SIRKO Paper Cut

00:00:00 Yeah, well let's get to...

00:00:00 Yeah, well let's get to... Give you on Sunday maybe. Yep. Save also coat or jacket of Logan. I... Anastasia, call? I'll call her. Call and say... Oh yeah, it's here for... I just had to give her... She just has like one...

00:00:30 We need to remember to get the easy rate. You can get the train station. Okay, yeah, we just got here. We were just wondering how close we were.

00:00:45 He's actually one minute away. One minute, okay. We wait. Alright, yeah, we're gonna wait for you. We wait. Logan's film is the yellow. It's very nice.

00:01:00 I'll cune it, yeah.

00:01:10 You guys have never seen a surgery before, right? No. Do you remember I proposed you to take part in the operation on Friday?

00:01:26 Yeah? As assistant here? You have a possibility to earn a lot of money. You have a possibility to earn a lot of money.

00:01:32 Yeah. We make more money if we learn how to do brain surgery. Well, you guys jumped in with both feet. Coming to a combat zone, seeing a horrible combat injury and some difficult brain tumor.

00:01:44 Yeah.

00:01:46 [RUS] So I'll tell you one story. [RUS] It's like a shock, but it's not a shock, it's a real story. [RUS] Some people ask:

00:02:00 [RUS] Why is a patient, 80-90 years old, with a malignant tumor, operated on by a very experienced surgeon? [RUS] But on the other hand, young people, only 20 years old, with trauma, are operated on by residents.

00:02:30 It's a good to imagine. Patient with pure prognosis only 6-12 months, but with money operated, experienced profession. But patient with severe brain trauma, young patient will have excellent results, excellent outcome, if you perform surgery in the right direction, complex surgery, you will be lived 40, 50 years. - And this patient operated by a resident. - And this patient operated by a resident. It's not only Ukraine, it's US also. - So what I say in the United States, the way I think about it is that a lot of neurosurgeons will only do elective cases. So that's like flying a 787, right? Those things fly themselves. I didn't have to do anything. And they leave the trauma to the most junior person.

00:03:29 Well, you know, a sick, bleeding, quagliopathic patient at 2 o'clock in the morning who's trying to die, that's a tough case. That's when you need the most senior person, not someone who's fresh out of training. But that's the way the system works a lot of times. - Yeah, it's true. - Because in the United States, what's the number one cause of a traumatic brain injury? - Well, that's a great question. - Is it like falls? The stereotypical patient used to be a 15 to 24 year old male in a traffic accident. And so you kind of, if you plot the graph of, is it TBI versus age, there's a big bump in teeth, they were just kind of draft. Well now there's a huge spike among the elderly because people are living longer with comorbidities and so many of them are on blood thinners. And grandma falls and bumps her head and she's going to have problems.

00:04:18 Ah! Where did you find?

00:04:49 I should not be carrying photography.

00:04:59 Go, go, go. He wants you to go first so he can film it.

00:05:07 I remember you need 50,000 hours recording. Uh-huh.

00:05:51 [RUS] Thank you. [RUS] Thank you.

00:06:43 [RUS] From 1 to 2 is a little... [RUS] Hi! [RUS] I'm glad to see you! [RUS] Tell me, I'm glad that I am too. [RUS] I'm glad that I am too. [RUS] Let's go!

00:06:59 Ready? Congratulations.

00:07:29 [UKR] I said that we're taking the maximum, [UKR] so that they reach, and the body, look, look. [UKR] And there were cars there that brought salad.

00:07:41 [RUS] Until we get the dose, we can't film.

00:00:00 People who was treated yesterday, on Monday, he will be evacuated in Odessa.

00:00:00 People who was treated yesterday, on Monday, he will be evacuated in Odessa. That's why we can see him from the ICU units, his way, his direction, right ahead to the emergency department,

00:00:18 after that to the ambulance. If you would like. You're saying on Monday? Yeah, yeah, that we've seen is getting transferred. That was on my lap. Yeah. Let me talk about it. Let me talk about it. Yeah.

00:00:36 First of all, let's say what you dislike. I organize this. Oh yeah, well, I don't know if we can, but we'd love to...

00:00:48 We'd love to, Ryan.

00:01:10 Ich habe es gut. No, we're getting you there. No worries. Oh, gosh. Whew. You can close it. Thank you.

00:00:00 Wow. Wow. So you felt the explosion? Yeah. It was very close to our house.

00:00:16 That's why this explosion wave shot down the entrance door. Sviatoslav wasn't 2 meters from this yard. We didn't have time to cry into gold. In this situation it was improved and the pollen covered the yard. My wife spent many hours in order to set us love, calm and don't afraid to this situation.

00:01:04 And another I remember, Sviatoslav, when I was in Kyiv, and an explosion near the house happened, Sviatoslav hid under my table, in my cabinet. He decided that the place is more safety for him. He didn't like to go away from this place in my cabinet after my office table. He realized in his brain it's more safety place in our flat. It's also true. That's why I remember these two situations when he was at home,

00:01:55 when explosion missile is happened.

00:02:00 He was at home and what he felt in this time, it's very interesting for another people understand

00:02:13 what the child feels in this situation. Yeah, I was saying that just living here, going about your life, continuing your life,

00:02:30 has some heroism in it. And people like Sviatoslav don't even realize that it's taking place because it's just his life. He's just growing, you know? Yeah, yeah, it's true. But I think that this week, when Sviatoslav was in Kazakhstan, was the best moment of the year for him.

00:03:00 best time because any alarm any explosion even without phone telephone without phone without messenger only spend time in the near the nature together with class makers it's beautiful a lot of activities like

00:03:26 Cozaki wiele lat temu

00:03:56 For sure. What was he gonna say? And I am sure these two pigs who live in his flat help him to...

00:00:09 [RUS] [music playing] [RUS] Alex is now in beautiful company [RUS] I think

00:00:27 In the morning, Alex will be fluently maybe speak Ukrainian, but these two women will speak English like native speakers. Yeah. Agree, yeah. Agree, yeah.

00:00:52 Laura, are you asleep now?

00:00:54 [RUS] I wish, no, I'm trying... [RUS] Because any voice, any from you and Logan, I'm sure you're very quiet and you'll mess me up.

00:01:07 [RUS] Yeah, well, we're just trying to think about what we need to do today.

00:01:19 I mean, let's say we start at 11. I'm suggesting we go to the hospital. We should see people there.

00:01:30 Go to the hospital only together with Anastasia, yeah? And Anastasia will tell me what would you like to do. And Anastasia will tell me what would you like to do. And if you need, I will give my colleagues to you in order to follow with you. It's a rule I saved you in the second hour day.

00:01:57 But anyway, all what you do, I will help you to organize this in the best way. So, thank you. Yes, so the academic school, the medical, whatever, there's some stained glass windows of medical scenes in the educational, well I'll ask on us to see it tomorrow, but stained glass windows of medical scenes is it is that somewhere on the campus of

00:02:38 Metchnikov I don't worry about it I'll ask us to see you you were here is this yeah it's all this part of our medical hospital this There are tables where I wrote about the Crimea war. I think it's a need to go to the entrance and film this information.

00:03:10 That's probably true. We'll be okay. We'll just sit and wait for like five minutes. - Tadeusz, myślę, że możesz...

00:00:00 You still up here Alex?

00:00:05 You still up here Alex? Yeah, I'm hanging out over here.

00:00:11 Okay, so should I be looking at you or should I be looking like I'm talking to someone else? Yeah, maybe it just looks like here. Maybe I'll be standing up too. I feel like... Maybe I'll be standing up. I feel like that might be more urgent. Stand up. Yeah. Or at least standing up. It doesn't seem particularly dangerous if you're just lounging.

00:00:37 Hey, where do you want to focus on walking to the shelter? If I'm walking towards the shelter? If I'm walking towards the shelter? Can we stage it that way? Can we stage it that way? So, yeah. Where do you go? Hey, where do you want to just look over your shoulder and talk to me?

00:00:51 As we're going, I'm going to move it up. Yeah, but that was it. I can work with you. Alright Alex. Alright Alex. So I'm going to be kind of looking that way. You can come back.

00:01:00 You can look. Yeah, you can kind of just look like we're like. Okay. Okay. And then go for it Alex. What's happening? So actually I got up early to get some work done and I was just stepping into the shower where I heard a big bang. Not that, oh this sounds bad. And then a few minutes later, Andri texted us and said, a few minutes later, Andri texted I can read this exactly here. And he said, preliminary launch of caliber cruise missiles has been carried out from Mishako Cape. We expect the cruise missiles to enter Ukrainian airspace within the next 30 minutes. There's already been one explosion in Dnepro. It's better to go down to the shelter. So that's where we're going. a little after four o'clock in the morning

00:01:58 actually i've never been down there before so i don't know what it's like here

00:02:03 hopefully we won't have to or i won't have to be down there long we'll see Yeah? Yeah. Yeah.

00:02:50 Yeah. Yeah, but I can't figure how to get the stairs on the first floor here.

00:02:59 Find the stairs instead. What is the big stairs, Shelton? Oh, that's it. Okay, I never went here before.

00:03:11 I think it... We can't take the stairs out of the spot. That'll get us down at least at two so you get some footage. Oh, here we go. This is cool.

00:04:33 Okay. Here's the lobby. Is that the shelter out here? No, you should have people outside. I'm sure you do a 180 around the building. There's a black out there. Should I keep my phone on? I think so. It sounds like they're coming down. It sounds like they're coming down. It sounds like they're coming down. It sounds like they're coming down. This is actually a really cool stairway. I never knew this was here. It was a little out of the first place where we walked down. We walked down and we tried to follow the shelter signs just so we knew. Like if there was something happening. Like exactly now we know that this was the staircase to use. Yeah. But we didn't know it was outside. We'd always do that door. Yeah. It's funny. I never knew this existed.

00:05:25 Okay, so, so, can you walk through the door? Okay. Okay. Shut up? Thank you.

00:06:14 I'm going to go. Can I hear you? Thank you.

00:06:59 Let me just test this here, make sure it works. This is locked. Okay, okay, Jack. *Splash

00:07:57 I'm going to use the water. There we are.

00:08:22 The Wi-Fi was down here earlier. And no cell service down there. Can you see that one more time for us? The Wi-Fi is down? Yeah, no Wi-Fi and no cell service.

00:08:41 You need to invite me up. Did you bring a mic?

00:08:45 Yes. Looks like a little. Yeah. Can you ring that bell? Huh? I don't have a mic with me. No, it's fine. I don't have a whole lot to do. I think we got the highlights coming down to the shelter.

00:09:09 - How you doing?

00:00:00 That arm, that alarm alarm on your phone.

00:00:00 That arm, that alarm alarm on your phone.

00:00:09 I know, I think we can just record this in both spots and then call it a day.

00:00:13 Yeah, I was going to say, I think it's tele and nobody else will do it.

00:00:28 figure out later.

00:00:30 Will you guys be able to get back to sleep for a few hours? Oh yeah, no problem. Well I know you can, I'm worried about that. Maybe, we'll see. Alright, so should I be looking at Laura right over there?

00:00:43 You can go over here. You can go over here. Yeah, just the camera left. So I'll direct my gaze right towards the corner of that space here.

00:00:52 Yeah. You want me to move over there? Help you? I'd be good. I'd be good. I'd be good. Okay. So just over, you can try to be like there or a little? Yeah, a little bit back. So I actually had just gotten up early, about 4:00 or so, to start getting some work done

00:01:13 since we're so busy. So I'd just gotten up early, about 4:00 or so, since I'm so busy running around all day with no time to do other work and catch up on emails. And just stepping into the shower, I heard this huge bang outside the window. And I thought, "Oh, crap. Here we go. I better hurry up and get my stuff done." And then Andrei texted and he said, "The preliminary launch of caliber cruise missiles has been carried out from a shockwave tape. We expect the cruise missiles to enter Ukrainian airspace within the next 30 minutes. There has already been one explosion in Dnipro. It's better to go down to the shelter.

00:01:58 So, this is the shelter.

00:02:00 I haven't had to do this before on my previous three trips. I'm not really sure how long to stay down here because there's not up here to be any Wi-Fi or cell service. But, Wi-Fi and cell service are down up in the room. But I think there's a special different Wi-Fi network down here we can try to log into.

00:02:22 go on one of the apps and see if you can track the progress of what's happening.

00:02:34 Do you want to open up your phone and just show the written message from Andre? Yeah, you already got it once, but here's another shot. And I just reinstalled the app. I was trying to figure out how to disable the alarms. I need to enable messaging. Do you have the app on your phone, Laura? Yeah, why don't you open it? Maybe we can pull that up to the camera.

00:03:09 Oh, is it not working now? Can we show you this? I mean, it says photos of my parents.

00:03:18 Oh, this one here? Yeah, critical error there. Cause it's just, it's cause it's not on. Oh yeah, there's no service.

00:03:30 What is the Tsunami G's password? Oh, it's the same one, right? Yeah. What is the password again? Isn't it Tsunami 12? It sort of stays in my memory. Tsunami.N.E.R. Oh good. Yeah, that's what I'm saying. Up there.

00:04:10 There we go. I'm going to correct the password. Let's try this again.

00:05:03 Amen.

00:05:31 E aí So it's now 5:20, it was 4:04 when Andre sent that, I think, but I just wanted to give

00:05:48 that text in the shelter heading back.

00:05:54 Oh yeah, text that. Yeah, so you can... Let her know we were here.

00:06:00 Yeah, just send it once as only I and then send it again as the lead. Oh, okay. So, wait, I'm in the shelter. It's now an hour and ten minutes since you had a message. I'm heading back to the room. Thank you for something like that. Oh, okay. Oh, wait, okay, start over. I was gonna say thank you.

00:06:32 Thank you. In the shelter. All is good. Okay, I just tried to text them. Oh. Yep, here we go. Russia just doing what Russia does. Red means the regions of Ukraine that are under attack by Russian missiles, and it's the entire country. And like if you zoom in, you can see the missiles on this one. I don't know how I think it's supposed to be.

00:07:51 ... Yeah, see every time I zoom in it kicks itself out.

00:08:00 Oh, that's pretty far north. So that's Belarus right there. Oh, okay, so I don't know what the code is here. These look like Shahids. Shahids? I'm from Texas. - There it is. - Yeah, yeah, we got the same thing.

00:08:31 Are we done? - Yeah. - All right. - You ready to go up? - Well, we have two parts.

00:00:00 So we've been blacked out all night and the neighborhood around the hotel is dark but this So we've been blacked out all night and the neighborhood around the hotel is dark but this place has some huge generators that keep it going and that's the really loud noise you hear

00:00:17 in the background.

00:00:21 And we were about power only five minutes? Yeah, when I got back last night, everything was fine until literally I walked into my room and everything went completely dark. The only thing on was a faint light in the hallway from the emergency exit stairwell right down the hall. And fortunately it came back on about 15 seconds later and it was fine all night.

00:00:52 I'm like 3 minutes in my room, but that's not...

00:00:56 Maybe you're closer to the generator. Yeah, they take care of the poor before they take care of the people at a luxury suite. Alright, so since I was camped out here, are you just going to be camping out of my stuff now? So we've been down here for a while and doesn't see how much else is going on.

00:01:23 So I think I'll head back upstairs and try to reconnect to cell service and better Wi-Fi and see if there are any updates. I would say, you know, if I couldn't tell Andre that he can come down to the shelter, he'd be pissed. That's a good point. Yeah, I would say that. Well, I've been down here for a while and doesn't see how much is going on.

00:01:50 And at least this way, I can honestly tell Andre. I did take your advice, but I did go to the shelter. All right.

00:02:06 Yeah, it's really telling, I think, that this place is like deserted. Are you guys going to hear that huge explosion now? No, but I did hear things like after you got Logan up, I heard that some bum bum bum.

00:02:23 Oh, that's probably further away. Yeah, we can log back on and get updates. Or I can log back on and get updates about exactly what's happening in the region. Okay, now you say, "I'm gonna log back in and get updates on what I'm doing." Yeah, I'm gonna log back in and get updates because there were some other sounds too after the initial really loud one, so maybe there's other blasts happening further away. Oh boy. Because we heard the air raid alarm. But I didn't hear the explosion.

00:00:00 I don't know if you've heard Andrew's other story.

00:00:00 I don't know if you've heard Andrew's other story. He had an endotectomy done. Dad, just a new arm, could have moved parts of his left arm, but he's a surgeon. So show them how your arm is doing now. And this is-- the elbow is OK? Yes, yes. Yeah, that's great. Almost OK. Congratulations. I ask you to look at the control, it's bad, the patient, and with the epidural hematoma.

00:00:25 Show me, show me. A contusion, I think this is generally minor hemorrhaging. I'm actually writing you a text message, here look. With this control, I discussed it. And where was the bleeding from? Parasagittal, temporal, bridging veins. Bridgin. - Bridgin. - Inflow outflow. But. Contralateral side. Posterior cranial fossa. - He was. - In psychomotor agitation. He scored 14 points. Not bad in terms of pain.

00:01:11 My opinion is to wait until at least the contusion develops. I don't know now, this morning he was so critical. I'll go take a look now. Discontinue mannitol, remove sedation and assess in an hour. Good. The inflow-outflow is in place, is it working? I'll go now. The inflow-outflow allows, sometimes, even to drain CSF in the subarachnoid space, also therapeutic like that... Yes, you're right. The vein bleeds, while it bleeds, it sometimes still functions. Compressed or coagulated immediately. - Injured vein, yes, yes. - Look, how the vein universally with hemorrhagic progression.

00:01:56 Yes, yes. - Because of the university. - And below the tentorium, yes.

00:02:05 - What is this? Do you have universal? -Now we need to stop analogue sedation and give TZ. Discontinue mannitol, turn off sedation. -Adjust the inflow outflow in an hour. -I'll write to you, okay? -Yes, you can call. We just turned on airplane mode for an hour because we were giving a presentation at the Congress of Military Surgeons and Anesthesiologists of Ukraine. We were put first with two presentations. By the way, you're also a presenter. Did you see? No. How did you not see? I'll show you now.

00:02:57 Rocarmando, Alex Volasko, Cherednichenko, Botikov, Gullidin, Sirko, Perepelitsa, Lambrozo, Starik. This is Coasar, our report, Nikita Lombroza. I always talk about my team.

00:03:30 That's why all the results are sent to teamwork.

00:03:34 Oh, yeah. Oh, yes. It's all about, exactly, teamwork. Yes, yes. For my glory, it's not need anything. So, you're a chairman. Yeah, your glory is your team. Yeah. How well your department does. My team and the results of work, my team.

00:00:00 Good afternoon!

00:00:00 Good afternoon!

00:00:30 The dear ones will give us the way along the road.

00:01:00 Oh, this one. Oh. Is this place? Yeah? Just a minute. Yeah, no. Okay. Oh, we find Alex Volatka, yeah? Right here. Oh, Alex Volatka is old. Can... Yes. You do incredible work. Your heroes receive outstanding care. you are leading the world in combat casualty care. Thank you for making me part of your team. Glory to Ukraine. I will always support you. And I will be back many times. Alivanka, Dallas, Texas. March 22nd. March 22nd, 2024.

00:01:48 That's right. 22, 3, 24. First visit.

00:01:55 You promised and you do. Many times. Many times. Four times at least. See, Rocco has much better hand raised. I find Rocco. To Andrei, Yuri and all of Mechnikov, Ukraine, To Andrei, Yuri and all of Mechnikov, Ukraine, I will forever support you. Shoulder to shoulder, we will stand. I shall return together to victory, Razum, pobacimus, Rocco Armando, colonel, retired USA. Medical Corps. Medical? MC, Medical Corps. Medical Corps, February 24, and again February 20, 2025. Razum for Ukraine. Also, you can see Alex Domoratsky from Razum for Ukraine.

00:02:45 Luke Tomich, inspired by your resilience. friends, Slava Ukraine. Yeah, and this from New York. Peter Kim Nielsen, Maxim Shapiro, Razumko pilot Nero team, heroes of medicine and humanity. Humanity, we are with you always. Slava Ukraine. To our friends and colleagues in Dnepro Mechnikov, visit two, visit three. Kim Nelson, Maxim Shapiro, September 2023, April 2024, June 2025. Alex also will have all, but it's small because it's a lot.

00:03:30 Yeah, we can add all the other things. Yes, yes. Oh, Jeff Koli. Do you remember Jeff Koli?

00:03:36 It's made by 38 government of Kansas.

00:00:00 through the radial artery up into the brain and he's injecting dye and trying to occlude

00:00:00 through the radial artery up into the brain and he's injecting dye and trying to occlude yeah you can see this stand yes and this metallic fragment metallic fragment what metallic fragment

00:00:16 located here here and this traumatic intracranial aneurysm it's uh soldiers two weeks after injury

00:00:30 So this person was initially injured and you said had surgery at a military hospital outside? The surgery removed the intracerebral hematoma and performed a decompressive cronectomy.

00:00:42 After that transferred to the medical hospital, Yuri and his team performed angiography, The problem is that when you put these stents in there, they need to be on what we call dual anti-pleyly. So aspirin is something stronger than aspirin. You can't do that too soon though because they might bleed in their brain, so it's a balancing act about the timing of all this. This is pretty high-tech equipment that Rocco helped them get.

00:01:27 He wrote a letter to the government and talked about the need for this type of technology. It's pretty impressive. What is that machine? It's a biplane C-arm, so you can look not only right to left, but front to back.

00:01:47 You know, get a full three-dimensional reconstruction.

00:01:52 And also the quality of imaging is so much better too. It's not grainy or seedy or anything like that.

00:00:00 I have...

00:00:07 Yes. Yes. What is your name? American. Okay. Nice to meet the two. These are people who are shooting a documentary. You are a patient.

00:00:30 You're near the patient and talk about the patient, and he'll film you.

00:01:00 and we see that this aneurysm was grown and it's very dangerous, therefore we perform flow diverter implantation with Fred Diggs with anti-thrombogenic covering We see that the patency of the PCA was preserved, but the aneurysm was excluded. We hope that this operation will be useful for this patient for preservation.

00:01:49 Show the fingers on the screen, you'll enter the office. This is one. This is a small splinter, close to the posterior circulation. And we see the flow diverter. This is a very density, very small cell.

00:02:36 This stand performs red direction of the blood flow to the PCA. This provides aneurysm exclusion. We see here the written.

00:03:07 We see the patterns of the whole branch of the PC. I think they may come back upstairs, so they just may go out there. Have you had a.

00:00:00 - You want to turn the light up again?

00:00:00 - You want to turn the light up again? - No. - Alex. - Alex.

00:00:09 - So, you see, you see. - We're going to see Yuri. - There was a unit for Yuri.

00:00:16 - Interventional practice. - Did you have any such? - No, there was no. - There was a director, yes.

00:00:24 - It's the first time. We had time in in just two weeks. Yes, Yuri would like to show you the first angiography. It's small

00:01:05 small aneurysm and we decided to do what we need to do. In such case we use next algorithm. we perform NGO through two or three weeks.

00:01:26 Two weeks, three weeks. In order to have possibility to prescribe double antiplatelet therapy.

00:01:34 If we see such an erythema, we will... How big was it today? Yeah, 8 segments. Show the one from today. And today, we see maybe... 3 times or... Increased volume and size. yeah no it's a lot bigger yeah good you have the standard you understand the process

00:02:24 Yeah from Rokar Mondar the Nation, yeah? Yeah, 8mm broken segment. Diameter, yeah? Yeah, decreasing risk or from all this.

00:02:42 Mateus, Mateus. Tedious, Tedious, yeah. I showed him in Facebook, Tedius is better than Tedious.

00:02:52 Thaddeus is better than Thaddeus. Yeah, yeah, I prefer Thaddeus. You like Thaddeus? Thaddeus, you need to say. I would like to repeat this Freddix, Uri,

00:03:08 implantation today sends to Rocco Armando donation. Donated devices from the USA, from Washington. yeah the device is a very kind of Long in device. So are you done now with the procedure? Big, bigger risk. And after that we see stagnation, contrasting the aneurysm.

00:04:06 So you're done? And now we see. Yeah, well, nice result. It's funny. But we use an anti-plastolate now. This is...

00:04:27 This was donated with Professor Shapiro. Yeah, Maxim. Maxim Shapiro, New York. Kim Nelson, we read there.

00:04:44 Yes? months ago. August 2025. So here is an article with your name on it. Thank you so much. Early multimodal neurointerventional, that's you, and neurosurgical management of penetrating cranioscabral injuries wartime experience from Ukraine. Andrei Sirko, Yuri Cherenchenko.

00:05:33 we need next and ron to go oh oh did you ask about the next article funny you should ask this is one

00:05:41 uh your name's on it but the next one is another one from andre two and the same as alex volatka

00:05:49 stop law new classification system for the printing engine posterior so here's a paper hard copy for

00:05:55 Thank you.

00:06:25 I was saying that it's a short segment, and then bigger freshener, greater chance that it will close. We'll have to switch to monotherapy, whatever may be. God forbid. Thank you. Thank you.

00:00:00 - No, talk to me.

00:00:00 - No, talk to me.

00:00:00 - No, talk to me. - No. So what's in this box? So what's in this box? - Yeah. - This device for saving the life of this patient. - This device for saving the life of this patient. - Oh, the same. - Oh, the same. - This is a Racco box. - Boxes from Washington DC. - No, yeah. - My Rokharmon. - There's a lot of them in here. - Yeah. - This one, this one. - Oh, yeah. - Next. - Rokharmon, that's great. - Yes, yes, yes. - This works one day, right?

00:00:35 - Exactly Zaporizhzhia, Mykolaiv, Kherson, right? From Kharkiv, maybe. From Kharkiv, maybe. Even from Kyiv. From Ukraine, yes. From Kyiv, if you have the possibility, to have this device. But, like Rocco Armando, you have this device which is critically important. Critically important. That's true. What is this? What is this device? What does it do? It's a device. It's because it's built. The aneurysm is protruding from the wall of the artery, so it's like a little step that goes across it.

00:01:40 It isolates the aneurysm from the circulation. Excellent. We use a trans-radial approach as a rule. This approach is most traumatic and most safe for such patients. This is the Arctic arch and then we use telescopic technique. Bigger cassettes, distal access, smaller cassettes, then micro cassettes. and then through the microcasite therapy, perform implantation of this device

00:02:30 to the wounded segment on the level of the neck of this pseudoneurysm and exclude it. - Yeah, Yuri and his team have a largest experience

00:02:48 in the world, treatment these severe wounded people using endovascular techniques. Usually, when Rocco Armando came to us, we spent half an hour together with us in the operating room, under the microscope, and half an hour together with Yuri in the endovascular cathlab. So we worked together with Alex and Rocco many times, it's very helpful and beneficial for our patients. I'm the younger generation, this is my first PhD in medicine, second PhD in medicine. And now Yuri paid a lot of money for me to have the opportunity to work with Vadim.

00:03:35 It's a joke, but it's true. Rocco, I remember you said when you were defending your dissertation,

00:03:43 what happened, what happened. - Yeah, one day defended the dissertation, the next day, his daughter was born. - Oh, that's great. - It's two, three days. We asked Vadim about the situation. Vadim not only operated, also prepared dissertation work.

00:04:05 - But his dissertation was being defended while the air raid sergeant was going, right? You sent me that footage. - Yes. - Yes. - That's great. Now I asked Vadim, his lead will protect from X-rays. This is a gift from Armando Rocco. Yes, it's better to see. His lead will protect him.

00:04:33 We're saying that you managed then... What did you manage? To defend the dissertation. Defended. Guys, my dissertation. What date was it? February 14th. February 14th. February 11th. February 11th, your daughter was born. And February 17th, the license. What license? For a car driver's government, it's a certificate, yes? And February 19th, I celebrated 50 years. 49. 49? 50? 49. Let's go.

00:00:00 [RUS-NEEDS] После операции, да?

00:00:05 After surgery, yes? Yes. Alarm. Alex, you can sit. Yes. And where are you running? Ah, yes.

00:00:29 I'll alarm and we continue to work, yeah?

00:00:35 Yes, I understand why my speech is not good now because I don't have enough practice. Oh, you're fine. It's better than Ukrainian language from Alex, yeah? Yes. Okay, so who's first here? Of course, it's our patient, we have a tumor yesterday.

00:01:02 That was cool. the week when you write yes,

00:01:59 I'll call my wife, I'll ask her.

00:02:06 Far away. Far away? Far away, I think, yes? Yes. By the blast wave, you can feel it's somewhere nearby. Tanya, are you alive? Are you okay? I'll call him now, he's sleeping. Alex, you came here. From the door

00:02:53 And with explosion.

00:03:46 There's the new app.

00:04:01 This is where we are now.

00:04:14 Missiles, 6.5-50 shells, and more than 50 shells. - It's northern, and now. She writes, collect your things, the most necessary documents, because fires, well anyway, she clearly, 4 hours, I see 16, and here, anyway, a bunch of hits, they're not landing. I didn't believe it at first. She's just scaring us. She's scaring us, giving targeting information. Yes?

00:04:52 I was starting, afraid to travel by train, but now I'll tell him, I won't go. And now there's no internet, right? Something's working badly.

00:05:00 And here we generally have Starlink.

00:05:04 Generally Starlink. Once again, permission? You don't mind being filmed? American friends will show you in a documentary film in a year or two. You don't mind? No. Are you ready to film? Yes, so tell them, like each of them on camera

00:05:27 say that they agree. What to say? And how are we living? How are you in such situations?

00:05:37 Yes, Anastasia? What does Thaddeus want? That on camera I'll say I don't mind.

00:05:44 Ah, can I speak Ukrainian? We don't mind being filmed and then shown in a Hollywood blockbuster. [VO CANDIDATE]

00:00:00 I asked, Katerina Fyodorovna also didn't object,

00:00:00 I asked, Katerina Fyodorovna also didn't object, for you to film here. And will show. - And will show, and... - This, where you have on Facebook, you can request him as a friend. This is legendary, special. I added him yesterday, friends. Let's go. - Should we check the CT scan? - Check CT scan very well. - Okay. - I can... - If you don't show it, I won't be on video. - Yeah, no, that's fine. I was getting the pictures with you.

00:00:53 I saved this video and sent it out to the our group and this group all my team. - There's a little bit of blood, there's a tumor cavity,

00:01:00 it's sort of sturgel foam in there, but no blood, no tumor. - Yes, for these complex cases, it's very good CT. I'm lucky, I'm happy.

00:01:14 Let's go. So, thank you. - Thank you.

00:00:00 This is what looked like before surgery. This is what looked like before surgery. There's a big tumor right there and it's gone now. That's what you just saw. After surgery I... Can you side by side? Oh, side by side. Can you freeze it? . . Step this way. Step this way. Get out like the layer of that light. Yeah, okay. So he's scrolling through. Yeah. Yeah. Yeah. Yeah. Yeah.

00:00:46 And that's where the camera went. Yeah. - All right. - Let's go. - Let's go.

00:01:02 - Yeah. - Yeah, it will be, you can hear it in your film, yeah? - Yeah. - I'm not special, but I'm a producer. - Yeah, yeah, exactly. No special effects. You are producer, you are director, you are star.

00:01:49 I was sitting at the computer on languages, leaning to the window, you heard it so well. Good job. Your emergency department is holding up like a sword-hospital. Thank you. Thank you. He flew, Alex. Merci.

00:02:51 [UKR-NEEDS] А пункцію робили?

00:03:13 Did you do a puncture? Did you puncture it? Now we'll wait. Who are you? I'm the wife. Ah, I understand. We don't film without permission, so don't worry. Where did you go, to dress? Come out of the intensive care unit. You can't walk here, dressed.

00:00:00 [RUS-NEEDS] Расскажите два слова, Викторий Васильевич.

00:00:08 Say a few words, Viktoriy Vasilievich. Well, this is with a lead-in. And in what situation? On the first. On the first. Yes. Yes. 120. That is, we're among, that is normal. Well, for now 2.1. And not worse, God forbid. And the position? While we don't forget yet. - It didn't stop? - No. - Well, maybe further lumbar function... - We can try to reduce it a little bit. - I want to stop everything in the evening and see what happened. - Yes, if he'll be in a coma, then we'll have to do a tracheostomy. - Maybe we agreed for tomorrow. - For tomorrow? Yes. - Well done.

00:00:49 - How much sedation now? - How much sedation now? - Fentanyl. - Fentanyl. We decided to decrease level sedation in order to check neurological examination and Anatoly decided to perform tracheostomy tomorrow. - It is a very severe trauma. - It is a very severe trauma. It's not will be a fast recovery. - How much fentanyl was he getting? - Two millimetres per hour. One millimetre of shots. - How many milligrams is that?

00:01:30 - It's a million. - It's all only fat. What do you see in the eye? It's a few millimeters. Maybe three or four millimeters.

00:02:03 and look like there's a ramp uh rossislava perform a lumber punch and then the color make it now we get you can see you can see moving again this uh yes If you decrease an oxidation, I think it'll be...

00:02:38 Like pain, yes, yes. And everything blood pressure and everything else is okay? It looks good? It's normal. Minus, minus This causes blood circulation

00:00:00 [RUS] Do you mind if I film?

00:00:02 You don't mind that I'm filming? No. And then show. [DELETED - ASR ARTIFACT] [DELETED - ASR ARTIFACT] [DELETED - ASR ARTIFACT] [DELETED - ASR ARTIFACT] And where is our Yulia? [INAUDIBLE] Yulia, let's go. We're going to get to the other side of -- We'd love for you to open the doors as you walk through. Okay. There you go.

00:00:52 All right. And action. All right, boys. Come on. Do I need an eye? There you are. Yeah, I'm making my shit out of the way.

00:01:18 Room four, to our patient, let's see how she's feeling. We're coming to you, morning time. What's the patient's last name? We asked her permission to film, and the nurses gave permission. And do you give permission? We operated on her yesterday with the American professor, And today we looked at her CT scan on the first floor, just when the explosions started.

00:02:08 The CT scan for such an operation, it looks good, there's still some swelling. Can I ask a question? And we'll examine her now, and then we'll step out and you can finish your questions. I understand a little bit about this. Go ahead and ask. Good question, because during the first operation I was there at the time when Vova had brain damage, it was the third day.

00:02:31 And I'm just now, well, sort of... - Are you afraid? Well, not that I'm afraid, I just remember that period, it was 20 years ago, when the head was the size of a pillow, and there were seizures, the seizures were severe. This is not hers. - Yes, I gave it to me. Take it there. No, the medical history on the computer and prescriptions.

00:02:57 How much dexamethasone did we prescribe? 8 mg twice? 8 is a lot. 4? Twice? You can do 3-3 days. I just started thinking about myself, in case there's a repeat. Look, you are in a ward where there is always a nurse and two neurosurgeons on duty. Vratislav Roslavovich will prescribe dexamethasone 4 mg three times a day. 4 mg three times a day. Fractionated heparin we'll start from tomorrow. And we'll see based on her condition. Now we'll assess her condition and check again tomorrow. If we don't like something a bit, we may, tomorrow, between the 2nd and 3rd day we'll prescribe Mannitol infusion once.

00:03:46 Mannitol about 11% 200 ml.

00:03:50 This is a hyperosmolar solution, which we use to reduce a bit.

00:03:54 Should I give her water, 2 liters? 2-2.5 liters. Don't limit it. As much as she wants, as much as she drinks, the excess fluid will come out in urine. Your task: first, we monitor blood pressure at least once every 4 hours, write it on a sheet, monitor temperature, write it on a sheet, drink water, as much as possible, and try to have her work her legs. Yes, I always say: gas, brake, gas, brake, gas, brake. Or, when people remember, there was a sewing machine, a Singer. Good to remember: 30 minutes passed, 30 times done.

00:04:44 What for? Prevention of blood clot formation in the legs, because this is very important. and fluid, so the brain receives more water.

00:04:57 Can I do this right now, you'll leave, I can already make her do it.

00:05:01 Yes. And I wanted to ask, on duty, tomorrow, for 24 hours, tomorrow is Friday, Rostislav Ruslanovich, Yes, after work I'll come for the 24-hour shift. So he'll be on duty from 8 a.m. Friday until 8 a.m. Saturday,

00:05:23 and will relieve me. Any questions can be asked, right? Yes. Let's go, let's go.

00:05:36 Good day once again. You don't mind that we're filming you on camera? For our descendants, you don't mind? What's your name? Victoria. And your patronymic? Victoria Oleksandrivna. Victoria Oleksandrivna. And how old are you? 71. Well, you're still young. Well, you're still young. Yes? I think you can easily live to 90-95, right? I think you can easily live to 90-95, right? I already have two great-grandchildren. Two great-grandchildren? Yes, let's start counting. How many children? One daughter. One daughter. How many grandchildren? Two. Three. And what are their names? Anton, Kirill and Natasha. And Masha.

00:06:26 Anton, Kirill and Masha. She started with great-grandchildren. I said at 71 years old she'll live to at least 90. She says she already has two great-grandchildren. And what are the great-grandchildren's names?

00:06:39 Vitya and Dima. Do they go to school? I wish that you live to see great-great-grandchildren. Good. Logan can film from there, and we can stand here if needed. Hello

00:07:27 Is it cold that you have so crowded? Raise your left hand. Squeeze my hand. Squeeze my hand. How do you feel the strength in your hands? Normal? Squeeze harder. Oh, you could break my fingers. Harder, harder. Give me your hand. And can you smile? Clear your throat, can you smile?

00:08:13 A smile. Like that, there's a beautiful woman. You can put on lipstick, you can pencil your eyebrows. She's a woman, but she's entering the history of world cinema. For her, it's still too early to sit up.

00:08:31 We allow sitting up around the third day.

00:08:35 Can I try to lift her eyelid? No, absolutely not sitting up earlier than the third day. And now, to be comfortable, you can put a pillow under, fold a blanket and for a period, especially when she drinks water. Yes, sir. I'm sure you don't have this in Ukraine, only in Ukraine.

00:09:04 Electric bed. Tell me again, to feed or not to feed? Do you want to eat? She'll be slender.

00:09:16 It's not that she doesn't want to, the body doesn't need it. The main thing is that she drinks water. Okay? Drink water. Can you work your legs like this? Feet up and down. Up and down. Oh, that's how it works. Compression stockings are a very good thing. What do they compress? They won't cut off circulation? The girls rolled them up a bit, is that not right? Should I straighten them out like this? So they don't cut off anything, they're fine? So there are no wrinkles, straighten them out. So I should straighten them like this? I'll tell you, I recently flew to America. 12-hour flight back, so I bought myself these additional things,

00:10:06 I took off the compression stockings like nothing had happened. Before that I flew to India, my legs were like logs, red, painful. But these compression stockings are a great thing and slowly work the toes, drink some water and let her sleep.

00:10:26 So don't overload her, let the brain rest. Let her be, the body doesn't need any food.

00:10:39 Alex, by the way I saw your control together with Alex. We were on the first floor, just when the explosions were, we were looking at your CT scan.

00:10:55 The tumor was removed completely, we took out her tumor.

00:11:03 Yesterday there was a prayer service for you, and now I want to offer a thanksgiving prayer. I'm a very believing person. Prayer services were ordered at the cathedrals. What will the prayer be? The prayer will be a thanksgiving. There was a prayer yesterday for your work, and today they'll offer a thanksgiving prayer service in the churches. «A lot of people pray for»

00:11:30 Alex Valatka, he's Lithuanian by heritage.

00:11:36 «A lot of pray for different people» Because with God's help, as they say, it's very important, we really acknowledge that this is...

00:11:47 Little icons. Yes, this is very important.

00:11:55 [VO CANDIDATE] Doctors are God's messengers. [VO CANDIDATE] Because a doctor is God's messenger. Therefore, with God's help... God does good things, [VO CANDIDATE] through our hands. And everything is done by hands. I'm very glad that the doctor [VO CANDIDATE] A doctor is a believing person, because, you know, God in reality, a doctor cannot just be like that, it's only God's gift in people. God willing, all will be well. God willing, all will be well. Antibiotics, which you don't need to take earlier tomorrow. Drink water, work the legs, the rest of the time sleep, rest. Okay?

00:12:38 Thank you. Thank you. Thank you. Can you bend the right leg then the left? Right, left, good job.

00:12:53 The catheter, I think, will stay for a day or two, and then we'll remove it.

00:12:57 No need to treat it, but the girls don't need to. Yulia, I think it will stay until Saturday, nothing bad will happen. No. No need to treat anything there. What else do we have, what are the instructions? monitor blood pressure, monitor temperature, drink water, work the legs a little bit, don't push too hard and sleep, drink water and sleep and work the legs, Yulia will write it down so the nurses come every 4 hours measure blood pressure and you write on a sheet here the pressure for example 100 over such-and-such, temperature such-and-such another column drinks and drank there 200 300 400 to monitor, now you can practically

00:13:44 So tomorrow morning, Yulia will show such a chart sheet, in the morning we come and look, throughout the day this was the pressure, this was the temperature, and you drank there, under observation, 2 liters, 2,200 there. Okay, okay, let's do it this way.

00:14:01 Okay, let's do it this way. All done, hold, five. Thank you all, thank you very much. We deliberated a long time about your operation, you know, measure seven times, cut once. And we did MRI with contrast, and angiography with contrast. And yesterday I even asked our general director to be excused, there was an event about stroke. We were supposed to run around there, participate. I said, no, Professor Valatka and I will go to the operating room and we won't rush. If it takes 2 hours, 3 hours, 4 hours, sometimes 6 hours. Well, we were lucky, the main stage of the operation was 80 minutes.

00:14:41 So we'll hope for the best. Thank God. Superstitious. Thank you. Thank you. Excuse me, you guys want to go in there and talk to her? Okay, thank you. Um, I don't know. I don't know what that is. Yeah, I think we've done a lot. Yeah, I think we've done a lot. We've seen a lot of people. We've seen a lot of people. We've seen a lot of people.

00:15:30 There's also a little church people out the window, but I don't know if we can get anything like that later. What is the church? No one knows. No one knows. Yeah. I tried to recover. I don't know if you saw that very briefly. Yeah. Yeah. Yeah, nothing.

00:00:00 You can go figure out the same pocket.

00:00:06 You can go figure out the same pocket. If you need to come in and get these, please do. My hedgehog is Leo. He is moving. Is it moving? Yeah. Can we start? Yeah, we can start.

00:00:30 - We locked it specifically. What does Lora want? Take the child from here. - And she won't be here? - Maybe she'll return at some point, but not too soon. - I specifically asked them to lock us in. Does she have keys? - Yes, she does. - Does she know which lock was used? Lower or upper? We need to try two pieces and figure out which one will work. Because we don't know about the lock. And we need to lock us so people don't work in. - Four is the one. - Yeah, she's trying to get him. - Try the one below the other lock.

00:01:19 Now we'll lock ourselves in and won't come out. Now we'll lock ourselves in and won't come out. Quietly, quietly, don't use force. And lock it, lock it, lock it, let him call you later or send you a text message.

00:02:18 on she doesn't know we need about it's okay then she's ready ask her if the balance is here yeah no no it's not close don't worry about it we're good I won't close it. And Andri, not that we've been doing this before, but can you do a clap in front of your face?

00:03:03 -Chopnete, so that the microphone has all the sound at the beginning. -There you go. -We ask you for the beginning, how you were growing, where you were growing, what was your childhood? I was born in the city of Verkhnodniprovsk, in Dnipropetrovsk region, 90 kilometers from Dnipro, where I now work and live with my family. My father Hryhoriy was a zootechnician and managed a large poultry farm. My mother, unfortunately, passed away many years ago. She was a librarian.

00:03:48 My father's name is Hryhoriy, my mother's Tetiana. What did this give me? My mother worked as a librarian, so I never lacked books. I always had many books, I read a lot. Now there's the internet, now you can find anything online very quickly. But at the time when I was born, it was very important for me to have access to information. At the same time, my father, who constantly worked with living creatures at work, you could say, birds, and at home loved to raise many different species of animals. There were cows, and sheep, and even pigs, and chickens, and geese, and ducks.

00:04:36 This instilled in me a love for all living things. So I understood how a living organism functions. On one hand, my mother gave me the opportunity to gain knowledge in the best way possible at that time, and my father instilled a love for living things. I'll say that I performed my first surgery while still being a schoolboy. We were raising rabbits, and one rabbit, a weasel, that's a predatory animal, wanted to get it out of the cage, and with its claw tore open his side, and his skin from the upper paws to the lower ones split open on both sides, and you could see his body, so I took a needle and thread, sewed him up, and he survived and lived longer than all the others,

00:05:27 because we kept him as a kind of talisman, so that's how it was. Unfortunately, my mother has been gone for 14 years, but my father is alive, everything is good, he's active, and continues to work the farm. I believe this is his secret to longevity, because he works from 5 in the morning until late evening, and he's also so energetic, he infects everyone around him with his energy. You probably got this hard work ethic and constant work from him?

00:06:00 First of all, it's really genes from my parents on one hand, and on the other hand - it's upbringing. And they showed respectful, kind treatment of people, respect for elders and love for all living things. Tell us about the time when you came to study. When I was studying at school, at the secondary school in Verkhnodniprovsk, what I liked most were the subjects, first of all biology, initially botany, then biology, geography, I liked physics. I participated in school olympiads, even competed in all-Ukrainian biology olympiads, traveled around Ukraine, participated.

00:06:53 And when I finished school, I finished school with a gold medal, the question arose where would I go next, what would I become. The easiest thing was, we went to Dnipro University, considering that I had a gold medal, and also had victories in regional biology olympiads, and they told me, you can enter the ecological faculty of Dnipropetrovsk University without exams. My father says, I've already arranged it, we'll submit the documents, after lunch you'll be enrolled, and you'll study here. But I said, no, I think I'll become a doctor after all. So let's go, at that time it was still called Dnipropetrovsk Medical Institute, we submit the documents, and I prepare to take exams.

00:07:47 The exams, as I remember now, were Ukrainian language, biology and physics. What I loved in school, that's exactly what I needed. And I entered the first year of the medical faculty. It was 1992, it was just the first year after Ukraine gained independence, The Act of Independence. And I entered the first group, first subgroup, and this subgroup was Ukrainian. From our entire large class. It was the first Ukrainian subgroup, where students studied in the Ukrainian language.

00:08:30 Most of them were from the western regions of Ukraine. But thanks to the fact that I ended up in this subgroup, I later met my future wife Tetiana. Her name is the same as my mother's. And I entered this medical institute. Then it became an academy, then became a medical university. It's actually a strong university, where we received knowledge. And I graduated from this university with honors. and I'm even listed in the book, the golden book of the medical academy. I love jokes, especially during the war, it helps us survive,

00:09:19 so I say, listed in the red book, like the red book for animals, for plants, as an endangered species and, what does this mean, to promote so that there are generations, so that there is reproduction, so that there are children, so that there are descendants, so that they follow in the footsteps. So it's a joke, but actually I'm really proud and I think, the children are already proud, grandchildren will be proud, that their grandfather was so legendary, that even in the "Golden Book" of the medical academy,

00:10:00 of the medical university, his name is written, out of 4 or 5 thousand people, 500-600 people were listed. Indeed, now when you look at it, it was many years ago. But then, when I was finishing the academy, the question arose, what would I become next. And at first I wanted to be an oncologist, to treat oncological diseases, a general oncologist. These are lung tumors, intestinal tumors, melanomas, malignant tumors as an oncologist.

00:10:45 Then I wanted to be a neuropathologist, but my father-in-law then said to Andriy: "Neuropathologist - that's somehow not a man's profession. Maybe you'll be some kind of surgeon, because neuropathologists read books, prescribe medicines and don't understand whether a person got better from that, whether they recovered on their own, or from the medicines that were prescribed. Now if you become a surgeon, it's a man's specialty, and you'll see the results of your work. And I decided to be a neurosurgeon. And I'll say more, that oncology didn't leave me, because my specialization in neurosurgery has two directions. This is neurotraumatology, which is injuries to the central nervous system, and this is neuro-oncology, which is brain tumors.

00:11:36 And my dream, that I wanted to be a neuropathologist, study the brain and be an oncologist, it came true. And I was lucky in my time that I again ended up first in a good university, studied at an institute, received such strong foundational knowledge, and then I had good teachers. My teacher, professor, first of all, Mosiychuk Mykola Markovych, he is the founder of the neurosurgical school in our region. And then I studied under Professor Zorin Mykola Oleksandrovych. I'll say that again, I'm proud that in the history of Dnipropetrovsk neurosurgery at this moment there are four professors that I know. This was the late Professor Mosiychuk Mykola Markovych, Professor Soliany Vadym Ivanovych, Professor Zorin Mykola Oleksandrovych, he is alive, hello, and I wish him many years of such full life and work.

00:12:34 The fourth is Professor Sirko Andriy Hryhorovych, so I'm proud that I am the continuer of such a dynasty, a glorious line of neurosurgeons, scientists, and I already have my own school, my students, this truly inspires me. Going back to the moment of your admission, you said that your father told you, look, I've already enrolled you here, and you told him, no, I'll probably go for medicine. What was that about? Why did you say that? Why did you want that? I never look for the easy path in life, I never choose what's simpler. I thought, ecological faculty, I'd be walking around checking pollution in these rivers, air.

00:13:22 somehow it was uninteresting, but this desire to help people first and foremost, it remained with me. I decided, despite the fact that you had to take an exam, that there was really great competition for one spot, there were many applicants, it wasn't easy to get into this institution, so I decided that I would choose not what's easier after all, but what's close to my heart, despite the need to pass more difficult exams. I'm satisfied and have never once in my life regretted that I decided to be a doctor. Can you give me some questions? Yes, can you help unlock that door?

00:14:11 Smokey. And I'll move in next to you. Maybe we need to say name, Logan. That's what? No. Do you need to close the other one? I'll return if that calls from me. Okay. I'll return before we do the handheld shot, but I'm going to get the sinusoidal and stuff ready for that. Okay. Okay, let's continue. So we talked about Andre's childhood growing up.

00:15:00 Can you, well I guess I can see this monitor. Alright, I'll sit down. And how he started university, why medicine, and how he got to new research. What else do you want to know? um let's say and you're going to answer her so you're looking at the correct side yeah um talk to me about uh talk to you about growing up in in the soviet union maybe not even dreaming of a country of his own but um um just the idea of it and then being able to have one and what it's meant and what it means.

00:16:15 It's quite a complex question, because it was, when it became independent, the year '91. At first, when we lived in the Soviet Union, there was an ideology, communist ideology. And I still caught the time when I was first an Oktyabryonok, wore a star, then I was a Pioneer, I wore a Pioneer necktie, then I was a Komsomol member, I was even a Komsorg of the school, secondary school number one in Verkhnodniprovsk. I was the school's Komsorg, even went to this training camp for Komsomol workers. That's how it was, you have to understand, propaganda, it always existed, and it was very serious back then.

00:17:02 What did I want then? I wanted, what could I do? I organized competitions for schoolchildren there, as Komsorg, in arm wrestling, competitions, come on guys, I participated in them myself, and then it all collapsed on me, meaning I was the last Komsorg of the school, on whom it all collapsed, and when Ukraine became independent, somehow more, I had already become more mature by then, and I began to be more interested in the history of Ukraine, More at that time, especially when I was preparing for the Ukrainian history exam, it was 10th-11th grade, I studied Subtelny's history, not only the books that were given to us at school, but those that had undergone such Soviet editing, written what they wanted to hear.

00:17:57 But I already began to read books on Ukrainian history that were not recommended during school. And then I began to search for information about Ivan Sirko, about the Cossacks, and the Zaporizhian Sich appealed to me. [VO CANDIDATE] It really resonated with me then, truly, I felt what they now call the concept of identity. Identity, that I was really more attracted to and liked more the fact that it was Ukraine, that we are an independent, sovereign state, that we have our own language. we must preserve all this, preserve and on the contrary spread it, multiply it.

00:18:46 That's why my parents instilled the Ukrainian language in me, despite the fact that as I said, most were Russian-speaking, but somehow I had pride when I was still at the institute learning to speak Ukrainian, and it was such a pride for us. And I'll say more, that when something is forbidden, you want it even more. And when I saw that Ukraine, because we follow our own path, which differs from the one they constantly push us toward, we go a completely different path. [VO CANDIDATE] And for this they hate us, for this they want to punish us, for this they want to kill us.

00:19:33 And I'll say more, that I'm proud that my son Bohdan, he really, somehow at that time we had Freedom, the "Svoboda" party, And he communicated with guys who were from Svoboda. And when there were events, you know, under Yanukovych, and when there were these events near our regional council, I'll say that Bohdan was also there. Bohdan was also there and police came to our home with searches and it was very, I'll say that at that time I was at work, my wife called and said that many police came who wanted to do searches in our home, to look for this literature, Ukrainian literature, patriotic literature.

00:20:32 and maybe they want to pin some attempts to participate in some riots, possibly terrorist acts. I then said, wait, don't open the door. I called my friends, they're so strong, bigger than me, friends, and I say, I need your help, because I won't get home quickly, but you must help. And they really came and followed the police through the rooms, so they wouldn't plant anything, so they wouldn't take him to prison later. Indeed, we had to go through this with my wife. They ransacked everything, took laptops, took patriotic literature, what we had at home.

00:21:20 And this really happened, and we worried for his life, for his freedom. Although he did nothing criminal, he only stood up, like the majority. Then at Maidan, but it wasn't the Maidan in Kyiv, it was in Dnipropetrovsk, near our regional state administration. I don't remember, after how many weeks we invited my relative, he's a lawyer, We went with the lawyer to get back both the laptop and return these Ukrainian books. They're now standing in his office, where Sviatoslav is now. And so indeed, I'm proud that my children have this orientation. And I'm proud that Bohdan grew up in this Cossack camp, and he knows all these traditions, and he cherishes them.

00:22:09 [VO CANDIDATE] And this is truly patriotism that's not for show. It comes from within, from the desire to remain a free person, a liberated, free person. And he also doesn't look for easy paths. I suggested several times that he come to the department, to go into neurosurgery. He says, no, I don't want to be in scheduled neurosurgery, I'll be specifically in the emergency department, where the most severe patients come, the most severely wounded, I'll operate on them. And I'll say more, even when he was an intern, he was like, I want to be closer to the front line. And he went to military hospitals, he went to advanced surgical teams, stabilization points.

00:22:54 And we prayed to God that everything would be fine with him. He helped surgeons, helped traumatologists. And most interesting, he sends photos from operating rooms. Here I am operating with neurosurgeons, surgeons. And then 2-3 days later he sends a video, the guys send it to him. After he left from there before New Year, a rocket, a bomb, flew nearby there, shattered the windows. Thank God, people remained alive, but in that operating room where he was 2-3 days ago, in the mobile hospital it was destroyed. That's the situation. So you can't tell it in one sentence, even in a paragraph. This came from the parents. Parents instilled love for the native land and maybe some roots, some genes were passed down from that legendary Ivan Dmytrovych Sirko born in 1612.

00:23:49 were passed down and it, for example, is preserved in me and continues in my children. Both in the older Bohdan, and in the younger one now in the Cossack camp.

00:24:00 Learning how to work with a saber, learning how to ride horses, in boats, how to treat himself and others with herbs. They learn to play the kobza, instruments and sing Ukrainian songs. and there was a question, could we go to the camp, film everything. Previously this was possible. And now the Koshovy, the otaman there, he worries about the safety of the children. He says, I would be happy to, but initially our camp was set up on a hill, and it was clearly visible from afar. Now we've removed all that and hidden it in the forest, so no one can find it, because we worry, you see drones, rockets. Someone will give information that there are not children there, but military personnel, for example, soldiers preparing for rotation, drones will fly in and strike children.

00:24:55 So there was a great desire to show this camp, it's truly beautiful, but it's better not to do it. What can I say, when we last took Sviatoslav there, we arrived, and there were many young deer, more than 30-40 of them, they were calmly on the hill. It's like in Askania-Nova, such nature. And tonight we spent from 4 to 6 in the morning in the basement, I said that I'm grateful to the Lord God,

00:25:30 that precisely at this time Sviatoslav was not with us, because for him this is the most difficult. If he sees air raid alerts, if he sees drones flying, rockets, he can no longer fall asleep, and it's very hard on his psyche. Why was it always important to you that they grew up knowing the traditions and went to these Cossack camps? Why is this important to you specifically? Because not all parents think this way. This came not so much from me, it comes from them themselves, it's their desire,

00:26:18 somehow it's that they want it, maybe it was passed down through genes, but I didn't say you'll go specifically to this camp. I can say that Bohdan initially studied taekwondo for a long time and was constantly traveling. Previously they went to Crimea, and in winter they went to the mountains, to the Carpathians. And he was always so active. And once he ended up at this camp, he liked it so much that he said, I'm staying for another session, for another session. And every summer he spent one, two, three trips there. When he grew up, he already became, what's it called, kurinny, he would come and already looked after the little ones, he was kurinny, he was the leader, he was the senior on the boats, then there was climbing on nets, he was the senior.

00:27:15 And I can tell you one story that happened, when he was kurinny, he calls me, says, "Dad, did you receive a patient with the surname Bernyk? You didn't?" I say, "No, I operated on an unknown person." And he says, because our, not the otaman, the assistant, of the otaman, the son was at war, he fought, and he came to you. I say, ask, is he red-haired, with a beard? He says, yes, it's the red-haired one with a beard, it's our otaman's son. I say, well, you know, I'll tell you, it's an extremely severe injury, he's in a deep coma, grade two coma. He probably won't survive, I say, but I operated until late at night and did everything necessary.

00:28:05 He says: "Yes, this is my assistant otaman's son, do everything you can." And gradually he recovered, he recovered well. And I remember then, this assistant came, Mykola Bernyk, and he came, he says: "I brought you a gift." I say: "What gift?" And he takes out such a three-liter jar of honey, and says: "This is for you. This jar of honey is for you."

00:28:30 And he recovered well, unfortunately, he died from coronavirus and pneumonia. But at that time we gave him the opportunity to live and we became friends with families, even of those people we saved. They used to stay longer for treatment, we don't have such possibility now. we must operate, stabilize, do procedures, we must evacuate these people so there are places to admit new ones, but previously there was an opportunity to treat them. And previously my wife Tetiana made cabbage pies, potato pies, and they would come with Sviatoslav, we would go to the wards and treat wounded fighters, their relatives, and I have many friends on Facebook too, and they remain, who congratulate me, there are birthdays, various holidays, we became friends.

00:29:23 And so we were friends for a long time with the Bernyk family, and now I see Mykola Bernyk is traveling. Indeed, that's how it is, you can't say that I told them, you must learn this. No, it came from within them somewhere, and I just watch, well, I'm proud. At three o'clock you have to start a conversation with Alex somehow, right? It can be short, it can be 10-15 minutes, if needed, we can continue. - So it's easy, is it need to start? - At 3:00 p.m. it's maybe 10, 15 minutes. - Yeah, yeah. - And after that we can continue. - Yeah, yeah, yeah, that's good. So keep going. I mean, I have something next, but go ahead. - We have done this question I had. What else do you want to ask?

00:30:17 - Why neurosurgery? Do you have a... Is medicine in your family? Are you the first doctor? Does he have the most advanced degree of any of his upward relatives? Can you explain a bit how he chose a neurosurgery, but I can ask if there are any other doctors in the family? Yeah, ask him that and then have him talk to you about the beeswax and his father and the bees and that kind of thing. - Tell me, if you were before you were doctors and about the wine? - Yes, I'll honestly say that doctors of traditional medicine in the family had never been.

00:31:05 My grandmother, she was, as they say, a bonesetter, she treated with her hands. Grandmother Kateryna, she lived in Novopokrovka, and she treated not only in her village, but all the nearby villages, if a person had a dislocation of some joint on their hand, on their leg, everyone went to baba Kateryna, there was a line there, because she could set dislocations of joints, She raised four children, because her husband died early. But with these hands she could set any joint dislocations.

00:31:50 My uncle was a veterinarian, also her son, who treated everyone around. But traditional medicine specifically in the family there wasn't. There were some bonesetters, such folk medicine, there were veterinarians, but I was the very first who became a traditional medical doctor. But now in the family I'm a doctor, my wife is a doctor, and Bohdan - he's the first generation after us, a doctors' neurosurgeon. We ask Sviatoslav, what kind of doctor will you be, will you be a neurosurgeon, he says, no, I'll be a traumatologist. Well, life will tell. Regarding what I showed and told yesterday, indeed, as I was saying about my teachers, Professor Mosiychuk, Zorin Mykola Oleksandrovych,

00:32:43 we learned so much from them. And this old thing, what was passed down from generation to generation, for example, wax. Only recently with humanitarian aid we received wax, which is synthetic wax, It's packaged, sterile wax, humanitarian aid from the USA, our friends Rock Armonda, Alexis Latka. But before this we used beeswax for a long time. When interns come, I joke, I say, we have special neurosurgical bees. These very bees, these are very rare bees that produce neurosurgical wax that we can use during surgical interventions. When the wax runs out not only in our operating room, in other operating rooms, I call my father and say, do you have wax, and he melts down beeswax, such pieces of wax, and how much do you need?

00:33:40 I say, well about half a kilogram, and here they bring half a kilogram, we cut it into three parts: we gave to one, gave to another, gave to a third, and our nurses, I say, from generation to generation, the recipe is passed down, how to mix this wax with oil, boil it for a while, sterilize it, and it's even better, than the synthetic wax that's brought from abroad. This wax is used exclusively for one purpose - to stop bleeding from bone. For example, if we take this skull and make a cut, here are the diploic veins,

00:34:26 which bleed, neither coagulation nor other materials can stop it. we need to apply this wax, it's sterile wax, but indeed it's produced by ordinary bees. And so we were on an excursion on Sunday late in the evening, it was already dark, with Alex and Volodya at our rest place in Dnipro, There was such a hut, there it interestingly says "Sirko's apiary". I showed it to Alex and Volodya, and they showed us 5 hives that were just made, bees weren't living there yet. And they showed hives in which bees lived 100 years ago.

00:35:16 So indeed there's nothing accidental about it, that's why Sirko works with bees for some reason. My father works with these bees, when I was in school, I also did it and know how to raise these bees. I had such small hives where we put the queen, and there she began to breed, and when she had multiplied, then we transferred them to larger hives. And now I use this wax from Sirko's apiary, only not Ivan Sirko's, but Hryhoriy's, my father Sirko's, and it's used in neurosurgery. - Yes, I think it won't be very long and we'll continue, because I still have shell fragments that need to be shown.

00:36:07 There's a lot to tell. I don't think so.

00:00:00 Michael DeBakey in the United States talked about how he felt simply by not being in New York or LA

00:00:00 Michael DeBakey in the United States talked about how he felt simply by not being in New York or LA that he had the ability to sort of carve his own way in medicine and do things that were outside the norm because he wasn't in the in the established sort of like you know capitals of medicine or capital you know of um and um yeah and we talked about a little in the car but it is is sort of a bit like from talking to Alex there's so many things that he does that's uh

00:00:47 um revolutionary right and so um and then also like um you know i'd love to know the uh the politics of this place um and then of mechikov so like you know we um on within his team he's he's the boss it's all this this this but like other people here have their own turf right their own uh space uh but like and also like um tell me and tell us about nepro i mean like uh it was it is it was a

00:01:32 center for um space um firms correct and um aerospace and uh just um um when we talked to bodon and bodon said bogdan sorry bogdan said that um bogdan called himself he didn't he said he he said that sviatsaslav would feel the pressure because because bodon and bogdan felt that he was not the good son um whatever and it might be a

00:02:20 translation thing but that was an interesting thing. So what is the question about this? That's a good question. It's more the... I have one question related to him working this but maybe I don't know if you have a specific... Well, I just, like, like, no, I think that just like, you know, he sent us that message, translating the Facebook memory of like, I'm proud of you. And like, that was something that I said to Bardan. I feel your pride in your son, Bardan.

00:03:05 and I would like you know him to speak to that but also you know the I don't know what it was with Bohdan but I feel like I feel like he I don't know I feel like he doesn't there's something there's something he's not allowing himself to see within himself that is strongly admirable you know and that's probably part of it part of the humility. Anyway, so we can go and ask your questions. I can tell you what questions I have. I wanted to ask a bit about when Andrei started to work in this hospital,

00:03:54 how his work changed during his years here, and especially from like the 2014 and from 2022. and then I thought about asking about Bahdan, how is it for him to work with his son. And here I can also ask these questions that you just asked about what Bahdan told us in his interview. And then I wanted to ask about the fact that they have many young, very young doctors. I wanted to ask him if that is something that always used to happen or is this related to the work? And then I have a question: what is the most difficult part in his work during the last years?

00:04:47 This is a very active work, how it changed? And then I wanted to ask him, he usually has a line of people waiting to get his consultation and he is on call almost like 24/7, his phone rings all the time. And he operates also regularly and I just wanted to learn how he manages all this. Yeah, and then you had the idea of knowing the right words. Yes, that is my next question. And then I wanted to ask this question related to many people leaving, many doctors leaving, but he chooses to stay while being a very well-known specialist and knowing many people abroad who would happily work with him elsewhere, but he chooses to stay here. Why?

00:05:43 - I will say about that and why I want him to talk about Ivan Sirko again is that there's a thought

00:00:00 stick near or when we're ready to go handheld and do that do the thing yeah

00:00:00 stick near or when we're ready to go handheld and do that do the thing yeah how long do you think that's gonna be so I might actually like there's a b-roll FX6 or something yeah or something yeah give me like a time when you think return for that like at least 30 minutes right yeah I think more yeah maybe an hour yeah 45 hour You get to clap again, yes. Yeah. And then, Andre, can I have you shift so you're facing your shoulders kind of like the... Right over there. Yeah, there you go. That's how you were before. Okay. Thank you, guys. And you've rolled. Okay.

00:00:54 [UKR] I want to return to the moment when you started working at the hospital. When was that? [UKR] I started working at the hospital in the year 2000. At that time there were many neurosurgeons at the hospital, and getting into the hospital was almost impossible. [UKR] I asked my father-in-law, that is, my wife's father, to find an opportunity to get me a job. [UKR] They hired me for only a quarter position. [UKR] At a full 0.25 position I started working. [UKR] From this I gradually grew. [UKR] 0.25 position in the department, 0.25 position in the admission-diagnostic department, [UKR] then 0.5 position in the department, then from 2001 I also started working part-time as an assistant at the Department of Nervous Diseases and Neurosurgery.

00:01:48 [UKR] That is, along with practical work, I also engaged in scientific work and pedagogical work. [UKR] First it was students, then interns, then already resident physicians. [UKR] That is, I grew both on the practical ladder - first a neurosurgeon, then head of the neurotraumatology department, head of the cerebral neurosurgery department - and at the institute first as an assistant, then associate professor, then professor. [UKR] So it was the year 2000 and until 2005 I worked as a neurosurgeon. [UKR] How has your work changed over these last 25 years at the hospital, and especially from 2013-2014 and 2022?

00:02:40 [UKR] I'll say it this way - in 2005 I defended my PhD dissertation at the Romodanov Institute of Neurosurgery in Kyiv, [UKR] became a Candidate of Medical Sciences, I already had the highest category in neurosurgery, [UKR] and then the director, the chief physician of the hospital Volodymyr Oleksiyovych Pavlovych, appointed me head of the neurotraumatology department. [UKR] That is, neurotraumatology, where I started, I became the head of this department. [UKR] This gave me the opportunity, so to say, freedom in my actions. [UKR] I looked at what was done before me, and what could be changed. [UKR] And many things were introduced into practice. Decompressive craniectomies were introduced, and monitoring of intracranial pressure, and cisternography in the diagnosis of nasal CSF leak - traumatic, spontaneous - and repair of skull defects with titanium implants.

00:03:39 [UKR] That is, this gave me freedom to introduce new technologies. And many of these technologies were introduced for the first time at Mechnikov Hospital, not only in Dnipropetrovsk region, but also in Ukraine. [UKR] In 2009, the chief physician Volodymyr Aleksiyovych Pavlov also decided to combine two departments - neurosurgery, two - and neurotraumatology. I became head of the combined department already at 60 beds. If before this there were 30 beds, it became 60 beds. [UKR] And I began to introduce new technologies not only in neurotraumatology, but also in neuro-oncology. These are technologies called the use of stereotaxis, neuronavigation in neuro-oncology, the use of intraoperative neurophysiological monitoring for removal of brainstem tumors, located near the brainstem.

00:04:36 [UKR] This is category five complexity, and we have achieved significant success here, and are alongside the Romodanov Institute of Neurosurgery as leaders in this direction in Ukraine. [UKR] Therefore, precisely the opportunity to be a department head, also the scientific level was growing, because in 2012 I defended my doctoral dissertation, became a Doctor of Medical Sciences, and in 2012 I gradually received, as they say, all awards, all titles, [UKR] that is, Honored Doctor of Ukraine, neurosurgeon of the highest category, Doctor of Medical Sciences, Professor, and in 2023 I received, I consider, one of my greatest awards, along with the Order of Merit 3rd degree - this is an award from the hands of the President of Ukraine Volodymyr Zelenskyy, which is called "National Legend of Ukraine."

00:05:36 [UKR] This is very honorable. This is not only my merit, this is the merit of the entire team, and of the team of Mechnikov Hospital, [UKR] headed by our general director Serhiy Anatoliyovych Ryzhenko, because this is truly thanks to such a large number of wounded being treated, [UKR] the results of treatment - they chose me among 10-12 people who were awarded this year, also worthy, very worthy people, [UKR] In various fields - these are athletes, these are actors, these are volunteers, these are also people who died in the war, heroes. [UKR] Da Vinci, you know well, was just awarded posthumously. [UKR] But these are awards for hard work, first of all, of the hospital team.

00:06:26 [UKR] Actually my next question is about your colleagues.

00:06:30 [UKR] Who are your colleagues? Tell us a bit about your team. [UKR] Now I'll turn it off so that I... [UKR] If it's important, take it.

00:06:40 Just a moment.

00:06:41 [RUS] Everything is important for you. [RUS] Hello.

00:06:46 [UKR] Okay, thank you. [UKR] Yes, thank you for watching. [UKR] Did you finish? [UKR] Go ahead, what's the question. [UKR] This is Kostya, and we're operating on him. We need an electroencephalogram, and we'll come to you. [UKR] We'll come, when to come, do the electroencephalogram, do it urgently, put him in the ward. [UKR] Well, you yourself are answering your own question. There should be a fresh electroencephalogram and there should be a fresh MRI. [UKR] And are they waiting? [UKR] Yes, yes, yes. [UKR] Thank you. I want this to be done. [UKR] Agreed, see you.

00:07:31 [UKR] I'll press airplane mode, because I turned it on for the first conversation. [UKR] Your team, who are they, tell us a bit about them. [UKR] Well, in fact, as you've already seen, there in the photos and among my colleagues, there are many young people. [UKR] Many young people and young guys. [UKR] First of all, why is this so? [UKR] Because, especially since 2022, the number of doctors has decreased almost by half. [UKR] Decreased almost by half, and there are three reasons for this - three doctors went abroad. [UKR] Abroad - those who have large families, that is, 3 or more children, those by disability - 3 people went just abroad.

00:08:26 [UKR] And they chose that life which they consider better for them, for their families. [UKR] I have no right to judge them, this is their choice, they left. [UKR] Several doctors, again, now I'll say, three doctors work in Dnipro, but they work in city hospitals and mainly provide planned neurosurgical care. [UKR] We call it abroad - elective cases, these are selected cases, that is, brain tumors themselves, other pathology, but there isn't such a number of wounded, seriously wounded, there aren't such difficult shifts, no operations at night.

00:09:14 [UKR] Yes, these are my students. I taught them in my time. They became doctors of the highest category, they became candidates of science. [UKR] The time came, they decided to go, as they say, to already engage in what they like. [UKR] Indeed, not what is most needed now - operating on the wounded - but what they like. This is also their choice. [UKR] One doctor moved to the endovascular neurosurgery department, Vadym Perepelytsia, this is my second PhD, whom I prepared, that is, Doctor of Philosophy. [UKR] He works there, saves the wounded, this is also his choice, he liked more not open operations, but precisely endovascular operations through vascular puncture. [UKR] And one doctor was mobilized into the ranks of the Armed Forces of Ukraine, works as a doctor in a military hospital. Therefore, the number of doctors decreased by half, but at the same time youth are coming.

00:10:15 [UKR] They know that I am always happy to share my knowledge, my experience. [UKR] And even surgical interns come. [UKR] Like surgeons, they say that we want to be neurosurgeons. [UKR] Andriy Hryhoriy, you saw him, and Artem. [UKR] And Mykhailo - these are unique people. Why? [UKR] Because their parents are also military. [UKR] They serve at the front. [UKR] And Mykhailo's father is a sergeant, now in the Pokrovsk direction. [UKR] Mykhailo saves the wounded at Mechnikov Hospital, his father is in the trenches defending Ukraine. [UKR] That is, these are people, one from Vinnytsia, one from Cherkasy, who don't have rich parents, who don't have a lot of money, as they say in connections, [UKR] these are not spoiled rich kids, these are the simplest people who came and said, Andriy Hryhorovych, we want to learn from you, we want to save with you,

00:11:07 [UKR] Indeed, and they work with me, you see, Mykhailo and I operate together, and he's a surgical intern, but he already has the training of a neurosurgeon who can provide care for neurotrauma. [UKR] Therefore, we will do everything so that he completes his neurosurgery residency in Kyiv, and they want to work in this department. [UKR] That is, the youth are smart, the youth are patriotically minded, they are not afraid of the proximity of the front line, explosions, shells. [UKR] They see that they can learn. They can learn from me both to work with their hands, and they can learn to write lots of articles, become scientists. [UKR] And perhaps, when they already become adults, learn to do everything,

00:11:54 [UKR] then say, thank you, you taught us, we will go head our own departments. [UKR] This is also not bad. Why? Because I see many professionals, [UKR] they made themselves, but they cannot prepare a team, [UKR] they cannot leave students after themselves. [UKR] I, like my teachers, Professor Zoryn and Professor Mosiychuk, I'm not afraid of competition. [UKR] Why? Because every year I do more and more complex things, I go up and pull along with me. [UKR] We conquered one peak, climb up here, while you climb up here, I climb even higher.

00:12:30 [UKR] And this is true, therefore they come from other departments, both at Mechnikov and around Ukraine, people are afraid, afraid of competition. [UKR] Therefore, I taught myself, you stay at that level. I don't have that. You saw Rostyslav Malyi, Oleksandr Volodymyrovych of the same age as me, but younger are Volodymyr Botykov, Mykyta Hulidin. [UKR] They already operate on tumors, they operate on them very well. I say, I'm happy for you, and if the team is strong, then our department is strong. [UKR] And what you see in the corridor every day near my office, 10 people sitting on block G, on block D, resident doctors come to my doctors.

00:13:18 [UKR] I understand that we are a top department not only in Dnipropetrovsk, Dnipropetrovsk region, but in the east and central Ukraine they come to us, because they know that we take on difficult things.

00:13:30 [UKR] I won't say who, but one of your colleagues told us that you're like a locomotive that pulls everything and everyone along with you. [UKR] This is so, but I'm proud of this, because while there are physical forces for this, it's good. [UKR] So, next. You mentioned your young doctors, this is exactly what I wanted to ask you, and one of these quite young doctors is also your son. [UKR] Can you recall the moment when you realized that your son would be a doctor, how was it, when was it, and how do you work with him now? [UKR] Well, Bohdan, he's an unusual person, he has such a tattoo on his skin - rebellious child,

00:14:16 [UKR] yes, born to revolt, that is, rebellious child, that is, he never in life so strongly obeyed, [UKR] because I tell him, he went his own way, this is good, this is good for any person, [UKR] that he chooses his path, sets difficulties before himself and tries to overcome them. [UKR] He wanted to breed fish too. [UKR] He was so involved that our whole house was full of aquariums. [UKR] He spent all his time - there we have a market, Ozerka. [UKR] He spent time there, bred fish, learned to breed those fish, [UKR] which lay eggs, which it was difficult for me to breed.

00:15:00 [UKR] But I succeeded. I will engage in industrial breeding of sturgeon, salmon, trout - go ahead. [UKR] Then I'll be a journalist, a politician. But when he was already finishing school, somehow he was more toward medicine. [UKR] Toward medicine he was pulled, then he decided to enter medical school, in medical school he studied very well, surgery attracted him. [UKR] He constantly participated in surgery olympiads, they found laboratories, made these incisions, did operations, created his own surgical channels. [UKR] That is, he engaged in surgery. When he finished and the question arose, what will you be? Well, probably, a neurosurgeon. He came to neurosurgery, but when he even came to neurosurgery, I still haven't decided whether I'll be a neurosurgeon, I want to try everything.

00:15:58 [UKR] And he tried himself - worked in the burn center, and in plastic surgery, and in ophthalmology, and in maxillofacial surgery, and in vascular surgery. [UKR] And wherever he was, he's like - I must learn this. [UKR] And I already said, he spent a lot of time in mobile hospitals, but this helped him because he's universal. [UKR] a universal doctor, he likes more trauma surgeon. [UKR] Abroad there is no neurosurgeon there, no surgeon or what kind of surgeon, [UKR] there is such a concept as trauma surgeon. [UKR] Trauma surgeon, he does these operations for trauma. [UKR] And this really pulls him, and he operates trauma quite well.

00:16:43 [UKR] I'll honestly say, when there are soft tissue defects, [UKR] there are defects, torn skin, such large wounds, [UKR] Even I, even experienced doctors from my department invite him: [UKR] "Bohdan, how to make an incision, how to rotate these skin flaps so they can be sutured, so there won't be a defect?" [UKR] And I'm amazed, and Rostyslav Malyi, Oleksandr Volodko, they watch when he assembles from those flaps the defects, how they then heal. [UKR] He operated on Viktor Rozov together with Mykyta Hulidin with a penetrating brain wound. [UKR] They did such repair that I think no one in Ukraine in the acute period would have done such a neurosurgical operation as Mykyta Hulidin did,

00:17:31 [UKR] and how Bohdan assembled these flaps, how it then healed. [UKR] Therefore, no one forces him: "If you want, try." [UKR] And there was an opportunity to rest during internship. [UKR] He went to mobile hospitals. [UKR] Went to mobile hospitals, for a long time there was no connection. [UKR] But indeed he never hid behind my last name. [UKR] He would arrive, negotiate, starting with doctors. [UKR] And then, when the chiefs of the hospital, of the medical service of the hospital, [UKR] learned his last name, they were surprised - how are you, the son of a professor, going here to the hospital, [UKR] this doesn't fit in the mind. [UKR] Usually the sons of professors are somewhere looking for a warm place.

00:18:16 [UKR] No, he goes where it's difficult, he goes where he can test himself. [UKR] This is all in him, he goes to the mountains alone, tests himself, [UKR] how he can live in the mountains without outside help, encounter those same bears, with wild dogs that are there or guard pastures, [UKR] but they're wild and they can tear a person apart, he constantly tested himself. [UKR] He's truly, as they say, wild, but in the good sense of this word, just as our ancestors were, they were such that they believed, they had their own faith, even not Orthodox faith, you remember these moments, but this says that a person is free.

00:19:03 [UKR] Free in their thinking, in their choice, in their behavior. [UKR] This doesn't violate generally accepted moral boundaries, but this says that a person is truly developing. [UKR] And therefore, English language he knows better than me, although we went to these courses together, but it comes easier to him, [UKR] he gets pleasure from it. [UKR] He was 20 years earlier than me, not 20, perhaps less, in the USA, because he just went on this Work and Travel program and was a lifeguard at pools. [UKR] He saved those children, he passed all these courses on saving lives, he knows the language well, he's not afraid of anything.

00:19:50 [UKR] He, for example, was returning back, either in London or where there was a connection, I, for example, was afraid, there were 12 hours, decided to go to the city.

00:20:00 [UKR] And he went to the city, came back. Similarly, he arrived in America, and the hotel where he arrived, that hostel was closed, already closed. [UKR] He found common language with African Americans, and they together with him on a bench until 5 in the morning, until they opened the hostel, they spent this time together. [UKR] This says that a person is very communicative, can find language with a child, with an adult. [UKR] I remember, he was 3 or 4 years old, we went then still to Prymorsk, and we're walking there, as they're called, [UKR] there, where first there's shallow water, and then the beach begins, and we cross over this little bridge.

00:20:48 [UKR] and a person is fishing, and he approaches at 3, maybe 3.5 years, and says: [UKR] "Well, are the fish biting?" [UKR] And the man turns around and can't understand who's talking to him,

00:21:00 [UKR] and then looks, and there's such a small one standing and saying: "Well, are the fish biting?" [UKR] That is, he's communicative, he can find language with anyone. [UKR] Indeed, he wants to be himself, I repeat. [UKR] He doesn't want to come to my department, he wants to make his own path independently, build his own career, but what he takes on, he does very qualitatively, like me, and he tries to do as best as possible. This is honest. [UKR] Are you proud of him? [UKR] Yes. And proud of the older one, and the younger one. [UKR] How do you manage to separate work, where you are colleagues, and the fact that you are father and son? [UKR] And here it's very simple, maximally simple, because at work our relationship with him and with other doctors is the same for me. I try so that there are no such, as I'm such a bad teacher's pet, not a favorite, somehow differently, somehow I single out or don't single out.

00:22:00 [UKR] We have a chat where we constantly exchange operation results, discuss cases, and if you operated poorly, I say so - poorly, whether it's Bohdan, or my doctor, or another doctor, this was done incorrectly, this is how it should have been done. [UKR] And when such an attitude is equal, and they know that I will judge not by family ties, not by the fact that someone has worked with me more years, such as, for example, Oleksandr Marchenko, or fewer years - I will single out someone, and not another.

00:22:30 [UKR] For me there are precisely objective criteria for assessment - there cannot be such favoritism at work. Precisely what goes is that you must do. Like we have requirements, job description, you must do such-and-such. This is one thing - at work come on time, don't leave home early, no one leaves, because there's a lot of work, and another is to perform those stages of intervention and perform them qualitatively. [UKR] Like today a doctor came, was on duty, did a CT control, after CT control an internal brain hematoma formed. [UKR] He came, we discussed with him all these moments, and he's worried, I see, he's worried, because the person was almost conscious, there in stupor,

00:23:15 [UKR] and such a complication, it could be, because this is trauma. [UKR] But he's worried, he's thinking how to do it. Did a CT control after the operation, sent me the CT control, says, I'll watch him, I'll call the intensive care in the evening, if it's necessary to operate on him again, I'll come. [UKR] Therefore, at home we communicate or outside the hospital as father and son, at work we communicate as head of center and a person who works in this department. [UKR] So there are no problems here. [UKR] Returning again to your work, you already mentioned that people are always sitting in line to you to consult with you. All the time on the phone they call you, either after an operation they say how everything went, or people ask something new. And at the same time you also operate regularly. How do you find strength, how do you in general cope with such a pace of work?

00:24:14 [UKR] Honestly speaking, I myself sometimes am amazed, why, because since 2022 there became much more work, I already told you that half fewer doctors, but the work is two, then three, sometimes four times more - if you multiply two decreased, four increased, this is a colossal load. [UKR] And what I wanted to say - our strongest link is our nurses. [UKR] If they leave, they only leave where? On maternity leave. [UKR] To give birth to a child and then return to the department. [UKR] This is the strongest link - unlike doctors, nurses, almost no one quit for other reasons. [UKR] Only go on leave, then they all return. [UKR] Many are happy. Strong nurses. I have a strong head nurse Lyudmyla Vasylivna Lazareva. She also prepares the team, you see, young nurses.

00:25:08 [UKR] In its time, when our such, Nataliya Shulhina, this is the head nurse, conducted competitions for the best nurse, the nurses of our department not only received victory at the level of Mechnikov Hospital. [UKR] They were the best nurses of Dnipropetrovsk region. [UKR] The best nurses. [UKR] And they participated in the competition "Best Nurse of Ukraine." [UKR] That is, this says that not only I prepare the youth.

00:25:39 [RUS] My head nurse also prepares the youth.

00:25:41 [UKR] And we truly at such a high level represent the department. [UKR] And therefore I feel more, one can say, drive from the fact that, despite the fact that we provide at the highest level care to the wounded,

00:26:00 [UKR] we don't slow down the pace, providing care for brain tumors. [UKR] We on one hand understand that if we say, we're now operating on the wounded, you go to Kyiv, somewhere look for doctors for yourself, [UKR] God willing, the war will end, the path to us will grow over, because they said, well no, at Mechnikov they operate, they only operate on the wounded, [UKR] there's no point going there, but this is not true. [UKR] Therefore, we try - if it's necessary to operate on a wounded person, we operate on the wounded person, warned everyone, [UKR] that your operation may be shifted in time, but if there's no wounded person now, we take planned cases, [UKR] therefore they come from everywhere. Even from Lviv, Uzhhorod, Kyiv come those cases where they were refused, they come here and we operate.

00:26:47 [UKR] Indeed it's difficult sometimes to consult, you understand that a person came to show CT control, MRI control after an operation. [UKR] I know that everything is fine there, but they want to come hear my opinion. Therefore, you can't say like that - go away, no need to show, [UKR] because people come, they come as to God, [UKR] and show the result, and you say, live long and happily. [UKR] And indeed, this helps to detect in time when there's a recurrence, [UKR] continued tumor growth. [UKR] And just last week, this week, [UKR] I operated on people whom my professor Mosiychuk [UKR] operated on 40 years ago, a woman. [UKR] Yesterday I operated on a woman who was operated on 20 years ago before me. [UKR] That is, people, they come when there's a recurrence,

00:27:30 [UKR] we detect it in time, and help them in time. [UKR] Therefore, even, sometimes, I want to say, I'm already tired from consultations, but this doesn't happen. [UKR] I think this won't happen. [UKR] What truly becomes with each day, month, week more difficult is when - well, I'm used to since '14 constantly being on the phone. [UKR] On the phone with my team of doctors, they know that you can always call, the phone lies near me, [UKR] Military neurosurgeons, since '14 they call. [UKR] I'm already used to it. [UKR] The phone, on the lowest sound, I see someone's calling.

00:28:11 [RUS] I take the phone, go to the kitchen.

00:28:16 [UKR] Without turning on the light, sometimes, open the refrigerator. [UKR] Found something in the refrigerator. [UKR] And while you look, they sent you a CT, you analyze, had a snack, ate something. [UKR] Because such moments happened that I ate and put an empty container in the refrigerator, and in the morning my wife discovered this. [UKR] I understood - so at night you woke up. [UKR] This is not difficult, I'm already used to it - woke up, consulted, came in 5 minutes, I'm already sleeping. [UKR] Very difficult now, when these Shahed attacks, ballistic attacks, and I have to go down to the basement together with my son. [UKR] Indeed this exhausts not so much physically, because 3-4 hours per day of sleep is enough for me, everything will be fine.

00:29:08 [UKR] But emotionally it's hard to watch how Sviatoslav reacts to this. [UKR] [VO CANDIDATE] It's very hard for Sviatoslav, and in 2022 I suggested to both my wife and younger son - let's, you go abroad, there it will be calmer, there it's better for you - but both my wife and Sviatoslav, we asked him several more times after this, they answered - no, we want to stay here, be with you, although indeed, when they bomb us heavily, I forcibly take them out to our country house 90 kilometers from the city. [UKR] so that they would be safe. [UKR] Although honestly I'll say, the place where we live, just there pass the routes of these same Shaheds.

00:29:58 [UKR] And we happen to observe in the evening how our helicopters hunt them, [UKR] helicopters, two helicopters, they caught this Shahed with light, they shoot it down, and we see like nuclear light, such a big flash, and we also observe this, although earlier we thought that this was the safest place in our country. [UKR] Actually about this I also wanted to ask. You are a very successful and well-known specialist not only in Ukraine, but also abroad.

00:30:30 [UKR] I'm sure that many of your colleagues abroad would happily want to work with you and take you closer to them, but you choose to stay here, in Dnipro, and work here. Why? [UKR] [VO CANDIDATE] I'll say that I can't do otherwise. I understand that precisely here, in Dnipro, I am most needed. And now, when already more than 2,500 wounded we have operated on with such severe penetrating head wounds, I understand that thanks to the work of my team, neurosurgeons, thanks to the work of Mechnikov Hospital, like with our general director,

00:31:17 [UKR] we are able to save them. [UKR] And from this time, I remember when the war just began, [UKR] the general director gathered all of us department heads [UKR] and said that our task is to do everything so that people survive. [UKR] This was truly the truth. [UKR] Then there wasn't yet such a load as now. [UKR] But then, this was '14, I remember even my first wounded person, [UKR] I operated, I'm friends with him now on Facebook. [UKR] Extremely severe brain wound, amputated limb, [UKR] multiple wounds of the chest cavity, abdominal cavity, [UKR] Dmytro Kraslianskyi, he miraculously survived.

00:32:03 [UKR] This was May 9, 2014, many operations, [UKR] then rehabilitation in Germany. [UKR] This is such a wound. I remembered, I remembered a photo when he got married, he was dancing a waltz on a prosthesis with his wife. [UKR] And I have this video saved. I understand that for the sake of such cases one must live. [UKR] And the first few weeks when the war began, we didn't know how to treat these brain wounds. [UKR] we didn't know. I quickly raised all the literature, starting from 1917. [UKR] World War I, World War II, Vietnam, Lebanon, Iraq, Afghanistan,

00:32:49 [UKR] North Caucasus, the first, second campaign of the North Caucasus. [UKR] Quickly read, rapidly read and saw that many moments are not disclosed.

00:33:00 [UKR] And people don't know how this needs to be treated. [UKR] We had experience treating severe traumatic brain injury, but this is traffic accidents, this is falling from height. [UKR] And we introduced the greatest experience in Ukraine with modern technologies that are now developing. [UKR] This is cranial pressure monitoring, another moment. [UKR] But brain wounds - whether bullet, whether mine-explosive, shrapnel wounds - we had no experience with this. [UKR] And therefore somewhere the first 40-50% of the first wounded I operated on personally. [UKR] How was it? Then helicopters still flew, then there was still such evacuation by helicopters. [UKR] And I understood that every evening work would end, I come home at 8 in the evening,

00:33:48 [UKR] and lie down to rest, lie down to sleep, because I know that somewhere at 10-11 there will be a phone call, [UKR] because either a plane or helicopter arrived at our Dnipropetrovsk airport - then it was still Dnipropetrovsk - [UKR] a plane arrived and these wounded are being rushed by ambulance to Mechnikov Hospital - then there was no curfew yet - [UKR] I knew that I have 2-3 hours to sleep because at 11 o'clock the call and I came here, there [UKR] In this blue room I had a complete set of bed linens, [UKR] to shave, brush teeth, because I knew that the operation might end at 5-6 in the morning, [UKR] and I no longer have sense to return home, I stayed here,

00:34:37 [UKR] shaved, brushed teeth, took a shower, and at 8 o'clock a new work day began. [UKR] This was truly such from 2014.

00:34:54 [RUS] From this everything began.

00:34:58 [UKR] And the first 40 operations I performed independently, and at this moment continued to teach the youth. [UKR] Then I assisted them. And when I saw that they themselves operate well, [UKR] I was already happy that they do these operations very well. [UKR] And we have such a cycle - we say, do, analyze, if something is wrong, change tactics, do again. [UKR] And such a cycle constantly, and when already 2,500 of these operations, we honed to the point that my colleagues do operations very quickly, [UKR] and with the best results. They operate better than anyone in the world, this I can tell you for sure. [UKR] Better than anyone in the world they operate. And that youth, they have already performed hundreds of those operations, that even in large clinics they cannot gather such a number of wounds in 10 years.

00:35:53 [UKR] But again I say, this is a component of many moments. First of all, this is such special leadership, that it's necessary to show by personal example, that you take complex cases, like neuro-oncology, neurotraumatology. [UKR] By personal example, that you not only operate, you also conduct scientific work, analyze, write articles, write books, participate in conferences, congresses, symposia, prepare the youth, your attitude toward patients, toward their relatives. This is also very important, it's necessary to respect people. [UKR] This is work in the team of Mechnikov Hospital. I respect, all department heads respect me, doctor centers, because 65% are combined wounds, when not only the head. This is also limbs, this is also the torso, this is also the face, this is also eyes. We work together.

00:36:54 [UKR] We have very close interaction with our anesthesiologists, very close interaction. That is, these characteristics - work in a team, and also work at Mechnikov Hospital - this is very costly. Why? Because, for example, I remember 2014, when I didn't have a microscope. [UKR] Now we have three microscopes standing. Before there wasn't a single microscope. [UKR] And I say to the general director Serhiy Anatoliyovych, I need a microscope. [UKR] We started to collect funds, but we're collecting them, well, we collected 100 thousand hryvnias. [UKR] But we were told that it costs 150 thousand euros. [UKR] And Serhiy Anatoliyovych says, I have an acquaintance, one of the leaders of a chain in Dnipro.

00:37:40 [UKR] And he said that he would make me a helicopter pad on the 9th floor of Mechnikov Hospital and buy me my own helicopter. [UKR] And Serhiy Ryzhenko says, but I don't need a helicopter, I need a modern microscope. [UKR] And he turned to me - Andriy Hryhorovych, which microscope do you need - I said. [UKR] And he himself went to Germany, chose this microscope, it cost, I'll say right away, two times cheaper. [UKR] It needed to be assembled there for 3-4 months, I didn't think that in a month it would arrive from Germany. [UKR] And this microscope, Opmi Vario 700, Carl Zeiss, Viktor Karachun, this is ATB Market, thanks to him we worked on it for these almost 10 years.

00:38:32 [UKR] We bought bulbs with our own hard-earned money, because they're designed for 500 hours, but thanks to this microscope we saved so many lives - both civilian and military wounded, and with tumors. [UKR] Then appeared a microscope which the Ministry of Health bought for us, thanks to Minister Viktor Liashko. [UKR] And now in microscopes we also have Mitaka - this is a gift from the people of Japan. [UKR] We have three operating rooms, and all these microscopes are engaged. [UKR] And the fact that we were the first, perhaps in the world, to introduce into practice, [UKR] we not only operate tumors under microscope, [UKR] we in complex cases of craniocerebral wounds operate under microscope.

00:39:17 [UKR] Doctors invite, indeed foreign clinics invite to come, but I said, while the war is going on, I think after the war it will be even better. [UKR] I stay here, stay together with my family, with my wife, with my older and younger son. And this is truly an example, because the nurses, when there's shelling, we all hide in the corridor, [UKR] Sometimes they run and cry. They're shaking like this, they're scared, and I calm them. [UKR] I say, there, for example, Tanya or Yulia. Do you see the department head crying? No. [UKR] Well, calm down, everything is fine, now it will end, we'll continue our work. [UKR] And it truly works. When they see that the department head never left, he stayed in place,

00:40:06 [UKR] that he works and work goes on. You saw what severe patients we have, no one cries. [UKR] No one cries, they all hold on, and truly I'm proud of the team of my doctors, nurses, junior nurses, [UKR] because I consider that they're the best. This is so. [UKR] Ted asked and mentioned about a cardiac surgeon from New York, Mike DeBakey. [UKR] He was talking with you about this yesterday and today during lunch, that that surgeon said that when he was not in New York, where is this whole main center of cardiac surgery, this gave him more of some opportunity to work a bit differently than others. [UKR] and to find some of his own methods there. [UKR] You just said that you also do [UKR] complex operations under microscope, [UKR] those which usually aren't done, right? [UKR] And Ted wanted to find out, [UKR] is this something only yours, [UKR] that you do, [UKR] or is this some general policy of the hospital, [UKR] because this is, for example, Dnipro, [UKR] and not Kyiv, and this gives more opportunity [UKR] to be a bit more inventive.

00:41:18 [UKR] Michael DeBakey, I know, I read about this famous vascular surgeon, indeed I read many books on surgery, how operations on the heart were performed, how transplantation was performed, the first heart.

00:41:30 [UKR] And indeed I admire the history of medicine, when someone first did surgical interventions. [UKR] And we talked yesterday, when there was no light, with Oleksandr Volodko, we remembered last year we watched in English the TV series The Knick, Knickerbocker Hospital, this is 1907 in New York, when you watch and see yourself in the image of that doctor, surgeon, who then did those surgical interventions. [UKR] And we said then with Oleksandr that now you can with ChatGPT or internet find any article and read this article. [UKR] Earlier this wasn't there, it was necessary only from Europe to receive this journal and read.

00:42:15 [UKR] On one hand, when you encounter a problem and you don't know how to solve it, you looked in the literature, but there's no solution to this question. [UKR] First of all, you must study all the literature. [UKR] Perhaps, before you someone already found this solution, and you don't need to reinvent this wheel. [UKR] But many such solutions, especially in the treatment of brain wounds, they were encountered for the first time. [UKR] Many such wounds previously weren't described at all. [UKR] And when you encounter this, you already have some baggage of knowledge quite large. [UKR] and you studied all the literature, you have experience of more than five - I counted two years ago - more than five thousand operations,

00:43:02 [UKR] you can already propose something of your own. [UKR] For this you, first, must have the level of highest category, doctor of sciences, professor, [UKR] and second, you must be head of department, that is, you make the decision, you're responsible for it. [UKR] You make the decision, you're responsible for it. [UKR] And you yourself must perform this operation. [UKR] If you performed it, and the person there has complications or died, you answer.

00:43:30 [UKR] But this is such a path of all, like such pioneers, who go first. [UKR] When they did this operation, everything worked out, did a second, third, fourth, fifth, [UKR] and then colleagues begin to do it, then we tell, [UKR] and these operations begin to be done in other clinics. [UKR] It's said that this was already long ago, and this, well, like, and today there was a conference, at this conference I hear, there, the methodology of early definitive surgery was proposed, there, in maxillofacial surgery, ophthalmology, [UKR] Although we were the first to prove that this methodology works. [UKR] When we see photographs from our book, [UKR] the one which I, they simply insert them, [UKR] we don't have such, how to say, plagiarism, [UKR] I relate to this very calmly, [UKR] but I see that this helped a person

00:44:24 [UKR] to study these illustrations, stages of operation [UKR] and do so that the person survived. [UKR] Super. Therefore, I never chase glory. It catches up on its own, but indeed it's very difficult the first time to make a decision. [UKR] You don't sleep, you think all night how to do better, when there's time. [UKR] With wounds, as a rule, there's no time for this. [UKR] And I want to say that I was lucky to work together with the endovascular team, with the endovascular center, [UKR] where we went today, where doctors operate through vessels. [UKR] Because many patients with head wounds require precisely combined operations. [UKR] Both such operations and open operations. [UKR] In Ukraine this doesn't exist. [UKR] In the world there it's even difficult to count on one hand centers where they can do this.

00:45:16 [UKR] And the team of Yuriy Vitaliyovych Cherednichenko, Vadym Perepelytsia, Andriy Miroshnychenko, and the fact that we work with them allows us to do unique things. [UKR] And plus, thanks to the help of American colleagues, Rostyslav Malyi, Oleksandr, they and we have what to work with. [UKR] Like today they closed an aneurysm, there the cost of this stent is there thousands of dollars. [UKR] If in hryvnias there are hundreds, 200-300 thousand hryvnias, these devices cost. [UKR] But thanks to this help we can save these wounded. [UKR] And wounded from all of Ukraine, military especially, who don't have these consumables, they're directed to Mechnikov Hospital.

00:46:02 [UKR] And our such position, I said, since '14, and the position of our general director, [UKR] He says: "We must help everyone." [UKR] And then, when it was necessary to have a microscope, I turned to the general director, he found a microscope. [UKR] I say: "Serhiy Anatoliyovych, we need another microscope." [UKR] He turned to the Minister of Health, we have a microscope. [UKR] "Serhiy Anatoliyovych, we need a good ventilator." [UKR] He found it.

00:46:30 [UKR] "And we need an MRI, one and a half Tesla, please." [UKR] At a modern level three Tesla is needed. And he connects all his acquaintances, all his contacts. [UKR] Regional council, regional civil administration, Ministry of Health, volunteers. [UKR] And they help us. Because the hospital, I already reported today at the Congress of military surgeons-anesthesiologists, accepted more than 50 thousand wounded, injured from Eastern Ukraine.

00:47:00 [UKR] starting from 2014, more than 50 thousand, and these 50 thousand need to be operated on. [UKR] And yesterday was the head of medical service with a brain tumor, [UKR] and he asks me, Andriy Hryhorovych, and how much will this cost, the operation? [UKR] I say, believe me, not only you, as head of medical service, [UKR] every service member receives free treatment from us. [UKR] How do we do this? This is already our question. That is, we, for example, titanium plates to do skull defect repair, looked for volunteers. [UKR] Many volunteers, both Tetyana Huba and everyone bought us titanium plates, screws. Then, as they say, they ran out of breath, because this is very much.

00:47:48 [UKR] There were times that we bought titanium plates, titanium screws with our own wallet. [UKR] Even neighbors in my building live, they say, Andriy Hryhorovych, we want to help. We collected money. Some bought diapers, I brought to the department. Others say, and we want to help. What operations do you do? I say, repairs. If we want to buy titanium screws, let's, we'll give you money. No need to give me money. I'll order, an invoice will come, you'll pay it, and we'll install titanium plate screws. [UKR] Only a week or two ago the hospital received these titanium plates, screws centrally. But until this we looked for ways so that people, military - these are our defenders, our heroes - so that they wouldn't pay money. And this is both for wounds and for brain tumors.

00:48:35 [UKR] Many brain tumors in service members, unfortunately, are discovered, both in the Armed Forces, and Security Service of Ukraine, and National Guard, they come, and we operate on brain tumors. [UKR] We operate for free, because we know that these are our hero people. [UKR] The maximum that I have as a fee is grenade launchers, these are shell casings, this is such weaponry. [UKR] They're already fired, but if they were not fired, I would have to make a declaration, [UKR] because the quantity of this equipment - they bring me downed Shaheds. [UKR] I say, where is this Shahed? Bohdan says, can I take it? [UKR] Take this Shahed, you'll have it at home. They bring me Mavics. In the neighboring office there's a Mavic, a working Mavic. These are gifts. Such a gift I'll take. Indeed, these, they say, with a dear soul. These are either the patients themselves or their relatives. Before the war these were gifts of icons. Icons you see in my office in the cabinet. Most of them are either embroidered with beads. This is handmade.

00:49:43 [UKR] Either the patients themselves made them, or their relatives then went to church, consecrated and brought to me - many icons both at home, many icons here. [UKR] Therefore, this is more than gratitude, because thanks to this I feel that I have support from somewhere above. [UKR] And this supports not only me, supports my family, my children, gives us strength, health to work. [UKR] Therefore, this is more than simply, as they say, handicrafts, that you do something with your hands - no, this is more, this is your message. [UKR] And as Oleksandr said today, on rounds in the ward we operated on a woman, complex tumor, [UKR] And the daughter, she already has three grandchildren and two great-grandchildren, she thanked, said, thank you for your golden hands.

00:50:39 [UKR] And Oleksandr says, this is thanks to the fact that the women confirm his words - God through your hands gives people life, gives people hope. [UKR] A few more questions, literally, we're almost finishing. What we noticed, and I personally, because I listened to your consultations actively - you for each person find your own approach, your own words, your own jokes, your own explanations, and with this you explain everything very simply to people, can even calm them when needed. [UKR] How do you do this? How do you find this something professional that over the years you do? [UKR] How does this happen with you and why is this possible? [UKR] Well, first, such a number of consultations, as you see, if there are more than 5 thousand operations, then consultations there are 20 thousand.

00:51:35 [UKR] I calculated that if 1,400 patients were treated in the department per year, and now 2,300, then even if we take on average 2,000, then over 25 years this is already 50 thousand patients passed through. [UKR] And on rounds I see each patient, and each patient, their information gets into my head. [UKR] I already said, as if in my head, like artificial intelligence. [UKR] If I see some picture, it analyzes and immediately gives me an answer, because I've already seen this. [UKR] Moreover, we now have chats, and in these chats all information is dropped: CT, MRI, before operation, after operation. [UKR] Therefore, when a person enters, I scan them immediately, like such a psychologist, I understand in what mood they came,

00:52:21 [UKR] How they relate to themselves, to their illness, how they relate to doctors, how they relate to me. Perhaps there they waited in line 2-3 hours, and they're already nervous, they need to go home. Need to immediately scan, understand. [UKR] And after this, you know, you don't even need to talk very much, sometimes two-three sentences, and you see the corresponding reaction of the person, you start to talk with them, how they answer to your first question, you understand in what key you need to go further. [UKR] This comes with experience, with years, and sometimes my colleagues, I sit them down, I say, learn, especially learn to talk with patients, with their relatives before the operation.

00:53:10 [UKR] The more time you spend before the operation with the patient, the better it will be if the operation ends with some complication or, God forbid, a fatal outcome. [UKR] It's necessary before the operation not to spare time, tell everything, say - ask more questions, and what other relatives do you have, let them come. [UKR] Because there were such situations, not often, there, in units, but when I have such a flow every day - operations, operations, operations, I operate on a complex tumor, fifth category of complexity, and I ask the doctor, the attending physician. [UKR] Did you talk with the relatives? No, we thought that you talked. [UKR] I say: "Well, you're so confident in me that there will be a good result of the operation, but you know that there can be such-and-such complications.

00:53:58 [UKR] Let's make this a rule." [UKR] A young doctor came. [UKR] Before the operation a day before, mandatory. [UKR] Here the patient sits with me, the relative. [UKR] I tell them the operation plan, complications, everything. [UKR] And they ask questions. [UKR] Then, even if a person dies after the operation, there will be much fewer questions. [UKR] Indeed, people die. [UKR] If you take, per year I operate only on tumors - 180-186 brain tumors, of this quantity 1-2-3 each year differently die.

00:54:30 [UKR] Not always this is from the neurosurgical operation. Sometimes this is pneumonia, an old man, sometimes this is pulmonary embolism, sometimes even coronavirus. [UKR] If this person dies during the first month after the operation, this is counted as postoperative lethality, [UKR] this is not necessary that this was hemorrhage, incomplete tumor removal, or ischemic stroke, or damage to some critical structures, [UKR] but these cases exist, and these are the most difficult cases, therefore over the years it's difficult for me to go to the morgue, to pathology. [UKR] Although I understand that after operations it's necessary to go, if a person died, to autopsy, but over the years this becomes more difficult. [UKR] And even more difficult this concerns planned operations. If we talk about cases of head wounds, this is very difficult.

00:55:24 [UKR] Why? Because every day, my work day, begins with rounds of the intensive care, called the combat block.

00:55:30 [UKR] there where wounded heroes lie, wounded fighters. [UKR] I every day see severely wounded fighters, [UKR] most of them the same age as my older son. [UKR] And in part of the cases I understand that despite the fact that we did everything,

00:00:00 Sorry about that. Sorry about that. Okay, so I wrote you a long note of what I wanted to have and make sure we got most of Can you do part of it on Friday? Sure. Sure, yeah. Because he talked a lot about your... Because he talked a lot about your... Yeah, I was wondering, like, never mind. I don't know if we... Yes, we can do it Friday there. I was just writing things that I wanted to make sure he might have talked about while you were going.

00:00:54 So it's... Thank you. We should get back to where we were and just do, you know, one or two more questions, okay? I will ask some of the last questions. Maybe, as a rest of the weekend, ask some of the time. Because part of this is covered for sure. Okay, great. I thought so. I wasn't just...

00:01:40 Let's return. What does it mean to you as a person from Ukraine? Right now, especially when a person who carries such an honorable mission and calls themselves Ukrainian, in a terrorist country, the Russia Federation, this evokes a desire to destroy that person. Simply destroy, kill, wipe off the face of the earth. [VO CANDIDATE] You understand even more how important it is to preserve this, to preserve your identity, and so that your children are Ukrainian, and most importantly, live in a free, independent, sovereign state. [VO CANDIDATE]

00:02:29 This is very important. And I feel this especially when I went to the Congress together with my team, with General Director Serhiy Vyzhenko to Vienna. We all took pride in the fact that, first of all, I always try to wear something, that shows that I am Ukrainian. It's either the shirt color of my tie, or a tie where there are flags of Ukraine, or it says "I am Ukrainian," or a Cossack is drawn. When people see me, they immediately start looking to see where it says Ukraine. I am proud, I show even more that I am from Ukraine. That's first. Second, we talk about Ukraine, we show maps of Ukraine,

00:03:19 here is Mechnikov Hospital, Dnipro, We show videos of the atrocities of the Russians, how they bombed the maternity hospital in Mariupol.

00:03:30 I remember now how Diana, 23 years old, died, and another girl, 27 years old, was brought to Mechnikov Hospital. We performed her angiography, I operated on her while she was pregnant with my team. I remember that conversation, the next day, the general director and I came to the polytrauma intensive care unit, And she says, thank you, thank you, you saved two lives, you saved my life and the life of my child. [VO CANDIDATE] This video I show to everyone. I show a video where a wounded fighter on the fifth day, his right side is paralyzed, he can't speak, but with his left hand on a tablet he writes "Glory to Ukraine!" [VO CANDIDATE] He misses the second letter "L," gets a little nervous, he realizes he missed a letter, but he writes "Glory to Ukraine!" [VO CANDIDATE]

00:04:18 And truly tears appear in my eyes. I show all of this. They give me 15 minutes for the presentation. For 5 minutes I talk about Ukraine, I show the atrocities of the Russians and I show the final slide with Churchill's words. [INAUDIBLE] And after these words people stand up and give a standing ovation. [VO CANDIDATE] This is what it means to be Ukrainian. [VO CANDIDATE] And I always carry with me, I even paid extra for a 50-kilogram suitcase,

00:05:00 in order to take flags with me, and also to take Petrykivka paintings. I speak from the stage at the end. This is a gift to the professor who invited me. And a plate, a large plate, about 40-50 cm, and there was a map of Ukraine painted on it. On this map of Ukraine there is Crimea, and Donetsk, and Luhansk regions, they are there. And the whole world sees that this is Ukraine, it is indivisible, in any case these borders will be preserved. [VO CANDIDATE] I give them a flag, a flag with the trident, and we unfold this flag. This was the first time at the Congress of European Neurosurgeons in Vienna, the flag unfolded and a photograph across the entire stage.

00:05:53 There is the same photo from the Congress of Neurological Surgeons in Los Angeles. Together with Alex Valadka, Rocco Armonda, Gregory Gavrylyuk, also a native Ukrainian, Randy Bell, we unfolded this flag and we showed it. And such pride fills me that we gave a flag to Rocco Armonda at one of my presentations. This was given to him by the Security Service of Ukraine, the special Alpha sector. These are the ones who created and implemented the operation "Pautina" - "Spider Web" And it is written on this "Spider Web" - life to the fatherland, honor to no one

00:06:44 And I translate for them "The life to motherland," "honor," "no one." This is what it means to be Ukrainian. [VO CANDIDATE] What could the world learn from Ukraine and why do people need to care about and think about Ukraine now? Learn, learn a lot. Being Ukrainian, I have been to Europe, I have been to the USA, I have never seen such respect, such attitude. I'll say this, that I was, for example, in Los Angeles, I was scared to walk the streets in the evening.

00:07:29 They warned me, the sun sets, stay in the hotel, it's really like that. In Ukraine, even during the war, a girl can calmly walk down the street at 9, 10, 11 at night, alone in the evening. We don't have such areas where you can go here but not there. There is risk, but Americans tell me, Andriy Grigoryevich, we come to you, our wives tell us, stay in the hotel, don't leave the hotel, you'll be killed, kidnapped, shot. We spent time with you? No, it's scarier for us. Our world is more frightening than yours, even during the war. [VO CANDIDATE] This is why we need to learn to respect each other. Yes, we have traffic violations and road accidents, but war brings out the best in a person.

00:08:19 the level of mortality decreases, that is, these violations of law and order, and from all this the best qualities of a person are forged. This is what we should learn. It is first of all to be human. And you ask, why should people care about Ukraine. For Ukraine, I think, you don't need to worry. Ukraine will endure. [VO CANDIDATE] Europeans and European countries need to learn to worry about themselves. Why? Because we are the dam that holds back the onslaught of water. The onslaught, in reality this is terror, sadism, genocide, of the Russians, a dam. [VO CANDIDATE]

00:09:05 And this is Ukraine. If Ukraine is broken through, next will be Europe. Europe will simply be washed away. They are not ready for war. [VO CANDIDATE] not completely ready, and the United States is not ready for war. And this is what Rocco Armonda says. In every one of his presentations he says, learn while there is time, we are not ready for war. This war could be with anyone, with China, with other countries. There could be a war, but if we have to fight, we are not ready, we must use this time to prepare. Therefore they need to fear not for Ukraine, but for themselves. [VO CANDIDATE] And understand that if they don't help Ukraine now, then no one will help them. [VO CANDIDATE] They will simply be washed away. [VO CANDIDATE] Washed away. [VO CANDIDATE] And therefore the hybrid war that has already begun, it is already happening. And Poland, Lithuania, Latvia, all these countries, drones are flying into them drones, they violate the airspace, they are simply testing. And what will the response be? If there is no response, next there will be escalation. We will do even worse, we will do even worse. Therefore, I think, that everything will be Ukraine, And what I wanted to say is that actually Rocco Armonda was the first who opened a window to Dnipro, to Mechnikov Hospital, specifically to our neurosurgery department.

00:10:23 A neurosurgeon who was not afraid, came here to us together with his assistant Ivan Bezkaravaynyy. He came with a walkie-talkie, they are military people, they tell us, we brought a walkie-talkie. For what? In order to communicate at the airport, so that we don't worry that we might get lost. When they came, they gave these walkie-talkies to my older and younger sons, and they play war outside the city. They run around and communicate with each other via walkie-talkie, and I want these walkie-talkies to only be needed in peacetime. [VO CANDIDATE] But they come, they help with a lot of consumables, instruments, technologies, but most importantly - their support. When they are present at our operational meetings, and my nurses and doctors see that the Americans are not afraid of shelling, not afraid of rockets, Shaheds, they came here, they are with us, they understand that the world has not abandoned them. [VO CANDIDATE]

00:11:22 People from far-away America, professors, neurosurgeons, one department head and another department head, they spend their vacation and their own money to spend this vacation, in quotes vacation, at Mechnikov Hospital, together with us in the operating rooms, in intensive care units, saving heroes. [VO CANDIDATE]

00:00:00 We need to make this crossing happen, people come and they show by their example how to help properly

00:00:00 We need to make this crossing happen, people come and they show by their example how to help properly There are a whole million questions but we'll be wrapping up now and probably continue on Friday so that we Don't keep them waiting any longer, people are waiting for us there, and on Friday when are you planning, well not here Maybe at your home when you and Alex are already back home, I mean just on Friday Alex and I will still After the operation we leave immediately, we said, around 4-5 o'clock, we head home and there we can continue the interview, maybe Tadeusz will have questions for my wife too, she'll also be happy to share. And I have shrapnel lying there at home, just ask, I'll get it and tell you something. - Yes, I immediately want to ask you, please tell me about those shrapnel pieces and also about this statuette that's on your desk.

00:01:02 This is a gift from Professor Rock Romond. It's such a monument. You could say it's symbolic. This is possibly an illustration of one of the first cases when help is being given to a wounded person, providing assistance and establishing intravenous access for infusion. But he can't find a place to hang the bottle, so he sticks his rifle in the ground, and the bottle with saline solution is hung on the rifle, and this solution flows into the vein. Now I'll read what's written here. And it's truly a gift, it stands here with me, and it inspires me.

00:01:53 So here it says limited edition military collection combat medic memorial combat medic mirror 2001 year number 390 of 5000 original San Antonio there are such memorials. And I also have a smaller one. But here Benjamin Franklin said. Benjamin Franklin. I'll show you. Benjamin Franklin. And this is our team's motto. Our team is Rock, Alex and me, Andriy Sirko. It says here Is the right something worth reading? "Or, do something worth reading"

00:02:46 That is, either write something worth reading, or do something worth writing about. This is our motto, we follow it, this motto, I repeat, once again, I like it: "Azere, write something worth reading, or do something worth reading" Benjamin Franklin. This is such a pen, so that I write and continue writing the article.

00:03:41 Yes. this is also from Rocco Armonde, Walter Reed, Andrey Sirko, magnificent doctor from Rocco Armonde I would like to show you this Russian fragment, metallic fragment, metallic splinter. You can see different types of metals. Of course, fragment. And if Ukrainian, these are metal shrapnel removed from the brains of our heroes. Removed metal shrapnel, such shrapnel, here are such shrapnel and bullets.

00:04:33 Out of 100 wounded, 4 are gunshot wounds, and 96 are shrapnel wounds. And the paradox is that the people who were wounded by such shrapnel, they survived. But there are wounds from such a small fragment, but it ruptures an important vessel, and the person will die. So this is a collection that my doctors and I removed over three months. These are shrapnel from the racists. And even parts of their shells that flew into the head.

00:05:19 That's all, all for that. Do you think you got it with that? Do you want like the close-up? No, I mean, wasn't there one where one patient didn't make it that there was a small one or something? Yes. You already got it? He said that? Yes, he said that. Okay. Do you want to get that one? Yes. All these are from... These are not from one person that we removed. The paradox is that such large ones, it happens, fly at low speed.

00:06:09 And you know that energy is MV squared divided by 2. Mass, velocity squared divided by 2. And there are shrapnel like this, its length is 7 centimeters, this one measures 7.5 centimeters, this one is about 7 centimeters, but with such shrapnel they are removed and people survive.

00:06:56 They survive. And on the other hand, such a small fragment can be fatal. Bullets are especially dangerous because they fly at very high speed. 500, 600, 700 meters per second, and these bullets are deadly, fatal. This is what was removed from the brain, and these are just gifts for me, gifts, from soldiers

00:07:47 it's a weapon, it's a bullet 5.42, 7.62 caliber it's from brain hour soldiers and this from gift from soldiers We also operate not only our soldiers, we also operate Russian soldiers. I was gonna ask you about that. Maybe tomorrow, yeah. I have one question, Andre, if you didn't already answer when you were explaining this. Why do you keep these? Why do you keep these? Why I keep them, because it's sometimes easier for me to tell people about the mechanism of injury, when I'm explaining to the patient's relatives, I show you that such a small bullet is large 1600-1700 meters per second,

00:08:54 And behind it follows a cavitation wave, which creates an additional expanding cavity and leads to injury of the surrounding vessels, brain structures. I have a skull, and I take this skull, from this skull I take out the brain, and then I tell people, to visually show, to explain where which structures are located, important brain structures, less important structures. And a person who doesn't even understand anatomy, physiology, they can imagine, they ask, what structure of the brain is damaged.

00:09:30 I say: "This one, and what is it responsible for? I explain what it's responsible for." So this is very useful in everyday work. And I also test my interns for speed, so they can quickly assemble this model. If they can't assemble it, I say: "Go study anatomy." - I say: "With a real brain, the real thing, it's easier." - But this is also emotional memory, right? - Of course, yes. And this is emotional memory. I remember all the patients, their wounds, the CT scans.

00:10:18 If you remind me, I'll show you a drone tomorrow. Teddy, if you remember me, today I'm showing my FPV drone, and I remember that I mean 3 minutes after President Zelensky gave me my award. It's music, very musical, and it's like you, the screenwriter, producer, are making this video. Oh, yes. Or Nastya will remind me. Yes. When people come, they trust: "Andriy Grigorievich, you will do everything right, all of this." I say: "I can't do it any other way, that's it." Because I'm a national legend. How can a national legend do something wrong? It's a responsibility. When I show the video, they sit like this, I say: "And this is my wife, and this is my son in the video."

00:11:09 They're sitting in the Mariinsky Palace, in the audience. Svyatoslav is sitting in a vyshyvanka. This is worth seeing. I will write it. I have a lot of people in my head that I have to write. What did you tell me? If you haven't filmed yet or if now is a good time, please film these icons in the section and also in this corner. But I think we should probably do that with the Ronin, right? Or you should do like a B-roll pass? Yeah, like I think, you know, all the Deboar, then like every little thing. You know, macrolins? Yeah, I don't know if you have any macrolins. I do, I brought some diopters. Yeah.

00:12:01 Look, look, look. Here, I will trade out your mic.

00:00:00 You really get go back to sleep

00:00:21 Yeah, I didn't take any I was thinking I probably should have records yes, I'm gonna take them back down No, you need to check out on the 2nd. You need to check out and then check back in. Potentially there's a good shot of the sunrise from my loft. Because you could hear the trolley and see the park. Yeah.

00:01:19 Or would you rather be in a room like the 9-minute where it's all on one floor?

00:01:30 Yeah, I like that, I saw the way you had everything organized out here. Yeah, and by a type of item. When we begin talk, I ask you silence complete at least 30 minutes, okay?

00:01:50 Yeah, no, we're actually gonna set this and get out of here and close the door.

00:01:54 Yeah, yeah. So we won't be here. Well, actually, that's right, that's how I apply it. No, no, so this has a shot of both of you. Yeah. And if we can get a copy of the zoom, then like we have this and that and we'll be good. So we'll get out of your way. Oh, I'm not like moving around and stuff while you guys are trying to... that way i'm not like moving around trying to shoot the screen while you guys are trying to present it's going to be kind of annoying for you guys yeah this one all right do you want me uh we're not going to come back in until you're done

00:02:41 it's maybe open. In corridor will be a lot of different voices, crowd.

00:02:48 We're not, we're gonna go change. I said it so you can close the door. Yeah, good luck. Thank you. Looks good. Thank you. - Sure, sir.

00:03:32 Okay. Sit down, please.

00:04:56 Welcome Andreas, we will quickly, fast, that's why he has an interval between our section. It's almost done.

00:05:45 It's a honor for me to have the first presentation in this meeting. This meeting will continue two days, today and tomorrow. That's why it's a very important talk.

00:06:03 I am proud to keep this talk to Gazerysio.

00:06:49 I'll get the third of the subcruciating tower.

00:07:31 exactly on time before 25 seconds

00:08:09 [UKR] Dear colleagues, we continue our congress and for the first presentation I invite with great pleasure [UKR] and we begin the section "Combat Neurosurgical Trauma" esteemed Serhiy Hryhorovych [UKR] with a group of authors from Mechnikov Hospital, Dnipro city, Ryzhenko Serhiy Anatoliyovych, Tolubayev [UKR] Yuriy Yuriyovych, topic of the presentation: new frontiers in neurosurgical treatment of severe penetrating craniocerebral injuries in wartime, effectiveness of military-civilian cooperation. [UKR] Esteemed Konstantyn Vitaliyovych, dear colleagues, can you hear me well?

00:23:56 [UKR] Together to victory, Glory to Ukraine and thank you for your attention. [VO CANDIDATE] [UKR] Andrey Hryhorovych, thank you very much for a very substantive professional presentation.

00:39:23 [UKR] Patients arrive already with working arterial pressure invasive monitoring access. Thank you, I thank Konstantyn Vitaliyovych, all your colleagues, the military medical leadership, as well as our American colleagues and other foreign colleagues who support us in this difficult time. Glory to Ukraine and together to victory! [VO CANDIDATE] [UKR] Glory to the Heroes. Dear Andrey Hryhorovych, thank you very much for your many years of such difficult work saving our wounded. [UKR] And pass sincere greetings to Alex Valadka next to you, pass greetings to Rocco Armonda, to leader Serhiy Anatoliyovych Ryzhenko and Oleksandr Mykolayovych Tolubayev. [UKR] Thank you! [UKR] Dear colleagues, we continue our session and for the next presentation I invite Bihlychenko Serhiy Ivanovych with the presentation topic gunshot injury of the spine and spinal cord. Current issues. National Military Medical Clinical Center, Kyiv.

00:40:26 [UKR] Good day. Thank you all for the opportunity to speak at this conference. Andrey Hryhorovych, very interesting, interesting in your presentation, truly emphasizes the relevance of gunshot wounds in neurosurgery. [UKR] And in my presentation this is gunshot injuries of the spine and spinal cord, current issues.

00:41:00 [UKR] According to foreign statistics, during combat operations in Iraq and Afghanistan between 2003 and 2008, [UKR] Spinal injuries were in 56% from explosives, 15% from secondary projectiles,

00:41:20 [UKR] and 20% caused by motor vehicle accidents.

00:41:26 [UKR] In the mechanism of spine injury, which was explosive,

00:41:31 [UKR] [INAUDIBLE]

00:41:38 I'll go find them. I'll recover my grades. A is the best. A, B, C, U, A+

00:42:05 [RUS] Yes, now we can have coffee. [RUS] - Did it switch?

00:42:21 [UKR] - Yes, Serhii Ivanovych, it came through.

00:42:30 [RUS] Did it switch? [RUS] It switched, just continue.

00:42:35 [UKR] So, penetrating wounds were 30%, blind wounds were 80%, and tangential wounds were 20%. [UKR] What I should note is that in 78% these were combined injuries. [UKR] By departments: thoracic section 38%, lumbar-sacral section 41%, and cervical section 21%. [UKR] Without neurological disorders only 15%. [UKR] By the nature of spinal sections, these are injuries to the cervical, thoracic, lumbar, sacral sections and combinations of several spinal sections. [UKR] Under gunshot damage development from gunshot wounds - types of gunshot weapons.

00:43:24 [UKR] These can be bullet, shot, and shrapnel wounds. [UKR] Under the characteristics of gunshot injuries, first of all is the direct damaging effect of bullets and primary fragments. [UKR] Also after the action of the primary projectile, spinal cord trauma is supplemented by secondary trauma, bone fragments, and hydrodynamic shock. [UKR] From the classification, penetrating, non-penetrating, and paravertebral injuries are distinguished, [UKR] by mechanism of injury: through-and-through, blind, tangential, [UKR] and depending on neurological symptoms,

00:44:00 [UKR] with complete conduction disruption, partial disruption, and without neurological symptoms. [UKR] I distinguish four types - this is rupture and complete transection of the spinal cord, [UKR] spinal cord contusion, development of lesions and ischemic infarction, and spinal cord concussion. [UKR] And here's a clinical example of a penetrating wound, where we see projectile located inside the spinal canal. [UKR] And an example of a non-penetrating paravertebral injury, where the metal fragment stopped paravertebrally. [UKR] The degree of bone structure damage can range from minimal to significant with defects of vertebral bodies.

00:44:57 [UKR] Diagnosis of spinal injuries. During visual examination, considering that in most cases these are combined injuries, where full evaluation is impossible due to concomitant injuries. [UKR] So, first is visual assessment, with suspicion based on wound projection, suspected spinal injury.

00:45:30 [UKR] It's determined additionally, if neurological assessment is possible, the level can be determined using the scale. [UKR] It's also possible to perform X-ray, but this will not be sufficiently informative. [UKR] The most informative is computed tomography, which allows determining the adequate level of injury, [UKR] the wound channel passage and the degree of bone structure damage. [UKR] Indications for surgical treatment of spinal injuries - penetrating injuries of the spine and spinal cord, [UKR] accompanied by CSF leakage and spinal injuries with spinal cord compression,

00:46:17 [UKR] bone fragments, blind injuries of spine and spinal cord, [UKR] unstable spinal injuries, presence of foreign body with compression of nerve and spinal structures. [UKR] In what cases should surgical intervention be delayed? [UKR] This is severe general condition of the patient, traumatic shock, severe combined spinal injury, spinal cord, internal organs, [UKR] trophic-paralytic and uroseptic disorders, sepsis, pneumonia, severe intoxication. [UKR] Surgical interventions for combined injuries should be performed after partial compensation of the patient's general condition, [UKR] after surgical interventions aimed at maintaining vital functions, [UKR] stopping bleeding, drainage, cavity closure and others, but do not delay surgical intervention

00:47:04 [UKR] until full compensation due to rapid development of septic and trophic disorders. [UKR] So, what are the main objectives in treatment? [UKR] Here we see on the slide two cases who received injuries, [UKR] and patients were not evacuated in time, were delayed up to two days,

00:47:29 [UKR] and in this condition patients arrived, we see already packed wounds,

00:47:37 [UKR] wounds, and there was no, I don't know what to do with it. [UKR] Therefore, the place and scope of care provision.

00:47:48 [RUS] The faster, first of all, they should be evacuated to the stage of specialized care. [RUS] September 3rd. [RUS] If you can't evacuate, that is, you can't evacuate. [RUS] Good.

00:48:05 [UKR] Good, Vitaliy. I wrote everything down. We will.

00:48:07 [RUS] Three hours with adequate therapy require stabilization of the condition.

00:48:17 [UKR] Mandatory is adequate surgical debridement of the gunshot wound with removal of all non-viable tissues and foreign bodies, [UKR] performing decompression of the spinal canal, removal of bone fragments, foreign bodies, necrotic tissues. [UKR] Most importantly is eliminating CSF leakage. [UKR] and performing spinal stabilization. [UKR] In our cases, observation only in 13% [UKR] where there were indications and possibility of performing spinal stabilization. [UKR] So, what methods of eliminating CSF leakage? [UKR] Suturing of ruptures and damage to the dura mater,

00:49:06 [UKR] defect closure with grafting material. [UKR] And on this slide we see small penetrating neck injuries at the level of, [UKR] this is the sixth vertebra, with presence of a small metal fragment, [UKR] adjacent to the spinal canal, decompression, [UKR] and the metal fragment was removed, [UKR] and using the "Hemopatch" preparation, wound closure was performed, [UKR] and additionally sealing was done with such preparation as "Hemopatch". [UKR] Suturing of the dura mater, and suturing of the proximal ends of the dural sac, [UKR] when there's complete rupture, nothing can be restored,

00:49:54 [UKR] and for sealing, for CSF leak prevention, suturing to the stump.

00:50:00 [RUS] Further on slides presented.

00:50:02 [UKR] And here are some of our clinical examples. [UKR] We see a through-and-through penetrating wound at the level of C6-7 [UKR] with rupture of the dura mater, [UKR] with severe damage to the spinal cord, [UKR] with significant damage to the posterior bone structures, [UKR] Decompression performed, removal of all bone fragments, revision of the spinal canal, removal of all non-viable tissue, washing of debris, [UKR] and restoration of integrity to prevent CSF leakage, hermetic suturing of the dural sac. [UKR] Next clinical example - this is penetrating wounds with hermetic suturing.

00:50:52 [RUS] This is entry and exit wound, small metal fragment, [RUS] passed through the foramen, and in the foraminal opening [RUS] stopped with point damage to the dura mater. [RUS] Through use of the operating microscope, through the small opening [RUS] with primary debridement of the gunshot wound, excision of damaged tissue

00:51:16 [UKR] We reached the foraminal area according to the report by Natalia Roz Horodovych,

00:51:23 [UKR] And [INAUDIBLE]

00:51:53 [UKR] Thank you [INAUDIBLE]

00:52:23 [RUS] In this case, fascia was taken and plasty of the dura mater was performed with fascia.

00:52:42 [UKR] - Anatomical example of gunshot wound with tangential thoracic injury, non-penetrating wound with gunshot fracture at level TH12, [UKR] with anatomical integrity disruption, spinal canal at level TH12, [UKR] the bullet passed through the spinal canal at level TH12,

00:53:01 [RUS] Filled with anatomical integrity restoration in places, [RUS] defect in him,

00:53:08 [UKR] vertebral damage, [UKR] intraoperative revision,

00:53:18 [RUS] all damaged tissue removed, [RUS] decompression. [RUS] In this case, there was no point in restoring,

00:53:26 [UKR] Spine under the dural sac - dural herniation before hermetic suturing [UKR] of the procedural section of the dural sac and transpedicular stabilization of the damaged spinal segment. [UKR] Another clinical example - gunshot through-and-through penetrating wound at level L4 [UKR] This is damage to the dura mater, cauda equina elements, in this case decompression, [UKR] laminectomy, removal of all bone fragments, transpedicular fixation and hermetic suturing of the dural sac.

00:54:16 [RUS] Next clinical conclusion - [INAUDIBLE]

00:54:41 [UKR] Decompression performed, i.e. removal of all bone fragments, hermetic suturing of the dural sac, [UKR] considering the nature of the wound, which may be contaminated with infectious complications, [UKR] in this case, at the first stage, transpedicular fixation is not performed. [UKR] This shows that it never passed through your areas. [UKR] Neither your selection passed, nor mine in the list. [UKR] In the middle of the sacrum with dural sac damage with presence of minimal accordingly.

00:55:27 [UKR] The treacherous nature of this wound is that attention can be drawn to a small wound,

00:55:34 [RUS] in the first week Aleksandr Ihor Aleksandrovna comes [RUS] to her place, that is, there are still single rooms. [RUS] We have two rooms occupied now by American neurosurgeons. [RUS] Two rooms. [RUS] In those rooms where other patients are staying, we cannot [RUS] move them out. [RUS] In the general ward we can give a spot. [RUS] We can say, today they stay in the general ward

00:56:00 [RUS] cerebral center and events, and tomorrow we'll transfer to a single

00:56:04 [RUS] vascular neurology room. [RUS] We want to establish the patient's position to give

00:56:12 [RUS] opportunity in full society. [RUS] Well, we'll put them in a general ward. [RUS] Yes, but first of all, that you won't then [RUS] transfer us, to a single room transfer with Tatiana [RUS] Aleksandrovna.

00:56:27 [UKR] Can you hear? [UKR] Can you hear? [UKR] Can you hear, she's not forgiving, stick to the schedule. [UKR] Ah, yes, processing of the surgical field, [UKR] all of them can be adequately processed when contaminated.

00:56:40 [UKR] Minimization of complications from excessive decompression [UKR] don't do without necessity. [UKR] During operations this is prevention of damage [UKR] drainage during spinal operations, drainage of the surgical wound for prevention of early treatment, [UKR] when managing wounds on the back and neck. [UKR] Surgical interventions should be performed only in specialized facilities, [UKR] surgical treatment, as conditionally shorter term, surgical treatment should be differentiated [UKR] and depends on the severity, form and type of wound. [UKR] Main objectives in spinal cord injuries - eliminating CSF leakage, removal of foreign bodies and necrotic tissue.

00:57:25 [UKR] Thank you for your attention. [UKR] Serhii Ivanovych, thank you also for your professional report.

00:57:30 [UKR] And before we proceed to our next session "Combat Surgical Trauma" of the maxillofacial region, [UKR] I want to emphasize for all speakers, please stick to the determined schedule.

00:57:42 [UKR] And I want to invite to the next presentation on the topic of specialized treatment of modern combat trauma in the maxillofacial region Kozlovskyi Serhii Mykolayovych and a group of authors from the National Military Medical Clinical Center of Kyiv and the Ukrainian Military Medical Academy. [UKR] Good day, dear colleagues. Can you hear me well? [UKR] Yes, all heard. [UKR] Good day, dear colleagues! From our team we want to greet the beginning of our congress, wish productive work, [UKR] further professional development, we wish health, goodness and our earliest victory. [UKR] For your attention, we present ready experience of maxillofacial surgery of the National Military Medical Clinical Center,

00:58:31 [UKR] where we will show our work, including the difficulties we encounter during this. [UKR] First, some statistical data. [UKR] In the general structure of medical losses, maxillofacial injuries we expect at the level of 4-4.5%. [UKR] What needs to be noted, that in the realities of full-scale war considering the nature of combat operations, [UKR] we have a significant increase in the percentage of severe combined blast injuries with maxillofacial component.

00:59:16 [UKR] According to our data, according to our clinic data, by cause of injury our statistical data is as follows, [UKR] Blast trauma is 60%, shrapnel wounds - 31%, bullet wounds - 8.5%, and non-gunshot combat trauma - 2.5%. [UKR] Of these, combined maxillofacial injuries - 84%, bullet - 11% and combined - 5%. [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data, [UKR] The structure of combat trauma, this is according to our clinic data,

00:00:00 [RUS] This is a huge problem. I'm happy that now he was spending his time in Kazakhstan.

00:00:00 [RUS] This is a huge problem. I'm happy that now he was spending his time in Kazakhstan. [RUS] Because if he was with me, he was not trained,

00:00:20 - Scared. Scared. Scared. Scared. Worry about and afraid the death is the youngest.

00:00:29 And we know the attack is finished and I wake up and go to work. - You have to get some sleep. I'm impressed that you can sleep there.

00:00:45 Oh, you sent that? Yeah, I sent information about our Congress to RUKO and translate to English. I see, okay. I am happy, I am very happy, that's why you can see it.

00:01:08 We see the front of the Pantolimono.

00:01:22 It's a craniofascial injury.

00:01:29 Is you already down there in the Univascular Center?

00:01:34 [UKR] - So, here's a combined injury and they gave this orbital complex.

00:00:00 that Alexander the Great and Jesus Christ both died.

00:00:00 that Alexander the Great and Jesus Christ both died. So you've got to get past 33. Well, that's also like... I don't know. What have I accomplished? All right, can I give her a call? Yeah, go for it. Can I get on speaker? Hey, how are you? I'm doing alright, how's it going? Good. Hold on, the southwest is going above my head.

00:00:46 Um, alright, there we go.

00:00:50 What's going on? Yeah, it's been really busy. Sorry to haven't called much. What time is it there? It is 4:39 in the afternoon and they changed their clocks last weekend so it's really getting pretty dark out there.

00:01:09 Oh, okay. How cold is it? You know, I want to know about the weather. Well, we're not low about 40. The first couple of days the highs were in the high 50s and I thought crap, I brought too many layers, but it's been in the low 50s, so the usual weather.

00:01:26 That's not bad. It rained a lot though in Warsaw on the first day here, that pretty much sucked, but it's fine now. Okay, how was your train ride? It was fine, no events. Oh, the big news by the way, last night we had dinner at Andre and Tatiana's

00:01:44 Tatiana says hi.

00:01:48 Go ahead. Yeah, Tatiana said hi. She says hello. Okay, good. Yeah, and I'll be back there tomorrow night, so I'll give her the gifts you got for her, and I'll give Andre his gifts then. Okay, okay. Yeah, so tonight we have sort of a little departmental, kind of my last night in town kind of thing, and then tomorrow, basically, Andre's killing time they take me to the train station late tomorrow night. Okay. All right. How's your guy doing? The guy, the amputee guy. He's doing okay. Anade did a nice reconstruction of his cranial injuries.

00:02:32 He's, he had a lot of other bad injuries. His head CT didn't look that bad, so that's very

00:02:38 encouraging. What was amputated? One of his arms, one of his legs. He got blown up pretty badly. I think the right was an AKA. Yes, they're both pretty high. So we did another, Andre had another lady yesterday, a woman in her 70s was very nice, so he did her first surgery 21 years ago for a meningioma right along the Falks in the midline. And after a couple of decades it recurred, and she was pretty nervous about having surgery again.

00:03:30 And so I actually spoke up, and I had done this once before with a patient of Andre's. They said, "Look, he is like the best skull-based surgeon I've ever seen. And if I needed something done, I would have him do it." So that other patient, she was young. She graduated from college and he did her surgery. She did fine. And she even mentioned that, she says, "If you see Dr. Volatka, tell him thanks." So I told the same thing about this lady. This lady surgery went pretty well. It was a technically difficult tumor, but Andre is very good, so he got to it pretty easily. She's doing great today. I saw the video of the other one at post-op and she's moving her arms and everything.

00:04:16 So that was... Oh yeah, that was for my last gig, yeah. Yeah, that was the other. So everybody, I haven't really told too many people that you're calling, but as usual, everybody

00:04:28 is equal in equal measure impressed and horrified I'm like oh come on you know we send people

00:04:38 off to war all the time it's not you know so well well before you before you go before you go too far down that road I know you're just waking up over there back home did you hear about all the attacks

00:04:53 in Ukraine, I say? No, because I'm not. So, listen. It is so, what we see here, it is such, you only get like the major, it's kind of hard to get the day-to-day stuff. I don't even, you know, I'm like, okay, you know, bombs here, bombs to the other side, back and forth. The only thing I saw was that Kiev had their electric taken out.

00:05:21 No, I just, it's hard to follow, A, and, I mean, it doesn't really bother me, but it's just hard to follow. Yeah, I was sitting by Andre and I pulled up Fox News and BBC and CNN and we scrolled through the top five or ten stories. None of them had anything to do with Ukraine. So let me be the first to tell you before you hear from someone else. I didn't get bombs last night. No, but Ukraine got hit with 650 or more drones and 50 or more cruise missiles. It's funny, we've been so busy running around and are falling way behind on emails and the usual crap. So I got up at 4 o'clock, I got up and I was stepping into the shower and I heard this huge explosion out there.

00:06:08 I said, oh crap, here it comes. And then right away, Andrei sends a text saying there's a bunch of missiles on their way from someplace in Russia. They should be there in 30 minutes. I said, "Perfect. I got 30 minutes for a quick shower." And then he said, "You should probably get down to the shelter." So it was the first time in all my visits here at the same hotel.

00:06:30 The first time I ever went down to their bound shelter. How long does it take to sprint down there? I'm sure you were... hopefully you weren't like,

00:06:40 usually strolling down there. You were legging it down there. It was fairly leisurely. Yeah, I see. I figure. Well, I hope it's a nice robust shelter. Well, it's a relative term. I mean, these things are not designed to be nice, but it was good. They had a separate Wi-Fi network down there, so I was able to log in and keep up with what's going on. They had tons of water. Also, by the way, the whole neighborhood around the hotel was black because electricity had gone out. but they have these gigantic generators that were in there making all sorts of

00:07:16 god-on-ful noise. Yeah, that's good. That's good. But the weird thing is that this is going on at 4:00, 4:35 in the morning, and then a couple hours later I'm back in the hospital and it's just another day. Yeah, so what I, we've been hearing about the, or maybe I just haven't been looking closely really, but yeah I've heard about the drones but I wasn't, you know, the missiles. the long range, whatever the heck they're doing. Yeah, it's just, like I said, it's a little hard to follow. And we're not getting that much information. It's not like they're covering every move everybody's making. See, so basically you've got to admit that you've missed being in, walking around the house, playing Ukraine the latest on speaker on my phone, right?

00:08:04 You love the guys with the British accents. Yeah, exactly, exactly. Well, yeah, I'd like to, yeah, I'd really like to have somebody give me the Reader's Digest version of what the heck's going on, as opposed to trying to like, that's why I don't do it, because you really can't get a good feel for, it's not like I have that app that you, that they have on the phone that's telling exactly, you know, what's going on by moment.

00:08:32 Oh yeah, speaking of apps by the way, so actually for the first time downloaded one of those that gives you the alarms and it was going off all the time and you're walking on the street and like nobody cares and you know the alarms are saying get to a shoulder. Matter of fact, I went to the usual church I go to on Sunday morning and I'm walking, actually I went up and talked to the priest afterwards and you know he doesn't speak much English. Yeah, I went to confession and kept in there all day. No, and then he introduced me to some doctor there, gastroenterology guy, who speaks English pretty well, and he and I were standing outside the front steps talking, and all the air raid sirens started going off. And he kept on talking, you know, and looking around, nobody seemed flustered at all. Yeah, that's all well and good,

00:09:22 that can possibly one day be your demise you know right well that's why when andre said get to a

00:09:30 shelter i figure i better i better take this one seriously that's good that's good all right well

00:09:36 hopefully you'll get out of there okay and um get that 24-hour train ride back to poland okay so i I have a home decorating question for you. Did you hear that? I have a home decorating question for you. Oh, God. The answer is no. So it was kind of strange. That poor soldier I was telling you about, he got blown up. We went in Sunday night to see him, Andre and I, and a couple of his comrades were there, and Andre gave him... He was really good at explaining to them nature of his injuries and the plan and he always introduces me as a big professor from america right

00:10:21 so then we went and did the surgery and um yeah no so we did the surgery everything went fine and

00:10:30 you know i did talk to them afterwards so the next day i think it was they kind of burst into his office with one of the senior hospital administrators and thanking andre and they gave me this I don't know how to describe it it's like a like a sculpture well no it's not the painting it's cast iron it's made out of Russian missile fragments and it shows this classic Cossack scene about a character sitting playing a banjo and there's a horse it's all very symbolic

00:11:00 and he's standing at a bunch of skulls and there's a big tree in the background it's kind of morbid It weighs about 40 pounds. It's about three feet tall and two feet wide and maybe four or five inches thick. It's complicated. So my thought was, look, you know what, I didn't really do anything to deserve that. I'd like to give it back to the hospital. But then other people said, you know, the problem is that would be rude to kind of refuse their gift.

00:11:27 So I'm trying to figure out a way to get it shipped back. It will look great on the mantelpiece in the living room.

00:11:33 Yeah, not a chance.

00:11:38 I'll send you a picture of it. You don't have to compete with that hammer thing. Oh, hey, that's amazing. I got another mace out of the deal, too. Oh, great. Perfect. Perfect. We went back to that Kasek place that Andrzej took on the first day,

00:11:54 and he got to talking to the guy. The Ukrainians are such nice people. Just out of the blue, this guy gives me this wooden mace. Oh, that's fantastic. It'll look nice in your office. It looks wonderful in your office.

00:12:10 No, they are wonderful people. Appreciate all the gifts. Send me a picture of, yeah, talk to Andre about the other. It sounds really cool. Send me a picture of it, but you're going to have, I mean, it would be a nightmare to bring home, right?

00:12:27 Yeah, I can't do it now. I mean, I have to buy a whole separate suitcase.

00:12:30 Leave it there, maybe leave it with him, and then we'll figure it out later.

00:12:34 Yeah, that's kind of what I'm thinking. All right, sounds like, yeah, I mean, it's so, I'd like to have it.

00:12:41 Yeah, I'll send you a picture of it so you can see what I'm talking about. Yeah, I'll send you a picture of it so you can see what I'm talking about. All right. Then you can Google the Cossack symbolism. Yeah. Yeah, I know about the Cossacks. Yeah, but the whole symbolism of the characters in this thing. Okay, yeah, I will. I'm joking. Are you able to pick me up Sunday afternoon, by the way?

00:13:00 Yes. Yeah, I'll send you the flight information again. So, yeah, I will.

00:13:09 I'm not doing much here. It would be a little bit earlier than usual because I'm trying to connect through Frankfurt so hopefully there won't be any delay making a tight connection. Where are you? Are you going into Warsaw? Yeah, going from Warsaw, a quick flight to Frankfurt and then back to the FW.

00:13:31 Straight through home? Okay. Warsaw, Frankfurt, Dallas. Okay, I want to go to Poland. You should. The Polish people are great. I know, I know. It's very, yeah, it's very civilized and very clean and, you know, all these other countries are, like, starting to be no-go zone, so. Well, Poland's getting ahead one of the biggest armies. And fortunately for you, there's a really nice hotel right by the train station, so it's

00:14:01 very convenient. All right. Well, really quickly, I would say, so... Wait, hang on, hang on. You're being fed a question. Could you mention the blackout at Andre's house?

00:14:15 Yeah. Eating dinner. When you showed up. When you showed up. Oh, yeah, did I... When I told you I saw Tatiana, I forgot to tell you that there was a blackout there.

00:14:28 So they didn't have electricity. No food for you. No, actually just the opposite. Tatiana's amazing. She had all these vegetables from their farm, their little country house, as Andrew calls it. And they have this thing called the power bank, which generates enough juice to power their refrigerator. So yeah, with these little kind of small little electric lights, it was, I mean, she wasn't

00:14:55 flustered at all by having an entertaining guest with no electricity.

00:15:00 Well, she made a comment before how they've integrated all of this into their daily lives and how, you know, it shouldn't be like that. However, you know, when she sees her neighbor, she goes about her business, it's, you know, war talk. And it's just, you know, having to adapt to all of that. But it seems like they do an amazing job.

00:15:30 I know that I saw pictures of the farm, and I think it's kind of a nice place for them to get away for the family. you know from being right in the middle of all the action so that's good though yeah Svankoslav is still at Kossack camp and he's having a great time Andre was showing me pictures of it yeah it's good for him to get away too that's good yeah she's

00:16:00 amazing but I can't imagine you know she's living it day to day three and a half years I guess you do kind of get all the um everything you need to kind of make stuff work right yeah when you don't have electric

00:16:18 or anything like that that's uh it's a roughly lift yeah well it's funny this you know this is

00:16:26 the first time i had to go to a shelter andre said yeah pretty much once maybe twice a week you everybody in ukraine's tired because that's uh the new reality unfortunately yeah it's it's amazing to me that, you know, for you guys that go in and operate and then come home, you know

00:00:00 of your visit, but you also know that at some point you're going to get on a train and you're

00:00:00 of your visit, but you also know that at some point you're going to get on a train and you're going back to, you know, at home, which is not a war-born area.

00:00:13 They're living at 24-7, 365 for three and a half years now.

00:00:19 Yeah, more than that. It's just inconceivable for, you know, it's just unbelievable to have to, you don't know whatever you wake up and you don't know what any given day is gonna bring that's that's to me

00:00:37 you know what the most difficult part especially for her yeah well that's why you know i always uh yeah i always breathe a sigh of relief whenever i cross the border back into poland you know you're

00:00:50 back in NATO territory. Yeah, for her as a mother, right? Especially with husband and children, you know, doing that every single day. I just, they're, you have to give it to them. They, you know, they're, it's all about survival, I guess, at this point. But hopefully things will turn around and get better.

00:01:20 Right? Yeah. Alright. We got everything we need? Uh, yeah. This is great. This is great. What's your first name?

00:01:30 Patty. Patty. You see pictures. You see pictures. This is Laura and Logan. Hey Patty, it's nice to speak with you again. You were awesome. Yes, you were perfect. This is great. You're gonna be a star. Alright. I said you're gonna be a star. Oh, God. No, they said you were perfect. This is exactly what they were hoping for. Well, that's good. Tell... My name is Alex. I'm your husband. I know who you are. I've been trying to pretend for like 35 years. No. Tell Tatiana I said hello, please. I will. I will. and tell her we're thinking of them and that until we meet again.

00:02:25 Sounds great. All right, thanks. Talk to you later.

00:00:00 - What need to?

00:00:00 - What need to? - Oh, is someone coming to you? - Yeah. - Yeah. - Oh, you know. - If you strike, like damage you might. - If you strike, like damage you might. - Okay, I'm sorry. - Let's go. - Let's go.

00:00:53 I think one thing that's tough about this camera is because it's lighter it gets beaten up more. Like when you're like driving like the heavier camera you kind of just can anger it. It's a lot harder to take the blow noise out. It's kind of like shooting you know like women or people who aren't dead strong say they want a smaller caliber gun because it doesn't kick as much. But actually some people say it's the opposite. But actually some people say it's the opposite. The heavier one because of the weight. Yeah, I think the heavier camera is much easier to hold still.

00:01:25 Mm-hmm.

00:01:30 That was kind of the point of building out those little kits I did for the smaller cameras on. All the spotlight. Give them some weight so they wouldn't whip around as quickly. Yeah, definitely. Ideally we would have had like eight. All the spotlight. All Venises. Oh, what's that?

00:02:16 Yeah, I think Javier would lose his mind, but as for that, I had to talk to him about my final payment for Revolution's Daughter. I told him that you were coming with me, and he didn't want to know what you were costing this time. I told him that. I was like, "You don't want to know." You wouldn't believe it. - What? - Okay? - Yeah. - Oh, man.

00:03:03 I'm going to go. So Alex, we'll have to ask Anastasia about the answer, or Andre himself can tell us. But I did have her bring up your Michael DeBakey kind of thought and comment. Yeah. Yeah. And I don't know Michael DeBakey, but a friend of mine who's a, I guess he's a, he works at

00:03:50 a children's hospital in Dallas for uh he's a doctor uh and does they do like you know um children with uh amputations and whatnot and uh anyway but he's also like a part-time documentarian and he did a documentary on debaiki so i've i've i've followed uh

00:04:13 I followed him a little closer than some just by coming in. So my first faculty spot was fresh out of residency at Baylor College of Medicine where DeBakey was. Uh-huh. And our chairman of neurosurgery had this happen.

00:04:30 Whenever he'd go out of town, he would ask one of the younger attendings to cover his patients. And he had his own chief resident and his own nurse, so things pretty much ran on autopilot. Right. there just in case. And so one evening, you know, some weeknight Wednesday or Thursday, I get a page. It is from the answering service. They say they have a new consult for the doctor who is my chair, Dr. Grossman. It's a consult from Dr. DeBakey. I want his patients. They don't want it that night has to be in the morning. I said, okay. So I call the chief resident and you know let him know. So the next day comes and the chief resident goes by. Turns out this guy is a prince from Saudi Arabia and what they do is you know the

00:05:20 hospitals have these like luxury floors. Have you ever been there? So it's a basic hospital but then they have a suite that looks like the suite a whole floor that looks like the Four Seasons or or something. Patients pay extra for that obviously, so many hundred dollars per day. So it's still a functional hospital room, but very, very upper class. So this Prince, they apparently bought out like the whole floor. And I was told that what they do is these guys from the Middle East would tell their families they're going to have tests by the famous Dr. DeBakey. And then they check into these luxury rooms, which is like a hotel. Then they go out

00:06:00 and drinking and going to strip clubs and stuff you couldn't do in the Middle East. So when my chief resident went by to wake him up, he said, "No, the prince isn't seen

00:06:09 doctors yet. He was up late last night. He's sleeping it off." So Logan DeBakey was, he either performed, did the first heart replacement or first open

00:06:22 No, he was, he actually got beaten out by the first heart transplant. He was just a No, he was, he actually got beaten out by the first heart transplant. He was just a He was a big pioneering vascular surgeon.

00:06:30 You know, a hardworking guy, technically very, very good, no question. - It was Bernard, you can say. - Yeah, Bernard, South Africa. - From South Africa. - Yeah. And the big, you know, kind of had a big ego and worked hard. He had a publicist. So he saw a member of the royal family, like in the 1960s or '70s, who flew out to him. And after the collapse of the Soviet Union, who was it? Was it Boris Yeltsin who they thought he was too sick to undergo some major surgery?

00:07:00 So Beke flew over there and said no the Russian president is fine, he's healthy. He actually did a lot. He was a military veteran so he helped the army a lot. So the VA hospital in Houston, so Michael Beke. And yet he would live in a nice house but not elaborate. Apparently he drove some Volkswagen Rabbit or something like that.

00:07:29 A very modest car. Well that way sounds like you. But another way is the ego. Yeah. If you have a huge ego, Alex, you somehow managed to really hide it very well.

00:07:53 I wish I was so surprised I told you some medical student once asked me how I keep so calm.

00:07:58 I've never thought of myself as calm.

00:08:00 Well, we have thought of you as such. But inside is a raging furnace. Your emotions are roiling? That's right. I just wish the voices would stop torturing me. What do they say, you're not good enough or you're too good, you're making other people look bad?

00:08:35 How did you get over your biggest fears, Alex? You can see Alex, you can talk about Minora.

00:08:43 Oh yeah, right here. Minora Center. That's a good question, Darius. I think a lot of it comes with time and age and wisdom. Somewhere along the way, I became one of those guys where even associate professor level people in other departments still call me Sir and Dr. Velodka, which is kind of funny.

00:09:03 When we were going to some function with the residents once at some evening dinner, and I went with my wife, and the residents referred to me as Sir, she burst out laughing. What was the hardest fear to get over? And then have you fully gotten over it? Oh, oh, all right.

00:09:29 That's such a big question. That's such a big question. I mean, when you're training as a surgeon, and Andre knows this too, you're training and you always have someone kind of standing over your shoulder, right? Or telling you to cut here or sew here. And then the first time you're left alone in a case where you're like the most senior person in a room maybe an intern to help. That's terrifying. You know, in operations you've sort of assisted on hundreds of times, suddenly you're the one doing it. That still comes up sometimes when you're trying to... When you have a big case or, you know, a really sick patient, or

00:10:04 an emergency case and the guy's really sick, you know, you get kind of scared, but just for Janet. Do you like if you have a similar case to one that went poorly the last time does that

00:10:18 cause fear when you go in or does that is that like I'm gonna do it better this or is there resolve? No it's more just an extra bit of wisdom. The whole point, well that's not the right thing. The only good thing about mistakes in surgeries what can you learn from them and that's why every hospital has a weekly or monthly M&M conference, morbidity and mortality, where you present all the neurosurgeons, all the orthopedic surgeons, all the vascular surgeons get together and talk about the complications and misses and mistakes and what can you learn from them or what can you do differently. So if something bad happens on a case, you try to learn from this so you don't repeat that mistake. But you can't run away from doing that case again.

00:11:09 Is a little bit of fear still a good thing? You can see right ahead the menorah center is a cultural business and spiritual complex. It's the largest Jewish center in the world or Jewish building. Yeah. Yeah. It's one of the largest Jewish centers in the world. It's the history of modern life. And Draco Armando was in the roof of this menorah center.

00:11:36 Oh, okay. Yeah, who took them? Like, they went to the Holocaust Museum too, right? Yes, yes. Attendance or what? Yeah, it was like the chief rabbi or something like that?

00:11:50 The head rabbi. The head rabbi. No, but Loden, not Loden, bad. A little bit of fear, absolutely, is a very powerful motivator.

00:12:03 Yeah, I mean, I find that, like, if you let fear rule you, that's not good. But if you can figure out how to just, like, keep it, you know, no farther than the front seat.

00:12:15 You know, you can't touch the radio, can't take the wheel. So, you know, I'm Catholic, and there's a part of every Mass where the priest is saying the prayers, and there's a line that says, he's talking to God, says, protect us from all anxiety. And I knew one parish of priests, when he would get to that part of the Mass, he'd always say, protect us from all needless anxiety. And I thought that was really a good way to look at it. Yeah.

00:12:46 Logan, were you raised going to any Catholic schools with Catholicism at all, or was LMU just a complete... Um, no, no, I mean, you know, let me just add what I was looking for. Yeah.

00:13:00 Yeah.

00:13:04 I don't have to say it again, but I enjoy the Jesuits approach to education.

00:13:15 Yeah, I'm a product of a Dominican grade school, a Dominican high school.

00:13:21 [RUS] They don't cook? [RUS] Whoever drinks alcohol should give you the money right away.

00:13:30 [RUS] Because the food is free, but you have to pay for alcohol. [RUS] I understand, but I can hear from your voice that you're well prepared, so let's have you be responsible for the alcohol.

00:13:45 [RUS] Now we'll park, and you know how fast they get together.

00:13:51 Yes, so there's a to get back to minimize my time away from the work at home. But I've always thought that at some point, you know, when the war is over or something, it would be great to see other parts of the country or even just other parts of Nipro.

00:14:36 So I don't know if that's a strength or a weakness or both, if I can kind of focus in and exclude other things. Which makes you very productive in some ways, but you probably are losing out on a lot of things too. Which makes you very productive in some ways, but you probably are losing out on a lot of things too.

00:14:49 You guys had a not completely positive outcome in any of the cases you guys have worked together

00:15:00 here? That's a good question. I can't remember cases that went bad. Or maybe, you know, they had very difficult, or maybe the patient was a little bit weak on on one side but for a couple of days transiently. But I do remember some really sick people in the ICU that didn't make it, despite a lot of work. You know, one of those nights I was spending in the hospital was in Atlanta. We had a patient with bad COVID pneumonia and kept fiddling around with his ventilator and his blood pressure. I thought he was in pretty good shape. And I went to get a couple hours of sleep. He came back in the morning and the guy passed away. Wow, I didn't see that coming. - Wait, wait, like you had operated on? - No, this is just doing ICU work, which is not a surgical patient. The guy's main problem was pneumonia. - I told it.

00:16:01 - Yeah, it's 'cause you know. - Smashburgers is here, that's good to know. - Wow. - Yeah.

00:16:12 - It's big time. In my research again, and so much of it is about Marsh because of the connection to Ukraine, you know, he had a patient that was, you know, the tumor was found much later than it would

00:16:30 have been in the West, especially then it was, you know, close to the very post Soviet and he still tried to operate even though it was too late. It's not like the patient immediately died, but he did not provide relief.

00:16:58 And the last couple of years of the young girl's life was not pleasant. It's always the tough decision, right? I mean, try a big risky operation because there is no alternative. But the, you know, surgery may make her worse than she was before.

00:17:18 Yeah, it's always a difficult choice. How do you tell a patient, you know, when it's on the edge, but you know it's like, this is not, we shouldn't operate on this. I mean, like, I'm sure it's always difficult to tell them that it's, But like that moment of we really can't do anything.

00:17:42 Well the hardest part is families so often want something, we'll try anything, that kind of thing. And that's, they have to give informed consent and you wonder is that really informed? If they're so desperate to try something. I mean it's like someone's family member suffered a stroke or traumatic brain injury, spinal cord injury. There's a million snake oil salesmen out there who will tout these treatments that don't help. Just because they read about it on Google or know their next-door neighbor's cousin had a similar problem that had surgery and was fine. You can't apply that to their own problem. And, yeah, it is sometimes hard saying no, but, boy, you don't want to be on the other end of that.

00:18:28 Agreeing to do something that you were a little plus-minus about and have it go bad, that's terrible. Well, let's put the shoe on the other foot. How would you like, would you want someone to try anything or do you think you'd be able to understand the numbers and be okay with it?

00:18:51 Accepting is a hard thing. So the thing is that it's funny, we talk a lot about, oh, well this patient is 60 years You know, somehow you don't get quite as upset when they have a bad problem. You know, somehow you don't get quite as upset when they have a bad problem. like a 30 year old you know the theory being that the younger person has more to live for but when you talk to people there's always something else to live for right you know when

00:19:10 you're young you want to see your daughter get married or you know i think you can go away and i try to yes okay where's the restaurant i i show you i can hear okay you guys ready to get out yep

00:00:00 [RUS] Two Nikitas.

00:00:00 [RUS] Two Nikitas.

00:00:30 So, you have about an hour away from here? It takes you one hour to get to work? One walk. Does it take you one hour to go home to work? You don't have to go home to work. So, after tonight, you have to go home for one hour? Maybe. Not so much. Yeah. It's a long way.

00:00:57 Not much cars.

00:01:00 [inaudible] I have a great day for the metro station 20 days in the Vallejo That's impressive Thank you for doing all that And finally, all of you gathered here I love my book

00:01:48 [RUS] - He says that after you came to us, you get younger every day. [RUS] - He says that after you came to us, you get younger every day. [RUS] I say, of course, if you're young, then among your plush ones, of course, Ulya envi...

00:02:00 [RUS] [inaudible], guys. [RUS] Artem, when are your teeth? [RUS] - Do you hear what teeth?

00:02:12 [UKR] - He grabbed on, he grabbed on, and tore apart. [UKR] So, the bread crust.

00:02:20 [RUS] First, I would like to say... [RUS] ...a few words about what happened... [RUS] ...and 9 days ago.

00:02:41 This strong man was born.

00:03:06 [RUS-NEEDS] Не волнуйся, я не говорю о этих событиях, ты не волнуйся.

00:03:28 [RUS] Don't worry, I'm not talking about these events, don't worry. [RUS] Nikita, do you have light beer? [RUS] Look, our guests don't have plates. [RUS] Two plates and utensils. They have nowhere to put this.

00:03:52 - Two minutes, yes. Man's man, wait it, man's man, start a game.

00:00:48 [RUS-NEEDS] Гришин, я берусь, я искаю третий за женщину, я знаю, он готовится.

00:01:00 [UKR] Hryshyn, I'll take it, I'm looking for the third toast to women, I know, he's preparing.

00:01:04 [RUS] They've got food. [RUS] Don't take the Zubrovka this last time. [RUS] Never says he doesn't have any. [RUS] Well, where are you going? [RUS] With Coca-Cola? [RUS] And I'm with him. [RUS] And I'm with him. [RUS] You're with him. [RUS] I filmed it. [RUS] That's him. [RUS] He's definitely from the medical account, Slav, for sure. [RUS] Doesn't watch by episodes, right?

00:01:28 Yes.

00:01:29 [UKR] And such shows are being rewatched. [UKR] You things.

00:01:32 [RUS] - We need to share everything there now! [RUS] - Ha-ha-ha! [RUS] - A little attention! [RUS] Viacheslav Lichnev, please, make this toast! [RUS] Come on, Slava!

00:01:45 [UKR] - We see, like Sauchtik, Vice, thank you, Alik!

00:01:47 [RUS] - Go! [RUS] - I want that I'm not sleeping, I want that you...

00:01:55 [UKR] - So learning English, I don't feel it yet.

00:01:57 [RUS] - This is the first one today.

00:02:11 I appreciate you for your help and everybody who supports us.

00:02:35 [RUS] Let's go!

00:02:52 - It's water, it's not a source. - It's dissolved. - It's my, uh, - You're using a store. - If I were drinking, I would have that. - Oh. - But not anymore. - Not good.

00:00:00 [RUS-NEEDS] Украинская цена очень специальной цены.

00:00:01 [RUS] Ukrainian toast is a very special toast. [RUS] Okay.

00:00:07 [UKR] Viktorovych, your toast.

00:00:11 [RUS] Dear friends, I really want the war in Ukraine to end. [RUS] And help to everyone. [RUS] Everyone. - Thank you.

00:00:30 [RUS] And my third toast: to women

00:01:00 This is the toast about women. It's also women. For wife, mother, daughter. Yes, she is the girl, young girl.

00:01:15 Yes? This is toast number three. For women.

00:00:00 Uh oh, he's getting up for it.

00:00:07 Uh oh, he's getting up for it.

00:00:16 I didn't know it was going to be at one of those kind of parties. Thank you so much for your efforts to help our country, help ourselves, and also to show the world, real situation in our city, in our hospital, and real situation in our specialization. So thanks to you, thanks to your project, also thanks to you.

00:01:01 Happy birthday, thank you. It's like very cool for everybody of our community to see you face to face like the god of neurosurgery, like American neurosurgery. Before the war, it's like to think about American neurosurgeon, it's like somewhere and we like, like, whoop on the stars. And one of the stars came to us. So, thank you so much. Thank you very much for your help, like, by the war, by the star, by everything. It's a show that other war, together with us, and we together will fight for freedom, for everyone's freedom.

00:01:40 [RUS] Ukraine, Europe, Ukraine. [RUS] Thank you very much. [RUS] Thank you. [RUS] Thank you. [RUS] Thank you. [RUS] Thank you. [RUS] Thank you. [RUS] Thank you.

00:00:00 I think it was too.

00:00:00 I think it was too. He might be a little bit interesting. His English is also really good. Oh.

00:00:11 [UKR] Good.

00:00:38 [RUS] [inaudible]

00:01:11 [UKR] Solid Vadym Ivanovych. That was back in '70. [UKR] Fifth, quarter. It was very pleasant to watch how our spectators developed. [UKR] Volodymyr Hryhorovych, Sesos. [UKR] Antoniy Dmytriy, there were many. And Holubytskyy Anton Ivanovych. [UKR] Our reception, today's neurosurgery, it's developing. [UKR] Very pleasant to see at what level we've preserved things. [UKR] Very pleasant to see Alex, that you see us as hosts. [UKR] Very pleasant for our young ones. This is our future.

00:02:00 [UKR] I really want that next time, next year, accordingly, that we will be hosting. [UKR] So they're not put to the cemetery, so you spend a pleasant time, so that happens, [UKR] exchanged experience, so everyone was honest. [UKR] Glory to Ukraine! [UKR] I now asked Nastasia to briefly translate.

00:02:59 I have a great friend of

00:00:00 What do you think about companies? What do you think about companies? Crazy companies Lost control I'm not making the challenge I'm not making the challenge Alona, Alona, where's me? I need a drink I need a drink So I've only recently met Alex a few days ago, but it's just been an incredible journey to come here with him and to meet all of you guys.

00:00:44 I think the work that you guys are doing is so incredible and it's just such an honor to be able to sit here and drink and eat food with you guys. And your country is just so brave and it's not an easy thing to let a film crew come in and have cameras in your face. Now I'm feeling what I do to you guys all the time. So I want to thank you guys so much for just being so kind and so just incredibly supportive to the project that we're trying to do.

00:01:13 [RUS] I think this is a very incredible reason. [RUS] Thank you. [RUS] Thank you.

00:01:20 [UKR] Excuse me!

00:01:25 [RUS] What do you think about Ukraine?

00:01:30 [RUS] Ukrainian people?

00:01:31 Yes.

00:01:33 [RUS] Ukrainian people are very kind and very sweet.

00:01:37 [RUS] I think that Ukrainian people...

00:00:00 [RUS-NEEDS] Я очень рада заходить сегодня, как в нашей компании.

00:00:14 [RUS] I'm very glad to visit today, like in our company.

00:00:31 [RUS] University in Kurdistan, Zolevod. [RUS] I'm very glad that your friends from America came.

00:00:38 [RUS] Come more often. [RUS] I'm very glad that our friends from the USA. [RUS] I would like you to spend more time here.

00:00:46 [RUS] And I would like you to be in Crimea. [RUS] Thank you for your support, for your kindness.

00:00:55 [RUS] Thank you for your support.

00:00:57 They are on the right side.

00:01:06 We are going to go to France and look at it.

00:01:11 We are going to do it. We are always good.

00:01:25 [RUS] Give me your tent!

00:00:38 So, we're going to be swimming in the river water.

00:01:00 So, we're going to be swimming in the river water. I'm not getting you. You're going to be the river water. So, yeah, we should ask you about the water. Actually, okay, Laura.

00:01:30 Alex and Jess, we ask Sasha to come with us to do this. We're going to talk on. I think it could be... He has plans that are there.

00:01:57 Oh! Yeah, I just wanted to come and hang out with you there a little bit. Yeah, you guys are just honest a little bit. No, no, no, it's all good. We just kind of wanted to get through what we were trying to do this. Yeah, I'm already in the chat. I mean, I'm going to be in a lot of the 7:15.

00:02:44 So you can get out of the elevator and check out and under a quick spanner? Yeah, because I guess what looks like the status is if you want us to film, if that's like important.

00:02:53 Because I guess we're just seeing that, like, if we're sort of going to work out probably like a lab there, we might want to come in and see it. That would be fine.

00:03:00 Maybe the main thing is we want to be on the train. Yeah, because we want to be like, there are a few people. It's not like he's just picking up the cookies, the tracers, but he's going to be popping. Yeah, that's a good point. I'm sorry, I don't have a challenge with us. The other thing is, if you're going to go back in to swim every Sunday on the next day, we are like, yeah, we have to probably use many of our computers to be smart,

00:03:30 but it's interesting too, So in the last two days you guys have been meeting many people at those three meetings. So you guys actually caught the interview out there. *laughter*

00:03:48 So I'm just going to the ICU. I've been just training them presentations. I still don't know what the answer is about me. Then you go to the OR and train them.

00:04:00 So you're doing surgery tomorrow? Yeah, there's a big post-pocytosis. Do you know what time that is? Before he won. Before he won. Is that early? So finish. He'll probably do it. We'll talk to dad if we want to film that or...

00:04:30 We also keep up filming some other doctors' interviews. That would be great. Yeah, because I'm even going to go off with this, wouldn't you? Yeah, it's good. No. We don't choose any other. Is that just like a brain surgery unit? No, no, we do it a way... But it's not a common... No, it's not every case. Like for epilepsy surgery, when you have to pay for the baby, I am using the squeaky bar.

00:05:26 After the ride, they couldn't do it in the bathroom. That was Brad Nehy. I don't know if I could do bathroom. I don't know if she'd run in this case of late, but she couldn't do it. She didn't do it. The guy's awake is the late, but I couldn't try to open a spot in the bathroom, thinking about the other way to do this. That was awesome. We use the local... The fantasy counter is great. And the guy gets great. After that, I learned I wasn't supposed to do that. I feel like better to get the taste.

00:06:15 Because you guys are also going to go to the retail store. Maybe. I heard that, but I think you guys did. Oh, okay. So that would just be... We would just go there. Yeah. Yeah, I think it'd be good for you guys. There's really cool machines. There's a lot of people. I don't know how you think it would be. I think it would be like a hero kind of thing. Where you just like a little dog. Where you just like a little dog. So, when you just come back to the conversation, I don't know how this works at all, but is it just going to be the same team or would it be other people who are going to do it? I think it would depend on how much money you're going to do it.

00:07:02 I was talking about that earlier, I said, if you have this good conclusion for the same thing, it certainly has something to do. Yeah, we're pretty much easier to raise money once we have something... We've been there, we know the people, we have the... We've got to get to the footage, we've got together a 3 minute trailer for this that looks exciting and gets a lot of support for buying money. That's pretty good at finding money. We talked about some of the romantic story, like these wounded soldiers in the Wynka. What about some things like Yuri Trenchenko? He's gonna be hanging out with Rocco. Where does some guy come in with a big end or something, and they wind up oil, and he's gonna go weld and die, and rupture, he can die. But that's gonna be... Rocco is going to be like an in and out game real quick. I mean, I don't think he's doing well, and he's trying to get it.

00:07:59 Well, it's like, that's up there,

00:08:00 and get stretched out, you know, and you know, and... It's good, I guess, in that case, where it's like, you know, I'm not sure if you're Well we do have to get on the train. How early do the trains let you go? So their train Monday night leaves at 22:46.

00:08:50 Is there a train on the way to go now? Yes. I haven't stopped a lot of the way. How long is that? I think last night I got on the way.

00:09:03 Well you're getting on the same train just a different night. We do. Yeah, you guys should come on the train, it's not like an airplane. But you gotta get on before you leave. Well, you know, what we can do is get on the train and get just a quick thought with you.

00:09:24 Before you leave, and then we then come around and get the shot from outside the train car and pull away. I just made you emotional, wasn't it? I just lost that thought. Whenever I think, I get lost. Just don't think. Don't think. You're hurting the team. The funny thing is, the main thing is, the most true, is meeting all of you guys.

00:09:53 It's hard to have other Americans and other non-Eurosurge people on the show. Die Musik

00:10:43 I'm so glad. Did you know that I used to be a smoker? I didn't actually know that. I didn't think I would ever be a smoker. Then I started drinking. Yeah. Sorry. No, no, no, I can do it. We're talking with these guys.

00:10:59 Do you have any needs of part of this? No. The board thing is getting out of time. So, we'll probably come in at like 10 or something, right? Like 11? Yeah, that'd be much more. We talked to you about, well, we need to talk to Andre about this too.

00:11:18 But like we, so drama is built on stage. You know, I would say stories like an arrow flying through the sky, and as storytellers you have to pull the ball as a moment as possible. So something to do with that. Here, Andre drove us past the temporary war. If you and him could walk past and talk about the evil, he goes there because he wants to remember us. Well, no, but he took us there because we wanted to remember.

00:12:03 It's important to remind us. We're thinking around sunset. [background noise] - Look, what do you see back to the theater? - It's... The thing is, is that I'm like... - The door, come on! - Oh, my God, you have your languages, you're good. - You're good. - You're good. I mean, I guess... - It's good, you're not a problem, you're not a problem, but we're all tough. - What are you doing? - Yeah, like what we talked about in British Columbia. - Richard comes on check. - Can I keep the... - Yeah.

00:13:21 I'm grateful that our path takes us from the hotel house. That everyone who reminds me that we're here for something.

00:13:29 That is profound. And they're going to pay for their lives. I would agree that pretty much everybody in the country knows somebody who has been injured by everybody. A lot of a good life knows. That's a good idea. That's a good idea. A lot. I mean, just think about, if this one hospital, I see 46,000... So the numbers are 50,000 a pound, that's 25,000...

00:14:14 ...and the number is 25,000...

00:00:00 That siren is usually delayed from yours, Laura. That siren is usually delayed from yours, Laura. Yep. Just a little bit though.

00:00:16 One of these days, Alex. One of these days. I like this. That's good.

00:00:26 Good reminder. with the sound and view Explosion. One more.

00:00:57 I'm hearing him. One more. That's close. This is how we do. My daughter has a PhD in clinical psychology.

00:01:43 She's hypervigilant. I mean the toll that takes, it makes us hypervigilant all the time. You start hearing a low pitch sound. You don't know if it's a siren about the start or not. Have you heard a trolley outside your window? You notice when it starts out, just kind of a low pitch hum? To me it sounds just like these sirens starting. I always got a paw or something. Is it just the trolley or is it going to be a real siren?

00:02:30 What's it? The hotel that I had there. Oh, yeah.

00:02:42 It's very symbolic. You can see also from my department, from room with special,

00:00:00 for tomorrow or yeah i think so here let me let me take some of the stuff stuff so you're not uh well

00:00:00 for tomorrow or yeah i think so here let me let me take some of the stuff stuff so you're not uh well i need to go up and get the keys no but i meant like so he's filming oh oh oh okay that's right

00:00:10 yeah let me get your uh let me take it one in a time actually this is my this is holy shopping

00:00:18 i actually have one those are my gray scrubs i'll take them back all right and here i'll take your Come on, backpack. Come on, backpack. Oh. You're not walking around as thaddy as press.

00:00:34 Ready? Ready? Yep. Yep. Oh, where do you think that was? It was a missile that exploded. The question is, did it strike something or did the air defenses take it out? We heard a couple of them. And it is about 8:00 or 9:00 or so at night. So who knows what's going to happen the rest of the night. Cool. Inside we go. We have a breakfast to go.

00:00:27 *scoffs*

00:02:13 I'm just going to take a shower a little bit. Yeah. Alright. Maybe just like, let's take our phone into the bathroom in case...

00:02:22 Let's just take our phone into the bathroom in case we get... Let's just take our phone into the bathroom in case we get... Okay.

00:02:34 I feel like usually the missile hits by now. From what we saw earlier today.

00:02:45 Thank you.

00:05:21 Thank you.

00:07:32 Thank you.

00:07:42 I'm always sick. O que é o que é o que é?

00:08:51 I don't understand. The mom's down there.

00:10:12 right

00:11:12 How many combat planes? Alright. Well, I guess this is not just anything recorded today. So it's not happening now. No. But that's 7. Yeah.

00:12:00 When you're getting there. Alright, let's do this up here.

00:12:12 You got a little bit of a gala though? Yeah, we probably should... We'll call, I'll call Dad. Well, no one's answering to this chat now. What? No one's answering this chat now. I feel like everyone was speaking except for us because we were walking around in the house though. Thank you.

00:13:15 Hey, sorry I woke you up. Hey, how was that? I don't know if you saw Andre's message. He said that they were going to their shelter. Oh, Andre's? Yeah. I'm wondering if that means we should as well. Or if you feel good. I don't know what I've seen. I don't know what I've seen. Yeah, I was just like, why is it happening? I just got a 10 minutes. I just got a 10 minutes. You can look at the group chat. There was like the alarm was going off, and then there's... It looks like there's K. I'm not sure what that is. Let me check the messages here. Can you hear me still? Yeah, I got you.

00:14:00 Oh, yeah. I see. I think that's just fine. Okay, now I'm visiting a cemetery. Terry, Terry, and Bob's here.

00:14:31 Okay.

00:14:54 Yeah, you'll have to like, scroll way down if you haven't opened it all day. I'm sorry, there's uh... Yeah, I'm scrolling and scrolling and there's a ton of messages. Yeah.

00:15:29 Wait, am I going backwards in time? You might be going backwards in time. Yeah, maybe that's... ... It would be the bottom, so you'd swipe your finger up to scroll it down. Is it Negros cinematography? Yeah, Negros cinematography.

00:16:42 I mean the assessment says there are no current indications of imminent large-scale missile strikes by strategic aviation overnight, however the situation may change.

00:16:52 And then the next thing he sends is we go to shelter.

00:17:01 I mean... You see there's that really long message with all the different types of like, it says report on enemy activity. At the very end of that message, there's like an assessment paragraph. But that's different than the message he sent immediately before. that which it says that KAB is from the south. What is a KAB? Is that the drone?

00:17:41 Yeah, I don't know.

00:17:50 Yeah, I don't know. I was over yesterday. We had a building under the shelter.

00:17:55 Yeah, that's kind of why I'm on here. I mean, timing is important. I mean, this is just 23.19.

00:18:06 That was, yeah. Okay, that's a precision-guided bomb.

00:18:13 A glide bomb. A glide bomb, okay, yeah. The glide bombs are not good, right? I mean, they're like worse than the drones, but they're not as bad as a cruise missile. Yeah, they're basically actually the love bomb, but you, instead of dropping a straight-up bomb,

00:18:30 or a plane, like, you know, you see one where two movies, it's kind of like you put fins on it, and it drops, and it kind of goes, you know, travels, horse-out-of-the-as-and-falls. Yeah, you can guide them pretty accurately there. Yeah, I think you're right, I think you're not as bad as just as a little, but generally, worse than drugs.

00:18:54 Yeah, you're right, there's just some kind of picture information here.

00:19:00 I could say the same way, I'm like, we're the only people there, last night. But then he gets like, Andre's like, "Oh, we're going to our shop there."

00:19:09 He's the guy who lives here. Yeah, we have some beds in there, shelter. That's true. So it's like, you just stay here to sleep there.

00:19:20 I thought he told me yesterday, when I first got his, he went out and he slept in a shelter, four to six.

00:19:30 He was up by their siblings. He just hangs out and he slept in a piece. He slept in there.

00:19:44 Yeah, I don't know if I can tell you how. How about this guys, what if we go down to the lobby and just ask them to go to the shelter and if they say no, then we're good.

00:19:57 If they say yes, then we'll go. Yeah, I'll just call them now.

00:20:05 I'll just call them on the phone. The group phone. Yeah, he can try to, you know, the language program might be an issue, but they may not speak English really well, but that's what I did yesterday, but I, you know, I got out of the shower, got arrested, couldn't reach you guys by phone, and I went down there, and I asked them, you know, where are any other Americans, they said that they hadn't seen it, it's just weird, so.

00:20:39 Alright, well I'll put my shoes on right now. I'll go down there for you.

00:20:46 Was there a shit move on side? Yeah, there was. I didn't hear it. What did you hear about? I felt the vibration.

00:20:57 I feel like something got the stairs moving. I don't know, I feel very anxious. I don't think I could go to sleep right now in bed. To be honest, like in this room. That's where you can hear me. Maybe I'll just go downstairs and try to just get some more space.

00:21:25 Okay, well, yeah, we'll go downstairs and... uh we'll check out what's going on. But, yeah,

00:21:36 alright, bye. Alright, bye.

00:21:50 Maybe we just call that. Well, yeah, let's go down and we'll report back. - I don't know if I'm gonna come back here. - Okay, well let's take everything that we think we need. - I have to put that in the door.

00:00:00 something like this was friday of my first week so my fifth night and it was like almost

00:00:00 something like this was friday of my first week so my fifth night and it was like almost five in the morning and then now and i was just hearing i was packing earlier listening to uh

00:00:12 ukraine the latest you guys do you forget this is a podcast telegraph and um they were saying i guess there's this window are you cold is she cold

00:00:24 you should hold them and close the window anyway there was this report i guess the u.s u.s intelligence just released the report uh recently that uh basically says they're allegedly their assessment is putin has no desire at all to uh

00:00:40 stop the fight i did see that he's all in for more land he thinks the cost they pay so far is worth it

00:00:47 yes i saw that i i didn't see like too much detail on i just saw that yeah i was kind of kind of half-list thing while I was trying to make sure I didn't leave anything.

00:01:00 The other thing is that you go to the shelter, when do you know when it's safe to come back up? Well, so the guy in the lobby, the security guard or like the doorman... Yeah, there's always a guy sitting there. Yeah, so he showed up, like his phone, he's like, the reason's yellow, he's like, you don't

00:01:14 need to go to the shelter. Yeah, we also looked like idiots because we left our key again. And we ran out to the shelter and then had to ask our key.

00:01:29 And then also there was a bunch of soldiers checking in. So I was at three, and I actually rode the elevators up the two floors because I'm lazy. And there was a guy getting out with a big military dress dude. Why is he prowling around at the... Yeah, there's probably like 10 soldiers in the lobby. They're trying to cover... One of them, his rifle doesn't have a bag, so he was just covering it with a sweatshirt, but it kept falling over. Did you get any film of it?

00:02:00 I did. I was like, I'm not going to film this. Yeah, you better... Don't point your gut at that, dude. What does your app say, Laura? I'm trying to log in. Okay, so actually this is the best we've seen it so far. Only a third of the country.

00:02:23 Good times. Yeah, I mean, that last explosion was pretty loud.

00:02:29 Yeah, that was definitely the loudest one we've heard. Logan, you asked a great question. Are these actual missile impacts or are these just the missiles being taken out by anti-aer defenses. I just feel like we don't have any telegram channels that like Andre and other people have that seem to like know. Oh okay, Andre just said something. Okay, TV video. Let's see what this shows. All right. Okay. Didn't really show much. Eight seconds of video. He'll follow up and see where that's coming from.

00:03:15 What? Can you see anything? Yeah, there's... Vaguely it's obviously night time. So it looks like something hit there? Sounds like it.

00:03:30 I mean that was definitely the blast we heard. That's exactly what it sounded like. It was close. It was close. Oh, okay, here's how the alert has been lifted. We've returned home. We should get away on a peaceful night. He just sends that. All right, chill. So let's see. The plan is we'll meet here in two hours. Yeah. So we're getting wigged out because we're here for a few days. Can you imagine living like this? I was just asking Dad. I wonder what on us to see us do it right now.

00:04:00 Sleeping? Yeah, I hope. Yeah, I mean, there's such a great analogy to alarm fatigue in the ICU.

00:04:08 I mean, nurses can't respond to every alarm, and they turn them off, but boy,

00:04:13 if we ignore all these, the one that comes through that window over there is... Yeah. I was saying to Alex, I was recording the sound of the air raid siren, I was saying to Alex, I was recording the sound of the air raid siren, and then I stopped recording the camera. I did the exact same thing, like 10 seconds before the impact. I did the exact same shit and I was pissed at myself. I couldn't. I was like, I'm going to copy this over the computer. No. And then I'm like, I can't believe I'm lamenting.

00:04:44 Well, Dad, you know, I hate to say this, but you're in a horrible place. There's something that explodes right out there. I know. All the glass everywhere. Yeah. Well, do you think the alarm fatigue, like, because obviously Andre's aware of that, right?

00:04:59 that kind of mindset or that phenomenon. Do you think that's why he's so careful? Were you guys around when somebody, one of the docs said, okay this is in Sumi, that's pretty far north.

00:05:17 They said that, we talked about how these alarms are so hypersensitive right, they go off all the time, but they said you don't go to the shelter until you hear the first explosion. Something like that. Well, this is our second night in a row dealing with that.

00:05:33 I mean, I guess my question is, because you're saying, like, do you think it's getting worse?

00:05:39 Do you think it's getting worse, or do you think this trip where you're just unlocking? Well, overall, I know the big picture, I remember saying that a month or two ago, if you look at the number of attacks per week or per month, it's a lot higher since Trump's inauguration in January. But that's the pattern over now. What is it? It's ten months or nine months he was sworn to January 21st. So it's like a baseball player's batting average, right?

00:06:11 That doesn't tell you whether he's going to strike out or hit a grand slam.

00:06:16 Yeah. Well, okay, let's all go back to bed.

00:06:23 Go back to bed at least for a few minutes. Yeah, I don't know. I'm like all amped up. I'm exhausted, but I'm also like amped up.

00:06:30 Welcome to life in Ukraine. That's what I'm saying. I mean, granted, you guys are working incredibly long days, but still dealing with this. I mean, after I talked to Logan and said, we better get down there. I'm in my room and every little sound you hear, you start listening.

00:06:45 Wait, is that going to lead to something? I told you my daughter had that great fresh hyper visual. That just wears you down. Yeah. Oh, shall we? Yeah.

00:07:00 Wow, this is fun. Welcome to my room. Yeah, this is a nice room. Too much glass for my liking. Too first class for your liking? No, too much glass. Too much glass. And the funny thing is, I'm actually, I remember before my first trip, this guy who's a four-star

00:07:23 Air Force General and was a space shuttle pilot, you know, pretty smart guy. He's a great guy to talk to. When I was going to Ukraine, he said, "Don't get a hotel room that faces east." And I looked that up. Actually, where I am now, I'm facing east. You guys are not, but I don't know if that's such a

00:07:41 veil of piece of advice now. Because the missiles could land anywhere, right? Any of the four directions on the map.

00:07:47 Well, east because... Good that's where Russia is so the missiles come from there and land here missiles and drones

00:08:00 And the other catch-22 when I catch 22, but you guys know it gets really warm in these rooms at night

00:08:04 So you gotta sleep with the windows open Yeah, then you can't close it with the blackout. Yeah

00:08:14 I've got like One more card to go then I've got this all copied off for you. So this is all of your, this footage you've taken?

00:08:25 Yeah. Hard drive. Yeah, all the footage I've taken the whole trip. Do you know how big it is? Let's see here.

00:08:36 I'll know in one second, let me see here. Pro, SuperFail, get info. 672 gigs plus. That's pretty big. I was going to say it's not that big. That's like one card. No, it's not. Plus, hang up, there's just a little bit more. Get info. 672 plus another 280 gigs So it's like a little less than a terabyte. Yeah, yeah. okay that's fine yep and it's i mean it's from the whole everything yeah it's not uh nothing yeah because right now i think we have like eight or eight terabytes left on those big drives

00:09:29 and i yeah i mean i've got um a stack of these you know

00:09:36 Yeah, exactly. I'm not that worried about it, but I was just curious. And I've got some of these. These are each 4 terabytes each. So we'll be able to... Actually, I can't help you guys. This is amazing. Actually, I can't help you guys. This is amazing. Yeah, you're shut up.

00:00:00 [RUS-NEEDS] Дякую вам за витальне слово.

00:00:27 [UKR] Speaker 1: Thank you for your welcoming words.

00:00:30 [UKR] Speaker 1: And for the next welcoming speech I invite the head of the Military Medical Clinical Center of the Western Region, Knight of the Order of Bohdan Khmelnytsky and Cavalier of the Order of Danylo Halytsky, Colonel of the Medical Service Vylan Yaroslav Mykhailovych.

00:00:48 [UKR] Speaker 2: Good morning, glory to Ukraine! [UKR] Speaker 3: Honorable Commander, guests, colleagues. I greet everyone with the beginning of an extraordinary event in the life of military medics, the 19th Congress of Surgeons and Anesthesiologists of the Armed Forces of Ukraine. [UKR] Speaker 3: I am extremely pleased that this event is taking place in the city of Lviv, a city famous not only for its cultural heritage, but also for its centuries-old medical traditions. [UKR] Speaker 3: The Military Medical Clinical Centers of the Western Region, like other military hospitals, are living through a difficult time, the years of war. [UKR] Speaker 3: Successfully fulfilling assigned tasks both in the rear and at forward levels of medical care provision. [UKR] Speaker 3: At the same time, it is worth noting a significant breakthrough in the development of military medical science and the gaining of invaluable experience by our doctors.

00:01:41 [UKR] Speaker 3: surgeons, anesthesiologists, who are rightfully considered experts in the treatment of combat trauma. [UKR] Speaker 3: Representatives of all civilized countries wish to communicate and exchange experience with Ukrainian military medics. [UKR] Speaker 3: Effective communication with various organizations that truly transmit this invaluable experience. [UKR] Speaker 3: At the congress, the experience of treating combat trauma will be presented by both young colleagues and experienced specialists from different regions of our country. [UKR] Speaker 3: The materials of this conference will undoubtedly become a significant scientific contribution and a driving force for the further development of medical science and practice. [UKR] Speaker 3: May this conference become a platform for fruitful exchange of knowledge, creation of new partnerships and generation of innovative ideas.

00:02:27 [UKR] Speaker 3: I wish everyone successful work, inspiration and significant results.

00:02:30 [UKR] Speaker 2: I'll say two words, and then I'll return to you

00:02:35 [UKR] Speaker 2: We then continue with military surgeons and anesthesiologists. [UKR] Speaker 1: And tell me please, technically is the first presentation ready? [UKR] Speaker 1: Dear colleagues, we'll now have a technical break for 10 minutes,

00:03:00 [UKR] Speaker 1: and in 10 minutes at 10 o'clock we will then begin our session. [UKR] Speaker 1: Thank you.

00:03:18 Speaker 1: Grazie.

00:03:52 Speaker 1: Thank you.

00:04:40 Speaker 4: Are you seeing this also? Speaker 4: I can't.

00:04:53 Speaker 4: I can. Speaker 5: Do you guys see it? Speaker 5: Do you guys see it? Speaker 5: Yeah, we can see it.

00:05:00 Speaker 5: Oh, so you can locate this. Speaker 5: Yeah.

00:05:12 Speaker 4: Okay, does that look a little weird? Speaker 4: A little weird.

00:05:19 Speaker 5: Is that how you're thinking? Speaker 5: Is someone recording this at all?

00:05:25 Speaker 4: Is someone recording this? Speaker 4: Is this whole session being recorded?

00:05:30 Speaker 4: Maybe, maybe. Speaker 4: Maybe we don't...

00:05:37 Speaker 4: I mean, we don't have to. That's gonna look too weird.

00:05:44 Speaker 2: You can also, if you see this, for you... Speaker 4: Yeah, this is good, yeah. It's gonna look too strange.

00:06:00 Speaker 4: Yeah, we'll just go with this. Speaker 4: Do I need to move this? Speaker 4: Is this cutting into your field?

00:06:18 Speaker 4: Thank you.

00:06:40 Speaker 2: We wait at night, I mean at night, I ate seven, six, five, and pshhh.

00:06:47 Speaker 4: Are you able to go back to sleep?

00:06:51 Speaker 6: We actually shot for like another 30 minutes, we just shot like the sunrise.

00:06:56 Speaker 4: Oh, you know it's funny, I was thinking about that because it was beautiful, and I said you guys need to sleep.

00:07:01 Speaker 6: But then we did eventually go back to sleep. Speaker 4: Hey Ted, do you have any stills of the shelter? Speaker 6: Um, you know, but I could pull them today. Speaker 4: Yeah, I didn't take any. I was thinking I probably should have. Speaker 4: Or I could just, yes, I'm going to take them back down. Speaker 7: Yeah, I can get some stills. Speaker 7: But by the way, is tomorrow morning, the last morning, we have the my room? Speaker 4: What's the other one? Speaker 4: No, you need to check out on the 2nd. Speaker 7: Okay. Speaker 4: Tomorrow's the 31st, so that's Sunday morning.

00:07:31 Speaker 4: You need to check out and then check back in. Speaker 7: Potentially there's a good shot of the sunrise from my loft.

00:07:39 Speaker 7: But especially from my loft you can see the flag. Speaker 4: That's why I wanted to put you guys in those rooms. Speaker 4: Because you could hear the trolley and see the park. Speaker 7: Yeah. Speaker 7: The sunrise was from the edge of my view. Speaker 4: So, something to talk about for your next trip. Speaker 4: Do you want to be back in the same room? Speaker 4: but it's not very functional because you have to run up and down the stairs a lot.

00:08:06 Speaker 4: Or would you rather be in a room like when I'm in, where it's all on one floor?

00:08:10 Speaker 7: I mean, like, for me, I only go up and down stairs when I'm going to bed and I have everything else.

00:08:17 Speaker 4: Yeah, I saw the way you had everything organized, all your camera.

00:08:21 Speaker 7: And by the type of item.

00:08:30 Speaker 2: When we begin talk, I ask you silence complete at least 30 minutes, okay? Speaker 7: Yeah, no, we're actually going to set this and get out of here, close the door. Speaker 7: Yeah, yeah, yeah. Speaker 7: So we won't be here. Speaker 8: You can also, if you'd like, maybe sit here.

00:08:48 Speaker 4: No, no, don't, if you have to get up, you... Speaker 4: No, actually, that's right, that's out of the fire. Speaker 7: No, no, so this has a shot of both of you. Speaker 7: And if we can get a copy of the Zoom, then, like, we have this and that, and we'll be good. Speaker 7: And if we can get a copy of the Zoom, then, like, we have this and that, and we'll be good.

00:09:00 Speaker 7: So we'll get out of your way. Speaker 5: I'm not moving around and stuff. Speaker 5: You are? Speaker 5: I'm not moving around, trying to shoot the screen while you guys are trying to present.

00:09:09 Speaker 5: It's going to be kind of annoying for you guys. Speaker 2: Yeah, a bit closer to me. Speaker 2: Oh, okay. Speaker 2: This one. Speaker 7: Alright. Speaker 7: We're not going to come back in until you're done. Speaker 7: Do you want to just close this? Speaker 7: Yeah. Speaker 8: If science will be in the corridor, it's maybe open. Speaker 8: If in corridor will be a lot of different voices, crowd, it's maybe better to...

00:09:36 Speaker 5: We're not, we're gonna go change... Speaker 8: I said it so... Speaker 5: Just close it. Speaker 5: Just close it. Speaker 5: Good luck, guys. Speaker 5: Good luck, guys. Speaker 5: Thank you. Speaker 5: Looks good. Speaker 8: Thank you. Speaker 4: Thank you. Speaker 4: Thank you. Speaker 4: Thank you. Speaker 4: Thank you. Speaker 4: Thank you.

00:09:58 Speaker 4: Thank you. Speaker 4: Thank you.

00:10:20 Speaker 2: Okay.

00:10:25 Speaker 2: Sit down with this.

00:11:26 Speaker 4: Oh, sweetie. Speaker 2: Welcome, Andreas. Speaker 2: You quickly, fast. Speaker 2: That's why he has an interval between our section. Speaker 2: It's almost.

00:12:32 Speaker 2: It's a honor for me to have the first presentation in this meeting. Speaker 2: This meeting will continue two days, today and tomorrow. Speaker 2: That's why it's a very important talk.

00:12:50 Speaker 2: I am proud to have this talk together with you.

00:13:36 [RUS] Speaker 9: Oops, turned on at 9:30, and you.

00:14:22 Speaker 4: ...

00:14:32 Speaker 4: Thank you.

00:15:00 [UKR] Speaker 1: Thank you.

00:15:24 [UKR] Speaker 1: Severe penetrating craniocerebral injuries in wartime, effectiveness of military-civilian cooperation. Honorable Andriy Hryhorovych, we invite you.

00:15:34 [UKR] Speaker 8: Honorable Konstantin Vitaliyovych, dear colleagues, can you hear me well?

00:15:40 [UKR] Speaker 1: Yes, everything's good. [UKR] Speaker 8: Thank you. First of all, I want to thank you for the honor and trust to speak at such a respected conference. [UKR] Speaker 8: And I want to say that together with me is a neurosurgeon, neurotraumatologist, world-renowned Professor Alix Valadka from Texas, from Dallas. [UKR] Speaker 8: This is his fourth visit to Mechnikov Hospital. And this week we have already operated together precisely on wounded military personnel, with severe brain injuries. [UKR] Speaker 8: Good morning! Glory to Ukraine! Glory to the heroes! [UKR] Speaker 8: What I wanted to say. The Ministry of Defense has developed an updated military medical doctrine, as you well know. [UKR] Speaker 8: And in this doctrine, which was recently presented at the "Person in the Army" conference, it is highlighted in red.

00:16:32 [UKR] Speaker 8: military medicine will continue to develop on the principles of a unified medical space and close cooperation with the civilian healthcare system. [UKR] Speaker 8: This is truly the case and has been so since 2014. Here I wanted to present both our hospital leadership team, and Konstantin Vitaliyovych, Serhiy Ivanovych, [UKR] Speaker 8: Oleksandr Mykhaylovych, Konstantin Yuriyovych, Mykola Mykolayovych - these are the ones with whom Mechnikov Hospital most closely cooperates precisely in matters of providing care to those wounded in the head, with craniocerebral injuries. [UKR] Speaker 8: What are the features of these injuries? High proportion of fragmentation mine-explosive injuries was 87, now it's 97%. The percentage of bullet wounds is decreasing from 13 to 3.5%.

00:17:23 [UKR] Speaker 8: High proportion of injuries with bone fragments - these are so-called secondary wound projectiles - 77%. [UKR] Speaker 8: High proportion of combined injuries - this accounts for about 67%. [UKR] Speaker 8: And it should be noted that there is a high percentage of combined injuries - where there are burns. [UKR] Speaker 8: What I wanted to say about military-civilian cooperation, about providing neurosurgical care [UKR] Speaker 8: in military mobile hospitals, damage control neurosurgery, [UKR] Speaker 8: about providing neurosurgical care at Mechnikov Hospital, [UKR] Speaker 8: and also to consider ways to improve treatment outcomes for this difficult category of wounded. [UKR] Speaker 8: Since 2014, 24/7 telemedicine consultations have been implemented [UKR] Speaker 8: together with military hospitals, military neurosurgeons. [UKR] Speaker 8: We never refuse, 24/7 on weekends, weekdays, and holidays.

00:18:15 [UKR] Speaker 8: We decide whom to operate on immediately in damage control mode, if to operate what is the optimal volume of intervention, and mandatory feedback, and then control, treatment results, all of this is discussed. [UKR] Speaker 8: When we know about the arrival of a wounded person, we prepare our forces, personnel, technical equipment, especially for combined injuries. [UKR] Speaker 8: In addition, on the initiative of Konstantin Vitaliyovych, training of military neurosurgeons in the workplace was organized. They lived and were on duty around the clock with us for one, two, three weeks. [UKR] Speaker 8: And we understand each other without unnecessary words. I'll say more, military neurosurgeons who went on rotations before this time, who are now, they have a very high level of providing neurosurgical care.

00:19:06 [UKR] Speaker 8: The results of their operations exceed what we see, unfortunately, in some civilian hospitals. [UKR] Speaker 8: Telemedicine is working. A 24/7 telemedicine consultation system, a closed group, you see 9 participants, which already includes more than a thousand photos, more than two thousand videos. [UKR] Speaker 8: Patient A, on the left, penetrating injury to the posterior cranial fossa, damage to suspected transverse sinus, a decision was made for immediate evacuation to Mechnikov Hospital for angiography and reconstruction. [UKR] Speaker 8: On the right, acute epidural hematoma related to combat actions, such a patient cannot wait for transportation, [UKR] Speaker 8: is immediately operated on in a mobile hospital. These issues are resolved immediately. [UKR] Speaker 8: We tried to implement smart glasses, but for this good Wi-Fi connection is needed,

00:19:58 [UKR] Speaker 8: although we transferred, thanks to Konstantin Kostyuk, these devices, and, perhaps, there were a couple of operations, [UKR] Speaker 8: which were conducted in telemedicine mode using smart glasses in military hospital operating rooms. [UKR] Speaker 8: When it is very important precisely to operate on site, there are such situations as, for example, shown on this slide, [UKR] Speaker 8: that CT shows that the patient has active bleeding, which even at the stage of performing CT is continuing, and you can see the swirling of blood precisely in this hematoma. [UKR] Speaker 8: And here is a clinical case. Very recently, October 17, you see a patient with such an acute hematoma, [UKR] Speaker 8: Inside there is swirling. This says that the hematoma arterial bleeding is continuing, and this patient needs to be operated on as soon as possible.

00:20:50 [UKR] Speaker 8: And the patient immediately underwent surgical intervention. Makhotin Serhiy Oleksiyovych operated, and after this, after stabilization, the patient was redirected to Mechnikov Hospital. [UKR] Speaker 8: You see good CT control after the operation, removal of this hematoma, as of 26-10 restoration of consciousness to the level of SOPR 9-10 points on the Glasgow Coma Scale and evacuation was carried out for further treatment by evacuation train to the city of Vinnytsia. [UKR] Speaker 8: Next. This is a graph of wounded arrivals at Mechnikov Hospital. You all know it well. At foreign conferences I say that this graph is written in blood, written in blood of both our military defenders and civilian wounded.

00:21:37 [UKR] Speaker 8: Currently the experience consists of more than 50 thousand wounded and injured. You see, 2014-2022 about 4.5 thousand severely wounded. This is over 8 years of the first stage of the war. And currently the figure is already more than 46 thousand severely wounded. [UKR] Speaker 8: And you see that every day on average Mechnikov Hospital receives 35 wounded patients. [UKR] Speaker 8: Regarding penetrating craniocerebral trauma, Mechnikov Hospital currently has the largest experience in Ukraine precisely in treating with penetrating craniocerebral injuries. [UKR] Speaker 8: This is more than 2.5 thousand who were primarily operated on at Mechnikov Hospital, plus more than 550 who were operated on in mobile hospitals.

00:22:23 [UKR] Speaker 8: That is, every sixth is operated on in mobile hospitals, and five out of six are operated on at Mechnikov Hospital. [UKR] Speaker 8: You see the dynamics of arrivals of these wounded by years. [UKR] Speaker 8: This is my neurosurgical team. Despite the average young age of neurosurgeons present in the photo, [UKR] Speaker 8: most of them have already performed hundreds of surgical interventions for penetrating craniocerebral trauma. [UKR] Speaker 8: performed 24/7. At the Congress in Vienna they told us that trauma in top European clinics was not performed, [UKR] Speaker 8: surgical intervention, because it was Saturday or Sunday, or it was night. We don't have that, operations are performed daily. [UKR] Speaker 8: We implemented such a cycle of improving treatment results, plan, do, check and act.

00:23:14 [UKR] Speaker 8: This is a comprehensive quality management improvement system. [UKR] Speaker 8: Constantly improving operation results, reducing the time of the operation itself, and the results are getting better. [UKR] Speaker 8: It works. [UKR] Speaker 8: At Mechnikov Hospital there is also its own closed Facebook Messenger group, 49 participants, [UKR] Speaker 8: surgeons, neurologists, anesthesiologists. [UKR] Speaker 8: In this group there is all information about the patient, you can find the operation plan, [UKR] Speaker 8: CT, before and after the operation, dynamics of condition. [UKR] Speaker 8: And you see, the database is already more than 10 thousand photographs and more than 22 thousand videos. [UKR] Speaker 8: We learn every day so that these results are as good as possible. [UKR] Speaker 8: From 1 to 8 operations are performed for penetrating trauma.

00:24:00 [UKR] Speaker 8: You see in this photo the busiest day, when in one day 8 surgical interventions were performed. [UKR] Speaker 8: Here are injuries to the anterior cranial fossa, and posterior cranial fossa, and lateral skull base, that is the pyramid of the temporal bone, and such injuries, severe injuries. [UKR] Speaker 8: As an example, I would like to show just one case of a wounded person who simultaneously had three locations that required intervention.

00:24:30 [UKR] Speaker 8: First - this is injury to the paranasal sinuses, these are frontal sinuses. Second - this is injury to the pyramid of the temporal bone. And third - this is convexity injury. [UKR] Speaker 8: That is, this wounded person needed to be operated on. And the video shows precisely this wounded person's stages of care provision at Mechnikov Hospital. [UKR] Speaker 8: It should be said that the average time from arrival of a wounded person to performing computed tomography is 22 minutes.

00:25:00 [UKR] Speaker 8: Alix Valadka, who is present with me, says it's rare in the USA to be able to do a computed tomography scan within 22 minutes from the beginning of arrival. [UKR] Speaker 8: and after this the patient is immediately submitted to the urgent neurosurgical operating room. [UKR] Speaker 8: Two neurosurgeons are on duty daily, and these operations are performed immediately. [UKR] Speaker 8: This is called early and comprehensive in volume neurosurgical intervention. [UKR] Speaker 8: Precisely this approach allows us to obtain results that speak for themselves. [UKR] Speaker 8: This is reduction of mortality, reduction of complications and improvement of quality of life of patients who are operated on. [UKR] Speaker 8: This is control of the same patient who I presented in this photograph.

00:25:49 [UKR] Speaker 8: I cannot not mention our friendship with American colleagues. [UKR] Speaker 8: Already more than 10 professors have worked at Mechnikov Hospital, both in open and endovascular operations. [UKR] Speaker 8: And have performed already more than 130 joint surgical interventions. [UKR] Speaker 8: What lessons do we exchange with the USA? First of all, that penetrating craniocerebral trauma is a complex scheme of neurovascular injuries and skull base injuries. [UKR] Speaker 8: And precisely microsurgery and neurovascular methods play a crucial role. [UKR] Speaker 8: Coagulopathy is discussed, the need for early decompression, wound treatment in this photo is Rocco Armonda from Washington D.C., who led forward surgical teams in Iraq-Afghanistan for 10 years, awarded the Bronze Star of the USA, a real legend of Ukraine and the USA.

00:26:42 [UKR] Speaker 8: Together with professors from America we have published many of our publications and in each publication we mention Ukraine, Dnipro. [UKR] Speaker 8: For example, this article is called "Stand up," so that the whole world knows. [UKR] Speaker 8: Ways of improvement. First of all, non-invasive possibility of diagnosing hematomas - this is the application of Infrascanner, as well as pupillometer for determining intracranial hypertension. [UKR] Speaker 8: Another analysis of causes of mortality of the wounded at the hospital stage and search for solutions. And analysis of causes of mortality and unfavorable treatment outcomes of the wounded, with penetrating injuries at the hospital stage.

00:27:28 [UKR] Speaker 8: You see the Infrascanner, we have it and we are now conducting research jointly with the team of Konstantin VitaliyovychOmunyk, [UKR] Speaker 8: in order to evaluate the effectiveness of this device in field conditions, use for diagnosing intracranial hematomas. [UKR] Speaker 8: Example, you see on the left red circles, we do CT and exactly corresponding to this we see brain contusions in the left hemisphere. [UKR] Speaker 8: Another case, one circle and corresponding to it on CT we see a focus of brain contusion. [UKR] Speaker 8: Results. Sensitivity 60%, specificity almost 80%, positive predictive value 25%, negative predictive value 95%. [UKR] Speaker 8: This allows conducting triage issues, determining which patient needs to be referred first to computed tomography.

00:28:19 [UKR] Speaker 8: Pupillometry - non-invasive method of assessing intracranial hypertension. This is much more effective, not ultrasound measurement of optic nerve diameter. Again, thanks to American colleagues, we have the opportunity to work with a pupillometer for non-invasive determination of intracranial pressure. [UKR] Speaker 8: Shows maximum pupil diameter, neurological index of pupillary reflex. I'll stop if needed, I can continue more. [UKR] Speaker 8: And this is real use of the pupillometer. On the right you see a bullet wound, diametrical wound. [UKR] Speaker 8: We operated together with Professor Rocco Armonda, entry hole, located bullet. [UKR] Speaker 8: And we check intracranial pressure the next day after the operation using the pupillometer.

00:29:05 [UKR] Speaker 8: intracranial pressure, in this case, is normal, the patient survived. [UKR] Speaker 8: We examined more than 170 patients, you see, on this slide. [UKR] Speaker 8: And our mortality data, you see, from anterior cranial fossa 6%, [UKR] Speaker 8: ending with posterior most severe injuries 21%. [UKR] Speaker 8: Here is presented the frequency of purulent-septic complications and quality of life. [UKR] Speaker 8: You see that good recovery, moderate disability even 84-76%. [UKR] Speaker 8: If we talk about injuries precisely operated in mobile hospitals, then the highest mortality, of course, is with injuries to the posterior cranial fossa and diametrical injuries. [UKR] Speaker 8: But what interests us, 27% - this is acute subdural hematomas, mortality with acute subdural hematomas.

00:29:57 [UKR] Speaker 8: And we are working on these issues, because despite the removal of subdural hematomas, [UKR] Speaker 8: we see such results in secondary ischemia. [UKR] Speaker 8: What is this related to? Many things. [UKR] Speaker 8: Mechanism of injury, polytrauma, coagulopathy, infectious complications. [UKR] Speaker 8: One thing, that data from military cohorts indicate that the closer the neurosurgeon, [UKR] Speaker 8: although it's dangerous, near the battlefield, the better the treatment results, [UKR] Speaker 8: if the patient is operated on in the first 5 hours. [UKR] Speaker 8: We published lessons of war, they can be found on the website of the Ukrainian Neurosurgical Association. [UKR] Speaker 8: In addition, on the YouTube channel of the Ukrainian Neurosurgical Association there are our lectures, more than 5 thousand views. [UKR] Speaker 8: Never give up, this photo is from Rocco Armonda, never give up.

00:04:12 [DELETED: "Thank you" - matches deletion rule]

00:07:13 [RUS] Speaker 1: To be continued...

00:08:16 [RUS] Speaker 1: To be continued...

00:09:24 [RUS] Speaker 1: To be continued...

00:12:35 Speaker 2: Okay. Speaker 3: What's up? Speaker 2: Everything good? Speaker 2: Is there anything I can do? Speaker 3: I gotta move this. Speaker 3: Can you go on the other side of this? Speaker 3: That's my candy to white. Speaker 3: You're gonna hold it with this one. Speaker 3: Got it? Speaker 2: Yeah. Speaker 2: I'm gonna hand you the white.

00:13:00 Speaker 2: Okay. Speaker 2: This is big. Speaker 3: Oh, you gotta hold it. Speaker 2: Hold it up, so you like this?

00:13:14 Speaker 3: No, it'll like take the weight, like, I gotta move the stand. Speaker 3: You're like leaning it against the stand. Speaker 3: Okay, so you wanna hold it like this? Speaker 3: Yeah, yeah, exactly.

00:14:06 Speaker 3: Okay. Speaker 3: Okay. Speaker 2: What do you want me to do now? Speaker 3: Oh, just give me a second. Speaker 2: Okay.

00:14:23 Speaker 2: I mean, like, this is crazy that he just has someone's, like, scans up while we've been Speaker 2: in his office. Speaker 2: What's that?

00:14:30 Speaker 2: That wouldn't happen in America. Speaker 2: He just has, like, someone's scans up more in his office on a computer. Speaker 2: He just has, like, someone's scans up more in his office on a computer.

00:14:38 Speaker 2: It's a HIPAA violation. Speaker 3: Sorry, what are you saying? Speaker 2: Just forget it. Speaker 2: I'm saying that it's crazy that we're seeing this person's personal information. Speaker 2: Like in America, this would be highly illegal. Speaker 3: Like on the screen right now? Speaker 2: Yeah.

00:15:03 Speaker 2: Even the fact that we filmed that surgery without that guy's permission. Speaker 2: I mean, you couldn't give permission.

00:15:12 Speaker 2: Yeah. Speaker 3: I mean, hopefully he like, moves forward and doesn't like...

00:15:25 Speaker 3: I'm trying to think how he usually sits. Speaker 2: I mean, wait, I'm sure we could tell him that one.

00:15:30 Speaker 2: Yeah. Speaker 3: I thought it would look best if his like, hands are like, on his desk.

00:15:37 Speaker 2: Like if he... push the chair in? Speaker 2: Yeah. Speaker 3: Where is the camera? Speaker 3: Some of the times it feels like very far away but also you can't see anything.

00:15:56 Speaker 2: Can't see like the office, you know?

00:16:05 Speaker 3: This chair is like massive.

00:16:09 Speaker 2: Well, I'm small.

00:16:28 Speaker 3: I feel like I'm too exhausted to like light. Speaker 2: Yeah, I'm just going to go. Speaker 2: I feel like almost high a little bit.

00:16:43 Speaker 3: I think it needs to be plugged in. Speaker 3: It doesn't have a control switch.

00:16:50 Speaker 3: Let's turn it on.

00:17:10 Speaker 2: I mean, I'm not going to be able to see. Speaker 3: I mean, I rolled on it so you can see.

00:17:26 Speaker 3: I mean, that's also a huge problem. Speaker 2: Yeah. Speaker 3: I don't really know what to do about that.

00:17:30 Speaker 2: I mean, you're going to have to reposition it. Speaker 2: I mean, we're going to have to take it out. Speaker 3: I know, which just, like, kind of defeats the purpose of setting up.

00:17:41 Speaker 2: Sorry, I just look so unhappy. Speaker 3: I mean, that's literally how you look. Speaker 2: No, I think that looks good. Speaker 2: I mean, I mean... Speaker 3: Where it feels like small in the frame. Speaker 3: Where it feels like small in the frame. Speaker 2: What ones are you on? Speaker 3: This is a 32. Speaker 3: But you do want to see like... Speaker 3: All the stuff. Speaker 3: Oh, this is kind of good.

00:18:19 Speaker 3: Thank you very much. Speaker 1: Oops.

00:20:13 Speaker 1: ...

00:26:30 Speaker 1: ...

00:28:02 Speaker 2: That shot was like a little too contrasty. Speaker 3: Yeah. Speaker 3: There's not really an easy way of doing that. Speaker 3: Walls will bounce. Speaker 3: His wall is a bouncer. Speaker 1: Walls will bounce.

00:28:20 Speaker 3: I think I just need to wrap this little more.

00:28:27 Speaker 1: I'm tired.

00:28:30 Speaker 3: Use it real quick while I refine the frame. Speaker 3: Just going to get the packaging outside for it.

00:29:16 Speaker 3: ...

00:30:12 Speaker 2: Can you try it with the 50? Speaker 2: Can you try it with the 50? Speaker 2: Can you try it with the 50? Speaker 3: Not yet. Speaker 3: Just thinking about it. Speaker 3: It's like the composition is like favoring like an eyeline looking this way, but it just doesn't really work. Speaker 3: For everything else. Speaker 3: It's like the lights on the other side.

00:00:00 Oh, this is actually really sweet.

00:00:17 Speaker 1: Oh, this is actually really sweet. Speaker 2: What is this? Speaker 1: It's like, I guess, Facebook. Speaker 1: It's like a picture from when the bomb went off at the hospital.

00:00:28 Speaker 1: And it's like him FaceTiming his son in the operating room. Speaker 1: He said, thank God you're alive. Speaker 1: I'm proud of you, my son. Speaker 2: Huh. Speaker 2: Like you mean your arms. Speaker 2: Okay. Speaker 2: Okay. Speaker 2: What? Speaker 2: Sorry. Speaker 2: Sorry. Speaker 2: I'm working here. Speaker 2: I'm working here. Speaker 3: Okay. Speaker 2: That is nice, though.

00:01:53 Speaker 4: Oh, he's not here.

00:02:13 Speaker 1: You need water? Speaker 4: I'm gonna bring it in all day. Speaker 4: I'm gonna bring it in all day.

00:02:34 Speaker 2: I'll Speaker 1: The computer screen.

00:03:08 Speaker 1: That's not what I want to do. Speaker 4: I'm going to move the camera. Speaker 4: More centered.

00:03:59 Speaker 4: You look here.

00:04:00 Speaker 4: You look here, like you're looking for that. Speaker 4: It just doesn't work.

00:04:07 Speaker 1: What if we got some of those small light strips?

00:04:14 Speaker 2: The problem is that they don't really work like reliably. Speaker 1: Cuz they're not like charged. Speaker 1: Yeah. Speaker 1: I mean, I don't even know where those are right now. Speaker 4: Man. Speaker 4: I just can't hold this here. Speaker 4: I don't know. Speaker 4: I could do this and just bounce it against this wall.

00:04:33 Speaker 4: I might try that. Speaker 4: Can you grab this stand? Speaker 4: Right here. Speaker 4: Okay. Speaker 4: Everything feels so heavy right now. Speaker 4: His light is like, the light is light. Speaker 4: It feels like 30 pounds on my arms right now.

00:05:23 Speaker 4: Oh, man.

00:06:01 Speaker 2: I think my body's just done. Speaker 1: Mm-hmm.

00:06:07 Speaker 1: What do you need? Speaker 4: I just need it. Speaker 4: I just need to get it. Speaker 4: Get the right spot. Speaker 1: Looks like the pin's maybe not in all the way. Speaker 1: Jesus. Speaker 4: I got the pin is stripped too. Speaker 4: It's like also causing problems here. Speaker 4: I'm going to go back here.

00:07:12 Speaker 2: enough light. Um, which I should have known that. What the fuck am I doing?

00:07:18 Speaker 1: Well can you, um, yeah.

00:07:22 Speaker 4: This is a hundred. Can you stand the mark? Speaker 2: This is a work. It's just his eye line can't be this way. It's like there's no, like that's not

00:07:42 Speaker 2: It's gonna be confusing. Speaker 1: Can't dad sit there? Speaker 2: Where? Speaker 1: In the chair? Speaker 3: No. Speaker 1: You have to sit there? Speaker 2: No, you're missing- like, no, 'cause it needs to be camera left, is what I'm saying. Speaker 2: The eye line needs to be camera left. Speaker 1: Does it look good if I look here?

00:08:01 Speaker 2: I mean, he looks fine, but I'm just saying he's- like, I see this being a problem.

00:08:07 Speaker 2: That he's not gonna be looking at someone, you know what I'm saying? Speaker 1: Can he look at the camera? Speaker 2: Well, none of the other interviews have. Speaker 1: My phone's broken.

00:08:29 Speaker 1: Could we? Speaker 4: I'm gonna try to like free up like a little.

00:08:43 Speaker 4: I just don't think this is gonna be enough. Speaker 1: Alright, bad idea. Speaker 1: What if Dad sat in a chair in front of the camera? Speaker 2: You can't see him. Speaker 2: Because it's a 32.

00:09:00 Speaker 1: His shoulder? Speaker 2: Yeah. Speaker 2: There's no way you don't see him. Speaker 2: Like think about it. Speaker 2: You saw some of them. Speaker 2: You were here. Speaker 2: earlier and you were on a longer lens than this.

00:09:54 Speaker 2: That's better. Speaker 2: Your scooter is far this way, so the chair will let you go, right?

00:10:06 Speaker 2: I mean to your right.

00:10:37 Speaker 1: Okay, so it's 2 o'clock.

00:10:44 Speaker 2: 2 o'clock? Speaker 1: So it's an hour? Speaker 2: Let's feel like we're not going to get this.

00:10:52 Speaker 2: You know, even if I start rolling now.

00:11:10 Speaker 4: Sorry, he keep looking.

00:11:15 Speaker 3: He's a bit taller than me.

00:11:26 Speaker 4: I can't move you.

00:11:51 Speaker 1: I feel like dad could poke his head in there. Speaker 4: Yeah. Speaker 1: Should I call dad and tell me?

00:12:00 Speaker 4: Yeah, to come over. Speaker 4: I think that would be wise. Speaker 1: Alright, I'm gonna tell him we're ready. Speaker 1: So, um, but also we kinda need to start the interview.

00:12:18 Speaker 1: Hello? Speaker 1: Yeah, we're ready. Speaker 1: Yes, we're ready. Speaker 1: Okay. Speaker 1: Sounds good. Speaker 1: No, we don't have them yet. Speaker 1: Um, yeah. Speaker 1: Alright. Speaker 1: Bye.

00:12:48 Speaker 2: I mean, once you see, then we could also, like, ask him to, like, move some things around Speaker 2: on the desk. Speaker 2: Yeah. Speaker 2: Like, move, if the skull moves, like, here. Speaker 4: Yeah.

00:13:06 Speaker 4: I think that feels better. Speaker 1: Okay. Speaker 1: Are we ready for him? Speaker 4: Yeah, I guess so. Speaker 4: I mean, kind of out of time.

00:13:30 Speaker 4: Did you get that answer? Speaker 1: Yeah, he said he's coming over with me. Speaker 1: He's going to be here in like 20 minutes. Speaker 4: Okay, I'm going to get it. Speaker 1: I'm going to tell Andre that we're opening. Speaker 1: Yeah.

00:14:00 Speaker 1: Oh, there we are. Speaker 5: Can I ask you your consultation for me? Speaker 5: How much does it cost? Speaker 5: How much does it cost?

00:14:09 Speaker 1: It's pretty expensive. Speaker 5: One million dollars, maybe two million. Speaker 5: One million dollars, maybe two million.

00:14:18 Speaker 1: Do we want him to sit in, Logan? Speaker 2: Yeah, you can come back in. Speaker 2: Oh, we'll wait for that, yes. Speaker 5: Maybe first, Laura, can you give it to me? Speaker 2: Laura, you want to give the interview?

00:14:30 Speaker 5: Do I want to... Speaker 5: I like the chief of neurosurgery department.

00:14:36 Speaker 5: Yeah? Speaker 1: Yeah. Speaker 5: It's true or not? Speaker 1: Sure, you can take a photo. Speaker 1: This would be me if my grandpa didn't leave Ukraine. Speaker 1: I could be here instead. Speaker 1: Yeah. Speaker 1: Chief of neurosurgery department at 29. Speaker 2: Very accomplished. Speaker 1: Yeah.

00:15:06 [RUS] Speaker 5: Vasilina [RUS] Speaker 5: Vasilina [RUS] Speaker 5: Tell her that if consultations [RUS] Speaker 5: Then somewhere after half past three [RUS] Speaker 5: Until half past four maximum they'll be [RUS] Speaker 5: Or better tomorrow morning [RUS] Speaker 5: I already consulted three people.

00:15:30 [RUS] Speaker 5: Or tomorrow morning.

00:15:44 Speaker 5: We have 50 minutes, because in 3 p.m. we will talk with Alex, with our international colleague from Israel.

00:16:00 Speaker 5: In 3 p.m., that's why 53 minutes.

00:16:00 Speaker 5: In 3 p.m., that's why 53 minutes. Speaker 1: It's Zoom, right? So you're going to take that here? Speaker 5: Yeah. Speaker 1: Okay. Speaker 2: Yeah, see if we can find that.

00:16:30 [UKR] Speaker 5: Like this.

00:16:39 Speaker 5: Yeah, exactly. Speaker 5: Maybe a lot of different... Speaker 2: Yeah, we'll probably remove a few things. Speaker 5: What things need to remove? Speaker 5: Can you explain to me?

00:17:00 Speaker 5: Maybe... Speaker 5: I think only the laptop, really. Speaker 5: Maybe a closed laptop.

00:17:08 Speaker 5: Will that be enough? Speaker 6: Yeah, you can close it. Speaker 6: I think it's connected to things. Speaker 6: Yeah, you can close it, but you don't need to fully remove it. Speaker 6: Uh, okay. Closer, yeah? Speaker 5: It's better. Yeah. Speaker 6: Okay. Do you want to see it move the skull somewhere else? Speaker 6: Out of the way, or... Speaker 6: I think we can move it behind.

00:17:30 Speaker 6: Yeah, we can move the skull. Speaker 6: To the background? Speaker 3: Remove? Remove? Speaker 6: No, no. Speaker 2: Click up on. Speaker 2: Press down there. Speaker 6: Should we move this? Speaker 6: Should we move this? Speaker 6: Can I just capture just a little bit so it's in shot, or is it going to be... Speaker 6: Yeah, we'll move it. Speaker 6: Let's see. Speaker 6: There it is. Speaker 6: Maybe let's get that cable a little... Speaker 2: Is it this cable you're saying? Speaker 2: Yeah. Speaker 6: Right, there you go. Speaker 6: Right, there you go. Speaker 6: I think I... Speaker 6: I think it's a lot less comfortable positions. Speaker 6: Yeah, it's a tough one. Speaker 6: Well, I mean, but this one's... Speaker 6: And then we need to see it in here because we're not doing it in the green.

00:18:19 Speaker 4: Okay, so should he be sitting there? Speaker 2: Probably. Speaker 2: Would you want Andre to put his hands on the desk? Speaker 6: So we're gonna have you sit and lean forward in this so you're not quite as we don't want you quite as relaxed

00:18:38 Speaker 6: You're just gonna be Speaker 6: No, no lean forward Speaker 2: Oh, yeah, like like hands on the desk. Yeah, more conversational right there you go

00:18:50 [UKR] Speaker 5: Vasilina, Lyudmila Vasilina, they're about to do the interview now,

00:19:01 [RUS] Speaker 5: quietly, and close the doors too, because everyone will be [RUS] Speaker 5: open.

00:19:16 Speaker 5: One more question. With glasses, maybe without?

00:19:21 Speaker 2: Yeah, without. Speaker 5: What is my hair?

00:19:31 Speaker 6: It looks like Anastasia should have the Speaker 6: the monitors. Speaker 6: and uh

00:19:48 Speaker 5: Looks better. Speaker 4: Looks good. Speaker 5: Yeah.

00:19:55 Speaker 5: Is this? Speaker 6: Yeah, yeah, that's good. Speaker 6: Also, in one of your, in one of the news pieces you showed sort of shrapnel that you pulled from the brain.

00:20:08 Speaker 6: the brain, do you have that handy to show during this or? Speaker 5: - Yeah. Speaker 5: And explain about this, yeah? Speaker 6: - Yeah, yeah. Speaker 5: - Yes, it's better if you want to in Ukraine. Speaker 5: - Yeah, yes, and we're gonna have-- Speaker 5: - Because I explain the more details, more, more.

00:20:29 Speaker 5: It's after this you can-- Speaker 6: - And we're gonna have Anastasia sit here, Speaker 6: so you should ask the question. Speaker 6: - Yeah. Speaker 6: Okay. Speaker 6: Maybe I could get a chair from here, right here. Speaker 6: I'll figure it out. Speaker 5: I can now show, and maybe a bit later you ask me to show the metallic fragment

00:20:52 Speaker 5: which was removed from the human brain during the last 2-3 months only. Speaker 5: Yes, I can take this, for example. Speaker 5: Yeah, yeah. Speaker 5: So you're saying we do that at the end? Speaker 6: Yeah, we'll do that at the end.

00:21:11 Speaker 6: And he'll pull off the camera so you can get over your shoulder. Speaker 6: Yes, I... Speaker 6: Yeah, yes. Speaker 6: Yeah, um, let me go, uh, see if I can get inside. Speaker 6: Here.

00:21:48 Speaker 6: Thank you.

00:22:34 [RUS] Speaker 5: Hi Nikita [RUS] Speaker 5: Did you win the GIA competition yesterday?

00:22:38 Speaker 4: No

00:22:39 [RUS] Speaker 4: We didn't have a serious organization [RUS] Speaker 5: Tell me [RUS] Speaker 4: I'm just of age [RUS] Speaker 5: You look good [RUS] Speaker 4: Thanks, on vacation [RUS] Speaker 5: I know, I'm telling you [RUS] Speaker 5: Yulia, you with the dog, not outside the window [RUS] Speaker 5: Watch and film Nikita [RUS] Speaker 5: Because, I'm telling you, nurse Katya will steal him away. [RUS] Speaker 5: She'll trade him for old Dima. [RUS] Speaker 5: Dima can't do squats and lift weights like you.

00:23:03 [UKR] Speaker 5: I'll tell you, Dmitry Yuryevich is giving it there.

00:23:05 Speaker 5: Yes. Speaker 5: Yes.

00:23:06 [UKR] Speaker 5: Well, I'm glad to see you.

00:23:08 [RUS] Speaker 5: Thank you. [RUS] Speaker 5: So, rest up, gather your strength. [RUS] Speaker 5: Thank you, trying to.

00:23:15 Speaker 5: I remember, Tadeusz told me, Logan is master of light. Speaker 2: We haven't had much time to do any lighting on this.

00:23:26 Speaker 2: Too much moving. Speaker 5: Yeah.

00:23:36 Speaker 2: Yeah, this is like no light at all. Speaker 2: Usually way worse. Speaker 2: It's like 10 stands. Speaker 5: Okay. Speaker 2: Everywhere. Speaker 5: Is this normal? Yes? Speaker 5: around me. Speaker 2: Yeah. Speaker 2: I think it looks normal. Speaker 2: I think it looks normal. Speaker 5: But if you Speaker 5: perform empty Speaker 5: table, it will be, it's not

00:24:00 Speaker 5: really... Speaker 2: No, it needs to feel like Speaker 2: your table, you know, your Speaker 2: office. Speaker 2: I want to say this, this Speaker 2: I want to say this, this Speaker 2: cord looks weird. Speaker 2: What is this powering? Speaker 2: Oh, it's your charger. Speaker 2: You can remove it. Speaker 2: Yeah, I can do that. Speaker 2: Yeah, I can do that. Speaker 2: That's just your mouse. Speaker 2: That's just your mouse. Speaker 2: Okay. Speaker 2: How's it going?

00:24:45 Speaker 2: yep

00:24:52 Speaker 6: it's normal those these yeah yeah that looks normal can you uh hand him this and have him trade out Speaker 2: his mic switch your hedgehog uh do you want to trade the one that he's wearing right yeah Speaker 2: thank you and he's got one on his desk here that do you want this too um sure is it is it rolling

00:25:12 Speaker 2: now it's red um yeah it's still rolling right it's rolling yeah just have it hidden wherever Speaker 6: it was behind the uh the soldiers is that where it was yeah something like that i had it facing the Speaker 6: um i had it facing the the microphone earlier or not the mic the speakers from his uh Speaker 6: from his uh

00:25:36 [RUS] Speaker 6: laptop [RUS] Speaker 5: Vasilina. [RUS] Speaker 5: Vasilina.

00:25:58 Speaker 6: - So, do you have a question? Speaker 6: - Yeah, obviously right here. Speaker 6: You sit there and you're gonna scoot in Speaker 6: to the left of the camera. Speaker 6: Anastasia, you're gonna scoot in to the left of the camera. Speaker 2: - He's gonna look like here. Speaker 6: - Yeah. Speaker 1: - So, left to the camera? Speaker 1: - Yes, so here, you're gonna sit here. Speaker 1: You wanna do him to look this way.

00:26:23 Speaker 1: And then he's looking at you. Speaker 1: - Okay.

00:26:27 [RUS] Speaker 5: Lock us from outside, because people are breaking through. [RUS] Speaker 5: Just close the doors, I'll open them later.

00:26:58 [RUS] Speaker 5: You look like pilots of a spaceship.

00:27:12 Speaker 3: And so just through the beginning, Speaker 3: what should we start with? Speaker 3: What are the best in his career? Speaker 3: What's in your country? Speaker 6: We started to talk about it yesterday. Speaker 6: I haven't talked about growing up near here.

00:27:26 Speaker 6: He grew up, I think, on a farm, Speaker 6: and then he won a gold medal in school, Speaker 6: and eventually came here for Memphis.

00:27:37 Speaker 6: So just ask him to talk about his growing up and also the life on the farm.

00:27:47 Speaker 3: Hello. Speaker 6: Hello. Speaker 3: Hello. Speaker 3: Can you figure out the same boxes?

00:27:56 Speaker 2: You can go figure out the same boxes.

00:28:05 [UKR] Speaker 5: My hedgehog went out.

00:28:29 [UKR] Speaker 3: - She can come back at some point, but not very soon. [UKR] Speaker 5: - I specifically asked to have us locked in. [UKR] Speaker 5: - Does she have keys? [UKR] Speaker 3: - Yes, she does. [UKR] Speaker 5: - Does she know which keys locked us: the lower or upper?

00:28:41 Speaker 3: We need to try 2 keys and figure out which one will work because you don't know about the lock. Speaker 3: And we need to lock us so people don't interrupt.

00:29:01 Speaker 3: Try the one below, the other lock.

00:29:09 [UKR] Speaker 5: Now we'll lock ourselves in and won't get out. [UKR] Speaker 5: Quiet, quiet, don't apply the village. [UKR] Speaker 5: Yes, and close, close, close, let her call you later or text you,

00:29:48 [RUS] Speaker 5: Then the show.

00:30:22 Speaker 2: If it's not close, don't worry about it.

00:30:30 Speaker 6: We're good. Speaker 4: Okay. Speaker 4: Second? Speaker 6: And Andre,

00:00:00 Speaker 1: Not that we've been doing this before, but can you do a clap in prayer face?

00:00:00 Speaker 1: Not that we've been doing this before, but can you do a clap in prayer face? Speaker 1: - Can you clap in prayer face? - Yes. Speaker 1: - So, if your microphone can record all the sound at the beginning. Speaker 1: - Here you go. Speaker 1: - We ask you for the beginning, how you were growing, what was your childhood?

00:00:18 Speaker 2: - I was born in the city of Dnepr-Petershk. Speaker 2: It's D-Petersk, it's 90 km from Dnepr, where I work and live with my family. Speaker 2: - I'm living with my family.

00:00:30 [UKR] Speaker 2: My father Hryhoriy was a zootechnician and managed a large poultry farm. [UKR] Speaker 2: My mother, unfortunately, she's been gone for many years. [UKR] Speaker 2: She was a librarian. [UKR] Speaker 2: My father's name is Hryhoriy, my mother Tetiana. [UKR] Speaker 2: What did this give me? [UKR] Speaker 2: My mother worked as a librarian, I never had a shortage of books.

00:01:00 [RUS] Speaker 2: I always had a lot of books, I read a lot.

00:01:04 [UKR] Speaker 2: Now there's the internet, now you can find anything on the internet, very quickly. [UKR] Speaker 2: But at the time when I was born, it was very important for me to get information. [UKR] Speaker 2: At the same time, my father, who constantly communicated with living, you could say, yes, birds, both at work, [UKR] Speaker 2: and at home loved to raise many different types of animals. [UKR] Speaker 2: These were cows, and sheep, and even pigs, and chickens, and geese, and ducks. [UKR] Speaker 2: This instilled in me a love for all living things. [UKR] Speaker 2: That is, I understood how a living organism functions. [UKR] Speaker 2: On one hand, my mother gave me the opportunity to gain knowledge the best way at that time, and my father instilled a love for living things.

00:01:52 [UKR] Speaker 2: I'll say that I performed my first operation while still being a schoolboy. [UKR] Speaker 2: We were raising rabbits, and one rabbit, a weasel, it's such a predatory animal, it wanted to get it out of the cage, [UKR] Speaker 2: and with its claw tore open its side, and its skin from the upper legs, lower ones, split on both sides, [UKR] Speaker 2: and you could see its body, I then took a needle with thread, stitched it up, well and it survived and lived longer than all the others, [UKR] Speaker 2: because we kept it as such a talisman, so that's the situation. [UKR] Speaker 2: Unfortunately, my mother's been gone for 14 years, but my father is alive, everything's good, he's active and continues to work on the farm.

00:02:43 [UKR] Speaker 2: I believe that this is his secret to longevity, because he works from 5 in the morning until late evening, but he, as they say, is a live wire and he infects everyone around with his energy.

00:02:56 [UKR] Speaker 3: You probably got this work ethic from him, these times of yours?

00:03:00 [UKR] Speaker 2: Yes, first of all, it's really genes on one hand from parents, and on the other - it's upbringing.

00:03:08 [UKR] Speaker 2: And they instilled such a respectful, good attitude towards people, first of all, respect for elders and love for all living things.

00:03:19 [UKR] Speaker 1: Tell us about the time when you came to study. [UKR] Speaker 2: When I was studying at school, at the secondary school of the city of Verkhniy Dniprovsk, what I liked more were subjects, first of all biology, first botany, then biology, geography, I liked physics, I participated in school olympiads, [UKR] Speaker 2: I even competed in all-Ukrainian olympiads in biology, traveled around Ukraine, participated. [UKR] Speaker 2: And when I finished school, I finished school with a gold medal, the question arose, where will I go next, what will I become.

00:04:05 [UKR] Speaker 2: The easiest thing was, we went to Dnipro University, considering that I had a gold medal, and also had victories in regional biology olympiads, [UKR] Speaker 2: they tell me, you can enter the ecological faculty of Dnipropetrovsk Medical University without exams. [UKR] Speaker 2: My father says, I've already arranged everything, we submit the documents, they'll enroll you after lunch, and you'll study here. [UKR] Speaker 2: And I say, no, I'll still, probably, be a doctor. [UKR] Speaker 2: So let's go, there was still Dnipropetrovsk Medical Institute then, we submit the documents, and I prepare to take exams. [UKR] Speaker 2: The exams, as I remember now, Ukrainian language, there was biology and physics.

00:04:54 [UKR] Speaker 2: What I loved in school, just what I needed. [UKR] Speaker 2: And I entered the first year of the medical faculty. [UKR] Speaker 2: This was 1992, it was just the first year after Ukraine gained independence, [UKR] Speaker 2: the act of independence and I entered the first group, the first subgroup, and this subgroup was Ukrainian.

00:00:26 [RUS] I want to [RUS] Speaker 1: No, wait.

00:00:36 [UKR] Speaker 1: Now Sergey Petrovich will give a toast, then Vyacheslav Ivanovich, and then my take.

00:00:43 [RUS] Speaker 1: Okay.

00:00:44 [UKR] Speaker 1: Grishin will speak, Sergey Petrovich will speak, third for the women. [UKR] Speaker 1: I know, he's prepared. [UKR] Speaker 1: Vyacheslav Ivanovich.

00:00:54 [RUS] Speaker 1: Next time don't bring Dibrova. [RUS] Speaker 1: When he says he's not here, where does he go? [RUS] Speaker 1: And he sits there.

00:01:03 [UKR] Speaker 1: And take off your hat.

00:01:06 [RUS] Speaker 1: Report on the little bear there, [RUS] Speaker 1: Vyacheslav, probably fell asleep. [RUS] Speaker 1: While mama doesn't see, [RUS] Speaker 1: while mama doesn't see, [RUS] Speaker 1: watching it again. [RUS] Speaker 1: Khalin Kuvaev. [RUS] Speaker 1: Vyacheslav Grishin, [RUS] Speaker 1: do you know what this is?

00:01:25 Speaker 1: A toast.

00:01:28 [RUS] Speaker 1: Come on, Slava.

00:01:29 [UKR] Speaker 1: Give it for the line. [UKR] Speaker 1: No. [UKR] Speaker 1: I haven't heard such English yet. [UKR] Speaker 1: This is the first. [UKR] Speaker 1: Can you say, well what?

00:01:51 [UKR] Speaker 1: And did you say that for Lora, right?

00:01:56 [RUS] Speaker 2: Ukrainian language. [RUS] Speaker 2: I thank you for your help. [RUS] Speaker 2: And everyone. [RUS] Speaker 2: May you. [RUS] Speaker 1: Cheers! [RUS] Speaker 2: Glory to the heroes!

00:02:28 [RUS] Speaker 3: - You don't like

00:02:55 [RUS] Speaker 1: - I want what he will say.

00:03:32 [RUS] Speaker 4: Good afternoon. [RUS] Speaker 3: Let's try [RUS] Speaker 3: Will you be Andryusha? [RUS] Speaker 3: Yes, for me and Alexey. [RUS] Speaker 2: Yes, for me and Alexey. [RUS] Speaker 3: And also for Alexey. [RUS] Speaker 3: Alexey.

00:04:06 [RUS] Speaker 3: Alexey. [RUS] Speaker 2: Alexey, I'll replace. [RUS] Speaker 2: Thank you. [RUS] Speaker 2: Lora, there are two seasons here.

00:04:27 [RUS] Speaker 1: Can you replace the plates there? [RUS] Speaker 1: People left. [RUS] Speaker 1: Two months.

00:05:06 Speaker 2: - My wife says this is the good stuff. Speaker 2: - Sergi said this picture. Speaker 2: - He picked all these mushrooms. Speaker 2: - My wife loves mushrooms. Speaker 3: - I take more picture for you. Speaker 3: - I take more picture for you and for wife. Speaker 3: - I take more picture for you and for wife. Speaker 2: - Yes. Speaker 2: - Yeah? Speaker 2: - Keep the wife happy.

00:05:28 [RUS] Speaker 3: And my food is also for you. I'll take photos.

00:05:35 [RUS] Speaker 2: Good? [RUS] Speaker 3: I want to go to Texas, Dallas.

00:05:41 [UKR] Speaker 3: I have a visa to America.

00:05:43 Speaker 2: Where? Speaker 3: Yes?

00:05:48 [RUS] Speaker 2: Sometimes! [RUS] Speaker 2: Yes, it's an interesting place right now. [RUS] Speaker 2: Andrey and I were talking about how we were looking at... [RUS] Speaker 2: Are you going to Dallas?

00:06:02 [RUS] Speaker 1: We're going to Washington now.

00:06:06 [RUS] Speaker 1: Armon's road to the Neurosurgical Congress in October.

00:06:10 [RUS] Speaker 3: I just wanted to come to the clinic, see how things are, what's there.

00:06:14 [RUS] Speaker 1: We're going with a serious team, Sergey Petrovich. [RUS] Speaker 3: Oh, Andryukha, Andryukha, my time is ending.

00:06:24 [UKR] Speaker 1: So that's exactly when it's time to travel, Sergey Petrovich.

00:06:27 [RUS] Speaker 3: I really appreciated what's happening.

00:06:31 [UKR] Speaker 3: But still, you need to fly, Petrovich.

00:06:34 [RUS] Speaker 3: Well, I flew more than Pliushch or all the others. [RUS] Speaker 3: And reported, and so on. [RUS] Speaker 3: And there are people like Cherednichenko, they grew out of us, but they don't realize it. [RUS] Speaker 3: That's very bad. [RUS] Speaker 3: Very bad. [RUS] Speaker 3: They think that they're just, they were like that.

00:06:51 [UKR] Speaker 1: That they were born that way.

00:06:52 [RUS] Speaker 3: That's wrong. [RUS] Speaker 3: That's so wrong. [RUS] Speaker 3: And that's very wrong.

00:07:28 [RUS] Speaker 1: Tell Nikita, Nikita can sit somewhere near Misa, and then Nastya will sit next. [RUS] Speaker 1: Vadim. [RUS] Speaker 1: No, Nastya is standing. [RUS] Speaker 1: Should we let him out? Otherwise we wanted to send him to the moon already. [RUS] Speaker 1: To the moon. [RUS] Speaker 1: And Karina says outside.

00:08:03 [RUS] Speaker 4: Logan, you won't film if Petrovich is about to give [RUS] Speaker 4: Oh, okay. [RUS] Speaker 4: Oh, okay. [RUS] Speaker 4: You want to film now? [RUS] Speaker 4: Film now. [RUS] Speaker 4: Logan, we have one more toast. [RUS] Speaker 1: Wait, don't rush.

00:08:19 [UKR] Speaker 4: Now he'll prepare.

00:08:23 Speaker 4: They might have the same definition of one more as I do. Speaker 1: Yes, it's Ukraine, Alex, it's Ukraine's 100 toasts. Speaker 1: It's very specific toast. Speaker 1: Okay. Speaker 1: Petrovich, your talk.

00:08:40 [RUS] Speaker 3: Dear friends, I really want to work in Ukraine to finish. [RUS] Speaker 3: And help everyone. [RUS] Speaker 3: Everyone. [RUS] Speaker 3: And my toast number three. [RUS] Speaker 3: a woman can be better

00:09:14 [UKR] Speaker 3: half of our community

00:09:21 [RUS] Speaker 3: maybe a mistake [RUS] Speaker 1: no, that's not it [RUS] Speaker 1: woman, it's not just woman

00:09:32 Speaker 1: It's neurosurgery. It's also a woman neurosurgery.

00:09:36 Speaker 1: For wife, mother, daughter, sister, young girl, baby.

00:09:49 Speaker 3: This is my toast number three. Speaker 1: For women.

00:09:57 [RUS] Speaker 1: - Another version - "For the Life".

00:10:00 Speaker 1: - "For the life".

00:10:09 [RUS] Speaker 5: - You have a critical. [RUS] Speaker 5: Desserts and coffee earned or can we?

00:10:16 [RUS] Speaker 1: - For alcohol we don't collect money from Russia, we pay for alcohol, and everything else can be ordered. [RUS] Speaker 2: - Can we have dessert? - Yes.

00:10:42 [RUS] Speaker 2: Good afternoon, Alex. [RUS] Speaker 3: Very good food.

00:11:01 Speaker 4: - What is this salad? Speaker 3: - Salad from Speaker 3: Buryak. Speaker 4: - Ah.

00:11:09 Speaker 3: - I don't know. Speaker 4: - Savage, red cabbage.

00:11:15 [RUS] Speaker 3: - No cabbage

00:11:44 Speaker 2: All right, okay. Speaker 2: Beet. Speaker 2: Ah, beet. Speaker 2: Yeah, yeah. Speaker 4: I've had beet before.

00:11:52 Speaker 4: Oh yeah, yeah. Speaker 4: The beet salad. Speaker 4: Beet, I guess it is for man. Speaker 4: Yes, beet.

00:12:00 Speaker 4: Beetroot, beans. Speaker 4: Yeah. Speaker 4: Delicious. Speaker 2: Very delicious. Speaker 2: Yeah.

00:12:27 [RUS] Speaker 1: Vadim, you handled the first task, you sat them down. [RUS] Speaker 1: Come over, order something for us. [RUS] Speaker 1: Well done. [RUS] Speaker 2: Who wants beer? [RUS] Speaker 1: - Anat

00:13:10 [RUS] Speaker 1: - Good bid for victory. [RUS] Speaker 2: - I already noticed that he won't. [RUS] Speaker 1: - Now we'll blow a refusal. [RUS] Speaker 2: - Here, and here's the anthill, look it's standing.

00:13:38 [UKR] Speaker 2: Did you see an ant?

00:14:07 [RUS] Speaker 2: Thank you.

00:14:08 Speaker 2: Here, I'll put that on. Speaker 2: - Me, video. Speaker 2: - Put that on. Speaker 2: - Me, video. Speaker 2: - I need to do it like a filmmaker. Speaker 2: Okay. Speaker 2: Thank you.

00:14:28 Speaker 2: - Thank you. Speaker 4: - I see, yeah. Speaker 4: - You gotta get one with this, and you can pass that button, and you can just pull it down. Speaker 2: - One, first.

00:14:56 Speaker 4: - Can you fit Bohdan in here?

00:14:59 [RUS] Speaker 2: - And for now she [RUS] Speaker 2: - And the bird will go.

00:15:30 [RUS] Speaker 2: - Here we are. [RUS] Speaker 1: - Thank you. [RUS] Speaker 1: - Photograph from there, Nikita. [RUS] Speaker 1: - Yes, come on. [RUS] Speaker 1: - Normal. [RUS] Speaker 1: - Check, check, please.

00:15:43 [RUS] Speaker 3: - Normal. [RUS] Speaker 2: - Normal. [RUS] Speaker 2: - Hold.

00:15:53 [RUS] Speaker 2: - That's my call.

00:16:02 [RUS] Speaker 4: Bad?

00:16:03 [UKR] Speaker 1: No, he's adjusting, he'll fix the light settings now.

00:16:08 [RUS] Speaker 1: You clicked well, but they're so swampy. [RUS] Speaker 4: That's why we were late.

00:16:20 Speaker 4: Yeah, no, it was my fault. Speaker 4: It was my fault. Speaker 1: Hold on. Speaker 1: Nikita, again. Speaker 1: Alex, repeat.

00:16:33 Speaker 2: I'll show you. Speaker 2: Oh, my goodness. Speaker 1: It says on/off, okay. Speaker 1: All right. Speaker 1: Come on, no, no. Speaker 1: You can just press it. Speaker 1: You can just press it. Speaker 2: Come on, come on.

00:16:50 [RUS] Speaker 2: - Come on, there,

00:17:19 Speaker 2: I'm listening to what? Speaker 2: Laura makes sense. Speaker 2: Alena, Logan. Speaker 2: Logan.

00:17:29 Speaker 2: Logan and... Speaker 1: No, no, no, no. Picture. Speaker 1: Your picture. Speaker 1: We're looking at Gibraltar. Speaker 4: Yeah. Speaker 4: Do you want me to set it so it can get us all in focus? Speaker 4: Of course. Speaker 2: Let me. Speaker 4: Okay. Speaker 2: Oh, focus on Alex, sorry. Speaker 5: I can't understand you.

00:18:18 [RUS] Speaker 2: Come on, this salad here. [RUS] Speaker 2: Will you have salad? [RUS] Speaker 2: What? [RUS] Speaker 2: Come on. [RUS] Speaker 2: I'll take this. [RUS] Speaker 2: Come on. [RUS] Speaker 3: Come on, I'll take this. [RUS] Speaker 3: Take this one.

00:18:56 Speaker 3: You have very tasty salad.

00:19:01 Speaker 1: I'm sorry, I'm not going to Speaker 4: I've got a camera over there. Speaker 4: Maybe here. Speaker 4: I know, I've got this bag, but... Speaker 4: Yes, yes, there you go. Speaker 4: Alright. Speaker 4: Alright. Speaker 4: Alright.

00:19:56 Speaker 2: Salad with. Speaker 2: Excellent.

00:20:28 [RUS] Speaker 3: - My Lenka adds, you know, lemon zest,

00:20:32 [UKR] Speaker 3: he has such a member collection, if you get it polar now,

00:20:35 [RUS] Speaker 2: or he adds vinegar. [RUS] Speaker 2: - That's a bomb altogether. [RUS] Speaker 2: - What are you saying, Andrey?

00:20:43 [UKR] Speaker 2: - Lenka adds zest or vinegar, while I don't see.

00:20:48 [RUS] Speaker 1: - Why? [RUS] Speaker 1: - Yes, there is, so what. [RUS] Speaker 1: After this video with the little bear, you can draw two conclusions. [RUS] Speaker 1: First, he has normal sexual orientation. [RUS] Speaker 1: - That's right. [RUS] Speaker 3: - But Sveta doesn't give it to him. [RUS] Speaker 1: - Normal sexual orientation, but problems with surrender. [RUS] Speaker 1: - Alena, hit the spleen one more time for canning.

00:21:17 Speaker 1: - Logan, Lora, one more, one more.

00:21:22 [RUS] Speaker 3: - How are they going? [RUS] Speaker 3: - Are they leaving today? [RUS] Speaker 3: - Leaving straight from here? [RUS] Speaker 1: - No, tomorrow Alex is leaving, they'll arrive already. [RUS] Speaker 3: - Where will they be now?

00:21:33 [UKR] Speaker 3: - Tomorrow they'll still work with us?

00:21:34 [RUS] Speaker 3: - They'll come.

00:21:35 Speaker 3: - Ah, yes?

00:21:36 [RUS] Speaker 3: I thought they would leave right now. [RUS] Speaker 3: - No, it's a preference. [RUS] Speaker 2: - In my opinion. [RUS] Speaker 2: - No, well I just think.

00:21:53 [RUS] Speaker 1: Nikita, sit down.

00:22:01 Speaker 1: Alex, one more.

00:22:03 [UKR] Speaker 2: Sergey Petrovich.

00:22:05 [RUS] Speaker 2: Smile. [RUS] Speaker 1: Are you filming Olya or Sergey Petrovich? [RUS] Speaker 1: I can't understand.

00:22:12 [UKR] Speaker 2: Sergey Petrovich.

00:22:15 [RUS] Speaker 2: Thank you, Olya. [RUS] Speaker 3: My dear. [RUS] Speaker 3: Coming for long. [RUS] Speaker 3: I won't get up anymore.

00:22:33 [RUS] Speaker 2: - Sonya, can we have some more regular water? [RUS] Speaker 2: - Ice there? - Without gas. [RUS] Speaker 3: - That's dangerous. [RUS] Speaker 2: - Ice, ice? - Yes, please. [RUS] Speaker 2: - Sonya, more ice, can we? - Yes, yes. [RUS] Speaker 2: - Artem, did you understand how to order in English?

00:22:52 [RUS] Speaker 2: Ice there, this, well, whiskey, ice and this, Sriracha and beer, right? [RUS] Speaker 1: Are you about to escape already? [RUS] Speaker 1: Well then come here, you'll speak on behalf of the youth movement. [RUS] Speaker 1: Well then come here, you'll speak on behalf of the youth movement.

00:23:24 Speaker 2: There you go.

00:23:29 Speaker 2: So, this one is going to make the cheese start with

00:23:54 [RUS] Speaker 4: - Alik

00:24:27 Speaker 4: Look at how many cameras I've got. Speaker 4: I do not ride a horse.

00:24:30 Speaker 4: I've ridden a horse, but I do not ride one. Speaker 4: I do. Speaker 4: I get around better in the car. Speaker 4: Am I out with battery on this one? Speaker 4: I am. Speaker 4: I bet. Speaker 4: Oh yeah, there's no way we're all going to be in focus. Speaker 4: You have to stop it down. Speaker 4: Yeah. Speaker 4: Only Andre. Speaker 4: Okay. Speaker 4: So, and then if you want to share, all you have to do is manipulate this thing. Speaker 4: Yeah, it's darker, but more is in focus.

00:25:17 [RUS] Speaker 4: I can show what you're doing [RUS] Speaker 2: Yes, I'll do it later [RUS] Speaker 2: Of course.

00:25:54 [UKR] Speaker 2: to send away, huh? For the bonus. [UKR] Speaker 2: For the bonus.

00:26:24 [RUS] Speaker 2: -Well done.

00:26:25 Speaker 2: -Well done. Speaker 2: -I think I'm fine. Speaker 2: -That sounds good. Speaker 2: -I think we're going to...

00:26:41 Speaker 4: -Logan, we ask you one more film of toast. Speaker 4: -Here we go. Speaker 4: -Yeah, second one.

00:26:51 [UKR] Speaker 4: Grisha Petrovich. [UKR] Speaker 4: Grisha Petrovich.

00:26:55 [RUS] Speaker 4: I gave. [RUS] Speaker 4: Did you give? [RUS] Speaker 4: Artem? [RUS] Speaker 1: Gave two toasts already. [RUS] Speaker 4: Gave two toasts?

00:27:05 Speaker 3: Yes.

00:27:08 [RUS] Speaker 4: I think you should come here already, right? [RUS] Speaker 2: What circus? [RUS] Speaker 2: Another circus, you can on the hook or on...

00:27:18 [RUS] Speaker 2: ...on the shoulders.

00:27:28 Speaker 4: Uh oh, he's getting up for it. Speaker 4: Oh, oh, what's up? Speaker 4: It's one of those, didn't know it was gonna be the one of those kind of parties.

00:27:47 Speaker 1: Wait, we already got this dog. Speaker 1: Let's go and eat some food. Speaker 1: You prepared? Speaker 1: Yes. Speaker 5: Okay, I want to say thank you so much for your efforts to help our country, help ourselves,

00:28:07 Speaker 5: and also to show the world real situation in our city, in our hospitals, and real situation in our specialization. Speaker 5: So thanks to you, thanks to your project, also thanks to you, thank you for your birthday, thank you. Speaker 5: It's very cool for everybody of our community to see you face to face, Speaker 5: like the part of neurosurgery, American neurosurgery. Speaker 5: Before the war, to think about American neurosurgery is somewhere, Speaker 5: and we look on the stars, and one of the stars came to us. Speaker 5: So thank you so much, thank you very much for your help, Speaker 5: by the war, by the stuff, by everything.

00:28:52 [RUS] Speaker 5: This shows that another country is together with us, we fight together for freedom, for everyone's freedom. [RUS] Speaker 5: Ukraine, Europe, Ukraine. Thank you very much. [RUS] Speaker 5: Have a good day. Thank you for subtitles. [RUS] Speaker 2: Thank you. [RUS] Speaker 2: Thank you. [RUS] Speaker 2: Thank you. [RUS] Speaker 2: Have a good day. [RUS] Speaker 1: And in English I'll ask from this, whatever his language is, for Natalia Sergeevna.

00:29:19 [RUS] Speaker 1: Yeah, I can't hear you.

00:29:26 Speaker 1: I like it. Speaker 4: Yeah, Logan, I don't know if there's any sitting down anymore.

00:29:56 Speaker 4: Yeah, that battery seems to be dead. Speaker 2: Yeah.

00:30:00 Speaker 1: Yeah. Speaker 2: Yeah.

00:30:46 Speaker 2: you

00:00:00 Speaker 1: yeah

00:00:00 Speaker 1: yeah

00:00:57 Speaker 2: whatever went on. Speaker 2: The, um, I can...

00:01:04 Speaker 3: Alex, Alex, Vadym would like to chat with you. Speaker 3: What? Speaker 3: Vadym would like to chat. Speaker 1: Okay. Speaker 1: Oh, nice. Speaker 1: Alright. Speaker 1: Do you mind me going to order it? Speaker 2: Alright, yeah. Speaker 2: I will order one. Speaker 2: What was that? Speaker 2: What was that?

00:01:34 Speaker 1: So what's the plan for tomorrow? Speaker 2: Well I was going to give it a toast, and you were going to give it a toast, and then Andre Speaker 2: was going to give it a toast. Speaker 1: Oh, okay. Speaker 1: We can toast tomorrow. Speaker 2: Yes, yes. Speaker 2: The plan for tomorrow. Speaker 2: What do you have for surgery? Speaker 2: You mentioned there's a whole surgery.

00:01:52 Speaker 1: I saw the rehabilitation center and maybe you want to...

00:02:08 Speaker 1: Yeah, he rocks him out. Speaker 4: If he would like to...

00:02:16 Speaker 4: ... Speaker 1: Would this be the same kind of dessert your wife made last night? Speaker 1: What? Speaker 1: Tatiana, what was the dessert she made last night?

00:02:37 Speaker 3: It's... Speaker 3: I couldn't repeat this. Speaker 1: I know, I know. Speaker 1: I just want it was the same kind. Speaker 1: The same kind? Speaker 1: Maybe I check. Speaker 1: Because it was yours and your wife was so good that I know it wouldn't be close.

00:02:59 Speaker 3: It's from this restaurant here. Speaker 1: Yeah, these are from this restaurant. Speaker 1: I'm looking to see what I want to order. Speaker 1: I'm sorry, you want an Indian Ukrainian? Speaker 1: I said, I would say that if I can be doing it, I will get 250 of them. Speaker 1: I'll see you tomorrow.

00:03:30 [RUS] Speaker 1: Yes, of course, we can chat. [RUS] Speaker 2: Ah, do you want another one? [RUS] Speaker 2: I don't see what's being balanced.

00:03:39 [RUS] Speaker 1: Yes, yes, yes. [RUS] Speaker 1: That's very little. [RUS] Speaker 1: That's the thing, because, [RUS] Speaker 1: Every day, in trouble, and in the car, [RUS] Speaker 1: and in the car, and in the car. [RUS] Speaker 1: Well, I don't know what I don't know. [RUS] Speaker 1: Well, naturally, it's not necessary, [RUS] Speaker 1: I don't know what I don't know. [RUS] Speaker 1: One from Venice, one from Amsterdam, one our girl from each. [RUS] Speaker 1: I'll show this at A2 level. [RUS] Speaker 1: Passed 80%. [RUS] Speaker 1: Need to say 20%, because that's approximately. [RUS] Speaker 1: You me? [RUS] Speaker 1: I'm all. [RUS] Speaker 1: I'm all. [RUS] Speaker 1: Well come on, here. [RUS] Speaker 1: Well come on, here. [RUS] Speaker 1: Come on.

00:04:39 [RUS] Speaker 1: You'll send it to me, and I...

00:04:51 [RUS] Speaker 1: Now this will be forever.

00:04:58 [UKR] Speaker 3: He'll draw it and imagine.

00:05:05 [RUS] Speaker 4: That's this nonsense that came on Facebook. [RUS] Speaker 1: He was asking what he ate yesterday, but it looks like Napoleon. [RUS] Speaker 1: I want to say that anyone can be. [RUS] Speaker 1: For this you need on foot, the city and passed. [RUS] Speaker 1: Just don't need to leave this. [RUS] Speaker 1: This is, let's say, a flash drive, but this is probably looking at a flash drive.

00:05:45 [RUS] Speaker 3: Very tasty. [RUS] Speaker 4: Well thank God, I have a compact disc.

00:05:51 [RUS] Speaker 1: Here I am from morning till evening going to work, going from work. [RUS] Speaker 1: I have this test on paper, I don't catch up. [RUS] Speaker 1: Looked, translated, into personal messages. [RUS] Speaker 1: I think this will be somehow. [RUS] Speaker 1: At first I was a complete dunce, complete. [RUS] Speaker 1: It's very tasty. [RUS] Speaker 1: But I think this.

00:06:12 Speaker 1: We'll ask you that one. Speaker 1: Yeah, it's like Kia. Speaker 1: It's like it's a... Speaker 1: It's a... Speaker 1: Yeah, yeah, yeah.

00:06:24 Speaker 4: But, the most important thing, Speaker 4: is that,

00:06:42 [RUS] Speaker 1: You can speak Ukrainian. [RUS] Speaker 1: You can speak Ukrainian. [RUS] Speaker 1: You can take

00:07:20 Speaker 4: She was wearing a mic back. Speaker 2: She did not work out with it, okay? Speaker 2: Yeah, no, it's fine. Speaker 2: But he wants to, who's doing the toast? Speaker 2: Him? Speaker 2: Okay, yeah, so he'll take it. Speaker 2: Yeah, please. Speaker 2: I even have a much bigger one.

00:07:57 [RUS] Speaker 1: Look at how I have it.

00:08:14 [RUS] Speaker 1: Bon appetit! [RUS] Speaker 3: Nastya, you'll translate, I'll ask to translate,

00:08:18 [UKR] Speaker 3: now Anatoliy will speak, because we already today [UKR] Speaker 3: were on the tongue, this rarely happens, [UKR] Speaker 3: okay.

00:08:26 [RUS] Speaker 3: 3 years hasn't sung.

00:08:57 [UKR] Speaker 3: The answer is that it started with father Saviudy Petrovych,

00:09:07 [UKR] Speaker 4: father Markovych, Solionyi Vadym Ivanovych.

00:09:13 [UKR] Speaker 3: This was still the 70th year.

00:09:17 Speaker 4: 64th, 5th.

00:09:20 [RUS] Speaker 4: It all began.

00:09:22 [UKR] Speaker 3: It was very pleasant to observe how our neurosurgery developed. [UKR] Speaker 3: To Naikom Oleksandr Zoryn, Volodymyr Hryhorovych, [UKR] Speaker 3: and there was also Hlysin, that Nikolai Dmytriy, there were many, and Holubytsky, Anton Ivanovych.

00:09:37 Speaker 3: Yes.

00:09:38 [UKR] Speaker 3: Or write this down. [UKR] Speaker 3: Today neurosurgery is developing. [UKR] Speaker 3: It's very pleasant to see at what level we are now. [UKR] Speaker 3: It's very pleasant to see Alex, who comes to us. [UKR] Speaker 3: Very pleasant for our young guys, for our fighters. [UKR] Speaker 3: I really want that next time, next year, [UKR] Speaker 3: Alex comes to us in a free, independent, peaceful Ukraine. [UKR] Speaker 3: So that no one hides in bomb shelters, so that we spend pleasant time, [UKR] Speaker 3: communicate, learn from each other, so that everyone is healthy. [UKR] Speaker 3: Glory to Ukraine!

00:10:23 [RUS] Speaker 3: Glory to the heroes!

00:10:26 [UKR] Speaker 3: I asked Nastya to briefly translate.

00:10:32 [RUS] Speaker 3: Oleksandr Kosofol, this toast,

00:10:36 Speaker 3: about Dnipropetrovsk region Speaker 3: neurosurgery, Speaker 3: about a founder

00:10:43 [RUS] Speaker 3: of Serhiy Hryho phase, [RUS] Speaker 3: Oleksandr phase,

00:10:49 Speaker 3: a lot of very famous Speaker 3: neurosurgery and professional,

00:10:54 [RUS] Speaker 3: like Solionyi Vadym Ivanovych,

00:10:56 [UKR] Speaker 3: Lysenko Nikolai Dmytryevych,

00:10:58 [RUS] Speaker 3: which was created by Maseichuk Nikolai Markovych [RUS] Speaker 3: in 1964-1965, and now it's 2025, 60 years ago.

00:11:18 Speaker 3: And now, Dnipropetrovsk, Dnipro. Speaker 4: There were two neurosurgery in 1967.

00:11:32 Speaker 4: Only two neurosurgery in all Dnipropetrovsk regions, only two neurosurgery. Speaker 2: don't have sugar they have that corn syrup right so like but like when in america you find Speaker 2: a coconut

00:12:00 Speaker 2: yes exactly Speaker 2: definitely you can find it

00:12:10 [RUS] Speaker 2: I always... [RUS] Speaker 1: Oleksandr, come on, toast. [RUS] Speaker 4: Here you based on this and that.

00:12:19 [RUS] Speaker 4: And sometimes... [RUS] Speaker 3: Come on, so Teddy gets in too. [RUS] Speaker 4: I'm in a different row and can't... [RUS] Speaker 3: Everyone getting in?

00:12:25 Speaker 1: Yes.

00:12:26 [RUS] Speaker 1: Didn't even frame with one shoulder. [RUS] Speaker 3: With an eye.

00:12:30 [RUS] Speaker 1: Now it's your turn, come on.

00:12:34 [RUS] Speaker 1: There's someone. [RUS] Speaker 3: Well done.

00:12:47 [RUS] Speaker 1: I think, is Rostyslav ready? [RUS] Speaker 1: Who will speak? [RUS] Speaker 1: Who will speak? [RUS] Speaker 1: You're saying who will speak?

00:13:02 [RUS] Speaker 1: He, by the way, will speak well. [RUS] Speaker 3: After Rostyslav will speak. [RUS] Speaker 3: He's growing fast. [RUS] Speaker 3: Last time he was appointed in charge over Rostyslav. [RUS] Speaker 3: Whom? [RUS] Speaker 3: Nikita. [RUS] Speaker 3: On duty with Anatoly.

00:13:19 [UKR] Speaker 1: I have such a position.

00:13:20 [RUS] Speaker 1: Anatoly said: "Can I appoint once?

00:13:24 [RUS] Speaker 2: Possible, with Anatoly?"

00:13:29 [RUS] Speaker 3: I came to check so there wouldn't be, you know, like physical violence, well, like in the army.

00:13:40 [RUS] Speaker 1: If you think I don't see, don't evaluate, Nikita, you're wrong. [RUS] Speaker 4: Akhmed Tuhaevych, you know, you know why I'm sitting here in this film. [RUS] Speaker 4: Of course, I know.

00:14:21 Speaker 2:

00:14:23 [RUS] Speaker 2: I was very glad that I was serious [RUS] Speaker 4: in Russian God forbid [RUS] Speaker 4: one on the number we'll see him [RUS] Speaker 4: in some cloud

00:15:09 [RUS] Speaker 4: this in America they're going [RUS] Speaker 4: to launch it for the general public [RUS] Speaker 4: for the general public of the American people

00:15:21 [RUS] Speaker 4: this is great [RUS] Speaker 3: This is that young woman's trace, yes? [RUS] Speaker 3: They, like him, these Emmy award laureates.

00:15:31 [RUS] Speaker 3: It's him, those. They too. [RUS] Speaker 4: This is a bomb, this is just a bomb, a bomb. [RUS] Speaker 3: Laura is now finishing a film about this Normandy landing, May 8th.

00:15:44 [RUS] Speaker 3: Documentary film, she's releasing it soon. [RUS] Speaker 3: And he was filming about a football team in Dallas, Texas, [RUS] Speaker 3: and he's number one on their channel by the number [RUS] Speaker 3: of views. [RUS] Speaker 3: He's a peculiar person. [RUS] Speaker 3: He constantly loses his phone, bank cards, but his [RUS] Speaker 3: brain works. [RUS] Speaker 3: He looks, he has completely different thinking. [RUS] Speaker 3: He looks at what he's doing, and he understands how it [RUS] Speaker 3: can be shown in films, whether it's worth it or not worth [RUS] Speaker 4: doing. Very interesting when they release this film, so we can see it. Very interesting.

00:16:24 [UKR] Speaker 4: And how many people in America will see it?

00:16:38 [RUS] Speaker 3: Soli, look this way. If you understand something, then you're great. [RUS] Speaker 3: This isn't a film, just scroll through photos. [RUS] Speaker 3: They took a short interview there somewhere, they were setting up the light now. [RUS] Speaker 3: This is in the office.

00:17:02 [UKR] Speaker 3: They have such a lamp that inflates.

00:17:05 [RUS] Speaker 3: The lamp inflates, and there's a button, if you need to diffuse the light, they press it,

00:17:09 [RUS] Speaker 3: This lamp becomes thicker, smaller. [RUS] Speaker 4: What, are they already eating sweets?

00:17:48 [RUS] Speaker 4: Pisces? [RUS] Speaker 3: Wait, now I won't throw it, and, Rusik didn't say?

00:18:00 [RUS] Speaker 3: What are you pulling? [RUS] Speaker 3: Serhiy Petrovych, I thought they wouldn't destroy the car. [RUS] Speaker 3: Look how much different stuff they stuck there. [RUS] Speaker 3: We drove around the city. [RUS] Speaker 3: Were they at your home?

00:18:15 Speaker 3: Yes.

00:18:17 [RUS] Speaker 2: Everyone?

00:18:18 Speaker 2: 7:00.

00:18:19 [RUS] Speaker 3: But they were filming. [RUS] Speaker 3: Yesterday just as they came and there's no light. [RUS] Speaker 3: And there's no light at Serhiy Petrovych's. [RUS] Speaker 3: Don't you have a generator?

00:18:27 [UKR] Speaker 3: And they put a candle.

00:18:30 [RUS] Speaker 3: Didn't set up a generator at home?

00:18:31 [UKR] Speaker 3: There is one, but it won't last like that.

00:18:33 [RUS] Speaker 3: But we specially then led... [RUS] Speaker 4: Set up a generator at home? There is.

00:18:38 [UKR] Speaker 4: I put a wire in the garage, ran it and we take turns,

00:18:43 [RUS] Speaker 4: me or Larysa, will turn it on. [RUS] Speaker 3: We showed them the shelter, they went home, then the alarm [RUS] Speaker 3: started, 4 hours I called, and they felt what it was like. [RUS] Speaker 3: Is your generator diesel? Yes. [RUS] Speaker 3: I have such a station that charges for the military.

00:19:01 [RUS] Speaker 4: I also have an electric one.

00:19:03 Speaker 2: Logan, for both of you, what time for the two of them at the thing I don't want to say Speaker 1: loudly?

00:19:24 [RUS] Speaker 1: Did he already order this?

00:19:30 [RUS] Speaker 1: What does he have?

00:19:37 [RUS] Speaker 1: What did you eat?

00:19:41 [RUS] Speaker 3: Did you have delicious porridge suzirya? [RUS] Speaker 1: Now more. [RUS] Speaker 1: What are you saying, to try? [RUS] Speaker 1: Try suzirya. [RUS] Speaker 1: Suzirya. [RUS] Speaker 1: Well yes. [RUS] Speaker 1: Rosyslava, smile, side, toasts, everyone. [RUS] Speaker 1: Ah, he's better plus 4, better plus 5. [RUS] Speaker 3: Ah, Tolich, did you give away your hedgehog?

00:20:41 Speaker 1:

00:20:50 [RUS] Speaker 3: Where do you have the generator on the roof?

00:20:55 [RUS] Speaker 3: No, I have a garage. [RUS] Speaker 4: You've never been.

00:21:00 [RUS] Speaker 4: I'll decide to invite. [RUS] Speaker 4: Listen, I have... [RUS] Speaker 3: Olya, don't leave. [RUS] Speaker 4: I have... [RUS] Speaker 4: My balcony faces the courtyard. [RUS] Speaker 4: I have 10 meters from the balcony to the garage. [RUS] Speaker 4: I put the generator there and ran a wire through [RUS] Speaker 4: the grate, through the balcony into the house. [RUS] Speaker 4: That is, outlets, switches. [RUS] Speaker 3: Didn't you have one at home? [RUS] Speaker 3: Already at your home. [RUS] Speaker 3: Was there, yes?

00:21:27 [UKR] Speaker 3: Together with Ukrainian.

00:21:32 [RUS] Speaker 1: Well, I did it poorly. [RUS] Speaker 4: It's better at my dacha.

00:21:37 [UKR] Speaker 4: I installed 20 Chinese batteries.

00:21:40 [RUS] Speaker 4: As soon as the power goes out, everything runs on my inverter.

00:21:44 [RUS] Speaker 4: But here I have to walk, turn it off here, turn it on there, and start the diesel generator. [RUS] Speaker 1: Do you live in a house? [RUS] Speaker 1: Or now there's a cycle? [RUS] Speaker 3: And then how do you know that the power appeared, that you need to go turn it off? [RUS] Speaker 4: I put one dummy there. [RUS] Speaker 4: It's visible from the balcony, that the power appeared, need to go turn it off. [RUS] Speaker 4: Well again hassle, walking back and forth. [RUS] Speaker 1: Do you live in a house? [RUS] Speaker 1: In a private one or... [RUS] Speaker 4: Well, at the dacha in a private one, and here in an apartment.

00:22:16 Speaker 4: I live in flat. Speaker 4: Second floor.

00:22:23 [UKR] Speaker 1: I just have such a small, like...

00:22:24 [RUS] Speaker 1: Vadym, what's your girlfriend's name, Vadym? [RUS] Speaker 1: Vadym, what do the girls call?

00:22:30 [RUS] Speaker 1: And the refrigerator, most important. [RUS] Speaker 3: Do you have this, yes, [RUS] Speaker 3: This is your signature suzirya. [RUS] Speaker 3: Cake? Suzirya cake. [RUS] Speaker 3: Can I have suzirya cake and latte? [RUS] Speaker 1: On regular milk it's like this, but...

00:22:44 [RUS] Speaker 3: Valiana cappuccino on regular latte. [RUS] Speaker 1: When I heard, when he came in, [RUS] Speaker 1: you can argue, [RUS] Speaker 1: And he's regular,

00:23:09 Speaker 1: I know. Speaker 1: Yeah. Speaker 1: Yeah. Speaker 2: Now, Alex, don't tell Logan he has to film Rostyslav.

00:23:19 Speaker 2: I mean he does.

00:23:23 Speaker 2: All right, all right, all right.

00:23:26 [RUS] Speaker 3: Wait, don't rush. [RUS] Speaker 3: Wait, don't rush.

00:23:38 [RUS] Speaker 5: I want to say that Alex and all our friends from U.S.

00:23:46 Speaker 5: that we don't have Tomahawks from US government, but we have you and you and you here and this

00:24:21 Speaker 5: Thank you.

00:24:40 Speaker 1: Thank you. Speaker 2: Thank you. Speaker 2: We're honored to be here.

00:25:03 [RUS] Speaker 1: Everyone will speak.

00:25:27 Speaker 2: No, they can come back. Speaker 2: Sounds good, right? Speaker 2: Good to hear you. Speaker 2: Tell Sasha we say hello. Speaker 3: Okay? Speaker 3: Yep. Speaker 3: I never say Olga. Speaker 3: I say Olya. Speaker 3: Olga is very official.

00:25:49 Speaker 1: Okay.

00:26:06 [RUS] Speaker 1: Thank you. [RUS] Speaker 3: Come on, Nikita. [RUS] Speaker 3: Come on, Nikita. [RUS] Speaker 3: Wait, don't rush. [RUS] Speaker 3: Poor Logan.

00:26:33 Speaker 1: I saw you during this visit in Dnipro.

00:26:39 Speaker 1: It was on Sunday in the ICU. Speaker 3: And it was a surprise for me. Speaker 3: And my thought was like, "Oh, superstar is here." Speaker 3: And this is, as Rostyslav said, really inspiring. Speaker 3: I am 100% sure that your visit inspires everybody here to do better, to be stronger.

00:27:06 Speaker 3: Thank you so much for your visit. Speaker 1: And thank you for a wonderful reason to come here today to laugh together. Speaker 1: Several hours ago there was a missile attack.

00:27:23 [RUS] Speaker 1: Now we're here, we're laughing, we're drinking, and all this is for you [RUS] Speaker 3: Wait, wait. [RUS] Speaker 3: I already know. [RUS] Speaker 3: Wait, now you'll put on him, this hedgehog. [RUS] Speaker 3: Wait. [RUS] Speaker 3: Wait, Artem. [RUS] Speaker 3: Aliona Yurivna, you're next. [RUS] Speaker 3: Good, we raise.

00:28:14 Speaker 3: Short toast like flash. Speaker 3: Thank you. Speaker 3: God bless you.

00:28:38 [RUS] Speaker 1: Can you [RUS] Speaker 3: Ice, here it goes, it goes.

00:29:00 Speaker 3: Give me this bill. Speaker 4: Give me this bill.

00:29:16 Speaker 1: You can choose a Speaker 1: You can choose a Speaker 1: This is amazing Speaker 1: She's very important Speaker 2: She bosses us around too Speaker 2: She bosses us around too Speaker 2: She's like Speaker 2: She's like Speaker 2: You need to monitor this Speaker 2: And then we're top Speaker 2: Thanks boss

00:29:42 Speaker 1: You will stay with bags

00:29:49 [RUS] Speaker 4: I'm also an underwater hunter, so you know.

00:29:53 [RUS] Speaker 4: And above water, and in water.

00:29:59 [RUS] Speaker 1: Hunting for mermaids like this? [RUS] Speaker 4: You didn't know, I have all the suits, all the guns. [RUS] Speaker 4: Three underwater guns. [RUS] Speaker 4: Andriy Hryhorovych knows, I have all the hunter guns. [RUS] Speaker 3: Yes, there was a time, Petrovych and I... [RUS] Speaker 4: We're lying in the landing and saying that...

00:30:21 [RUS] Speaker 3: No, but first we went out when there was dew,

00:30:24 [UKR] Speaker 3: and now the sun was setting, around 4-5.

00:30:27 [RUS] Speaker 4: We're lying with Andriy Hryhorovych, we say: [RUS] Speaker 4: "Everyone's assholes, and we're class, handsome." [RUS] Speaker 4: What to do? [RUS] Speaker 4: Petrovych is getting ready to blow up the church... [RUS] Speaker 4: And two ducks fly by, we kill them both. [RUS] Speaker 4: Yes, that was it. [RUS] Speaker 4: Of course. [RUS] Speaker 3: At the opening of hunting season, when we went.

00:30:47 [UKR] Speaker 3: Volodymyr Oleksiyovych.

00:00:00 [RUS] Speaker 1: We arrive, and Borya Pavlenko, God rest his soul, was still alive.

00:00:00 [RUS] Speaker 1: We arrive, and Borya Pavlenko, God rest his soul, was still alive.

00:00:04 [RUS] Speaker 2: Oh, Lord, what a good person. [RUS] Speaker 1: Yes, with his dogs. [RUS] Speaker 1: They set up such spreads there. [RUS] Speaker 1: Back then they still brought diesel generators, refrigerators, whiskey in the refrigerators.

00:00:15 [RUS] Speaker 1: This will be later, I'll say who it comes to.

00:00:17 Speaker 2: My dear friend, do you know this?

00:00:24 Speaker 2: I know what it is. Speaker 3: How do you say hedgehog in Ukrainian?

00:00:36 Speaker 2: I'm in English. Speaker 4: Hedgehog and then Hedgehog. Speaker 4: *Skills

00:01:40 Speaker 4: I can't film it with this? Speaker 4: Stand over here. Speaker 4: Oh wow, I love it.

00:02:05 [RUS] Speaker 4: - Wait, and this one... [RUS] Speaker 4: - Hedgehog. [RUS] Speaker 4: - Hedgehog. [RUS] Speaker 1: - Hedgehog. [RUS] Speaker 1: - Hedgehog. [RUS] Speaker 4: - And where is this one? [RUS] Speaker 4: - Morin, do you understand what this is?

00:02:15 Speaker 4: - Uh-huh. Speaker 4: - Uh-huh. Speaker 4: - Uh-huh. Speaker 4: I just wanted to say thank you for letting us be alive. Speaker 1: Is this one? No, no, no. Speaker 4: We're not going to do that.

00:02:30 Speaker 4: Thanks for letting us be alive. Speaker 4: We really want to be alive. Speaker 4: We really want to see what we like here. Speaker 4: Thank you. Speaker 4: Thank you. Speaker 4: Thank you.

00:02:51 Speaker 3: All right, I'll do one too. Speaker 3: I mean, I was going to do one earlier, but once we got Nick filming, I might as well do one now. Speaker 3: Let me, uh, here we go. Speaker 3: I got one. I got it. I got it. Speaker 3: I just wanted to say thank you so much for inviting us into your lives Speaker 3: and allowing us to show the excellent work that you do to witness your bravery, your pride in your country, Speaker 3: and the continued, unconquerable spirit that each of you show us.

00:03:42 Speaker 3: It is a true gift and an honor to be here with you and I'll mess up saying it, but Slava Ukraini. Speaker 3: Very well done.

00:04:00 Speaker 3: Thank you. I learned it from the best. Speaker 3: He's got a new profession coming.

00:04:37 Speaker 4: -

00:05:10 Speaker 4: Oh, look at that. Speaker 3: You guys ordered the restaurant's namesake. Speaker 3: I want this cake for me.

00:05:20 Speaker 3: That exact one. Speaker 4: I want for cake.

00:05:47 Speaker 3: Let's see if I can get everyone down this way. Speaker 3: I'll send this to everybody down there.

00:05:53 Speaker 3: Okay, am I in there? Speaker 4: I want more

00:06:00 Speaker 4: Here we go Speaker 3: Okay, and then this way. I got the happy... Speaker 3: Everyone over here, I got the... Speaker 3: I got that part of the table just a second ago.

00:06:30 Speaker 3: Let me go here. Speaker 3: All right. Speaker 3: Oh, wait. Uh-oh. Speaker 3: Uh-oh. Speaker 3: Logan's coming for a toast. Speaker 3: This is... Speaker 2: This is momentous here. Speaker 2: Alex, what do you think about companies?

00:06:47 Speaker 2: All right. Speaker 2: We're going to hear this. Speaker 2: Crazy, crazy company. Speaker 4: We've lost control. Speaker 4: Here, here, here.

00:06:58 Speaker 2: They are very, they are very hardy work. Speaker 4: You are now. Speaker 2: Yeah, yeah, you're up, you're standing.

00:07:06 Speaker 2: Alex, Alex, Alex. Speaker 2: They are very hardy work and very funny.

00:07:12 Speaker 1: Yeah? Speaker 1: Uh-oh. Speaker 4: I think the work that you guys are doing is so incredible.

00:07:30 Speaker 4: It's just such an honor to be able to sit here and drink and eat food with you guys. Speaker 4: And your country is just so brave. Speaker 4: And it's not an easy thing to let a film crew come in and you don't have cameras in your face. Speaker 4: now i'm feeling what i do to you guys all the time so i want to thank you guys so much for just Speaker 4: getting so kind and so uh just incredibly supportive to the project that we're going to do Speaker 4: and uh i think it's an incredible applause Speaker 4: That's not me

00:08:25 Speaker 4: Yes, please

00:08:31 Speaker 4: Logan excellent. I was beautiful and beautiful. Please. Thank you Speaker 3: I'm not asking you to, you're not getting up, but thank you Anastasia. Speaker 3: Thank you for being with us and helping our crew, you know, fit in. Speaker 3: Thank you. Speaker 3: Anastasia, best of the best.

00:09:35 [RUS] Speaker 4: - Hahahahaha [RUS] Speaker 4: Come on, come on, go, go. [RUS] Speaker 1: Further. [RUS] Speaker 4: Come on, come on.

00:09:40 Speaker 4: Tell her to speak like Bani. Speaker 4: I love it. Speaker 4: Four words. Speaker 4: I love it. Speaker 4: I love it. Speaker 4: I love it.

00:09:58 [RUS] Speaker 1: - Hold it in one hand.

00:10:00 [RUS] Speaker 2: - Should I say yes or no?

00:10:03 Speaker 1: - Quiet, attention, please, attention, please.

00:10:08 [RUS] Speaker 4: - Need to repeat, quiet. [RUS] Speaker 4: - Like, you speak, they'll translate for you. [RUS] Speaker 4: - We'll translate for you. [RUS] Speaker 2: - Everyone across from me.

00:10:23 [RUS] Speaker 1: I am very happy to be in Kyiv, in our company. [RUS] Speaker 1: Universal Studios in Hollywood. [RUS] Speaker 1: I am very happy that our friends from the USA. [RUS] Speaker 1: I would like you to spend more time here.

00:10:49 [UKR] Speaker 2: - Well, ask for whose address is Miner. [UKR] Speaker 2: Come to Miner. [UKR] Speaker 2: - I don't know Miner's address.

00:10:59 [RUS] Speaker 2: - Thank you for your help and support.

00:11:00 [RUS] Speaker 2: - Mirror, opposite the entrance to Central Miner. [RUS] Speaker 2: When you come, I'll pick you up. [RUS] Speaker 2: - I don't know.

00:11:22 [RUS] Speaker 4: Alenka, I'll punish you at home. [RUS] Speaker 4: Well done. [RUS] Speaker 4: 11:12, tomorrow there will be a great hangover.

00:11:35 [UKR] Speaker 4: Thank you, thank you. [UKR] Speaker 4: Thank you, you wrote them off. [UKR] Speaker 4: Thank you, you wrote them off. [UKR] Speaker 4: I didn't write them off for you. [UKR] Speaker 1: Thank you. [UKR] Speaker 1: Mary, keeper, were you scared? [UKR] Speaker 4: Thank you to our friends from the USA.

00:12:02 [RUS] Speaker 4: Cool, cool, well done.

00:12:21 [RUS] Speaker 2: This is classic. [RUS] Speaker 1: Where's Yuzhik? [RUS] Speaker 1: Where's Yuzhik? [RUS] Speaker 1: Let's go again.

00:12:30 [RUS] Speaker 1: Olya with Kalyna said: [RUS] Speaker 1: "Until this, oh, until this". [RUS] Speaker 1: Everyone.

00:12:39 [RUS] Speaker 2: Where are our pies? [RUS] Speaker 2: A slip of the tongue by Fry. [RUS] Speaker 2: Which one? [RUS] Speaker 1: Buy eggs, squid, [RUS] Speaker 1: later on don't say. [RUS] Speaker 1: Who's going to count the money for the booze? [RUS] Speaker 4: I'm participating.

00:13:25 [RUS] Speaker 1: This will be the Oscar, best female role.

00:14:13 Speaker 3: Where's Nick? Where's Nick in the camera? Speaker 3: He's over there. Look at him. He's got it. Speaker 4: He's got it.

00:14:22 Speaker 4: Action! Speaker 4: Oh wow.

00:14:29 [UKR] Speaker 4: Very, very grateful to you. I, honestly speaking, am very glad to have come, very glad that you made such... [UKR] Speaker 4: ...a visit, so that we ourselves... [UKR] Speaker 4: ...sister. [UKR] Speaker 4: You've already met our people, our humanity, what is happening with us...

00:14:55 Speaker 1: I would like to thank you about your crazy step.

00:15:00 Speaker 1: Your step. Speaker 1: Your step. Speaker 1: From your point. Speaker 1: We are here in this time, with this thing, who is highlighted our life. Speaker 1: And would like to show all people around the world about how we live, what we are.

00:15:20 Speaker 1: say Logan, brave and in this time, kind people, motivated.

00:15:29 Speaker 2: - Under rocket attacks. - Yes. Speaker 1: But you never give up, never give in. Speaker 1: - Very appreciated for your work and support, especially in operation.

00:15:50 [RUS] Speaker 1: Olya, I love you. [RUS] Speaker 1: Turin operation. [RUS] Speaker 1: And I would like to see how you work in the operating room.

00:15:58 [UKR] Speaker 1: Under the microscope.

00:16:11 [RUS] Speaker 4: Ukrainian moon.

00:16:15 [RUS] Speaker 4: Ukrainian moon. [RUS] Speaker 1: I want to welcome you again, greet you.

00:16:23 [RUS] Speaker 1: I want to welcome you again. [RUS] Speaker 4: Thank you for your help. [RUS] Speaker 4: Thank you very much.

00:16:32 [RUS] Speaker 4: I want to wait for the film, what will be in a few minutes.

00:16:37 [RUS] Speaker 1: I'm waiting for the documentary to see. [RUS] Speaker 4: We are waiting for peace, so that we can come to you. [RUS] Speaker 4: We wanted to share how you work.

00:16:54 [RUS] Speaker 4: This is for us. [RUS] Speaker 3: Are you dedicated?

00:17:00 [RUS] Speaker 3: Do you have America? [RUS] Speaker 4: What visa? [RUS] Speaker 4: American. [RUS] Speaker 4: American.

00:17:09 [UKR] Speaker 2: I want a visa [UKR] Speaker 1: Nikita, there's Mykyta.

00:17:41 [RUS] Speaker 1: You know, the dyed lynx Mykyta.

00:17:43 Speaker 1: - Cargo 300.

00:17:45 [RUS] Speaker 1: - Even...

00:18:09 Speaker 4: - Oh, oh, oh, oh, he's... Speaker 4: - Oh, oh, oh, oh, he's...

00:18:50 Speaker 4: *Music* Speaker 1: yeah Speaker 1: as always

00:19:38 Speaker 4: Right, I know. Speaker 4: Is he working though overnight? Speaker 4: No. Speaker 4: Oh.

00:20:00 Speaker 4: Yeah. Speaker 3: I, every... Speaker 3: Logan, unfortunately, the people we want to... Speaker 3: The people we want to film are all on Monday, it sounds like. Speaker 3: Yeah. Speaker 3: Too bad. Speaker 3: Yeah. Speaker 3: Nick? Speaker 3: Thank you. See you.

00:21:13 Speaker 1: -

00:21:14 [RUS] Speaker 4: Ah, one night? [RUS] Speaker 1: Oh, I get it. [RUS] Speaker 1: I want, and here, one night.

00:21:21 [RUS] Speaker 1: Ah, okay, we'll now... [RUS] Speaker 4: Well done. [RUS] Speaker 4: Let's continue. [RUS] Speaker 4: What was in here, one night? [RUS] Speaker 4: One night - he's an assistant 2 professor. [RUS] Speaker 4: Here's 1 professor. [RUS] Speaker 4: Here's 1 professor excellent.

00:21:40 Speaker 4: not second Speaker 4: the second

00:22:22 Speaker 4: we will have meeting together again

00:22:53 [RUS] Speaker 1: Mikhalych, you're doing great. [RUS] Speaker 1: Our school. [RUS] Speaker 1: What a Dzhambul. [RUS] Speaker 1: Should we try you? [RUS] Speaker 1: Before I forget.

00:23:04 Speaker 4: Yes.

00:23:06 [RUS] Speaker 4: Before I forget.

00:23:08 [UKR] Speaker 2: I'm catching my own question.

00:23:13 [RUS] Speaker 1: Vadim, you'll say how he's on the parachute.

00:23:18 Speaker 1: Yes.

00:23:23 [UKR] Speaker 1: So, Artem, get ready.

00:23:27 Speaker 1: No. Speaker 1: Sonia.

00:23:30 Speaker 1: I think it's not worse than a teacher. Speaker 1: Karina, it's already said tos, then I'm gonna go. Speaker 1: Take a bottle. Speaker 1: What kind of taxidermy?

00:23:51 Speaker 1: I don't know. Speaker 4: uh-oh one final is this the last one no i'm the last one i know you're the last one okay all right

00:24:21 Speaker 1: Hello. See you again in the near future. See you soon. Yeah.

00:24:28 Speaker 1: Okay. Speaker 4: Thank you. Speaker 4: Empty. I need water. Speaker 4: Here. Speaker 1: Uh-oh. Speaker 4: Yeah, why not. All right, for Alex's toast, I'll get some compote.

00:25:50 Speaker 4: - Speaker 4: You have so many patients. Speaker 4: I'd also like to thank you all for welcoming new members of the team. Speaker 4: I know they've been working very hard because this all came together very quickly because Speaker 4: they believe in what you all are doing. Speaker 4: And especially Thaddeus leading them, Speaker 4: said, yeah, we definitely want to go through training Speaker 4: and get the story out. Speaker 4: They will probably be back in February Speaker 4: when Rocco comes back. Speaker 4: So hopefully you'll get to see them again. Speaker 4: And finally, aside from being some of the best doctors Speaker 4: and nurses I've ever worked with, Speaker 4: I'd also like to thank you for what you're Speaker 4: doing for the rest of the world, which Speaker 4: is defending freedom when many other countries won't help.

00:26:48 Speaker 4: We really are incredibly brave, resilient, and are not going to quit. [VO CANDIDATE] Speaker 4: And I will keep coming back and working with you through the war and the reconstruction. [VO CANDIDATE] Speaker 4: That's it. Speaker 4: Boom. Speaker 1: Good work. Speaker 1: Glory to Ukraine. Speaker 1: Glory to USA. Speaker 1: Glory to Alex. Speaker 1: Cheers. Speaker 1: Thank you.

00:28:15 Speaker 4: - Speaker 4: idea is that you need a good climax to the statue. Speaker 3: Oh yeah, I mean it's, you know, we are going to have Bakkan go to the cemetery with us,

00:28:28 Speaker 3: so that's going to be pretty emotional, I think. Speaker 3: We're going to the one with all the flags, you know, and I think he knows people who are Speaker 3: buried there you know classmates I don't know Sasha is we should ask maybe yeah I

00:28:52 Speaker 3: mean we're we're gonna film him swimming in the river first I'm not kidding he's

00:28:57 Speaker 4: gonna swim in the river so yeah we should ask Sasha can join us because that would Speaker 3: be a little uh I mean that's a good Logan Laura Alex suggests we ask Sasha to Speaker 3: come with us to to the cemetery with with Bohdan I think it could be um because

00:29:28 Speaker 3: he has he has friends that are there

00:29:35 [RUS] Speaker 4: Have you settled the bill? [RUS] Speaker 1: We're already leaving. [RUS] Speaker 1: Or you'll settle with Rostik, tomorrow say what's there?

00:29:43 Speaker 4: Oh!

00:29:44 [UKR] Speaker 4: Well, you can set, and I...

00:29:46 [RUS] Speaker 4: Tell us tomorrow. [RUS] Speaker 1: How much did you party? [RUS] Speaker 1: You only have to pay for alcohol. [RUS] Speaker 1: Don't have to pay for food.

00:29:58 Speaker 1: Show?

00:30:13 [RUS] [To be continued...]

00:01:26 [RUS] To be continued...

00:01:46 [RUS] [Subtitles by DimaTorzok]

00:02:10 Yeah.

00:03:30 Speaker 1: Yeah. Speaker 1: Yeah. Speaker 1: Yeah. Speaker 1: Yeah. Speaker 1: I'm going to, I'll head over there. Speaker 1: Yeah. Speaker 1: I'm missing some mics, so. Speaker 2: Okay, cool. Speaker 2: All right. Speaker 1: One of the little ones? Speaker 2: Okay, yeah. Speaker 1: All right.

00:04:12 Speaker 2: Hold on. Speaker 2: All right. Speaker 2: All right. Speaker 2: I'm heading over there. Speaker 2: I'm heading over there. Speaker 2: I'm heading over there.

00:05:11 [RUS] Speaker 2: To be continued...

00:05:59 [RUS] Speaker 1: Future apartments and minuses there will pay for...

00:06:39 Speaker 1: E aí

00:08:11 [RUS] Speaker 1: To be continued... [RUS] Speaker 1: To be continued...

00:09:15 Speaker 1: ah Speaker 1: uh Speaker 1: ah Speaker 1: ah Speaker 1: and

00:09:32 Speaker 3: ah Speaker 3: ah Speaker 3: and

00:09:42 [RUS] Speaker 3: Petro, get up!

00:10:08 Speaker 1: E aí

00:10:43 [RUS] Speaker 3: To be continued...

00:11:47 [RUS] [To be continued...]

00:12:32 [RUS] Speaker 3: To be continued...

00:12:38 Speaker 1: Obrigado.

00:13:19 [RUS] Speaker 3: To be continued...

00:14:37 [RUS-NEEDS] А давайте выкину.

00:15:14 [RUS] Speaker 3: Let me throw it out.

00:16:04 [UKR] Speaker 3: Answer on the screen!

00:16:21 [RUS] Speaker 3: To be continued...

00:17:16 Speaker 2: We had both of you in surgery here in film, so we might want to talk with you tomorrow. Speaker 1: Okay, we'll clear it with your boss though. Speaker 1: I'm sorry.

00:18:49 [RUS] Speaker 1: To be continued...

00:21:21 [RUS] [Subtitles by DimaTorzok]

00:22:08 I used to have a jacket. Speaker 1: I used to have a jacket. Speaker 1: What happened to my jacket? Speaker 1: yeah

00:23:04 Speaker 2: oh yes they hung up somebody hung up

00:23:17 [RUS] Speaker 3: Thank you.

00:24:41 [RUS] Speaker 3: To be continued...

00:24:56 Speaker 3: Thank you.

00:25:18 Speaker 2: I already got it.

00:25:22 Speaker 1: No. Speaker 2: No. Speaker 2: Forevermore. Speaker 2: I'm going to hurry. Speaker 2: It was my luck. I would just change all the batteries back to what they were.

00:26:07 Speaker 2: And...

00:26:11 Speaker 2: Can't forget my money. Speaker 1: You will.

00:26:34 Speaker 1: forever Speaker 2: I'll put it all at home. Speaker 2: We've got it. Speaker 2: We've got it. Speaker 2: We've got it. Speaker 2: Here we go. Speaker 2: Here we go. Speaker 2: Whoops.

00:27:10 Speaker 2: Okay. Speaker 4: Okay, what can I carry? Speaker 4: Uh, uh oh.

00:27:20 Speaker 2: Want any cell phones?

00:27:26 Speaker 2: Ha ha ha! Speaker 1: Cell phone?

00:27:30 Speaker 1: Yeah, cell phone. Speaker 2: I know, I know, right? Speaker 2: Well, it's funny because he couldn't get his business website to work. Speaker 2: You know what? This is my fault. You take it. Speaker 2: I'll, uh, I'll, uh,

00:28:02 Speaker 1: who's backpacking that there, is it? Speaker 1: I don't know. Speaker 1: I think it was one of the most funny roadways.

00:28:10 Speaker 1: Yes, yes, this is good. Speaker 3: Yes, it's the, like, this is long. You need a backpack. Speaker 3: You need a backpack. Speaker 3: Yeah.

00:28:26 Speaker 1: Let's go.

00:29:31 Speaker 3: - Speaker 1: I'm impressed by it. Speaker 1: I'm very, very bad.

00:29:55 Speaker 4: Do you have pain in your head? Speaker 4: It's a very common question on your surgery round. Speaker 4: I just feel racist in LA. Speaker 4: Spanish? Speaker 4: Really? Speaker 1: Yeah, I don't know. Speaker 4: I forgot. Speaker 4: No, I mean, it's so funny because in our private, not private, but the big university hospital, Speaker 4: I'm warning rounds, most people speak English, but in Parkland, in the ICU, it's the opposite. Speaker 4: And there's also some really weird obscure languages. Speaker 4: Like, there's a little colony of people somewhere, like Guatemala, Speaker 4: who speak some language that's a variant of ancient Mayan dialect,

00:00:00 [UKR-NEEDS] Враховуючи те, що спеціальна асоціяна повернення військовослужбовців до строю є основним завданням

00:00:01 [UKR] Speaker 1: Considering that the specialized association for the return of servicemen to duty is the primary task [UKR] Speaker 1: of surgical and anesthesiological support of the Armed Forces of Ukraine. [UKR] Speaker 1: Therefore, I wish us all a good, productive conference and peace to all of us soon. [UKR] Speaker 1: Thank you. [UKR] Speaker 1: And for the next speech I invite the president of the public organization,

00:00:24 [UKR] Speaker 1: Ukrainian Association of Medicine and Defense Forces, Doctor of Medical Sciences, [UKR] Speaker 2: Colonel of Medical Service Roska Vasyl Romanovych.

00:00:33 [UKR] Speaker 2: Thank you, Volodymyr, esteemed Kostyantyn Vitaliyovych. [UKR] Speaker 3: Journalists will come in, and then we'll close. [UKR] Speaker 2: I congratulate everyone on the beginning of the 19th Congress of Military Surgeons-Anesthesiologists.

00:00:43 [UKR] Speaker 2: This is one of the most relevant, most powerful conferences that takes place every year. [UKR] Speaker 2: This year, first with the support of the Commander of Medical Forces, was created [UKR] Speaker 2: Ukrainian Association of Medicine of Defense Forces. [UKR] Speaker 2: In fact, this is the first congress conducted under the auspices of our association. [UKR] Speaker 2: The association is planned to unite and create such a scientific platform [UKR] Speaker 2: so that all military medics, of all security forces, can even more demonstrate their skills, their knowledge, their professional achievements with one goal,

00:01:28 [UKR] Speaker 2: to improve the treatment of even more of our warriors and wounded. [UKR] Speaker 2: I congratulate everyone on the opening of our congress, wish everyone strong health and new achievements. Thank you.

00:02:04 [RUS] Speaker 2: Good morning.

00:02:07 [UKR] Speaker 3: Good morning. Glory to Ukraine! [UKR] Speaker 4: Esteemed Mr. Commander, dear colleagues, I congratulate everyone on the beginning of an extraordinary event in the life of military medics, the 19th Congress of Surgeons and Anesthesiologists of the Armed Forces of Ukraine.

00:02:21 [UKR] Speaker 4: I am extremely glad that this event takes place in the city of Lviv, a city that is famous not only for its cultural heritage, but also for centuries-old medical traditions.

00:02:35 [RUS] Speaker 3: We'll resume at 10:00.

00:03:04 [UKR] Speaker 4: combat trauma. Ukrainian military medics want to [UKR] Speaker 4: cooperate and exchange experience with representatives [UKR] Speaker 4: of all civilized countries. Effective communication with various [UKR] Speaker 4: organizations that truly provide this advanced experience. [UKR] Speaker 4: At the congress will be presented experience of combat trauma treatment [UKR] Speaker 4: by both young colleagues and experienced specialists [UKR] Speaker 4: from different regions of our country. The materials of this conference

00:03:48 [UKR] Speaker 3: I'll say two words, then I'll return to you. [UKR] Speaker 3: I'll say two words, then I'll return to you.

00:03:54 [UKR] Speaker 3: And after that, I look at you and you speak. [UKR] Speaker 1: The congress of surgeons and anesthesiologists begins.

00:04:00 [UKR] Speaker 1: And tell me, please, about technical issues. [UKR] Speaker 1: Is the first presentation ready? [UKR] Speaker 1: Dear colleagues, then now a technical break for 10 minutes. [UKR] Speaker 1: And in 10 minutes, at 10 o'clock, we'll begin our session.

00:04:24 Speaker 1: Gracias. Speaker 1: Gracias.

00:05:08 Speaker 1: Thank you.

00:05:59 Speaker 5: Are you seeing this also? Speaker 5: I can't.

00:06:16 Speaker 6: Do you see it? Speaker 6: Do you guys see it? Speaker 6: Yeah, I can see it. Speaker 6: Oh, so you can rotate this one. Speaker 6: Yeah.

00:06:31 Speaker 5: Okay, does that look a little weird? Speaker 5: Is this whole session being recorded? Speaker 5: Maybe, maybe.

00:06:56 Speaker 5: I mean, we don't have to, that's going to look too weird.

00:07:03 Speaker 3: You can also, if you see this, for you, you know, this. Speaker 5: Yeah, this is good, yeah. It's going to look too strange. Speaker 5: Okay, maybe. Speaker 5: Yeah, we'll just go with this. Speaker 5: Do I need to move this? Speaker 5: Is it cutting in your field?

00:07:35 Speaker 5: Thank you.

00:07:59 Speaker 3: We wait nine, minute, nine, eight, seven, six, five.

00:08:06 Speaker 5: Do you ever get, go back to sleep? Speaker 7: We, well, we actually shot for like another 30 minutes.

00:08:13 Speaker 7: We just shot with the sunrise. Speaker 5: Oh, yeah, it's funny. Speaker 5: I was thinking about that because it was beautiful. Speaker 5: I was thinking you guys need to sleep. Speaker 7: But then we did eventually go back to sleep. Speaker 5: But, Dad, do you have any stills of the shelter? Speaker 7: No, but I could pull them today. Speaker 5: Yeah, I didn't take any. Speaker 5: I was thinking I probably should have. Speaker 5: Or I could just take them back down. Speaker 6: Yeah, I can get them still. Speaker 6: But by the way, is tomorrow morning, the last morning, we have the-- Speaker 6: my room? Speaker 5: What's it on there? Speaker 5: No, you need to check out on the 2nd. Speaker 5: Okay. Speaker 5: Tomorrow's the 31st, so that's Sunday morning.

00:08:50 Speaker 5: You need to check out and then check back in. Speaker 6: potentially there's a good shot of the sunrise from my loft, but especially from my loft you can see the flag, the Speaker 5: all Ukrainian flag. That's why I wanted to put you guys in those rooms, because you can hear the trolley and see the park.

00:09:07 Speaker 6: Yeah, the sunrise was on the edge of my view. Speaker 5: So, something to talk about for your next trip, do you want to be back in the same room, Speaker 5: but it's not very functional because you have to run up and down the stairs a lot, or would Speaker 5: you rather be in a room like what I'm in where it's all on one floor?

00:09:29 Speaker 6: Either way, I mean like, for me, I only go up and down the stairs when I go into bed and

00:09:35 Speaker 6: I have everything else done. Speaker 5: Yeah, I saw that you had everything organized, all your camera. Speaker 6: and by a type of item.

00:09:49 Speaker 3: When we begin talk, I ask you silence, complete at least 30 minutes, okay?

00:09:56 Speaker 6: Yeah, no, we're actually gonna set this and get out of here, close the door.

00:10:00 Speaker 3: Yeah, yeah, yeah. So we're gonna be here. Speaker 3: You can also, if you would like, maybe sit here.

00:10:07 Speaker 5: oh you have to get up to you no actually that's right that's out of wire Speaker 6: no no so this has a shot of both of you yeah and if we can get a copy of the zoom Speaker 6: then like we have this and that and we'll be good so we'll get out of your way

00:10:24 Speaker 6: no one's not like moving around

00:10:30 Speaker 3: a bit closer to me a bit oh okay this this one

00:10:37 Speaker 6: do you want me uh we're not going to come back in until you're done let's close this or do you

00:10:42 Speaker 3: want to yeah if science will be in corridor it's maybe open if in corridor will be a lot of different Speaker 5: voices crowd it's maybe better we're not we're going to go change i said just close it yes

00:10:59 Speaker 5: good luck guys thank you looks good thank you all right Speaker 3: Okay.

00:11:44 Speaker 3: Sit down, please. Speaker 3: I'm going to go.

00:13:02 Speaker 3: - Welcome, Andreas. Speaker 3: We'll quickly, fast. Speaker 3: That's why he has an interval between our section. Speaker 5: A ver cómo está.

00:13:51 Speaker 3: It's a honor for me to have the first presentation in this meeting. Speaker 3: This meeting will continue two days, today and tomorrow. Speaker 3: That's why it's a very important talk. Speaker 3: I am proud to keep this tool together with you.

00:15:08 Speaker 3: *Klucht

00:15:24 Speaker 3: .

00:15:39 Speaker 5: before 25 seconds

00:16:15 [UKR] Speaker 1: Dear colleagues, we continue our congress and for the first presentation I invite with great pleasure and we begin the section "Combat Neurosurgical Trauma" [UKR] Speaker 1: Dear Serhiy Andriy Hryhorovych, with a group of authors from Mechnikov Hospital, city of Dnipro, Ryzhenko Serhiy Anatoliyovych, Tolubayev, Oleksandr Mykolayovych and Skrybets Yuriy Yuriyovych. [UKR] Speaker 1: The topic of the presentation is new frontiers in neurosurgical treatment of severe penetrating craniocerebral injuries of wartime, effectiveness of military-civilian interaction.

00:16:51 [UKR] Speaker 1: Dear Andriy Hryhorovych, I invite you. [UKR] Speaker 3: Dear Kostyantyn Vitaliyovych, dear colleagues, can you hear me well? [UKR] Speaker 3: Yes, everything is fine.

00:17:00 [UKR] Speaker 3: Thank you. First of all, I want to thank you for the honor and trust to speak at such a respected conference. [VO CANDIDATE] [UKR] Speaker 3: And I want to say that with me is neurosurgeon, neurotraumatologist, [UKR] Speaker 3: world-renowned Professor Alex Valadka from Texas, from Dallas. [UKR] Speaker 3: This is his fourth visit to Mechnikov Hospital.

00:17:19 [UKR] Speaker 3: And this week we've already operated together on military wounded with severe brain injuries.

00:17:26 [UKR] Speaker 5: Alex Valadka. Good morning. Glory to Ukraine. Glory to the Heroes. Glory to the Heroes. [UKR] Speaker 3: What I wanted to say. The Ministry of Defense developed an updated military medical doctrine, you know well. [UKR] Speaker 3: And in this doctrine it was presented recently at the conference "Person in the Army" and highlighted in red. [UKR] Speaker 3: Military medicine will continue to develop on the principles of a unified medical space and close interaction with the civilian healthcare system. [VO CANDIDATE] [UKR] Speaker 3: Indeed it is so and indeed it has been since 2014. [UKR] Speaker 3: Here I wanted to present our hospital leadership team, and Kostyantyn Vitaliyovych, Serhiy Ivanovych, Oleksandra Mykhaylivna, Kostyantyn Yuriyovych, Mykola Mykolayovych.

00:18:18 [UKR] Speaker 3: These are those with whom Mechnikov Hospital cooperates most closely specifically in matters of providing help to the head-wounded, craniocerebral wounded. [UKR] Speaker 3: What are the peculiarities of these wounds? High proportion of shrapnel mine-explosive wounds was 87, now it's 97%. [UKR] Speaker 3: percentage of bullet wounds is decreasing from 13 to 3.5%. [UKR] Speaker 3: High proportion of bone fragment wounds - these are so-called secondary wounding projectiles - 77%. [UKR] Speaker 3: High proportion of combined injuries - this comprises about 67%. [UKR] Speaker 3: And it should be noted that a high percentage of combined injuries - where there are burns. [UKR] Speaker 3: What I wanted to say about military-civilian interaction,

00:19:05 [UKR] Speaker 3: about providing neurosurgical care in military mobile hospitals, damage control neurosurgery, [UKR] Speaker 3: about providing neurosurgical care at Mechnikov Hospital, and also to consider ways to improve treatment results of this difficult category of wounded. [UKR] Speaker 3: Since 2014, round-the-clock telemedicine consultation was introduced together with military hospitals, military neurosurgeons. [UKR] Speaker 3: We never refuse, round the clock, on weekends, on weekdays, on holidays. [UKR] Speaker 3: We decide who to operate immediately in damage control mode, if to operate - the optimal volume of intervention, and mandatory feedback CT control, treatment results, all this is discussed. [UKR] Speaker 3: When we know about the arrival of a wounded person, we prepare our forces, personnel, technical equipment, especially for combined injuries.

00:19:58 [UKR] Speaker 3: In addition, on the initiative of Kostyantyn Vitaliyovych, internship of military neurosurgeons at the workplace was organized. They lived and were on duty round the clock with us for one, two, three weeks. [UKR] Speaker 3: And we understand each other without extra words, and I'll say more, military neurosurgeons who went on rotations before, who are now, they have a very high level of providing neurosurgical care. [VO CANDIDATE] [UKR] Speaker 3: The results of their operations exceed the result that we see, unfortunately, in some civilian hospitals. [UKR] Speaker 3: Telemedicine is operational. Round-the-clock telemedicine consultation system, closed group, you see 9 participants, which already includes more than a thousand photos, more than two thousand videos.

00:20:43 [UKR] Speaker 3: Patient A, on the left, penetrating wound of the posterior cranial fossa, damage suspicion of transverse sinus, [UKR] Speaker 3: decision made for immediate evacuation to Mechnikov Hospital for angiography and reconstruction. [UKR] Speaker 3: On the right - acute epidural hematoma related to combat operations, such a patient cannot wait for transportation, is immediately operated in a mobile hospital. These issues are resolved immediately. [UKR] Speaker 3: We tried to introduce smart glasses, but for this you need good Wi-Fi Connection, although we transferred, thanks to Kostyantyn Kostyuk, these devices, and possibly there were a couple of operations that were conducted in telemedicine mode using smart glasses in military hospital operating rooms.

00:21:32 [UKR] Speaker 3: When it's very important to operate on site. There are such situations, as, for example, shown on this slide, that CT shows that the patient has active bleeding, which even during the CT scan continues, and you see the swirling of blood in this hematoma. [UKR] Speaker 3: And here's a clinical case. Very recently, October 17th, you see a patient with such an acute hematoma,

00:22:00 [UKR] Speaker 3: inside there is swirling, this says that the hematoma arterial bleeding is continuing, and this patient needs to be operated as soon as possible. [UKR] Speaker 3: And the patient immediately underwent surgical intervention, Makhotin Serhiy Oleksiyovych operated, [UKR] Speaker 3: and after this, after stabilization, the patient was redirected to Mechnikov Hospital. [UKR] Speaker 3: You see a good CT control after the operation, removal of this hematoma, as of 26-10 restoration of consciousness to the level of SOPOR 9-10 points on the coma Glasgow scale [UKR] Speaker 3: and evacuation was conducted for further treatment by medical train to the city of Vinnytsia. [UKR] Speaker 3: Next. This is a graph of wounded arrivals to Mechnikov Hospital. You all know it well.

00:22:45 [UKR] Speaker 3: At foreign conferences I say that this graph is written in blood, written in blood of both our military defenders and civilian wounded. [VO CANDIDATE] [UKR] Speaker 3: Currently the experience comprises more than 50 thousand wounded and injured.

00:23:00 [UKR] Speaker 3: You see, in 2013-2022 about 4.5 thousand severely wounded. This is over 8 years of the first stage of the war. [UKR] Speaker 3: And currently the number is more than 46 thousand severely wounded. And you see that daily on average Mechnikov Hospital receives 35 wounded patients. [UKR] Speaker 3: Regarding penetrating craniocerebral trauma, Mechnikov Hospital currently has the largest experience in Ukraine specifically in treatment of penetrating craniocerebral wounds. [UKR] Speaker 3: This is more than 2.5 thousand who were primarily operated at Mechnikov Hospital, plus more than 550 who were operated in mobile hospitals. [UKR] Speaker 3: That is, every sixth is operated in mobile hospitals, and five out of six are operated at Mechnikov Hospital.

00:23:48 [UKR] Speaker 3: You see the dynamics of these wounded arriving by years. [UKR] Speaker 3: This is my neurosurgical team. Despite the average young age of neurosurgeons present in the photo, most of them have already performed hundreds of surgical interventions for penetrating craniocerebral trauma. [VO CANDIDATE] [UKR] Speaker 3: Performed round the clock. At the congress in Vienna we were told that trauma in top European clinics was not operated, surgical intervention, because it was Saturday or Sunday, or it was night. We don't have that, operations are performed daily. [UKR] Speaker 3: We introduced such a cycle of treatment results improvement - plan, do, check and act. This is a comprehensive quality management improvement system.

00:24:37 [UKR] Speaker 3: Operation results are constantly improving, operation time is decreasing, and results are becoming better. This works. [UKR] Speaker 3: Mechnikov Hospital also has its own closed Facebook messenger group, 49 participants, neurosurgeons, neurologists, anesthesiologists. In this group there is all information on the patient, you can find the operation plan, CT, before after operation, condition dynamics. [UKR] Speaker 3: And you see, the database already has more than 10 thousand photographs and more than 22 thousand videos. We learn every day so that these results will be as good as possible. [UKR] Speaker 3: From 1 to 8 operations are performed for penetrating trauma. You see in this photo the busiest day when in one day 8 surgical interventions were performed.

00:25:27 [UKR] Speaker 3: Here are wounds of the anterior cranial fossa, and posterior cranial fossa, and lateral skull base, that is the pyramid of the temporal bone, and such wounds, severe wounds. [UKR] Speaker 3: As an example, I would like to show just one case of a wounded person who simultaneously had three locations that required intervention. [UKR] Speaker 3: First - this is a wound of paranasal sinuses, these are frontal sinuses. Second - this is a wound of the temporal bone pyramid. [UKR] Speaker 3: And third - this is a convexity wound. That is, this wounded person needed to be operated. [UKR] Speaker 3: And on video specifically this wounded person stages of care provision at Mechnikov Hospital. It should be said that the average time from the arrival of a wounded person to Mechnikov Hospital to conducting computed tomography is 22 minutes.

00:26:19 [UKR] Speaker 3: Alex Valadka, who is present with me, he says, rarely in the USA can you in 22 minutes from the beginning of arrival do a computed tomography, and after that the patient is immediately submitted to urgent neurosurgical operation. [UKR] Speaker 3: Daily two neurosurgeons are on duty, and these operations are performed immediately. This is called early and comprehensive in volume neurosurgical intervention. [UKR] Speaker 3: Specifically this approach allows us to obtain results that speak for themselves. This is reduction of mortality, reduction of complications and improvement of quality of life of patients who are operated. [VO CANDIDATE] [UKR] Speaker 3: This is the control of the same patient who is presented in this photograph. I cannot not mention our friendship with American colleagues.

00:27:12 [UKR] Speaker 3: Already more than ten professors have worked at Mechnikov Hospital, both open and endovascular operations, and have already performed more than 130 joint surgical interventions. [UKR] Speaker 3: What lessons are we exchanging with the USA? First of all, that penetrating craniocerebral trauma is a complex scheme of neurovascular injuries and skull base injuries. [UKR] Speaker 3: And specifically microsurgery and neuroendovascular methods play a decisive role. [UKR] Speaker 3: Coagulopathy is discussed, the need for early decompression, wound treatment. [UKR] Speaker 3: In this photo is Rocco Armonda from Washington D.C., who led the forward surgical group in Iraq-Afghanistan [UKR] Speaker 3: for 10 years awarded the Bronze Star USA, a real legend of Ukraine and the USA.

00:28:01 [UKR] Speaker 3: Together with professors from America we have published many of our publications, and in each publication we mention Ukraine, Dnipro. For example, this article is called "Stop-the-bleed," so the whole world knows. [UKR] Speaker 3: Ways of improvement. First of all, non-invasive possibility of conducting hematoma diagnostics - this is the application of infrascanner, and also pupillometer for determining intracranial hypertension. [UKR] Speaker 3: Other analysis of causes of mortality of wounded at the hospital stage and search for solutions. And analysis of causes of mortality and unfavorable treatment results of wounded with penetrating cranial wounds at the hospital stage.

00:28:47 [UKR] Speaker 3: You see the infrascanner, we have it and we are now conducting research jointly with Kostyantyn Vitaliyovych Homunyk's team to evaluate the effectiveness of this device in field conditions, use for diagnostics of intracranial hematomas. [UKR] Speaker 3: Example. You see, on the left red circles, we do CT, and just corresponding to this we see brain contusions in the left hemisphere. [UKR] Speaker 3: Another case, one circle, and corresponding to it on CT we see foci of brain contusion. [UKR] Speaker 3: Results. Sensitivity 60%, specificity almost 80%, positive predictive value 25%, negative predictive value 95%. [UKR] Speaker 3: This allows conducting triage therapy, determining which patient needs first

00:29:37 [UKR] Speaker 3: to be directed to computed tomography. Pupillometry is a non-invasive method of assessing intracranial hypertension. [UKR] Speaker 3: This is much more effective than ultrasound measurement of optic nerve diameter. Again, [UKR] Speaker 3: thanks to American colleagues, we have the opportunity to work with pupillometer for

00:00:00 [UKR] Speaker 1: pupils, neurological index of pupillary reflex. I won't stop, if needed, I'll conduct more. And this is real use

00:00:00 [UKR] Speaker 1: pupils, neurological index of pupillary reflex. I won't stop, if needed, I'll conduct more. And this is real use [UKR] Speaker 1: of the pupilometer. Indeed you see, gunshot wound, diametrical wound, operated together with professor [UKR] Speaker 1: Rocco Armonda, entry hole, bullet located. And we check intracranial pressure on the next day [UKR] Speaker 1: after surgery using the pupilometer. Intracranial pressure, in this case, is normal, patient survived. [UKR] Speaker 1: More than 170 patients we examined, you see, on this slide. And our mortality data, you see, from anterior cranial fossa 6%, ending with posterior most severe wounds 21%. [UKR] Speaker 1: Here frequency is presented of purulent-septic complications and quality of life. You see, that good recovery, moderate disability even 84-76%.

00:00:54 [UKR] Speaker 1: If we talk about wounds specifically in operated mobile hospitals, then the highest mortality, of course, is with wounds of posterior cranial fossa and diametrical wounds. [UKR] Speaker 1: But what interests us, 27% - this is acute subdural hematoma. [VO CANDIDATE] [UKR] Speaker 1: Mortality with acute subdural hematoma. [UKR] Speaker 1: And on these questions we work. [UKR] Speaker 1: Because, despite removal of subdural hematomas, [UKR] Speaker 1: we see such results in brain ischemia. [UKR] Speaker 1: What is this connected with? Many things. [UKR] Speaker 1: Mechanism of injury, polytrauma, coagulopathy, infectious complications. [UKR] Speaker 1: Data from military cohorts show that the closer the neurosurgeon, [UKR] Speaker 1: although it's dangerous, near the battlefield, the better the treatment results, if patient is operated in first 5 hours. [VO CANDIDATE]

00:01:45 [UKR] Speaker 1: We published lessons of war, they can be found on the website of Ukrainian Neurosurgical Association, [UKR] Speaker 1: besides that, on the YouTube channel of Ukrainian Neurosurgical Association there are our lectures, [UKR] Speaker 1: more than 5 thousand views, no bragging, this photo from Rocco Armonda, never give up.

00:02:02 [UKR] Speaker 1: Together to victory, glory to Ukraine and thank you for attention. [VO CANDIDATE]

00:02:09 [UKR] Speaker 2: Andriy Lvovich, thank you very much for a very meaningful professional report. I understand that the next report is also yours. [UKR] Speaker 1: Yes, Konstantin Vitaliyovich, I will present with your permission. [UKR] Speaker 1: Yes, please. [UKR] Speaker 1: As I already said, penetrating traumatic brain injury - this is first of all injury of skull base and injury of intracranial vessels. [UKR] Speaker 1: I would like to focus on this today. Large author collective, because these doctors participate in providing aid to wounded, both open and endovascular interventions. [UKR] Speaker 1: Want to say, that in December will come out second update, from Brain Trauma Foundation, recommendations for treatment of penetrating traumatic brain injury. [UKR] Speaker 1: The first was in 2001. What's very important, that our experience, our publications were involved in compiling these guidelines,

00:03:03 [UKR] Speaker 1: and our publications helped finish these guidelines, and very pleasant, that about us they spoke at Congress of Neurological Surgeons in Los Angeles, [UKR] Speaker 1: which was in October, together we were with Ice Valatka, Rocco Armonda. [UKR] Speaker 1: Besides that, we managed for first time in history to conduct such joint symposium, which is called "Traumatic brain injury in military and civilian wartime. [UKR] Speaker 1: Joint section of European Association of Neurosurgeons, and also Ukrainian Neurosurgical Association, where I am president of this association". [UKR] Speaker 1: You see, two hours of lectures were dedicated to these questions. Sergiy Anatoliyovich spoke and entire team of neurosurgeon doctors. [UKR] Speaker 1: We for first time, after beginning of full-scale invasion, had opportunity to go abroad and represent Ukraine with large delegation. Hall stood, applauding long and thanked all of us, there were more than ten of our reports.

00:04:00 [UKR] Speaker 1: What I wanted to say? New, what Mechnikov Hospital proposed, is minimally invasive technologies. Minimally invasive technologies, what does it mean? These are not aggressive technologies, but technologies that allow removal of hematoma, removal of bone fragments, detritus, and elimination of intracranial hypertension, and elimination at same time of hydrocephalus. [UKR] Speaker 1: Therefore abroad they discuss, what sanitation to do, radical or aggressive. Our answer of any neurosurgeon who operates penetrating TBI, learn to operate brain carefully using minimally invasive and low-trauma method. [VO CANDIDATE] [UKR] Speaker 1: I asked at congress in Los Angeles, what needs to be done with this patient. Decompression, place ventricular drain or simultaneously do decompression and place ventricular drain. They thought. I said, at Mechnikov Hospital such patient needs to be operated immediately after admission and preferably operated under microscope.

00:05:02 [UKR] Speaker 1: But before this preferably do angiography. We did angiography, didn't find vascular damage, aneurysms, AV fistulas, and therefore found only manifestations of angiospasm, as you see here, and went to operating room, stages of operation. [UKR] Speaker 1: And I detailed told at previous conference, how we take bone flap, perform radical closure, plastic of dura mater. [UKR] Speaker 1: But the main thing we do this operation under microscope. Under microscope all Mechnikov Hospital, in my department, they well operate brain tumors. [UKR] Speaker 1: Therefore operation for removing hematomas, you see, hematoma from left lateral ventricle is removed, [UKR] Speaker 1: even in this case hematoma is removed through foramen of Monro of third ventricle.

00:05:49 [UKR] Speaker 1: This is, possibly, first experience of combat trauma in world, when even from lateral ventricle, [UKR] Speaker 1: of third ventricle completely removed hematoma.

00:06:00 [UKR] Speaker 1: You see CT control after intervention, and this is video of patient on fifth day after surgical intervention. [UKR] Speaker 1: Right side still he has, hemiplegia, there are motor disorders, but we had tears in our eyes, when he tried to write "Glory to Ukraine", [UKR] Speaker 1: he couldn't do it quite, he was a bit nervous, but we knew, that everything will be fine, because such interventions they allow removal of hematomas [UKR] Speaker 1: Totally no need to perform ventricular shunting and you see MRI control exactly 40 days after surgical intervention. [UKR] Speaker 1: And was also pleasant to receive visit from patient himself on 40th day after brain wound. Hemiparesis, he completely lost it, strength in arms and legs, 5 points, small motor disorders, but he completely communicates.

00:06:57 [UKR] Speaker 1: When is it necessary to do angiography? When there is massive SAH, intraventricular hemorrhage, when trajectory of wound projectile passes through pterion or sylvian fissure, circle of Willis, interhemispheric fissure, penetrating fronto-orbital traumas, bihemispheric damage. [UKR] Speaker 1: There is active leakage of arterial blood from entry or exit opening. And also to all patients who have such suspicion, should maximally quickly perform invasive angiography, which by its diagnostic value is much higher, than CT angiography.

00:07:30 [UKR] Speaker 1: Here example of such injuries, you see wound in area of sphenoid wing, massive SAH in cisterns, you see here aneurysm. Further other wound, massive SAH, sylvian fissure, and you see in this case arrows show both damage of anterior cerebral artery, and middle cerebral artery, as visible on these two slides. [UKR] Speaker 1: These interventions, majority of them, became possible thanks to support of our colleague from Washington, professor Rocco Armonda. [UKR] Speaker 1: He delivers humanitarian cargo, which allows performing closure of these aneurysms, delivers stents. [UKR] Speaker 1: And it's no secret, that many patients, Cherednichenko Yuriy Vitaliyovich, who is presented on slide, operates,

00:08:20 [UKR] Speaker 1: We take from other hospitals and military hospitals, and civilian hospitals, if we know, that this is military, he needs help, and thanks to support of our colleagues we have what to do these interventions with. [UKR] Speaker 1: You see statistics, only in 2 years 1300 angiographies, on average 655 per year. If compare Iraq-Afghanistan, there there were on average 37 angiographies, and total for all time 64 neurovascular injuries, with us only in 2 years there were 253 injuries. [UKR] Speaker 1: Majority - these are extracranial, vertebral, carotid, intracranial, comprised at that moment 37%. [UKR] Speaker 1: And if in world were published 11 cases, then now Mechnikov Hospital has experience of treating more than 100 cases of wounds,

00:09:11 [UKR] Speaker 1: in this case vertebral arteries. You see publication on this issue, which was joint with our American colleagues. [UKR] Speaker 1: Today 56 intracranial arterial injuries, among them 37 were treated by endovascular route. [UKR] Speaker 1: You see 27 traumatic pseudoaneurysms, one of largest, possibly, largest experience in world, [VO CANDIDATE] [UKR] Speaker 1: 8 direct carotid-cavernous fistulas, 5 dural arteriovenous fistulas and 16 arterial occlusions. [UKR] Speaker 1: These are examples, how distributed these patients. Further, at that moment 10 patients underwent endovascular treatment, 7 first endovascular, then open surgery, 3 open surgery endovascular, closed aneurysms in 8 cases with coils, in 2 cases using onyx, 1 reconstructive, 9 reconstructive interventions.

00:10:07 [UKR] Speaker 1: Clinical case participant in combat operations 47 years during artillery shelling. You see, Glasgow Coma Scale 12 points. [UKR] Speaker 1: On CT diametrical wound from left to right, here where fragment is located, through interhemispheric fissure, massive subarachnoid hemorrhage in basal cisterns, patient performed angiography. [UKR] Speaker 1: immediately Cherednichenko Yuriy Tarich performed, was identified aneurysm of right anterior cerebral artery [UKR] Speaker 1: and conducted its closure, performed embolization of this aneurysm. [UKR] Speaker 1: Open operation next stage. [UKR] Speaker 1: In this case you see reconstructive exclusion of aneurysm of right internal carotid artery. [UKR] Speaker 1: You see fragment, see aneurysm, and using embolization with coils with system support was performed embolization of this aneurysm. And this is first case, when we operated in 2023, in May, together with professor Rocco Armonda.

00:11:12 [UKR] Speaker 1: He for first time saw level of providing aid in Ukraine to wounded. Severe wound, bilateral subdural hematomas, skull base fracture, bone fragments flew into lateral ventricle, flew into third ventricle. [UKR] Speaker 1: Severe wound he asks, what will you do. Answer is this. First angiography. On angiography found aneurysm of anterior cerebral artery and closed this aneurysm. [UKR] Speaker 1: Next stage went for surgical intervention, performed removal of subdural hematomas. Under microscope removed bone fragments from lateral ventricles, third ventricle. [UKR] Speaker 1: Here you see shadow of coil after embolization. After this performed plastic of skull base of this patient, and after this reconstruction of convexity defect was performed.

00:12:03 [UKR] Speaker 1: And he says, I thought, that I came to teach you in Ukraine, but those lessons, which I learn here, we will use in USA. [VO CANDIDATE] [UKR] Speaker 1: And when he returned, he sent several photos of civilian penetrating trauma after car accident, fall from height, [UKR] Speaker 1: where they used our approaches, hypervascularized, pericranial flaps, our accesses and our developments. [UKR] Speaker 1: In this case shown anterograde-retrograde embolization of direct carotid-cavernous fistula performed Yuriy Cherednichenko with team Andriy Mirashlichenko and Vadym Perepelytsia. [UKR] Speaker 1: And here traumatic dural arteriovenous fistulas, which were treated surgically. [UKR] Speaker 1: You see trajectory, where metal fragment stops, intracerebral hematoma and fistulas.

00:12:52 [UKR] Speaker 1: Results. Mortality comprised 5.3%. In 17 patients survived, one woman died. Unfortunately, this is civilian wounded. You see, what large metal fragment flew into center of brain, multiple bone fragments, performed angiography. [UKR] Speaker 1: Yes, we identified aneurysm of middle cerebral artery, but in acute period, if to perform stenting, then need flow diverter to insert, need to prescribe double antiplatelet therapy, which cannot be done. [UKR] Speaker 1: Patient performed decompressive craniectomy, unfortunately, she died not from repeat rupture of aneurysm, but due to progression of secondary brain ischemia, brain swelling.

00:13:39 [UKR] Speaker 1: Early invasive cerebral angiography implementation gives its results. And this new concept of early multimodal surgical intervention for penetrating traumatic brain injuries truly improves results of treatment of penetrating trauma. [VO CANDIDATE] [UKR] Speaker 1: What I wanted to say, not everything is so good, there are many more questions, which need to be solved, but they are connected not so much with our capabilities, capabilities of military hospitals, but so much connected with trauma itself. And this problem exists not only in Ukraine, but in such developed countries, as Germany, Switzerland, United States of America. [UKR] Speaker 1: You see CT of patient, and this fragment flies diametrically, and on its path we see, that it reaches brainstem, and occurs vascular damage, which leads to intracerebral hematoma, intraventricular hemorrhage.

00:14:31 [UKR] Speaker 1: We talked with military neurosurgeon, we understand, if not to operate, he will arrive at Mechnikov Hospital in Coma-3, if to operate, there is threat that there will be hemorrhage. [UKR] Speaker 1: In any case should thank neurosurgeon, he went, was not afraid, stopped partial hemorrhage, did decompression, saved life to this patient. [VO CANDIDATE] [UKR] Speaker 1: And you see, operation was 16th, 10th. Patient alive, delivered to Mechnikov Hospital. [UKR] Speaker 1: At Mechnikov Hospital performed immediately angiography, and you see shrapnel, and you see pseudoaneurysm, traumatic aneurysm. [UKR] Speaker 1: Again decision made to perform endovascular intervention in delayed period, because in acute need to occlude posterior cerebral artery.

00:15:23 [UKR] Speaker 1: And today, in half hour this patient, already passed two weeks, goes to endovascular operating room Chernichenko Yuriy Vitalich with team perform angiography. [UKR] Speaker 1: We will look at state of aneurysm and today already possible using endovascular method to place stent, for this to preserve patency of artery and after this prescribe double antiplatelet therapy. [UKR] Speaker 1: This is what in first lectures I said. Military-civilian cooperation. We think, we work as one whole. We don't distinguish military civilian doctors, military civilian wounds. We work for result, and results speak for themselves. [VO CANDIDATE] [UKR] Speaker 1: You see these photos. And these cases of wounds, unfortunately, they happen, when fragments fly into area of internal carotid artery, such hemorrhages. What to do? Need vascular neurosurgeon, need access on neck, need blood reserve, possibility to perform intervention.

00:16:26 [UKR] Speaker 1: In future, when this will be, such patients need to be operated in hybrid operating room, when there is simultaneously possibility to perform angiography, endovascular intervention and immediately perform open surgical intervention. [UKR] Speaker 1: These monographs we maximally distributed from beginning of war using internet, so that everyone could familiarize with them. [UKR] Speaker 1: And I'll finish my report with words of professor Rocco Armonda. We hope, that these efforts will improve care for patients with TBI, and will lead to further progress in care for victims of senseless violence, which has struck our streets and our world. [UKR] Speaker 1: I wanted once more to thank all our military doctors, all those, who save wounded. We see high level of providing aid at prehospital stage. [VO CANDIDATE]

00:17:18 [UKR] Speaker 1: At first stages stabilization points, forward surgical groups, mobile hospitals, patients arrive operated carotid arteries, sutured end-to-end, artery works.

00:17:29 [UKR] Speaker 1: Patients arrive already with working access for invasive measurement of arterial pressure. Thank you, I thank Konstantin Vitaliyovich, your all colleagues, leadership of military-medical forces, and also our American colleagues and other foreign colleagues, who support us in this difficult time. Glory to Ukraine and together to victory! [VO CANDIDATE] [UKR] Speaker 2: Glory to heroes, dear Andriy Hryhorovych, thank you very much for your longstanding such hard work on rescue of our wounded. [UKR] Speaker 2: And pass sincere greetings near you, Alex Valadka, pass greetings to Rocco Armonda, to director Sergiy Anatoliyovich Ryzhenko and Oleksandr Mykolayovych Tolubayev. [UKR] Speaker 2: Thank you. [UKR] Speaker 2: Thank you. [UKR] Speaker 2: Dear colleagues, we continue our session and for next report I invite Bigichenko Sergiy Ivanovych with theme of report "Gunshot injury of spine and spinal cord. Actual issues. National Military-Medical Clinical Center of Kyiv city".

00:18:32 [UKR] Speaker 3: Good afternoon. Thank everyone for opportunity to speak at this conference. [UKR] Speaker 3: Andriy Hryhorovych, very interesting, interesting your reports, truly emphasize relevance of gunshot wounds in wartime. [UKR] Speaker 3: And in my presentation this is gunshot injury of spine and spinal cord, actual issues.

00:19:21 Speaker 3: a lot of information you gave there.

00:19:25 Speaker 3: We have incredible experience. Speaker 1: Maybe a cup of coffee and go to the endovascular center, I think.

00:19:40 Speaker 1: I need coffee in order to recover my brain.

00:19:52 [RUS] Speaker 4: And plus, this means, that in Americas. [RUS] Speaker 4: Again, and we have on one first slide. [RUS] Speaker 4: Again, and we have on one first slide. [RUS] Speaker 4: A-plus. [RUS] Speaker 4: Yes, now can drink coffee.

00:20:27 Speaker 4: Thank you.

00:20:54 [RUS] Speaker 1: Good

00:21:00 [RUS] Speaker 1: Maybe, sleep? [RUS] Speaker 4: Maybe

00:21:25 [RUS] Speaker 1: I think, we are boiling coffee [RUS] Speaker 1: I think, we are boiling coffee

00:21:30 [RUS] Speaker 1: Hello, Artem [RUS] Speaker 1: Alex, we are preparing coffee

00:21:47 Speaker 1: coffee go to endovascular center after that go to our patient we operate

00:21:54 Speaker 4: Monday and go to patients we operate tomorrow or yesterday yeah after that

00:22:01 Speaker 1: maybe I think we it's a great mission yeah yeah yeah yes like I said so much

00:22:14 Speaker 4: so much information yeah that's why you're the world's expert

00:22:23 Speaker 1: and they told about the patients which perform on geography today yes yes

00:22:29 Speaker 4: yeah

00:22:49 [RUS] Speaker 1: Normal. [RUS] Speaker 1: no this food before was I wore this jacket [RUS] Speaker 1: was was was espresso okay drink coffee and wait for your team

00:23:16 [RUS] Speaker 1: Valeriy Kuras

00:23:36 [UKR] Speaker 3: Determined possibility neurological, [UKR] Speaker 3: by such scale level can be determined. [UKR] Speaker 3: Also determined can perform radiography, [UKR] Speaker 3: but this will not be sufficiently informative. [UKR] Speaker 3: Most informative will be computed tomography, [UKR] Speaker 3: which gives possibility to determine adequate level of wound, [UKR] Speaker 3: passage of wound channel, degree of damage of bone structures. [UKR] Speaker 3: Indications for operative treatment of spine wounds - these are penetrating injuries of spine to spinal cord, [UKR] Speaker 3: which is accompanied by CSF leak, spine injury with indirect compression of spinal cord,

00:24:23 [UKR] Speaker 3: bone fragment, instability of spine wound to spinal cord, [UKR] Speaker 3: unstable spine injuries, [UKR] Speaker 3: paravertebral injuries, [UKR] Speaker 3: presence of foreign body [UKR] Speaker 3: by sign of compression of nerve and vascular structures. [UKR] Speaker 3: In which cases delay? [UKR] Speaker 3: Performed delayed surgical interventions. [UKR] Speaker 3: This is general severe condition of wounded,

00:24:44 [RUS] Speaker 3: traumatic shock,

00:24:46 [UKR] Speaker 3: severe combined wounds of spine, [UKR] Speaker 3: spinal cord, internal organs, [UKR] Speaker 3: trophic paralytic and uroseptic disorders, [UKR] Speaker 3: sepsis, pneumonia, severe intoxication. [UKR] Speaker 3: Operative interventions for gunshot spinal injuries should be performed after partial compensation of general condition of patient, after surgical interventions, aimed at maintaining vital functions, stopping bleeding, drainage of cavities, too, but not to delay surgical interventions until full compensation in connection with rapid development of septic and trophic paralytic disorders. [UKR] Speaker 3: So, what are main tasks in treatment. [UKR] Speaker 3: Here we see unfortunately two cases, which received wounds, [UKR] Speaker 3: and in time patients were not evacuated, with delay remained up to two days,

00:25:36 [UKR] Speaker 3: and in such state patients arrived, where we see already infection,

00:25:42 [RUS] Speaker 3: Hello?

00:25:46 [UKR] Speaker 1: Good afternoon. [UKR] Speaker 1: Say only quickly, Vitaliy. [UKR] Speaker 3: Therefore, place of providing and volume of aid, the faster, first of all, they must be evacuated to stage of providing specialized aid. [UKR] Speaker 1: Third January? [UKR] Speaker 1: If... [UKR] Speaker 1: Okay, okay. [UKR] Speaker 1: You, so if impossible to hold... [UKR] Speaker 3: Okay, I wrote down, everything, we will.

00:26:14 [UKR] Speaker 1: Agreed.

00:26:16 [RUS] Speaker 3: Yes, let's-let's.

00:26:19 [UKR] Speaker 3: Wait until stabilization of condition of wounded. [UKR] Speaker 3: Mandatory adequate performance of primary surgical treatment of wound with removal of all non-viable tissues and foreign bodies. [UKR] Speaker 3: Performance of decompression of spinal canal, removal of bone fragments, foreign bodies, necrotic tissues. [UKR] Speaker 3: Most important this is elimination of CSF leak and performance of stabilization of spine. [UKR] Speaker 3: In our cases observations only in 13% what were indications and possibility of performing stabilization of spine. [UKR] Speaker 3: So, what methods of eliminating CSF leak? [UKR] Speaker 3: Suturing, tears and damage of dura mater.

00:27:06 Speaker 3: from my books yes i know that

00:27:36 [UKR] Speaker 3: Using preparation "Hemopatch", performed on wound suture, [UKR] Speaker 3: and additionally sealing, performed with such preparation, as "Hemopatch". [UKR] Speaker 3: Suturing of hard-soft shell and suturing maximally close to dural sac. [UKR] Speaker 3: When complete rupture, nothing to restore is impossible,

00:28:00 [UKR] Speaker 3: and for sealing, for elimination of CSF leak, suturing close to dural sac. [UKR] Speaker 3: Further in recent months. [UKR] Speaker 3: And here are some our clinical examples. [UKR] Speaker 3: We see through-and-through penetrating wound at level C6C7 [UKR] Speaker 3: with rupture of dura mater, [UKR] Speaker 3: damage, partial damage of spinal cord, [UKR] Speaker 3: significant damage of posterior parts of bone structures. [UKR] Speaker 3: Performed decompression, [UKR] Speaker 3: removal of all bone fragments, revision of spinal canal, [UKR] Speaker 3: removal of all non-viable washing of detritus [UKR] Speaker 3: and restoration of integrity prevention of CSF leak,

00:28:45 [UKR] Speaker 3: hermetic suturing of dural sac. [UKR] Speaker 3: Next clinical example - this is penetrating gunshot wound [UKR] Speaker 3: at level TH11, TH12. [UKR] Speaker 3: As you you have?

00:29:24 [RUS] Speaker 1: We with Alex did

00:29:27 [UKR] Speaker 1: Two reports 15 minutes each, everything went well. [UKR] Speaker 1: Very good. [UKR] Speaker 1: We first they put us, this is honor such, that this conference goes two days,

00:29:41 [UKR] Speaker 1: and us first they put. [UKR] Speaker 5: These are military surgeons, military anesthesiologists in Ukraine. [UKR] Speaker 5: - Intraoperatively after decompression, laminectomy we see presence...

00:00:00 [UKR-NEEDS] Віталій Казович запрошував на день народження,

00:00:04 [UKR] Speaker 1: Vitaliy Kazovych invited me to his birthday, [UKR] Speaker 1: he says: remember that on January 3rd you came to me for my 50th, so don't plan anything. [UKR] Speaker 1: - Now what, I'll show, I noticed. [UKR] Speaker 1: Nothing, he's alive there, the old man with the crossbow. [UKR] Speaker 1: He was holding on, I can already have some coffee, already relaxed a bit.

00:00:46 [UKR] Speaker 1: The main thing is there's no operation. [UKR] Speaker 2: Gunshot wound, sacral cross fracture, abdomino-spinal injury with gunshot fracture at the level of TH12. [UKR] Speaker 2: Meanwhile.

00:01:02 [RUS] Speaker 2: Good, baby.

00:01:06 [RUS] Speaker 2: this is also thank you for the food bye bye

00:01:16 [RUS] Speaker 1: gritin sfon at tatyana

00:01:19 [UKR] Speaker 2: Intraoperative procedure, removal of all dural compressions. [UKR] Speaker 2: In this case, since there was no point in restoring, [UKR] Speaker 2: the spine of the dural sac, so the dural case, [UKR] Speaker 2: case, hermetic suturing, principally the production of the dural sac [UKR] Speaker 2: and stabilization and radicular damage to the spine production. [UKR] Speaker 2: Another clinical example - gunshot bullet wound penetrating paravertebral at the level of [UKR] Speaker 2: L4 with damage to the meningeal sheath, elements of the cauda equina, decompression,

00:02:04 [UKR] Speaker 2: zamionect

00:02:34 [RUS] Speaker 1: Where are you located now? Because I can barely hear you.

00:02:41 [UKR] Speaker 1: Maybe closer to the exit? [UKR] Speaker 1: Oh, now I can hear, yes.

00:02:48 [UKR] Speaker 2: ...decompression was performed, removal of all tissue fragments, hermetic suturing of the dural sac. [UKR] Speaker 2: Considering the nature of the wound, which may be contaminated, development of purulent infectious complications,

00:03:02 [UKR] Speaker 2: In this case, in the first stage, performing transportation republicational accidental expressions is not performed. [UKR] Speaker 1: Oh, Dasha, why do I always solve questions that I'll never get through in your places. [UKR] Speaker 1: And I won't get through at Grigoruk's, and I won't get through at Volcherinka.

00:03:37 [RUS] Speaker 1: These are just the entrances already to this. [RUS] Speaker 1: Every week Tetyana Aleksandrovna comes and asks for a place for him, [RUS] Speaker 1: and even in a single room. [RUS] Speaker 1: We have two rooms occupied now by American neurosurgeons. [RUS] Speaker 1: In those rooms, where in others the patients are lying, we can't evict them. [RUS] Speaker 1: In the common room we can give a place. [RUS] Speaker 1: You can say, today he'll stay in the common room in the Center of Cerebral Neurosurgery, [RUS] Speaker 1: and tomorrow we'll transfer him to a single room in vascular neurology.

00:04:12 [UKR] Speaker 1: On such conditions...

00:04:19 [RUS] Speaker 1: In the common room we'll put him in the GAD block. [RUS] Speaker 1: Yes, but on the condition that you won't terrorize us later, [RUS] Speaker 1: terrorize Tatyana Aleksandrovna with the single room.

00:04:31 [RUS] Speaker 2: Okay, I won't, what are you, what are you, what are you, what are you, what are you, what are you, what are you, what are you, what are you, what are you, what are you, what are you

00:04:52 [UKR] Speaker 2: not to do. During the operation this is prevention of damage [UKR] Speaker 2: to the dura mater, in drainage during operations on the spine, [UKR] Speaker 2: drainage of the operative wound for prevention of wound healing, [UKR] Speaker 2: during suturing of wounds on the back and suture. Therefore, operative interventions [UKR] Speaker 2: should be performed only in specialized hospitals, [UKR] Speaker 2: operative treatment, as soon as possible in the shortest term, [UKR] Speaker 2: urgent treatment should be differential and depend [UKR] Speaker 2: on the severity, of the patient and type of wound. [UKR] Speaker 2: The main task with injuries

00:05:25 [RUS] Speaker 2: of the spine and spinal cord

00:05:27 [UKR] Speaker 2: is elimination of CSF leak, removal of foreign bodies

00:05:29 [RUS] Speaker 2: and necrotic tissues.

00:05:31 [UKR] Speaker 2: Thank you for your attention. [UKR] Speaker 3: Sergiy Ivanovych, thank you [UKR] Speaker 3: for the professional report. [UKR] Speaker 3: And before proceeding to the next [UKR] Speaker 3: our session "Combat Surgical Trauma" [UKR] Speaker 3: of the maxillofacial area, [UKR] Speaker 3: I want to emphasize for all speakers, [UKR] Speaker 3: please, adhere to the designated regulations. [UKR] Speaker 3: And I want to invite [UKR] Speaker 3: to the next report [UKR] Speaker 3: On the topic of features of specialized treatment of modern combat trauma of the maxillofacial area Kozlovskyi Serhiy Mykolayovych and a group of authors from the National Military Medical Clinical Center of Kyiv city and the Ukrainian Military Medical Academy.

00:06:09 [UKR] Speaker 4: Good day, dear colleagues. Can you hear me well? [UKR] Speaker 4: Yes, everything is audible. [UKR] Speaker 4: Good day, dear colleagues. On behalf of our collective, we want to congratulate you on the beginning of our congress, wish fruitful work, [UKR] Speaker 4: further professional development, wish you health, goodness and our soonest victory.

00:06:30 [UKR] Speaker 4: To your attention, is presented, I'll look at the prepared experience of the clinic's work regarding maxillofacial surgery of the National Military Medical Clinical Center, [UKR] Speaker 4: about which we will show our work, and including we'll show those difficulties which we encounter during this. [UKR] Speaker 4: First some small statistical data. [UKR] Speaker 4: In the general structure of sanitary casualties, maxillofacial injuries we expect at the level of 4-4.5%. [UKR] Speaker 4: What needs to be noted, that in the realities of full-scale war taking into account the nature of combat operations, [UKR] Speaker 4: we have a significant increase in the percentage of severe combined blast trauma with a maxillofacial component.

00:07:22 [UKR] Speaker 4: According to our data, according to the data of our clinic, so by cause of injury we have such statistical data, [UKR] Speaker 4: Blast trauma comprises 60%, fragmentation injuries 31%, bullet 8.5% and non-gunshot combat trauma 2.5%. [UKR] Speaker 4: Of them combined injuries of the maxillofacial area - this is 84%, bullet - 11% and combined - 5%. [UKR] Speaker 4: Structure of combat trauma, this is according to our clinic's data, of course, the data will be corrected after the end of the war, when we will approach this.

00:08:14 [UKR] Speaker 4: Maxilla orbital complex 36%, injuries of the lower jaw 14%, multiple, that is upper and lower jaws 11.5%, soft tissues 31%. [UKR] Speaker 4: Briefly we'll stop on the features of this area. [UKR] Speaker 4: First, this is a branched vascular network. [UKR] Speaker 4: As a plus, this gives us quite high good regeneration. [UKR] Speaker 4: As a minus, this is of course, that in the beginning bleeding. [UKR] Speaker 4: Presence of posterior sections of upper respiratory tract - this is the threat of asphyxiation.

00:09:05 [UKR] Speaker 4: Considering the modern course, combat and nature, [UKR] Speaker 4: this impossibility of timely provision of help in the consequences at The Zero Line. [UKR] Speaker 4: This leads to the fact that, unfortunately, these wounded, with corresponding trauma, [UKR] Speaker 4: reach the stage of medical aid. [UKR] Speaker 4: Close location of important organs - brain spinal cord, main vascular organs, eyes. [UKR] Speaker 4: This leads to the fact that in most cases maxillofacial injury is combined, [UKR] Speaker 4: further complicates the course of treatment and requires involvement of related specialists in the treatment. [UKR] Speaker 4: Presence of powerful masticatory musculature - this leads to displacement of fragments, imitation of defects.

00:09:56 [UKR] Speaker 4: A considerable number of soft tissue defects we can cover at the expense of local tissues, which during correct surgical treatment. [UKR] Speaker 4: Next - these are teeth and dental prostheses. [UKR] Speaker 4: In our opinion, performing only osteosynthesis with multi-fragmented gunshot fractures of the jaws is insufficient for fixation and stabilization of fragments, therefore if possible we necessarily perform fixation with the help of interdental splints. [UKR] Speaker 4: But here it's necessary to take into account the general unsatisfactory level of sanitation of the population of Ukraine, sanitation of the oral cavity, hence the infection of wounds with diseased teeth, which get into touching tissues during the injury.

00:10:44 [UKR] Speaker 4: And a significant number of our injuries, they have communication with the oral cavity, which leads to prolonged wound healing, [UKR] Speaker 4: well and requires reliable isolation of the oral cavity from wounds during surgical work. [UKR] Speaker 4: Features of specialized treatment - this is a comprehensive approach to treatment with involvement of specialists of related specialties, [UKR] Speaker 4: This is otolaryngologist, ophthalmologist, neurosurgeon, vascular surgeon, thoracic surgeon. [UKR] Speaker 4: This, what needs to be done at the stages of conducting diagnostics and laying out the surgical intervention plan. [UKR] Speaker 4: Next, very important, this is thorough early surgical intervention of the wound with primary plastic, [UKR] Speaker 4: of soft tissues and surgical fixation of bone fragments, adequate drainage of wounds to surrounding spaces.

00:11:35 [UKR] Speaker 4: In our opinion, the optimal term for conducting civilized treatment, namely thorough early, this is the first to fifth day after receiving the injury. [UKR] Speaker 4: Intensive therapy, comprehensive treatment and, what is even more important, this is ensuring full nutrition, civilized support, civilized injury. [UKR] Speaker 4: On the following slides we will show examples of injuries of the maxillofacial area, which were operated on by us. [UKR] Speaker 4: Patient's appearance on admission, here blast trauma, fragmentation injury of the lower zone and middle zone of the face

00:12:21 [UKR] Speaker 4: with multi-fragmented fracture of the department of the lower jaw [UKR] Speaker 4: and remaining of a large fragment, [UKR] Speaker 4: zone of the zygomatic arch,

00:12:30 [UKR] Speaker 4: with completely destroyed execution.

00:12:34 [RUS] Speaker 4: Removal was performed,

00:12:37 [UKR] Speaker 4: careful treatment of the wound and fixation [UKR] Speaker 4: at once with the help of reconstructive plates [UKR] Speaker 4: and the appearance on the pillows. [UKR] Speaker 4: Here is an injury of the lower jaw - this is a blast injury, fragmentation injury with comminuted fracture of the lower jaw, with the presence of massive defects of soft tissues, external nose, lips, cheeks and skin. [UKR] Speaker 4: Surgical treatment was performed, fixed with metal plates, which allowed to achieve stabilization of the fragments, isolation from the oral cavity was performed with reliable suturing, esophagus. [UKR] Speaker 4: And the patient was subsequently transferred to the next stage of treatment for conducting of fragments, in part of the further.

00:13:26 [UKR] Speaker 4: This patient, who this patient has a blast injury, with comminuted fracture of the body of the lower jaw, on both sides, with 12-ordered department.

00:14:09 Speaker 1: We are going to go off. Speaker 5: yeah you can how are you good i heard it went well yes it's a it's a usual situation it's at

00:14:22 Speaker 1: least one two times per week we are going to underground shelter i even sleep today from

00:14:30 Speaker 1: 4 to 6 a.m but i am ready to work oh you can see photo from kosa camp it's happy i am

00:14:41 [RUS] Speaker 1: I am very glad, because Sviatoslav is now in Kozak. [RUS] Speaker 1: Because this is the most difficult for him. [RUS] Speaker 1: He was a child, he's afraid, afraid of death. [RUS] Speaker 1: This is a huge problem. [RUS] Speaker 1: I am glad, that now he is spending his time in Kozak.

00:15:09 Speaker 1: Because if he was together with me, he would be... not exhausted, scarified, scared, yeah? Speaker 1: - Scared. Speaker 1: - Scared, scared, worried about and afraid the death, he is the youngest than we.

00:15:29 [RUS] Speaker 1: We know, that the artillery has ended, and I got up and [RUS] Speaker 1: I am very glad, therefore... [RUS] Speaker 1: You can see, Sviatoslav

00:16:22 [RUS] Speaker 1: This is craniofascial injury

00:16:27 Speaker 1: Yes. Speaker 5: Is he right down there in the end of the S-

00:17:17 Speaker 4: So, for some reason, it's bad, yes, I see it thought it would take you longer, so they

00:17:22 Speaker 5: I went back to the hotel. Speaker 1: Yes? You can hold? Speaker 1: Please. Speaker 1: Please. Speaker 5: Yeah, let's go to the room to see if they're safe. Speaker 1: Yes.

00:17:38 [RUS] Speaker 1: Smart, I can't.

00:18:23 Speaker 1: Hello, how are you? Speaker 1: I am sure after this night you would like escape to home as fast as possible, yeah? Speaker 1: or escape maybe maybe maybe tomorrow together with Alex if you don't have Speaker 1: key ticket yes Alex maybe it's your large suitcase and yeah I need help you

00:18:53 Speaker 1: You need my help. Speaker 5: She never lets anyone take that. Speaker 5: Because that's all their... Speaker 5: I mean... Speaker 5: She is very strong. Speaker 1: Very strong. Speaker 5: She's like a Cossack. Speaker 1: I think it's a parachute. Speaker 1: It's need to jump from the plane.

00:19:12 Speaker 1: She always has a parachute. Speaker 1: The paracupers, that's what they're called. Speaker 1: Yes. Speaker 1: That's on D-Day. Speaker 5: Oh, that's right. Speaker 5: I remember I'm reading you worked on a documentary.

00:19:33 Speaker 5: You were still working on it. Speaker 5: But yeah. Speaker 5: I know that was D-Day, but did you ever hear about the Battle of the Bulge? Speaker 5: with General Anthony McCullough. Speaker 5: Oh, nuts? Speaker 5: Oh, we did. Speaker 5: Oh, we did. Speaker 5: Yeah, we did. Speaker 6: We did a veteran tell us that story. Speaker 5: I actually, that's in my canned talk I give, because people always ask me, Speaker 5: "Where do the Ukrainian people think about the war and the fighting?" Speaker 5: And I say, "Well, let me tell you a story from 80 years ago when the Americans were surrounded by the Germans Speaker 5: as it wasn't looking good. Speaker 5: I'll tell them that, Speaker 5: and then I'll tell them the story about Snake Island.

00:20:18 Speaker 1: - Uh, no. Speaker 1: - Uh, no. Speaker 1: - Hi. Speaker 5: - Did we get another mic? Speaker 5: - We need that as I'm so. Speaker 1: - Maybe your hair need to remove from your case? Speaker 5: - Oh, yeah. Speaker 1: - Okay.

00:20:47 Speaker 1: Yes, we... Speaker 5: We're just going to say hi to him briefly. Speaker 5: You can always come back and interview him later. Speaker 5: I obviously just not going to walk around with you. Speaker 5: I obviously just not going to walk around with you.

00:21:05 [RUS] Speaker 5: - Yes, we'll do this and then two patients.

00:21:13 [RUS] Speaker 1: After this I have time for inter

00:21:40 [RUS] Speaker 5: I'm saying that he can

00:22:10 [RUS] Speaker 7: Look, CT control this is some vessel.

00:22:17 [RUS] Speaker 1: And where was the bleeding from? [RUS] Speaker 7: Parasagittal, temporoparietal, bridging. [RUS] Speaker 1: Bridging. [RUS] Speaker 7: Bridging. [RUS] Speaker 7: Bridging. [RUS] Speaker 7: Inflow outflow, but...

00:22:30 [RUS] Speaker 7: Contralateral site. [RUS] Speaker 7: Posterior cranial fossa. [RUS] Speaker 7: Posterior cranial fossa. [RUS] Speaker 1: And what condition was he in? [RUS] Speaker 7: In psychomotor agitation he scored 14 points, he was really not bad. [RUS] Speaker 7: My opinion, wait until at least the contusion forms. [RUS] Speaker 7: And the level of consciousness? [RUS] Speaker 7: Now I don't know, in the morning he was kizik. [RUS] Speaker 7: What? [RUS] Speaker 7: Bad, I'll go look now. [RUS] Speaker 1: Drip mannitol, remove sedation and evaluate in an hour. [RUS] Speaker 1: Good. Let the inflow outflow stay, is it working?

00:23:07 [RUS] Speaker 7: I'll go now. [RUS] Speaker 1: Inflow outflow allows, sometimes, even to liquidate [RUS] Speaker 1: in the subarachnoid space also therapeutic such, this... [RUS] Speaker 1: Yes, you're speaking correctly. [RUS] Speaker 1: The vein bleeds, while it bleeds, it's still functioning, it happens,

00:23:24 [RUS] Speaker 1: they pressed or coagulated, and immediately...

00:23:28 [RUS] Speaker 7: - Look, [RUS] Speaker 1: We just went into airplane mode for an hour, because we were giving a report at the Congress of Military Surgeons and Anesthesiologists of Ukraine. [RUS] Speaker 1: They put us first with two reports. [RUS] Speaker 1: By the way, you are also among the presenters.

00:24:11 [UKR] Speaker 1: Did you see?

00:24:12 [RUS] Speaker 1: Artem, well how did you not see? [RUS] Speaker 1: Well how did you not see? [RUS] Speaker 1: I'll show you now.

00:24:30 [RUS] Speaker 1: you see roka armonda alex volodka cherednichenko botikov malyi guligin

00:24:37 [RUS] Speaker 1: Sirko, Perepelitsa, Lombroza, Starik. [RUS] Speaker 5: - Standing Logan.

00:24:42 Speaker 1: - Yes.

00:24:47 [RUS] Speaker 1: - This is Kosar, our report, Nikita Lombroza.

00:24:55 [RUS] Speaker 5: - I understand that he's new. [RUS] Speaker 1: - I understand, yes.

00:25:01 Speaker 1: I always tell about my team.

00:25:05 Speaker 1: That's why all the results are sent to teamwork.

00:25:09 Speaker 5: - Oh yeah, it's all about, exactly. Speaker 1: - Yes, yes. Speaker 1: For my glory, it's not need anything.

00:25:18 Speaker 1: For my glory. Speaker 5: - Yeah, your glory is your team. Speaker 5: - How well your department does. Speaker 5: - How well your department does. Speaker 1: - My team and the results of work my team. Speaker 5: - Here comes our team right here. Speaker 5: - Here comes our team right here. Speaker 1: - Oh. Speaker 5: There. Speaker 5: Yeah. Speaker 5: No, no, I thought you were rolling. Speaker 5: No, no, I thought you were rolling. Speaker 5: Just trying to get out of the way. Speaker 5: How are you? Speaker 5: I'm well. Speaker 5: Wait, don't go ahead. Speaker 5: Anastasia's changing in there. Speaker 5: Oh, she? Speaker 5: Okay. Speaker 5: Anastasia's made it before Eddie? Speaker 5: Oh, wow. Speaker 5: Oh, wow. Speaker 5: Hello. Speaker 5: Hello. Speaker 5: Did you get sleep last time? Speaker 5: Yeah, we went to the shelter in the middle of the night. Speaker 5: Yeah, we went to the shelter in the middle of the night. Speaker 6: I didn't hear it. Speaker 6: I was so... Speaker 6: Where are we going?

00:26:00 Speaker 6: We're in the vascular center. Speaker 6: It's clean. Speaker 6: But I didn't hear. Speaker 5: Well, I was already awake. Speaker 5: I was getting up early. Speaker 5: I was getting a shower and stuff. Speaker 5: And I kept trying to call them. Speaker 5: And they were like you. Speaker 5: They were so exhausted. Speaker 5: We were looking up the phone call. Speaker 6: Well, my dog was asleep, so it wasn't bad. Speaker 6: She would have woke me up. Speaker 6: Your what? Speaker 6: Oh, yeah. Speaker 6: Oh, yeah. Speaker 6: She was asleep. Speaker 6: She would have woke me up because it was too bad. Speaker 5: so we just slept did you show andre a picture of your dog

00:26:35 Speaker 1: uh early in the morning i realized we have electricity but we didn't have water water yes Speaker 1: without water but we always have some bottles bottle with water from my countryside house Speaker 1: we get possibility to reach this water underground maybe 20-30 meters Speaker 1: at your house yes it's very clean clean water is even better than from our general system Speaker 1: it's better that's why we take this water in order to have possibility to drink it's for drinking Speaker 1: for prepare food from our countryside every weekend or maybe for two weeks we gave yes yes

00:27:32 Speaker 1: uh 40 50 liters for week for week that's very heavy for week no but in this uh but still that's Speaker 1: many containers many containers here it's true i four containers for five liters in each two two it's Speaker 1: a 10 and 10 20 yeah so the slow also one one and maybe funny this is why it's in my home

00:28:05 [UKR] Speaker 1: Very hot

00:29:01 [UKR] Speaker 1: You can refer to me in the sense that we [UKR] Speaker 1: Came to Mechnikov Hospital together with an American neurosurgeon who is now working with Professor Sirko. [UKR] Speaker 1: This is already the fourth visit. [UKR] Speaker 1: To the military it's sweet, that you're not just from the street, that you work at Mechnikov Hospital [UKR] Speaker 1: and you receive permission from the military-civil administration for filming at Mechnikov. [UKR] Speaker 1: They were filming those containers, yes, that I was talking about. [UKR] Speaker 1: It's true, electricity goes to them, because there are refrigeration units there.

00:00:00 Speaker 1: you need

00:00:00 Speaker 1: you need

00:00:15 Speaker 2: today we also have permission from bird yeah yes Speaker 3: - I was joking that he said he got permission Speaker 3: from the bird for the picture.

00:00:32 Speaker 2: - And do you start the fly? Speaker 2: It's also a...

00:00:39 Speaker 3: - Yeah, I tried a hummingbird like that Speaker 3: when I was in San Francisco, we were walking. Speaker 3: It was like a perfect, right in the middle, Speaker 3: with light cell phone. Speaker 3: My daughter-in-law dabbles at the photographer. Speaker 4: How did you do that?

00:01:09 Speaker 2: We go to the endovascular center for two reasons.

00:01:13 [RUS] Speaker 2: The first reason - Alex would like to give a gift to Yuri Denysenko the neurosurgeon here. [RUS] Speaker 2: And after that we would like to see the patient, whom we see every day in our military block, in the ICU unit.

00:01:33 Speaker 2: today they will perform angiography and decided what need to do maybe implantation of the stand Speaker 2: yes it's patient we saw on monday tuesday wednesday and even today and this two weeks after Speaker 2: injury it's a time we can to perform angiography and treat this traumatic intracerebral aneurysm

00:02:15 [UKR] Speaker 2: And is there anything to change? [UKR] Speaker 2: Yes, if there is, we need to change. [UKR] Speaker 2: Because the endovascular center we can go without, but when we go to the ICU, [UKR] Speaker 2: Let them be in your pocket. [UKR] Speaker 2: They'll be there in the ICU. [UKR] Speaker 2: Say that I'll take it. [UKR] Speaker 2: Just let him take it off for sure, so there won't be any questions, don't even forget.

00:02:39 [UKR] Speaker 2: Especially since it's very hard for him to put on and take off with that thing of his.

00:03:12 [RUS] Speaker 1: Thank you. [RUS] Speaker 2: Well, not farewell, but pre-farewell. [RUS] Speaker 2: Now.

00:03:26 [UKR] Speaker 2: Yes, on Magdeburg Street, law 4.

00:03:30 [RUS] Speaker 2: And this is called? [RUS] Speaker 2: Suziriya, now I'll share with you.

00:03:33 [UKR] Speaker 2: Yes, yes, yes, Suziriya station.

00:03:37 [RUS] Speaker 2: Yes, share with this location.

00:03:45 [UKR] Speaker 2: I've never been there. [UKR] Speaker 2: I'm saying, across from Minora. [UKR] Speaker 2: It's very close. [UKR] Speaker 2: We go down there, the main thing is to be careful not to get re-parked. [UKR] Speaker 2: I wanted not to take the car today, couldn't call a taxi. [UKR] Speaker 2: I took the car, thinking if anything, I'll pick up someone, for example Alex, we'll go and park.

00:04:13 [UKR] Speaker 2: Here we have Intermezzo, and this is from the other side.

00:04:17 [RUS] Speaker 1: I see, I see.

00:04:22 [UKR] Speaker 2: So, roughly speaking, we can try to turn here. [UKR] Speaker 2: And here somewhere try to park. [UKR] Speaker 2: There used to be flowers here earlier, remember, a big store. [UKR] Speaker 1: Yes, yes, yes. [UKR] Speaker 1: - We'll be looking for something. - Yes. [UKR] Speaker 2: It's just that earlier we went to this avocado bar, I said yesterday that they love avocado so much, [UKR] Speaker 2: that when we come there on the last day, no one can look at their food, [UKR] Speaker 2: because they shove avocado everywhere possible, all salads, all those. [UKR] Speaker 2: And this is also Ukrainian cuisine. Well, we tried at this Intermezzo. [UKR] Speaker 2: Of course, they're worse than what my wife cooks, but in any case the atmosphere there. [UKR] Speaker 2: It's called "Intermezzo" - it's a poem by Kotsiubynsky.

00:05:13 [UKR] Speaker 2: Oh, 8 minutes, 2.5 kilometers. [UKR] Speaker 1: My mom works in a restaurant, and there, you know, at the turn, Porichchya, supposedly Termezzo,

00:05:23 [RUS] Speaker 1: - I asked what you told me about the avocado bar

00:05:52 [UKR] Speaker 2: It's not just words, this is the real situation. [UKR] Speaker 2: I wouldn't have called, when I heard the explosion, [UKR] Speaker 2: and it was written that in the next 30 minutes [UKR] Speaker 2: there might be ballistic missiles, so I wrote. [UKR] Speaker 2: Well, Alex woke them up. [UKR] Speaker 2: Because he says: "I'm calling, they're not picking up, [UKR] Speaker 2: I went to knock on his door". [UKR] Speaker 1: I went to his door, until they got up.

00:06:17 [RUS] Speaker 2: I say, Alex is our old crisis bomb.

00:06:21 [UKR] Speaker 2: He's so active.

00:06:26 Speaker 2: 64.

00:06:29 [UKR] Speaker 2: He just had a birthday, October 21st. [UKR] Speaker 2: I'm saying between us today, that I brought up here. [UKR] Speaker 2: It's a secret, when we gather. [UKR] Speaker 2: Velogan wants to turn on the fire alarm for us.

00:06:50 [RUS] Speaker 2: Fire alarm, water will run. [RUS] Speaker 2: Check that everything is closed.

00:06:56 Speaker 2: - Yeah. Speaker 5: - Do you want it in the bag? Speaker 5: You can grab that bag. Speaker 5: You can put it in my hand. Speaker 5: - Okay, good. Speaker 1: - I'm gonna go get back back if you want. Speaker 5: - Either one. Speaker 5: - Either one. Speaker 5: - Back back. Speaker 5: - It's easier.

00:07:52 Speaker 3: Thank you. Speaker 2: so Speaker 2: Second report, I say thank you to military personnel, military surgeon, anesthesiologist who save life from frontline to advanced medical center to stabilization point, points to military hospitals.

00:08:45 Speaker 2: and also thank you our American and other international colleagues for their support, Speaker 2: continued support. Speaker 2: Thank you. Speaker 2: I also said we never make a difference between military or civilian neurosurgeon. Speaker 2: We never make difference between military and civilian wounded people.

00:09:12 [RUS] Speaker 2: We also work together to save lives. [RUS] Speaker 2: To be continued...

00:10:12 Speaker 2: Good morning. Speaker 2: Good morning. Speaker 2: Please.

00:10:24 Speaker 2: Oh. Speaker 3: Yeah. Speaker 2: I would like to show a lot of boxes from Roca Armanda, Washington DC.

00:10:34 Speaker 2: This is shipment from Washington DC. Speaker 2: health hospital donation destination I ask I mean I may I may be maybe later

00:11:09 Speaker 2: about it maybe later I ask Alex is showing us Alex use the light to show us

00:11:18 Speaker 5: there we go

00:11:30 Speaker 2: Alex oh maybe Speaker 2: I show you Speaker 2: It's Speaker 2: From Speaker 2: Roka Armanda Speaker 2: Medical doctor Speaker 2: To Razum for Ukraine Speaker 2: Razum Health Speaker 2: Hospital donation Speaker 2: Destination

00:12:00 Speaker 2: Mechnikov Hospital

00:12:00 Speaker 2: Mechnikov Hospital Speaker 5: - All right, you guys walk off, turn back off the light, Speaker 5: and then we'll catch up to you, okay? Speaker 5: Did you get that?

00:12:12 Speaker 2: - Okay, super. Speaker 2: - Yeah. Speaker 2: - Best of the best. Speaker 2: Okay, let's go. Speaker 3: - All right, turn back off the light. Speaker 3: - You got the lights up? Speaker 2: - No, no. Speaker 3: - Yeah, no. Speaker 3: - Okay, I think you can't wait to stop.

00:12:30 [RUS] Speaker 2: You save lives?

00:12:35 [RUS] Speaker 2: I think, this.

00:12:42 [RUS] Speaker 3: American flag?

00:12:43 Speaker 2: Yes.

00:12:45 [RUS] Speaker 2: This is what I wanted to show. [RUS] Speaker 2: Good afternoon! [RUS] Speaker 2: Vadim, where's the flag? [RUS] Speaker 2: Good afternoon!

00:12:58 [UKR] Speaker 2: Where is the flag of the United States of America? [UKR] Speaker 2: Greetings. [UKR] Speaker 2: Who is this with us? [UKR] Speaker 2: No, seriously, where? [UKR] Speaker 2: No, seriously, where? [UKR] Speaker 2: Well so let's hang it. [UKR] Speaker 2: I'll hang it. [UKR] Speaker 2: I told Andriy Yuriyovych that the Americans would come.

00:13:26 [RUS] Speaker 2: I even know where it hangs.

00:13:30 [UKR] Speaker 2: Yes, Valery Alexandrovich, help.

00:13:33 [RUS] Speaker 2: Valery.

00:13:35 Speaker 2: Oh!

00:13:38 [RUS] Speaker 2: It's here. [RUS] Speaker 2: It's usually here. [RUS] Speaker 2: This is for...

00:13:45 Speaker 2: Oh! Speaker 2: Oh!

00:13:52 [RUS] Speaker 2: It's here.

00:13:53 Speaker 2: Oh! Speaker 2: is this place yeah just yeah no okay oh we find alex volatka yeah right here oh alex volatka is

00:14:11 Speaker 3: all can read this you do incredible work your heroes receive outstanding care you are leading

00:14:20 [RUS] Speaker 3: the return to peaceful and combat

00:14:50 Speaker 2: Four times at least. Speaker 2: See, Rocco has much better hand right now. Speaker 2: Yes, I find. Speaker 2: Oh, Rocco. Speaker 2: To Andrei, Yuri, and all of Mechnikov, Ukraine, I will forever support you. Speaker 2: Shoulder to shoulder, we will stand. Speaker 2: I shall return together to victory, Razum, we will win.

00:15:09 Speaker 2: Rocco Armando, colonel, retired USA. Speaker 3: Medical Corps. Speaker 2: Medical? Speaker 3: MC, Medical Corps. Speaker 2: Medical Corps. Speaker 2: sort of february 24 and again february 20 20 25 rather for ukraine also you can see alex domoratsky

00:15:31 Speaker 2: from a razon for ukraine luke tomich inspired by your resilience slava ukraine yeah and this Speaker 2: from New York: Peter Kim Nielsen, Maxim Shapiro, Razum Copilot Neuro Team, Heroes of Medicine and Humanity. Speaker 2: Humanity, we are with you always.

00:16:00 Speaker 2: Slava Ukraini! Speaker 2: To our friends and colleagues in Dnipro Mechnikov, visit 2, visit 3:

00:16:07 Speaker 2: nelson kim nelson maxim shapiro september 2023 april 2024 june 2025. alex also will have all

00:16:18 Speaker 3: but it's neat small because it's a lot yeah we can we can add all the other things yes yes oh jeff Speaker 2: collie do you remember jeff holly it's made by 38 government of kansas it's the kansas governor yeah Speaker 2: yes plastic surgeon and the burn surgeon jeff collie Speaker 2: russell andrews you are saving ukraine and the world Speaker 2: alex malikawa the man kufler from from Speaker 2: Puerto Rico, yes, the professor is the best serving the bravest.

00:17:00 Speaker 2: Maybe, maybe, maybe, maybe soon.

00:17:04 Speaker 5: We're just changing lenses. Speaker 5: We're just changing lenses. Speaker 5: Yeah. Speaker 5: Quick second here. Speaker 5: That was great. Speaker 5: Thank you.

00:17:21 Speaker 2: Alex. Speaker 2: Sit down, please.

00:17:54 [RUS] Speaker 2: but you on the femoral transfer transfer doing away

00:18:14 [RUS] Speaker 2: now I'll ask and my you light here turn off the light here yes now still

00:18:22 Speaker 3: here oh okay so he's threaded a catheter through the radial artery up into the brain and he's Speaker 2: injecting dye and trying to occlude yeah i would like to show you you can see this stand yes and Speaker 2: And this metallic fragment located here, and this traumatic intracranial aneurysm.

00:18:58 Speaker 2: It's soldiers, two weeks after injury.

00:19:06 Speaker 3: So this person was initially injured and you said had surgery at a military hospital? Speaker 2: Had surgery, removed intracerebral hematoma and performed a decompressive craniotomy.

00:19:17 [RUS] Speaker 2: transfer to Mechnikov hospital Yuri and the team perform angiography find this aneurysm

00:19:27 [RUS] Speaker 2: now

00:19:36 [RUS] Speaker 3: who said and any more haven't done now I will dial type the words

00:19:51 Speaker 5: It seems like I'm looking at a lot of this. Speaker 3: This is pretty high-tech equipment that Rocco helped him get. Speaker 3: He wrote a letter to the government and talked about the need for this type of technology. Speaker 3: It's pretty impressive. Speaker 3: What is that machine?

00:20:14 [RUS] Speaker 3: This is biplane angiography, in order to look not only from the right and from the left and from the right. [RUS] Speaker 3: And get a three-dimensional structure.

00:20:27 [RUS] Speaker 3: And also the image quality is much better, not combined. [RUS] Speaker 2: I asked, are you now providing him with a head and mask? [RUS] Speaker 2: Rostyslav, have you already finished? [RUS] Speaker 2: So, did you get it? - Yes. - Yes. - Yes. - I already. - Yes. - I already finished. - Yes. - Yes. - Yes. - Yes. - I already [RUS] Speaker 2: the fragment yes and when will you do the puncture this [RUS] Speaker 2: then call either Rostyslav that already the script must be that everything has been done yes yes [RUS] Speaker 2: come on come on now let's go Vadim Andreyevich what do you think if we [RUS] Speaker 2: If we lift this mask, can he come in?

00:21:13 Speaker 2: Yes?

00:21:15 [RUS] Speaker 2: No need? [RUS] Speaker 2: No need? [RUS] Speaker 2: If you go to the room, then it can be done.

00:21:23 [RUS] Speaker 5: No need to insert something into something, then don't. [RUS] Speaker 5: But if he...

00:21:29 [UKR] Speaker 5: He just like that?

00:21:30 [RUS] Speaker 5: If he needs a mask, then the mask will be fine. [RUS] Speaker 5: But we don't need him everything in order.

00:21:36 [RUS] Speaker 5: What-what?

00:21:37 Speaker 2: - Yes, and you think who? - You Speaker 2: - I?

00:21:43 Speaker 2: - No, I don't think he's going to go to the... Speaker 3: - Can he go to the mask? Speaker 3: - Just with the mask, we think about it, one moment. Speaker 2: - Now.

00:22:07 [RUS] Speaker 6: 1 second [RUS] Speaker 2: but we specially flew from America so he needs to put on yes probably this

00:22:25 [RUS] Speaker 3: yes now that moment which one can take this here some here this blue but [RUS] Speaker 3: - That's not it. [RUS] Speaker 3: - That's not what you need if you're on the floor.

00:22:55 [RUS] Speaker 2: now they'll come to you and there you'll tell yes come in this already the coat of the gift is gone [RUS] Speaker 2: come on come on come on come on come on come on Vadim this I'm telling you half the day stand next to

00:23:06 [UKR] Speaker 2: Vitali then

00:23:15 [RUS] Speaker 2: Yura Yura stand and stand near the patient near the patient and tell about the patient

00:23:54 Speaker 2: -

00:24:20 Speaker 5: Is this Yuri or? Speaker 2: Yuri. Speaker 2: This is Yuri.

00:24:38 [RUS] Speaker 2: Yura, show on the screen with your finger, and then you'll go into the office, sit by the screen here, show.

00:24:53 Speaker 3: Is it okay? Speaker 3: The view is better. Speaker 3: The view is better. Speaker 3: Yes, it's very good.

00:25:00 Speaker 5: It wasn't very good. Speaker 5: It wasn't so long. Speaker 5: Let's continue. Speaker 5: Ok.

00:25:29 [RUS] Speaker 2: is this a flow diverter stent or not stand tick this is no probably and in this coils were placed to and what on like this looks [RUS] Speaker 6: and here this what is this here this and this just contrast got there and the flow diverter it just exits later

00:25:51 [RUS] Speaker 6: therefore in the artery itself passed the phase of contrasting and there the contrast was delayed that is you just [RUS] Speaker 2: flow diverter what is it called just flow diverter stent not the name there Fred and there Fred [RUS] Speaker 2: Baby, something Baby others. [RUS] Speaker 2: Yuri, show what's on the screen here. [RUS] Speaker 2: Yuri, Vadim, come here.

00:26:30 [RUS] Speaker 2: I spoke about you today at the conference of military neurosurgeons. [RUS] Speaker 2: now I'll show firstly about this case I spoke that you will now be doing [RUS] Speaker 2: now I'll show look Yuri [RUS] Speaker 2: Vadim, now, attack, attack, attack, attack, attack, attack, attack, where did you run?

00:26:59 [UKR] Speaker 2: Yuri, look, the microphone will hang on you now, will clip on.

00:27:09 [RUS] Speaker 2: One was an effective northern northern co-author, this is Ryzhenko Tovbaievsky Skrebets, [RUS] Speaker 2: and new approaches to surgical treatment of penetrating parameters. [RUS] Speaker 2: The main part of this intracranial injury. [RUS] Speaker 2: Rocco Armando, Alex Volodko, Cherednychenko. [RUS] Speaker 2: Where is Perepelytsia? [RUS] Speaker 2: Oh, Perepelytsia. [RUS] Speaker 2: And we were just talking about this case. [RUS] Speaker 2: And they put us as the first report, they have two days going on. [RUS] Speaker 2: And today first, and after the opening. [RUS] Speaker 3: Now to add, because this is unique.

00:27:34 Speaker 3: okay

00:27:48 Speaker 3: there Speaker 2: you can see this patient in the film tomorrow in ICU unit maybe

00:28:02 [RUS] Speaker 2: sit down tell Alex here where is Vadim Vadim come here sit down [RUS] Speaker 2: sit down at the table Alex sit down sit down Vadim sit down and Yuri will show us

00:28:23 Speaker 2: oh

00:28:29 [RUS] Speaker 2: everything everything there is [RUS] Speaker 2: before this there wasn't such there wasn't that we would place [RUS] Speaker 2: This is the first time in Yuri's practice and maybe several, [RUS] Speaker 2: maybe, one or two cases in the world for combat wounds.

00:28:58 [RUS] Speaker 2: Maybe.

00:29:04 [RUS] Speaker 3: I see that the aneurysm... [RUS] Speaker 2: - This is three... - Yes, wood.

00:29:12 [RUS] Speaker 3: - Yes, this is wood. - Yes. [RUS] Speaker 3: - This is wood. - So what, it's becoming bigger, and only two weeks?

00:29:17 [RUS] Speaker 2: Yes, Yuri wants to show you the first angiography. [RUS] Speaker 2: This is a small aneurysm.

00:29:27 [RUS] Speaker 2: And we decided that we need to do it.

00:29:30 [RUS] Speaker 3: In such a case we use the following algorithm.

00:29:38 [RUS] Speaker 3: We do angiography after 2-3 weeks.

00:29:46 [RUS] Speaker 2: We spoke on rounds, to improve the possibility [RUS] Speaker 4: to undertake dual antiplatelet therapy. [RUS] Speaker 4: If we see that we are getting.

00:00:00 Speaker 1: and

00:00:00 Speaker 1: and Speaker 1: how

00:00:25 Speaker 2: volume and the size. Speaker 3: Do you have a stand? Speaker 3: Where do you have a stand? Speaker 2: Fredix stand. Speaker 2: From Rokar Mondadonation, yeah?

00:00:49 Speaker 1: - 8mm are working segment?

00:00:55 Speaker 2: - The diameter, yeah? Speaker 1: - Yeah, the decreasing of the risk of the...

00:01:02 Speaker 2: - Mateus, Mateus, Teddius, yeah.

00:01:08 Speaker 2: I showed in Facebook Teddius is better than Teddi.

00:01:12 Speaker 4: - Teddius is better than Teddi. Speaker 2: - Than Teddi. Speaker 2: - Yeah, yeah, yeah, no

00:01:25 Speaker 2: Fredix, Yuri, who is today sent to Rocco Armando a donation

00:01:32 Speaker 1: - donated devices from Washington DC

00:01:38 Speaker 3: - Yeah, the device they put in front of Fred Speaker 2: - Send this donation, we have a possibility to save lives

00:01:45 Speaker 2: this wounded personnel, wounded soldier

00:01:49 [RUS] Speaker 1: This is a very, very small device, this is the width length. [RUS] Speaker 1: Only 8 mm. [RUS] Speaker 1: To minimize the risk of thrombosis, this is the length. [RUS] Speaker 1: So are you ready for this procedure?

00:02:16 Speaker 1: and after that we see stagnation, contrast, aneurysm. Speaker 1: So you're done? Speaker 1: It's all finished? Speaker 1: Now we see.

00:02:30 Speaker 1: Yeah. Speaker 3: It went well? Speaker 1: Very well. Speaker 1: Very nice result. Speaker 1: It's funny. Speaker 1: but we use an anti-plastolate now

00:02:42 Speaker 1: this is Speaker 1: this is Speaker 1: donated with professor

00:02:55 Speaker 2: shapiro maxim shapiro new york yeah kim nelson we read

00:03:30 Speaker 2: uh Speaker 3: So here is an article with your name on it. Speaker 3: Thank you so much. Speaker 3: Early, multimodal, neuro-interventional, that's you, Speaker 3: adeniosurgical management of penetrating craniosc cerebral injuries, wartime experience from Ukraine.

00:03:51 Speaker 3: Andrey Sirko, Yuri Cherenchenko. Speaker 1: We need the next article. Speaker 3: Oh, did you ask about the next article? Speaker 3: Funny you should ask.

00:04:00 [RUS] Speaker 3: This is one from Anat, but the next one is from Andrey. [RUS] Speaker 2: This is Alex Valadka. [RUS] Speaker 2: Stop.Vo. [RUS] Speaker 2: New classification system for penetra. [RUS] Speaker 3: Here's a publication for you. [RUS] Speaker 3: Thank you. [RUS] Speaker 3: Thank you. [RUS] Speaker 2: Thank you. [RUS] Speaker 2: So... [RUS] Speaker 2: Well done! [RUS] Speaker 2: Thank you. [RUS] Speaker 2: Well, God willing, that he recovers... [RUS] Speaker 2: with these medications or now and we'll need to about now we left for three hours we'll switch [RUS] Speaker 1: gave Brilinta in two hours we will add give aspirin 300 and until leaving for Brilinta this Vadim

00:04:42 [RUS] Speaker 2: or whoever to this Denis Dudin will tell will tell that is and a short segment and there give big

00:04:48 [RUS] Speaker 1: Fred more likely it will close then we'll have to switch to monotherapy what can

00:04:56 Speaker 2: well done thank you let's go photo photo photo together with yuri with alex near this Speaker 2: nikita's doing photo for memory all team teddy's uh tadeusz team and the yuri team

00:05:26 [RUS] Speaker 2: I just photos Alex this is not surgical team and after that all together Aleksandr

00:05:36 [RUS] Speaker 2: this is with Aleksandr this Valeriy Aleksandrovich Valeriy Aleksandr come here well don't be shy but

00:05:49 [RUS] Speaker 4: look at Tadeusz Tadeusz [RUS] Speaker 2: now Nikita give take not take camera [RUS] Speaker 2: tadeusz logan lora anastasia come closer here old old team oh just right and men

00:06:39 [RUS] Speaker 2: squat squat Vadim well done and Andrey Yurievich asked [RUS] Speaker 1: He says: "He said to serve in the morning, I say: "No". [RUS] Speaker 1: - I was waiting for my hour this flow diverter.

00:06:56 [UKR] Speaker 1: - Such operations?

00:06:57 [RUS] Speaker 2: - Such an operation, yes, and just we came. [RUS] Speaker 2: So... [RUS] Speaker 1: - We had an accident yesterday. [RUS] Speaker 1: - You got flooded? [RUS] Speaker 1: - Yes, I came at night, looking at the patient, I walk in and here...

00:07:11 [RUS] Speaker 1: Well, literally before my eyes it burst, and it reached here.

00:07:15 [RUS] Speaker 1: - And almost... [RUS] Speaker 2: Two words say, that there where the boxes are standing, say in these boxes arrived this

00:07:22 [RUS] Speaker 4: flow diverter, let's go. [RUS] Speaker 4: - Show it, Logan, Nik showed,

00:07:43 [RUS] Speaker 3: - 700 drone

00:08:13 [RUS] Speaker 1: I never know [RUS] Speaker 2: I say, where's the flag? [RUS] Speaker 2: He doesn't know [RUS] Speaker 1: There was such a rush today. [RUS] Speaker 1: Okay, let's go [RUS] Speaker 2: Yuri, I'll be the producer [RUS] Speaker 2: Now Yuri, opened the box and said:

00:08:35 [RUS] Speaker 2: "In this box there's a Freddy that saves the life of this patient"

00:08:40 [RUS] Speaker 4: - How where we worked? - Yes, it's true. [RUS] Speaker 2: here Yura no [RUS] Speaker 2: good

00:09:36 [RUS] Speaker 2: but don't be shy from the side come here stretch out come on and relax Vadim and here you'll help don't run away

00:09:56 Speaker 1: - You're going to change the box?

00:10:15 Speaker 2: - I'm changing the

00:10:23 Speaker 3: Oh, oh, oh.

00:10:29 [RUS] Speaker 2: Don't run away. [RUS] Speaker 3: So, tell me, tell me about what's in this box?

00:10:40 [RUS] Speaker 1: This box, for saving lives,

00:10:44 [UKR] Speaker 1: I went to your

00:11:15 [RUS] Speaker 2: These are destroyed people and and civilians, yes, with narcotics.

00:11:20 [RUS] Speaker 1: - You use for Donetsk? [RUS] Speaker 2: - These are many patients from the forces.

00:11:29 [UKR] Speaker 2: - From the forces, from the forces, from Donetsk, Luhansk, Zaporizhzhia, Mykolaiv, Kherson. [UKR] Speaker 2: - From the forces, from the forces, from Donetsk, Luhansk, Zaporizhzhia, Mykolaiv, Kherson.

00:11:36 [RUS] Speaker 2: - From Kharkiv, maybe. [RUS] Speaker 2: - From Kharkiv, maybe. [RUS] Speaker 2: And from Kyiv, if you have the opportunity, you have this device. [RUS] Speaker 2: But from Rocarmonda, you have this device.

00:11:49 [RUS] Speaker 2: - This is critically important for us. - It's true.

00:11:55 [RUS] Speaker 4: - What is this? What is this device?

00:12:00 [RUS] Speaker 2: - This device...

00:12:08 Speaker 3: wall of the artery so it's like a little kind of a stent that goes across it and Speaker 3: wall of the artery so it's like a little kind of a stent that goes across it and Speaker 3: includes the, isolates the anderson from the circulation.

00:12:17 Speaker 3: - Excellent. - The arterial, we use Speaker 1: - Trans radial? - Trans radial approach as rule. Speaker 1: This approach is most Speaker 1: a dramatic and most safe for and and we go this way through the aortic arch and then we use Speaker 1: telescopic technique bigger cassette smaller access smaller cassette then micro cassette and then Speaker 1: and through the micro cassiter we perform the implantation of the device to the wounded segment

00:13:09 Speaker 1: on the level of the neck of this pseudonym and exclude it. Speaker 2: Yeah. Yuri and his team have the largest experience in the world. Treatment of these Speaker 2: technique. Usually when Rokka Armata came to us, the half time spent together with me in Speaker 2: open neurosurgical operation room under microscope and half time together with Uri team in endovascular Speaker 2: cath lab. That's why we work together with Alex Rokka many times. It's very useful, helpful

00:13:50 [RUS] Speaker 2: for our patients. [RUS] Speaker 2: Young, this is my first Ph.D. in medicine, [RUS] Speaker 2: no, second Ph.D. in medicine. [RUS] Speaker 2: And now Yuri paid a lot of money [RUS] Speaker 2: for me, to give the opportunity [RUS] Speaker 2: to work with Vadim. [RUS] Speaker 2: It's a pity, but it's true. [RUS] Speaker 3: - Roka, I remember, that you [RUS] Speaker 3: when you were doing your dissertation, [RUS] Speaker 2: Vadim one day defended the dissertation, and the next day his daughter was born. [RUS] Speaker 2: Maybe it's 2-3 days. We asked Vadim about this situation.

00:14:35 [RUS] Speaker 2: Vadim not only operated, but also defended the dissertation. [RUS] Speaker 3: - But he was defending when with air raid sirens were, yes? [RUS] Speaker 3: You sent me that picture

00:15:12 [RUS] Speaker 2: Defend dissertation. [RUS] Speaker 2: English. [RUS] Speaker 2: Defend.

00:15:18 Speaker 2: Defender my dissertation work.

00:15:20 [RUS] Speaker 2: What date was it? [RUS] Speaker 1: 14 February. [RUS] Speaker 2: 11 February. [RUS] Speaker 2: 11 February. [RUS] Speaker 2: 11 February.

00:15:30 [RUS] Speaker 2: Daughter. [RUS] Speaker 1: 17 February right.

00:15:36 [RUS] Speaker 2: Right what? [RUS] Speaker 3: Right what?

00:15:42 [RUS] Speaker 2: -Certificate, yes? -Yes. [RUS] Speaker 2: -19 February, I celebrate 50 years.

00:15:48 Speaker 3: -49. Speaker 2: -49? -50? Speaker 2: -Let's get it.

00:15:58 [RUS] Speaker 2: Okay, well done. [RUS] Speaker 2: Andrey Yurievich met, says: "I told Vadim to serve". [RUS] Speaker 2: Alex and I now at the conference will tell about this case, about you, and then come to you to film.

00:16:10 [RUS] Speaker 2: I'm my own director. [RUS] Speaker 1: -Then before this the elevator broke there, and Dmitrievna from the construction department needs to fix it urgently. [RUS] Speaker 1: Ukrlift, not Ukrlift, but someone else. [RUS] Speaker 1: But reported to me that we didn't give 7000, and therefore the elevator isn't being fixed. [RUS] Speaker 1: And the main thing, got very angry.

00:16:34 [UKR] Speaker 1: Well, finally found who's doing it, I say: "Found urgently".

00:16:37 [RUS] Speaker 4: Ah, well, urgently, urgently on Monday. Or even Tuesday, on Monday.

00:16:42 [RUS] Speaker 4: Well, report, I already reported.

00:16:47 [RUS] Speaker 3: In general, take us. [RUS] Speaker 2: Yes, Yura, thank you. Thank you, well done.

00:16:53 [RUS] Speaker 3: We need to go to the patient, and they want to sit on interview.

00:16:58 [RUS] Speaker 3: They want you not to have in mind time.

00:17:02 Speaker 2: we have enough time Speaker 2: no we have time Speaker 2: but this is excellent

00:17:31 [RUS] Speaker 2: story, yes? [RUS] Speaker 2: story - this is excellent example for filming [RUS] Speaker 3: yes, angiography

00:17:39 Speaker 2: yes

00:17:40 [RUS] Speaker 3: I don't know, for this, I don't know, if this is too much detail [RUS] Speaker 3: or if this takes a photograph [RUS] Speaker 3: they want a bit of medical, but it's not just about you and about the people and Ukraine

00:17:51 [RUS] Speaker 2: no, in any case they will have enough material [RUS] Speaker 2: Good [RUS] Speaker 2: And we want [RUS] Speaker 2: To cut

00:18:06 Speaker 2: Thread

00:18:07 [RUS] Speaker 2: And detach

00:18:08 Speaker 2: Thread

00:18:10 [RUS] Speaker 2: Now we [RUS] Speaker 2: Will go to CT [RUS] Speaker 2: And look

00:18:15 Speaker 2: CT

00:18:16 [RUS] Speaker 2: We operated [RUS] Speaker 2: We operated [RUS] Speaker 2: Or rather [RUS] Speaker 2: It's quick [RUS] Speaker 2: Good day [RUS] Speaker 2: Very quick [RUS] Speaker 2: Let's go [RUS] Speaker 2: And you had a swelling? [RUS] Speaker 2: And you had a swelling? [RUS] Speaker 2: After the operation, yes?

00:18:55 Speaker 2: Yes. Speaker 2: air alarm alex you can sit yeah

00:19:11 [RUS] Speaker 2: and where are you running

00:19:14 Speaker 2: okay, sit down please