seamless. The lights must not go out even for a moment.

 

 

​​— So the experience of the first blackouts forced you to seek fundamentally new approaches to patient safety?​

— Absolutely. The events at the start of the war made it clear that we could no longer react on a case-by-case basis. We needed an autonomous power source that operates continuously, automatically, and is capable of sustaining the entire center’s vital functions without interruption. Critical situations like those—when we stood in semi-darkness, illuminating the surgical field with cell phones, or when a patient was forced to spend the night on a narrow table because the elevators were out—simply must never happen again. The cost is too high. And it was solar energy that provided the answer to this challenge.

 

 

​— Recognizing this need, our foundation installed a hybrid solar power station at your cardiac center. Tell us, how exactly has this impacted the facility’s daily operations? ​

— For our cardiac center, this project has been a real boost. The 50 kW solar power plant, together with energy storage systems capable of storing 96 kWh, now fully covers our critical needs. It powers high-tech equipment: syringe pumps in the intensive care unit, ventilators, patient monitoring systems, and, of course, the operating rooms. Moreover, the station ensures the autonomous operation of the medical elevators—the very ones whose breakdown once forced us to leave a patient on the fifth floor overnight. The issue with small equipment and the safety of staff movement in the hallways has now also been completely resolved.

 

 

​​— So can we say with confidence that patients are now safe from unexpected power outages in the operating rooms?​

— That’s now technically impossible. Such extreme scenarios involving cell phones and flashlights are a thing of the past—a lesson we’ve learned, but one that won’t happen again.

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— New challenges lie ahead, including possible winters with power outages. Have your personal feelings changed when you enter the operating room now, knowing about this autonomous backup system on the roof?​​

— There’s a clear understanding now that everything is under control. It’s a sense of reassurance, because you know the hospital will have power no matter what—no matter what the enemy plans or does from the outside. The fact that this backup exists—that it’s real and working—provides psychological protection for the entire medical staff. We know that the solar panels on the roof accumulate energy every day, which, in the event of an emergency power outage, will instantly sustain our patients’ lives.

The enemy may cut off power to entire cities, but it is no longer able to turn off the lights in the operating rooms, where we fight to save lives, or disrupt the work of the people who provide care for our patients every minute.