Rehabilitation for wounded Ukrainian soldiers
Tetiana Korzun, medical director of the Vinnytsia Oblast Clinical Medical Rehabilitation Center for War Veterans and Population Protection of the Vinnytsia Oblast Council, talks about the peculiarities of their work and the secrets of rehabilitation.
“Sometimes you have to be a ‘cold fish’ because you can’t handle all the emotions”
The Vinnytsia rehabilitation center is crowded. Among the civilians and doctors, you can see the olive-green uniforms of the Ukrainian Armed Forces. Some wander imposingly to undergo therapy, while others are in a hurry to go to the military medical commission.
“Excuse me, Tetiana Borysivna, we need to resolve this quickly. They’re calling from another hospital. The patient has a meniscus injury, there is even a conclusion from Pirogovka. Can he undergo surgery here?” A man in a white coat enters the office of the rehabilitation center director.
“If there is a conclusion, then yes. We’ll be waiting for him,” answers Tetiana Korzun.
Tetiana has been a doctor for almost a quarter of a century. Since 2017, she has been practicing rehabilitation medicine. At first, she rehabilitated athletes and children with diseases of the musculoskeletal system and nervous system. In 2020, the medical center began providing post-COVID rehabilitation, and after February 24, 2022, it began working with the military.
At the beginning of the full-scale invasion, the Vinnytsia Rehabilitation Center had a very rough idea of how to work with patients with combat injuries. Through trial and error, the doctors developed effective methods of rehabilitation that they now use in practice.
“I remember discussing with the team in the basement how we would act. We were sure that we could work in a coordinated manner. At the end of March last year, we already received the first military personnel,” Tetiana Borysivna recalls.
At first, it seems that the rough glasses separate her from the pain of her patients. However, every time we talk about human fate, tears appear in the doctor’s eyes.
“Sometimes you have to be a ‘cold fish’ because you can’t handle all the emotions. I share people’s pain, I want to help, and I do, but at the same time I don’t let the experience get close to me, to the very depths — my heart just can’t take it,” she says.
“Rehabilitation involves three periods – acute, subacute and long-term”
The hospital has four departments: physical and rehabilitation medicine, therapeutic, neurological, and surgical.
“The full-scale invasion was the impetus for the development of rehabilitation. However, our specialists have already been moving in this direction as the Department of Physical and Rehabilitation Medicine has been operating here since December 2019. Rehabilitation includes three periods: acute, subacute and long-term. Our team deals with the second and third,”explains the doctor.
The duration and specifics of treatment depend on the diagnosis and pathology, so the military can stay in several departments at the same time. Most often, doctors have to restore the health of soldiers after explosive injuries, shrapnel, and gunshot wounds, and they also treat diseases of the bone and muscle systems.
The facility creates individualized comprehensive rehabilitation programs for patients. Specialists from various fields are involved: physical and rehabilitation medicine, occupational and physiotherapists, surgeons and neurologists, and psychologists. Sometimes the recovery process is painstaking and slow, but rehabilitation is a series of small victories, dozens of daily decisions, and efforts on the part of patients. The doctors’ task is not only to treat but also to encourage treatment.
Tetiana Korzun recalls a patient who was so injured by shelling at the front line that he had to have skin transplants on his legs. The nerves in his limbs were severed, and the tissues were cut by shrapnel. But the defender did not lose his optimism, and this significantly accelerated his recovery.
Another patient, a young officer whose shoulder joint was blown out by a bullet, had a slim chance of saving his arm. The traumatologists were putting the limb together like small pieces of a mosaic. In the end, they even managed to preserve the functionality of the arm.
“We are fighting no less fiercely for the harmonious adaptation of the military, so our main postulate is that the patient is at the center of everything. It is he who determines the success of treatment,” says the medical director.
“We keep every story like a relic”
Our conversation is interrupted by a call. A soft female voice comes through the speaker. It’s a volunteer on the line.
“Tetiana Borysivna, we are collecting some stuff for the defenders. Do you require some?”
“I’m glad to hear it! Yes, of course. It is very important.”
“We want to bring a lot of goodies and coffee to make the soldiers happy. If you need other things, let us know.”
Coffee and sweets can also be considered a way of rehabilitation. With their help, doctors build bridges with patients.
“In addition to treating the military, we communicate with them, live with them for a significant part of their lives. Their stories deserve a separate book: how fighters get into the Armed Forces, how they react to combat, how they change and grow in courage.
Many are afraid to go back. Some, on the contrary, are looking forward to a speedy recovery, because they have their comrades ‘over there’ [at the front line]. We listen to every story and keep it as a relic. They have seen very terrible things, but communication frees them — they cry and unburden themselves of their emotions. Many of them still withdraw into themselves. It takes time to reach out through the wall they build between themselves and society,” says Tetiana.
The doctor says some people become aggressive or apathetic, and this is nothing more than an attempt to escape from reality, which causes pain. That is why the military need a specific approach. You need to gradually build trust with them. For example, there was a patient who slept with a knife under his pillow. He was a scout at the front. He asked the doctors to step loudly and not to approach him from behind, because his self-defense reflex was immediately triggered.
“Once a defender came on a rotation. He had received a huge number of mine-blast injuries. A military man by vocation, he always returned to his comrades. But now we are not talking about nobility, but about the consequences of a long stay in the zone of intense hostilities. The man lost his health to such an extent that it affected his cognitive abilities. And how many of them are there? Who have lost their health, who have seen their comrades die, who feel shame and guilt?” the doctor reflects.
Tetiana is convinced that the hardest time will come after the war is over, because society is not morally prepared for its consequences.
“The service members are not what they used to be. They will never be the same. We [civilians] are also different. This is a new way of looking at reality. As long as the war goes on, we need to comprehend and accept it. If we don’t do it now, or at least don’t try to, then society will not be able to find common ground later. We just need to be sensitive and grateful — these are the points of contact.”
Author: Inna Tsaruk. The piece was written as part of a master’s project at the UCU School of Journalism and Communications