An Eyewitness Account to the Bloodiest Shelling of Belgorod

Artem, Emergency Physician
Readovka.ru (Original in Russian)

We were at war...and I slept. — I'm from Belgorod. I was born, grew up, and studied here. I am 24 years old, I have been working for six months as an ambulance doctor, and at the same time I am doing my residency training as an anesthesiologist and resuscitator.

February 23 was the birthday of a friend. We went and congratulated her. We discussed the subject of war because we had all sorts of thoughts and conversations during that week. I said at the time: "Come on, what war, it's the ravings of a madman", I went to bed and woke up at about 7-8 in the morning. My mom calls me and says, "Tom, the war has started. When I woke up, I said, "What war? What? With whom?!" My parents saw and heard it all, they live in Razumnoye, and it was loud enough. I slept through it all safely, and then I saw it on the news.

Readovka note: the village of Razumnoye is located to the southeast of Belgorod, closer to the border.

The emotions that I had at that moment about the war were a lack of understanding of what it was about, and why we were invading the territory of the nearest state. Belgorod is a city where most people have relatives or close friends close by. Accordingly, there was incomprehension and denial.

Later, I realized that this invasion was provoked. From my purely simpleminded point of view, there was talk of Ukraine joining NATO and deploying nuclear weapons there. This was the trigger to launch this whole campaign. But it was still emotional: the same people were there, and I felt sorry for them. Initially, my position was regret and denial. Then we heard that we were all pigs and dogs and that we were not worthy to live. That already changes your views a little bit. Then you look at this situation in the long term. I realize that not all the people there are like that, but there is a certain stratum that found itself in power. And of course, they are angry at this whole situation - not some nationalists, but ordinary people who used to go to Russia to visit relatives or work, even just to shop. They were losing their homes, and their towns were being shelled, so it's unsurprising. When a city is shelled, the attitude itself changes.

Of course, I wish it would all be over sooner. But we support our guys. And naturally, since we are in the border region, we work closely with the military. We are constantly organizing collections of humanitarian aid, food, various construction materials, and warm clothes. How could we do otherwise? There are ordinary people there, brave people, husbands, sons, and brothers, and they need our help. They protect us, and if it were not for their work, the work of air defense, I think the city would look very sad. I do not understand their approach, when some people in the country start saying that ours are military aggressors and occupiers, and therefore we will not support them, this war, or even support the other side (and this is not about humanitarian aid for civilians). The guys didn't choose all of this and certainly didn't want all of this. As I said, the conflict was provoked and has been brewing for a long time. Sad all this is a great tragedy for all of us.

Soon we began to bring in the wounded from time to time. Both our own and prisoners. Once I was supposed to participate, but I never made it to the exchange of civilians. My grandmother and her two grandchildren remained on Ukrainian territory - the children were studying at their school. And only recently there was an exchange; they were exchanged for two grandmothers who were trying to leave the Kherson region but decided to leave through Rostov to hide in Kyiv. They were consulted and then agreed to be exchanged.

Preparation is never superfluous — When I was still studying at the institute, I did some volunteer work, I was a member of the Volunteer Medics organization. This is an all-Russian volunteer organization, and I was responsible for first aid, I was an instructor. We were mainly engaged in accompanying sports events, educational activities, and all sorts of actions. During the Covid, we collected baskets for grandmothers. But my part was first aid. I either trained people or was present at the events as the person responsible for it. Assistant - soccer, volleyball, basketball games, etc. Well, they also had humanitarian training camps. I always liked first aid, so when I came to the ambulance, all these skills came in handy, and I was allowed to fully realize myself in this regard, to open up. I am now an instructor. We have a lot of sites in Belgorod, where all the responsible persons from the administration, schools, in general, and any educational institutions are trained - we train the teaching staff. And this program is constantly expanding, plus there is room for all comers. The Belgorod Region Ambulance Service and the Territorial Center for Disaster Medicine are involved in this.

We were preparing for the shelling, there were general discussions, master classes, and lectures on how to act in emergencies - it was read and discussed throughout the year. In general, by and large, it probably gave us some understanding of how to act. There was no chaos in my head. Even before that, when I was studying at the institute, I often participated in inter-university competitions on emergency aid. And in the sixth year, I went to one of the Olympiads almost every two months. Moscow, Krasnoyarsk, and Kursk participated there. One of the stages in each Olympiad was the emergency stage, where the actors were painted, in makeup, with a sea of blood, screaming. In truth, such training gave me moral stability so that I would not get lost. In my head, I realized that this was no longer a production, no longer an Olympics, but at the same time, it provided some emotional stability. It's a matter of habit - when a person has already been in a similar situation, even if it's a simulation. And it helped me a lot not to get lost.

December 30 — December 30 was an ordinary day. We worked in a brigade: me, a driver, and a paramedic. The day was just like a day, I still remember that we all drove in the morning, there was a very beautiful dawn - we were changing early. And we thought: what great weather, it smells like spring, everything is gorgeous. Who knew how it would turn out?

We were on a call at the time of the shelling. We heard something bang, quite long - but somehow we had got used to it, because there had been shelling before, but the only one we remembered, the tragic one, was on July 3, when a family was killed on Mayakovsky Street. And so, we have already gotten used to it and did not pay much attention to it. However, when we called the dispatcher to talk, then we heard: "Drop the call you ar on now.” We were just finishing up. And it was urgently necessary to move to the place. It was clear that we had to drive up a little bit more, to grab body armor, but it was almost on the way. We grabbed our gear, put it all on in the car, and drove to the place.

People often asked whether it was scary to go there, knowing that they might be shelled again because the phenomenon of the second strike has not been canceled. In truth, no one thought about it at all. The thought never even crossed my mind. I might have been scared if I had thought about it. We were driving along Bogdan Khmelnytskyi Avenue, and we saw smoke from the stadium, from the center, from the Belgorod department store.

All the brigades were immediately sent to the scene of the shelling. We have a special tablet for communication: we receive a call and go to it. There were a lot of points, and about 2-3 brigades were sent to one point. Some brigades were completely in the thick of it. There was a brigade, which was near the stadium already free, and they saw with their own eyes how it came. But I didn't catch it, I didn't see exactly how something falls and explodes with shrapnel flying. I saw the direct aftermath. Fireworks in the sky are no news to anyone: we have already seen how air defense works a thousand times. And some of my colleagues caught the impact itself.

We drove very quickly, even though we were initially far away. It probably took us about 10-12 minutes to get there, and we were quickly handed a bag with our belongings; well, given that we had to get into the car and given the small detour, maybe a little more. But here we were lucky that the traffic police worked very well and organized a corridor for us. When we arrived, the cars were separated. We could drive without interruptions. This helped a lot and made the situation of such a transportation loop in the delivery of the wounded easier. There were certain difficulties at the sites of the strikes because the cars were burning in the middle of the road, but in general, the roads were free and open for us, and we thank you very much for that.

We arrived at the point near the Mayak shopping center and the Pobeda movie theater, which is the very center, the heart of Belgorod. There was a brigade a little farther ahead of us. The wounded were already being sorted. There was a doctor, who came from the military hospital, which is a little higher up; he helped with the sorting. Several wounded were brought to us at once, we opened the car, and a wounded woman was immediately loaded. At that moment another elderly woman was brought to me on a stretcher. But there was a severe head injury, she was not breathing; in fact, they asked me to put her down, to cover her, but there were no options - she had a wound incompatible with life. In the distance, I saw that somebody had already been covered. Then when I returned to the place, I knew that it was a girl, a young girl. She was lying covered, and next to her was her brain on the asphalt. We had to sorted it all out at once.

I had a girl put in the car at this point. When I started looking, I realized there was something wrong. Started unbuttoning her clothes, looking at her chest. They'd already tried to give her first aid. But she had multiple shrapnel wounds. She was covered in duct tape. They were trying to cover the wounds with duct tape, maybe military, maybe someone else. But when I lifted the duct tape, I saw over the heart area, over the aorta area, a heavy damage, plus a lot of small puncture wounds. The carotid artery was severed, and the heartbeat was gone. The girl was already dead. I had her taken out of the car and the stretcher used for those who could still be helped.

They brought in a woman and a man. We took the two of them away. The man was wounded in the left clavicle, there was a fracture; the vessels and fingers were damaged. We sanitized the wound, the paramedic started to put a catheter in, and I went to examine the woman. She had a surface wound on her chest, and a piece of shrapnel had penetrated her shoulder. We bandaged her, anesthetized her, put in a catheter, and started her on a drip. She was left in a sitting position, she was quite stable, and we moved her that way, and we moved the man in a supine position. A doctor from the military hospital came up, looked at the man, and said: "Let's take him straight to us, let's hurry up, no further triage, we'll do it ourselves - we need to get him on the operating table as soon as possible.

The hospital that was supposed to take everyone was on Kharkiv Hill. That is, it takes four times longer to get there from the center. And it was the military doctors who took a substantial part of the injured. They are generally accustomed to such situations when they can start taking people in an influx. And we took the man straight away and put him on the operating table. But, as far as I know, it did not go well: we performed surgery and moved him to the intensive care unit, but on December 31 at 8:30 am he died. But I know for sure that everything is safe with the woman.

There was also a girl of 14 years old with damage to her thigh and buttock with a closed wound - but she is fine. The fragments were deep, but she was stabilized, and eventually, all the fragments were removed safely in Moscow. And when we made one run and came back for the second time, there were stable casualties. There was a man with just a contusion and a grandmother. She was far away from the explosion sites, but she fell and hit the curb with her ribs, her ribs were fractured. But they went to the hospital on their own, their son-in-law or husband came - I don't remember who, and they decided to go to the trauma center themselves. They took a man with a concussion with them, but he was so drunk that it was unclear whether he was concussed by the explosion or by wine vapors.

More brigades from distant districts were brought to us, they all flocked to the city: Razumensky post, Severny post, all the way to the town of Stroitel, all of them were eventually sent here. But they went back after a while.

People were taken to Moscow, having already contacted the hospital; they were delivered on the second day. They were taken there in helicopter air ambulances. They checked the severity of their condition. And children were mostly sent to Moscow. There is more space there, and maybe there is equipment that we do not have. Imagine, a total of 150 victims in one day. Not all hospitals can perform certain operations on a scheduled basis. Plus we had to free up some beds here - it was assumed that there could be a second attack. There are not enough operating rooms and doctors.

Readovka. In total, as a result of the AFU [Armed Forces of Ukraine] missile attack in Belgorod on December 30, 2023, 21 people died on the spot, four died of wounds in hospitals, and 109 were wounded.

A very important point in these cases is triage. What is triage generally?

When there is a mass emergency, you need to clearly define who to help first. We most often use the START system: four light marks: black, red, yellow, and green are assigned to each type of victim. The green ones are for those with minor abrasions, bruises, and nothing more. Yellow is for closed fractures, minor bleeding with stable hemodynamics, and no impairment of consciousness - maybe only slightly lethargic and no respiratory disturbance, frequency is normal, and saturation is good.

Note by Readovka. The START system, from "simple triage and rapid treatment," was originally developed by doctors in Newport Beach, California in the 1980s. Initially, it was planned to be used in natural disasters, but it quickly spread worldwide and is used as a standard method of medical triage in terrorist attacks, man-made disasters, and generally any incident with mass casualty intake.

The red category includes all serious injuries, automatically all amputations, all arterial bleeding, and all venous bleeding, also pregnant women and children fall into the red category by default - even if the child was not injured but was in the epicenter, it falls into the red category.

And then there's the so-called black category. These are people who either have an injury incompatible with life at all, no matter what you do, or they are people who are unconscious and not breathing - that is, people in a state of clinical death. People in the black category are the last to be helped. And this was not a scandal, but a misunderstanding: there was a student of medical college, who was very indignant about the fact that the "ambulance" was helping someone, and she was working on a person, doing cardiopulmonary resuscitation, and no one came to her, no one helped. The reason why they didn't come up and help, is that if they had continued to pump the person together with her for 30 minutes, the chance that they would resuscitate him in such conditions - well, five percent. And in that time, the people who can still be helped will die. That's why there is a medical triage: save those who can be saved. As ugly as it sounds, that's the truth. Not that there are clear criteria and boundaries in our legislation about triage. But for mass emergencies, this is the only logical option. In the terrorist attacks in the St. Petersburg metro, in Moscow, the same methods and techniques were used.

There were explosion injuries, where limbs were blown off, something like that, but not many; most of the wounds were shrapnel wounds, and most of these shrapnel wounds were on the upper part: chest, neck, and head. Few had leg wounds.

Shrapnel comes in different shapes, too. There is a primary shrapnel agent - this is what appears when the shell bursts, part of the shell, and there are secondary agents - glass, and stones, set in motion by the explosion. And more often the damage is just from the "secondary" - it blows out glass, wounds, cuts. Although cluster shells, of course, have an additional part, so that the fragments fly as much as possible. This "popcorn" bursting that we hear all the time, is designed for this purpose, to hit the living mass.

In about 30 minutes, not a single seriously injured person was left on the street. They were either in the transportation stage or already in the hospital.

Communication was difficult that day. All communication systems were probably jammed. My tablet failed almost immediately. I received most of my information via cell phone - luckily, there was one; and the tablets of the brigades worked again one after another.

The realization and heaviness came at the end of the working day when everyone went away and started to go on regular calls. There came the realization of what had happened in the first place. Of course, it's really scary. You never expect something like this. At first, we only heard the bangs, but I had no idea how tragic it would turn out to be.

(Translation by DeepL + language washing by LanguageTool + Final check: Professor Tanja Barth)

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