The Persistence of Humanity
This is not a film about war. It's a film about what persists through war.
In Dnipro, Ukraine — 60 miles from the front — a family of neurosurgeons rebuilds shattered skulls with beeswax from their father's farm, while the war that breaks the bodies also threatens to take the land the wax comes from.
Bees aren't a bunny trail — they're the thread.
The land that heals is the same land under threat. That's the whole film.
The Subjects
Ivan Sirko
Ivan Dmytrovych Sirko was the most legendary Koshovyi Otaman (head commander) of the Zaporizhian Sich. Born around 1610, he was elected to the position at least 12 times — an unprecedented vote of confidence from the fiercely democratic Cossack assembly. Across a career spanning more than 50 major engagements, he remained undefeated against Ottoman, Tatar, Polish, and Russian forces.
Known as a kharakternyk — a Cossack sorcerer-warrior — Sirko's legend transcended military prowess. He was said to possess supernatural abilities: invulnerability in battle, the power to control weather, and the ability to catch musket balls. After his death in 1680, he was buried near Kapulivka along the Dnieper. On his deathbed, he allegedly ordered his right hand to be cut off and carried into battle for seven more years — and it was.
His most famous cultural legacy is the Reply of the Zaporozhian Cossacks to Sultan Mehmed IV, a letter of extraordinary defiance and profane wit, immortalized in Ilya Repin's 1891 painting. The letter itself has become a symbol of Ukrainian resistance and dark humor in the face of imperial threat.
Ilya Repin, Reply of the Zaporozhian Cossacks (1891)
Oil on canvas, 203 x 358 cm · State Russian Museum, St. Petersburg
The painting depicts Ivan Sirko (center, standing) and the Cossacks drafting their gleefully defiant reply to the Ottoman Sultan's demand for submission.
“O sultan, Turkish devil and damned devil's kith and kin, secretary to Lucifer himself. What the devil kind of knight are thou, that canst not slay a hedgehog with your naked arse? The devil shits, and your army eats. Thou shalt not, thou son of a whore, make subjects of Christian sons. We have no fear of your army; by land and by sea we will battle with thee. F**k thy mother. Thou Babylonian scullion, Macedonian wheelwright, brewer of Jerusalem, goat-f**ker of Alexandria, swineherd of Greater and Lesser Egypt, pig of Armenia, Podolian thief, catamount of Tartary, hangman of Kamyanets, and fool of all the world and underworld, an idiot before God, grandson of the Serpent, and the crick in our dick. Pig's snout, mare's arse, slaughterhouse cur, unchristened brow. Screw thine own mother! So the Zaporozhians declare, you lowlife. You won't even be herding pigs for the Christians. Now we'll conclude, for we don't know the date and don't own a calendar; the moon's in the sky, the year with the Lord. The day is the same over here as it is over there; for this, kiss our arse!”
Translation varies by source. This version synthesizes the most commonly cited scholarly renderings.
Medical & Scientific Context
Click each step to learn more.
Step 1: The Apiary
The Sirko family maintains an apiary in the agricultural region near Dnipro. Andrii's father tends the hives, producing raw beeswax and honey from sunflower-rich Ukrainian farmland. This is not a medical supply chain — it is a family inheritance. The same land that the Cossacks fought to defend centuries ago now produces the material that saves soldiers' lives.
Step 2: Raw Beeswax Harvest
Raw beeswax is harvested from the hive frames after honey extraction. Unlike commercial bone wax (which blends beeswax with paraffin wax and isopropyl palmitate as a softener), Sirko's material is pure — unrefined beeswax with natural properties intact. The wax retains trace compounds from Ukrainian wildflowers and sunflower pollen.
Step 3: Sterilization Lab
At Mechnikov Hospital, the raw beeswax is processed through the sterilization laboratory. The wax is heated, purified, and sterilized to medical-grade standards. When ready, it is formed into the small pellets used during surgery. The scent of honey reportedly fills the operating room when the wax is applied — an incongruous sensory detail amid the trauma of wartime neurosurgery.
Step 4: Cranial Reconstruction
During neurosurgery, bone wax is applied to the cut edges of the skull to control bleeding from bone. In penetrating traumatic brain injuries from shrapnel and blast fragments, cranial reconstruction is critical. Dr. Sirko applies the sterilized beeswax directly to seal and reconstruct damaged skull sections. The technique traces back to Sir Victor Horsley's 1885 formula (7:1 beeswax to almond oil) but Sirko's method is uniquely tied to the land and family that produce the material.
Mechnikov Hospital in Dnipro operates as a Level I Trauma Center receiving casualties within 15–30 minutes of injury — an unprecedented proximity of advanced neurosurgical care to active combat. By comparison, WWII casualties waited hours to days for definitive care, and even in Iraq/Afghanistan the golden hour was aspirational rather than routine.
The hospital has treated over 50,000 wounded soldiers since February 2022, with over 2,000 penetrating traumatic brain injuries. Their survival rate of approximately 95% surpasses any historical wartime neurosurgery benchmark. 82% of patients arrive unconscious. Over 200 surgeons work 24/7 across 50 operating rooms.
The scale is driven by the unique mechanisms of this conflict: heavy shrapnel/blast injuries from artillery and drones, combined with the proximity of Dnipro to the front lines. Dr. Armonda's comparison stands — two days in Ukraine equals the worst month in Iraq.
Key Locations
Dnipro, Ukraine
Logistics & Context
Dnipro (population ~1 million) is Ukraine's fourth-largest city, situated on the Dnieper River. Formerly a “closed city” during the Soviet era due to the Yuzhmash rocket factory, it was renamed from Dnipropetrovsk in 2016 as part of decommunization. The city sits approximately 60 miles from the front lines, making it both the nearest major urban center and the primary receiving point for wounded soldiers.
Narrative Significance
On January 14, 2023, a Russian Kh-22 cruise missile struck a residential building on the Dnipro embankment, killing 46 people including 6 children and injuring over 80. This is the Cossack heartland — there was once a proposal to rename the city Sicheslav (“Glory of the Sich”). The city has a significant Jewish community centered around the Menorah Center, the largest Jewish community center in the world. Dnipro's resilience is visible: 10K races resume hours after air raids; children play beside bombed-out buildings.
Kapulivka — Ivan Sirko's Gravesite
Site Description
The memorial complex at Kapulivka features a bronze bust of Ivan Sirko atop a kurgan (burial mound), a gravestone, a small chapel, and a watchtower. Sirko was originally buried near Chortomlyk on the Dnieper. In the 1950s, the planned Kakhovka Reservoir threatened the original burial site. In 1967, his remains were exhumed and reburied at Kapulivka. During the exhumation, his skull was removed for anthropological study and was not re-interred until 2014.
Travel & Access
Kapulivka is approximately 3 hours from Dnipro by car, situated in the Nikopol district. The area is near Russian-held territory and access may be restricted depending on the military situation. Other Sirko monuments include a bust in Kharkiv/Merefa and representation in the Paris military museum.
Khortytsia Island
Historic Significance
Khortytsia is the largest island on the Dnieper River and the historic heart of the Zaporizhian Sich. A reconstructed Cossack fortress and museum opened in 2009, depicting life in the Sich as it existed during Ivan Sirko's era. The island sits in the Zaporizhzhia region, now a contested zone in the current conflict. The Kakhovka dam destruction in June 2023 altered the river's water levels and revealed ancient features previously submerged.
Narrative Thread
The same lands where Ivan Sirko fought 350 years ago are now battlegrounds again. The Zaporizhian Sich heartland — the territory “beyond the rapids” of the lower Dnieper — overlaps almost exactly with the current conflict zone. Heritage preservation is under active threat.
Approximate distances from the Zero Line (front) to key positions.
Research Library
01 Ivan Sirko — Legendary Cossack Ataman (17th Century)
Summary
Ivan Dmytrovych Sirko (c. 1605–1680) was the most renowned Koshovyi Otaman (supreme commander) of the Zaporizhian Cossack Host. He was elected to this highest position at least 12 times by the Sich's democratic assembly — an extraordinary record reflecting unparalleled trust from the fiercely independent Cossack warriors. Over a military career spanning decades, Sirko commanded in more than 50 major battles and engagements, remaining undefeated against Ottoman, Crimean Tatar, Polish, and Russian forces.
Sirko was born around 1605 (some sources say 1610) in the town of Merefa near Kharkiv. He rose through the Cossack ranks to become the Zaporizhian Host's greatest military leader. His legend as a kharakternyk — a Cossack sorcerer-warrior believed to possess supernatural powers — added mythic dimensions to his historical record. He was said to be invulnerable in battle, to control weather, and to catch enemy musket balls in midair. Upon his death in 1680, he was buried near the Chortomlyk Sich on the Dnieper. His deathbed instruction — that his right hand be severed and carried into battle for seven more years — was reportedly honored by his fellow Cossacks.
Kapulivka, in the Nikopol district, is his final resting place. The memorial complex includes a bronze bust of Sirko atop a kurgan (burial mound), a traditional gravestone, a small chapel, and a watchtower.
Reply to the Sultan
The most famous cultural artifact associated with Ivan Sirko is the Reply of the Zaporozhian Cossacks to Sultan Mehmed IV of the Ottoman Empire. According to legend (and several historical sources), the Sultan sent a letter demanding the Cossacks' submission and surrender. The Cossacks, under Sirko's leadership, composed a response of breathtaking defiance and elaborate profanity.
The letter became the subject of Ilya Repin's celebrated 1891 painting Reply of the Zaporozhian Cossacks, one of the most famous works of Russian art. Repin spent over a decade on the painting, traveling to the Zaporizhian region to study Cossack descendants. The painting depicts Ivan Sirko (center, standing, white-haired) presiding over the drafting of the letter as his men roar with laughter.
The letter itself, in its bawdy entirety:
“O sultan, Turkish devil and damned devil's kith and kin, secretary to Lucifer himself. What the devil kind of knight are thou, that canst not slay a hedgehog with your naked arse? The devil shits, and your army eats. Thou shalt not, thou son of a whore, make subjects of Christian sons. We have no fear of your army; by land and by sea we will battle with thee. F**k thy mother. Thou Babylonian scullion, Macedonian wheelwright, brewer of Jerusalem, goat-f**ker of Alexandria, swineherd of Greater and Lesser Egypt, pig of Armenia, Podolian thief, catamount of Tartary, hangman of Kamyanets, and fool of all the world and underworld, an idiot before God, grandson of the Serpent, and the crick in our dick. Pig's snout, mare's arse, slaughterhouse cur, unchristened brow. Screw thine own mother! So the Zaporozhians declare, you lowlife. You won't even be herding pigs for the Christians. Now we'll conclude, for we don't know the date and don't own a calendar; the moon's in the sky, the year with the Lord. The day is the same over here as it is over there; for this, kiss our arse!”
Modern Significance
Ivan Sirko's legacy has been explicitly invoked in modern Ukraine's defense. In 2019, President Zelensky formally named the 92nd Mechanized Brigade “Ivan Sirko” — one of Ukraine's most distinguished combat units, fighting in the very regions Sirko once defended. The Kapulivka memorial complex remains a site of national pilgrimage. In 1966, French President Charles de Gaulle visited the Sirko memorial during a trip to the Soviet Union — a notable diplomatic gesture acknowledging the Cossack military tradition. The 92nd Brigade's modern combat operations in eastern Ukraine create a direct line of continuity from the 17th century Sich to the 21st century battlefield.
02 Michael DeBakey — Pioneering Surgeon from Houston
Summary
Dr. Michael Ellis DeBakey (1908–2008) was one of the most influential surgeons in modern medical history. Based at Baylor College of Medicine in Houston, Texas, DeBakey pioneered numerous cardiovascular innovations that saved millions of lives worldwide. His contributions include the invention of the roller pump (a key component of heart-lung machines enabling open-heart surgery), the development of Dacron arterial grafts for replacing diseased blood vessels, and the refinement of coronary artery bypass grafting procedures.
DeBakey performed some of the first successful carotid endarterectomies, aortic aneurysm resections, and multi-vessel coronary bypass operations. He was a tireless advocate for medical research funding and helped establish the National Library of Medicine. Over a career spanning seven decades, he operated on more than 60,000 patients and trained generations of surgeons worldwide. He continued to operate into his late 80s and remained active in medicine until shortly before his death at age 99.
Military Medicine
Before his cardiovascular career, DeBakey's formative experience was in wartime surgery. During World War II, he served as an Army Colonel in the Surgeon General's office, where he was instrumental in conceptualizing and implementing the Mobile Army Surgical Hospital (MASH) system — the innovation of bringing surgical capability closer to the front lines rather than evacuating casualties to distant rear-area hospitals. This principle of proximity-of-care directly parallels the model now operating in Dnipro.
After the war, DeBakey played a central role in establishing the Veterans Administration (VA) hospital system, ensuring that returning servicemembers had access to specialized surgical care nationwide. He was awarded the Legion of Merit for his military service.
Houston Parallel to Dnipro
The structural parallel between DeBakey's Houston and Sirko's Dnipro is a key thematic thread in the SIRKO documentary. Both cities became global centers of surgical innovation through the confluence of war, institutional investment, and individual brilliance. DeBakey transformed Houston into the world capital of cardiovascular surgery; Sirko and his colleagues at Mechnikov Hospital are transforming Dnipro into an unprecedented center of wartime neurosurgical expertise. The difference: DeBakey's innovations came after the war, synthesized from lessons learned. Sirko's innovations are happening in real time, 60 miles from the front line.
03 Dr. Rocco Armonda — U.S. Army Neurosurgeon
Background
Dr. Rocco Armonda is a retired Colonel in the United States Army and former chief of neurosurgery at Walter Reed National Military Medical Center. During the Iraq and Afghanistan wars, Armonda was one of America's leading military neurosurgeons, treating some of the most severe traumatic brain injuries sustained by U.S. service members from IED blasts and gunshot wounds. His experience at Walter Reed gave him an unmatched frame of reference for understanding the scale and intensity of wartime neurotrauma.
The Key Quote
“Just for comparison, two days in Ukraine is equivalent to the worst month we had in Iraq.”
This single statement from Armonda encapsulates the staggering scale of the neurosurgical crisis in Ukraine. During the peak of the Iraq War, American military neurosurgeons might see a handful of severe TBI cases per week. At Mechnikov Hospital in Dnipro, the team treats multiple cases per day, every day, with no end in sight. Armonda's comparison provides the American audience with a visceral frame of reference for what Dr. Sirko and his team face continuously.
Work in Dnipro
Armonda traveled to Dnipro to support the Ukrainian neurosurgery team. He delivered medical supplies and technology, and notably scrubbed in alongside Dr. Sirko's team to observe and assist in surgeries. His assessment of the experience was characteristically humble: “I was doing a lot more learning than teaching.” This reversal — the veteran American military neurosurgeon learning from the Ukrainian team — speaks to the unprecedented expertise that Sirko's team has developed through the sheer volume and intensity of their caseload.
Armonda and Sirko have co-authored scientific publications together (2025), contributing to the growing body of literature on wartime neurosurgery techniques developed in Ukraine.
04 Dr. Alex Valadka — American Neurosurgeon Volunteer
Background
Dr. Alex Valadka is a Colonel in the United States military and a neurosurgeon affiliated with UT Southwestern Medical Center in Dallas, Texas. A seasoned trauma neurosurgeon with decades of experience, Valadka volunteered to travel to Ukraine to assist in the wartime neurosurgical effort — not as a military deployment, but as a personal decision to contribute his skills where the need was greatest.
Why He Volunteered
Valadka's decision to volunteer was driven by a combination of professional duty and personal conviction. As a neurosurgeon trained in trauma care, he recognized that the scale of traumatic brain injuries in Ukraine was unlike anything the modern world had seen. He connected with the Razom Co-Pilot Project, a volunteer initiative coordinating American medical professionals to support Ukrainian hospitals, and arranged to work alongside the neurosurgery team at Mechnikov Hospital in Dnipro.
On the Ground in Dnipro
During his time at Mechnikov, Valadka operated in an environment where 1 to 8 urgent craniotomies per day were routine. The hospital had treated over 2,000 penetrating traumatic brain injuries since the full-scale invasion began — a caseload that would take decades to accumulate at even the busiest American trauma centers. The mechanisms of injury were overwhelmingly blast and shrapnel, from artillery, rockets, and increasingly from drones — a pattern distinct from the gunshot-predominant TBI profile in American civilian trauma.
Patient #14,296
One of the most powerful moments of Valadka's time in Dnipro involved a wounded soldier he helped treat — the hospital's 14,296th combat patient since the invasion began. During their interaction, the soldier and Valadka exchanged military patches — a deeply meaningful gesture in military culture, signifying mutual respect and shared sacrifice. They embraced, and Valadka was visibly moved, holding back tears. The encounter crystallized the human connection at the heart of the medical mission.
Commitment
Valadka has described his commitment to Ukraine's medical effort in unambiguous terms: “Tour of duty will last until the war is won.” This is not a one-time visit — it represents an ongoing commitment to return and serve alongside the Ukrainian surgeons for as long as the conflict continues.
05 Serhiy Ryzhenko — Chief of Mechnikov Hospital
Role
Serhiy Ryzhenko is the General Director of Mechnikov Hospital in Dnipro, overseeing what has become one of the largest military trauma centers in the world. Under his leadership, the hospital receives and treats “50 to 100 very seriously wounded people” per day — a staggering and relentless flow of casualties from the front lines approximately 60 miles to the southeast.
By the Numbers
The scale of Mechnikov's operations defies peacetime comparison:
- By 2023: 21,000+ wounded soldiers treated, with over 2,000 amputations performed
- By 2025: 50,000+ total patients from the conflict, a number that continues to climb
- Over 200 surgeons working continuously, 24 hours a day, 7 days a week
- 50 operating rooms running simultaneously
- Approximately 95% survival rate among patients who reach the hospital
- 82% of patients arrive unconscious
Under Fire
In October 2024, Mechnikov Hospital itself was struck by a Russian missile, damaging facilities and injuring staff. The hospital continued operating through the attack, treating both its own wounded staff and incoming combat casualties simultaneously. This event underscored the reality that the medical infrastructure itself is not safe from targeting.
“Hospital of Miracle Survivors”
Mechnikov has earned the unofficial designation “Hospital of Miracle Survivors” — a testament to the extraordinary outcomes achieved by Ryzhenko's team under impossible conditions. The 95% survival rate, achieved with patients arriving in critical condition from high-energy blast injuries, represents a genuine advance in what is medically possible in wartime. Ryzhenko's leadership in maintaining institutional function under sustained wartime pressure is itself a story of organizational resilience.
06 Dnipro, Ukraine — City Profile
Overview
Dnipro (formerly Dnipropetrovsk until 2016) is Ukraine's fourth-largest city, with a population of approximately 1 million. Situated on the Dnieper River in central-eastern Ukraine, the city has historically been an industrial and scientific powerhouse. During the Soviet era, it was a “closed city” — access restricted due to the Yuzhmash factory, which produced intercontinental ballistic missiles and later became Ukraine's primary space rocket manufacturer. The city was renamed in 2016 as part of Ukraine's decommunization laws.
Proximity to the Front
Dnipro sits approximately 60 miles from the front lines, making it the closest major Ukrainian city to active combat. This proximity is both a vulnerability and a strategic asset: wounded soldiers can reach Mechnikov Hospital within 15–30 minutes of injury, enabling the kind of rapid surgical intervention that saves lives. It also means the city is within range of Russian missiles, drones, and potentially artillery.
January 14, 2023
The defining attack on Dnipro occurred on January 14, 2023, when a Russian Kh-22 cruise missile struck a residential apartment building on the embankment. The strike killed 46 people, including 6 children, and injured more than 80. The attacked building became a symbol of the war's toll on civilians and a focal point of international condemnation. Dr. Svitlana Vitalieva, an ENT physician at Mechnikov, lost her husband and parents in this strike.
Cossack Heartland
Dnipro sits in the historic Cossack heartland. There was once a proposal to rename the city Sicheslav (“Glory of the Sich”) in recognition of its Zaporizhian Cossack heritage. The city's identity is deeply intertwined with the Cossack tradition of independence, martial skill, and democratic self-governance — traditions that resonate powerfully in the current conflict.
Jewish Community
Dnipro is also home to a significant Jewish community and the Menorah Center — the largest Jewish community center in the world. This multicultural dimension adds complexity to the city's identity, layering Cossack heritage with Jewish history, Soviet industrial legacy, and the current wartime reality.
Resilience
The city's resilience is visible in countless small acts of defiance: 10K road races resume hours after air raids. Children play in parks adjacent to bombed-out buildings. Cafes open, weddings happen, life continues — all under the constant threat of attack. This resilience is not denial; it is a conscious choice to maintain normalcy as an act of resistance. Dnipro embodies the film's core thesis: the persistence of humanity through war.
07 Ivan Sirko's Gravesite (Kapulivka)
The Memorial Complex
Ivan Sirko's final resting place is at Kapulivka, a small settlement in the Nikopol district of the Dnipropetrovsk Oblast. The memorial complex features a bronze bust of Sirko mounted atop a kurgan (a traditional burial mound), a gravestone marking the actual burial, a small chapel, and a watchtower overlooking the surrounding steppe. The site has the character of a modest but dignified national shrine — a place of pilgrimage for Ukrainians honoring their Cossack heritage.
History of the Burial
Sirko was originally buried near Chortomlyk on the Dnieper, the site of one of the Zaporizhian Sich settlements, following his death in 1680. For nearly three centuries, his remains lay undisturbed. In the 1950s, the Soviet government's plan to construct the Kakhovka Reservoir threatened to flood the original burial site. In 1967, Soviet archaeologists exhumed Sirko's remains and reburied them at the Kapulivka site.
During the 1967 exhumation, Sirko's skull was removed from the skeleton and retained for anthropological study — including facial reconstruction attempts. The skull was held at various Ukrainian academic institutions for decades. It was not re-interred with the rest of the remains until 2014, when the skull was finally returned to Kapulivka in a public ceremony with military honors. The delayed reunification of the skull with the body carries its own symbolic weight, especially for a filmmaker documenting a neurosurgeon who reconstructs shattered skulls.
Travel Logistics
Kapulivka is approximately 3 hours by car from Dnipro, traveling south toward Nikopol. The area is near Russian-held territory, and access depends on the current military situation. The Nikopol district has been subject to regular shelling from Russian forces across the Dnieper. Any production visit would require current security assessments and possibly military coordination.
Other Monuments
Beyond Kapulivka, Ivan Sirko is memorialized in several other locations: a bust in Kharkiv/Merefa (his birthplace region), and representation in the Paris military museum (Musée de l'Armée), where Cossack military tradition is acknowledged in the context of European military history.
08 Zaporizhian Sich Heartland
Historical Territory
The Zaporizhian Sich was the semi-autonomous Cossack state that existed from the 15th to the 18th centuries in the territory of the lower Dnieper River, below the rapids. The name “Zaporizhia” literally means “beyond the rapids” (za porohamy) — referring to the series of granite rapids on the Dnieper that historically formed a natural barrier. The Sich (from the Ukrainian word for “clearing” or “fortification”) was both a military camp and a democratic polity, where Cossacks elected their leaders and governed by council.
This territory covered much of what is now the Dnipropetrovsk and Zaporizhzhia oblasts of Ukraine — the exact regions at the center of the current conflict. The Cossacks controlled the steppes, conducted raids against the Ottoman Empire and Crimean Khanate, and maintained a fiercely independent political identity that resisted absorption by either Poland-Lithuania or Muscovy.
Khortytsia Island
Khortytsia is the largest island on the Dnieper River, located within the city of Zaporizhzhia. It is the most iconic site associated with the Zaporizhian Sich, serving as a natural fortress and gathering place for Cossack warriors. A reconstructed Cossack fortress and Sich Museum opened on the island in 2009, featuring recreations of the wooden fortifications, barracks, and workshops that would have existed during Ivan Sirko's era. The museum complex depicts daily life in the Sich: military training, craft production, democratic assemblies, and the rituals of Cossack society.
Current Conflict Overlap
The geographic overlap between the historic Zaporizhian Sich territory and the current war zone is one of the documentary's most powerful thematic elements. The same lands where Ivan Sirko fought the Ottomans and Tatars 350 years ago are now battlegrounds between Ukraine and Russia. Zaporizhzhia city and oblast are partially occupied; the front line runs through territory the Cossacks once defended with the very spirit now invoked by Ukrainian soldiers.
Kakhovka Dam Destruction
In June 2023, the Kakhovka Dam — the same dam whose reservoir construction in the 1950s necessitated the exhumation of Ivan Sirko's remains — was destroyed, causing catastrophic flooding downstream. The receding waters revealed ancient features previously submerged for decades, including remnants of Cossack-era settlements and earlier archaeological sites. The destruction simultaneously represented environmental catastrophe and inadvertent archaeological revelation.
Heritage Under Threat
Cultural heritage preservation in the Zaporizhian Sich heartland is under active threat from the conflict. Museums, monuments, and archaeological sites in occupied or contested territory face damage or destruction from combat operations, deliberate targeting, and neglect. The Khortytsia museum complex, while currently in Ukrainian-controlled territory, exists in a region subject to regular missile and drone attacks. The preservation of Cossack heritage — physical and cultural — is inseparable from the larger fight for Ukrainian sovereignty.
09 Beeswax in Neurosurgery
Bone Wax Basics
Bone wax is a hemostatic material used in surgery to control bleeding from bone surfaces. Standard commercial bone wax is composed primarily of beeswax blended with a softening agent — typically paraffin wax and/or isopropyl palmitate. It works mechanically: pressed into the cut or broken bone surface, it physically seals the bleeding channels (Haversian canals and marrow spaces), stopping hemorrhage through tamponade rather than biochemical clotting.
Bone wax is used routinely in craniotomies, spinal surgery, sternotomy, and orthopedic procedures worldwide. It is one of the oldest surgical materials still in active use, with a lineage stretching back over a century.
Horsley's 1885 Formula
The modern use of bone wax is attributed to Sir Victor Horsley, the pioneering British neurosurgeon who in 1885 developed a formula of 7 parts beeswax to 1 part almond oil for use during cranial surgery. Horsley's formula was remarkably effective and remained the standard for decades. Subsequent commercial formulations substituted paraffin and synthetic softeners for almond oil, but the fundamental principle — beeswax applied to bone to control bleeding — has not changed in nearly 140 years.
Sirko's Technique
Dr. Andrii Sirko's use of beeswax in neurosurgery at Mechnikov Hospital adds a distinctive dimension to this established practice. Rather than using commercial bone wax, Sirko sources pure beeswax from his father's apiary — the family beehives maintained on agricultural land near Dnipro. The raw beeswax is brought to the hospital and sterilized in the hospital's processing facilities to meet surgical-grade standards.
When applied during cranial reconstruction for penetrating traumatic brain injuries, the pure beeswax releases the scent of honey into the operating room — an incongruous and haunting sensory detail amid the violence of wartime surgery. The OR smells not of antiseptic alone, but of Ukrainian wildflowers and sunflower pollen, carried in the molecular memory of the wax.
Scientific Comparison
Pure beeswax versus commercial bone wax: the scientific differences are subtle but real. Pure beeswax retains natural propolis compounds and trace plant-derived materials that are removed in commercial processing. Some research suggests that pure beeswax may have mild antimicrobial properties from these retained compounds, though definitive clinical comparisons in the neurosurgical context are still emerging. The practical differences in Sirko's setting may be less about chemical superiority and more about supply chain resilience — when commercial supply lines are disrupted by war, a local apiary provides a reliable, renewable source of surgical material.
Cultural and Agrarian Thread
The beeswax connection is the documentary's central metaphor and structural thread. It links the agrarian Ukrainian landscape (sunflower fields, apiaries, the family farm) to the operating room (cranial reconstruction, skull repair) through a single material. The same land that grows the flowers that feed the bees that produce the wax that heals the soldiers is the land under attack. The cycle is complete and devastating. As the production notes state: “Bees aren't a bunny trail — they're the thread.”
10 Wartime Neurosurgery Evolution
Triage and Timing
One of the most critical factors in wartime neurosurgery outcomes is the time between injury and definitive surgical care. At Mechnikov Hospital in Dnipro, wounded soldiers arrive in the operating room within 15 to 30 minutes of injury — an extraordinary proximity of advanced neurosurgical capability to active combat. This near-immediate access to a full neurosurgical team with CT scanning, microsurgical instruments, and ICU post-operative care is historically unprecedented.
WWI Through Ukraine: Evolution of Care
The progression of wartime neurosurgical outcomes tells the story of medical progress under fire:
- World War I: Penetrating head wounds were largely fatal. Surgery was crude, delayed (often by days), and performed without imaging or antibiotics. Survival rates for severe TBI were estimated below 50%.
- World War II: Introduction of antibiotics and improved evacuation (DeBakey's MASH concept) improved outcomes. Neurosurgical intervention became more systematic, but delays of hours to days remained common. Survival improved but remained well below modern standards.
- Korea/Vietnam: Helicopter evacuation dramatically reduced time to surgery. Microsurgical techniques improved. Survival rates for penetrating TBI climbed, but the case volumes were lower than in the World Wars.
- Iraq/Afghanistan: The “golden hour” became doctrine. Advanced body armor reduced torso casualties but increased the proportion of head and extremity injuries. IED blast injuries created complex polytrauma patterns. Military neurosurgeons like Armonda developed new protocols.
- Ukraine (2022–2026): Unprecedented scale combined with unprecedented proximity of care. Over 2,000 penetrating TBIs treated at a single institution. 95% survival rate. The highest volume and best outcomes in the history of wartime neurosurgery.
Ukraine's Unique Aspects
The Ukraine conflict presents neurosurgical challenges distinct from any previous war:
- Scale: Over 2,000 penetrating traumatic brain injuries treated at Mechnikov alone — a volume that would take decades to accumulate at any peacetime trauma center.
- Mechanisms: Predominantly shrapnel and blast injuries from artillery, rockets, and increasingly from drones. Unlike Iraq/Afghanistan, where IED blast and gunshot wounds predominated, Ukraine's injury pattern is dominated by high-energy fragmentation.
- Civilian factor: Mechnikov treats both military and civilian casualties, including children and elderly wounded in missile strikes on residential areas.
- Proximity of care: 60 miles from front to Level I trauma center. 15–30 minutes from injury to OR. This proximity is unique in modern warfare.
95% Survival Rate
The approximately 95% survival rate achieved at Mechnikov for patients who reach the hospital alive represents the highest wartime neurosurgical survival rate in history. By comparison, penetrating TBI survival in Iraq/Afghanistan was significantly lower despite the most advanced military medical system ever deployed. The key factors: proximity (less time with brain exposed to secondary injury), volume (surgical team with unmatched experience), and institutional resilience (50 ORs running 24/7).
Endovascular Techniques
One area of particular innovation at Mechnikov is the use of endovascular neurosurgical techniques — catheter-based procedures to treat blood vessel damage in the brain without open surgery. Dr. Yuri Cherednychenko heads the endovascular/radiology department, and Dr. Vadym Perepelytsia (who defended his dissertation in February) has contributed to advancing these minimally invasive approaches in the wartime context.
Drone Warfare Challenges
The increasing use of drones in the Ukraine conflict has created new neurosurgical challenges. FPV (first-person view) drones deliver small but devastating explosive charges with high precision, creating penetrating injuries with irregular fragmentation patterns. The surgical team has had to adapt protocols for these novel injury mechanisms, which differ from traditional artillery shrapnel in size, trajectory, and depth of penetration.
STOPWAR Algorithm
The STOPWAR algorithm is a clinical decision-making protocol developed from the Ukrainian wartime experience for managing penetrating TBI. It systematizes the triage and treatment decisions that Sirko's team has refined through thousands of cases, providing a framework that can be applied by other surgical teams facing similar caseloads. The development and publication of this algorithm represents the translation of wartime clinical experience into sharable medical knowledge.
11 “Breadbasket” Ukraine
Agricultural Powerhouse
Ukraine has long been known as the “breadbasket of Europe” — and increasingly of the world. Before the full-scale invasion, Ukraine was a global agricultural titan:
- 45 million tonnes of grain produced yearly
- Approximately 10% of the world's wheat exports
- Over 50% of global sunflower oil production
- Major exporter of corn, barley, rapeseed, and soybeans
- Critical supplier to food-insecure regions in Africa and the Middle East
Ukraine's agricultural output is not merely an economic statistic — it is a matter of global food security. The country's rich black soil (chornozem) is among the most fertile on earth, and Ukrainian farming traditions stretch back millennia.
Naval Blockade
Russia's naval blockade of Ukraine's Black Sea ports, beginning in February 2022, halted grain shipments that millions of people worldwide depended upon. The blockade triggered a global food price crisis and threatened famine in vulnerable nations. By mid-2022, international organizations estimated that 47 million people were facing acute hunger at least partly due to the disruption of Ukrainian grain exports.
Black Sea Grain Initiative
The Black Sea Grain Initiative, brokered by Turkey and the United Nations in July 2022, created a humanitarian corridor for grain shipments. Between August 2022 and July 2023, the initiative enabled the export of approximately 33 million tonnes of Ukrainian grain and foodstuffs. However, Russia withdrew from the agreement in July 2023, citing unmet demands, and the corridor collapsed. Ukraine subsequently established alternative export routes through the Danube River and overland through Europe, but capacity remained limited compared to the deep-water Black Sea ports.
Sirko's Agrarian Connection
The documentary's agrarian thread connects directly to this macro-level story. The beeswax from the Sirko family apiary comes from bees that feed on the same sunflower fields that make Ukraine a global agricultural power. The sunflower — Ukraine's national flower and its most iconic crop — is the link between the family story and the geopolitical story. The bees pollinate the sunflowers; the sunflowers produce the oil that feeds the world; the bees produce the wax that heals the wounded. When the land is mined or occupied, all of these cycles break.
Mined Farmland
Ukraine is now one of the most heavily mined countries on earth. Millions of hectares of agricultural land are contaminated with mines, unexploded ordnance, and cluster munitions. Demining will take decades and cost billions. The immediate human cost: farmers killed or maimed working their own fields. The long-term cost: reduced agricultural output, food insecurity, and the slow death of the agrarian traditions that define Ukrainian rural life — including beekeeping.
12 Cossack Heritage in Modern Ukraine
Cossack Identity in Modern Life
The Cossack heritage is not a museum piece in modern Ukraine — it is a living, breathing element of national identity that has been dramatically revitalized by the war. The Cossack values of independence, democratic self-governance, martial courage, and defiant humor map directly onto the qualities that Ukrainians have displayed since February 2022. The Cossack Sich was a voluntary association of free warriors who chose their own leaders and fought for their own land — a template that resonates powerfully with a nation of volunteers defending their democracy against imperial aggression.
Military Traditions
The Ukrainian military has explicitly embraced Cossack heritage in its unit designations and culture:
- 92nd Mechanized Brigade “Ivan Sirko” — Named by President Zelensky in 2019, this is one of Ukraine's premier combat units. The brigade fights in eastern Ukraine, in many cases in the same geographic regions where Ivan Sirko conducted his campaigns 350 years ago.
- 55th Artillery Brigade “Zaporizka Sich” — Named directly for the Cossack state, this unit invokes the Sich's legacy of fierce independence and martial skill.
- Numerous other units incorporate Cossack symbolism, names, and traditions into their identities, patches, and battle cries.
Maidan 2013–2014
The Euromaidan revolution of 2013–2014, which overthrew the pro-Russian Yanukovych government, was suffused with Cossack imagery and rhetoric. Protesters explicitly invoked the Cossack tradition of popular assembly (the Sich rada) as they gathered in Kyiv's Maidan Nezalezhnosti (Independence Square). The self-organization of protest camps, the election of informal leaders, and the willingness to face state violence all echoed Cossack political traditions. The Maidan became, in a sense, a modern Sich — a gathering of free people choosing their own future.
Dnipro/Zaporizhzhia Pride
The cities of Dnipro and Zaporizhzhia carry particular weight in the Cossack heritage narrative. These cities sit in the heart of the historic Sich territory, and their residents often identify with Cossack traditions more intensely than Ukrainians from other regions. The proposal to rename Dnipro as “Sicheslav” reflects this deep identification. In Zaporizhzhia, Khortytsia Island's Sich Museum serves as both tourist attraction and sacred site. The current war has intensified this regional pride, as residents see themselves defending not just their homes but the ancestral Cossack homeland.
Military Continuity
The 92nd Brigade's combat operations create an extraordinary line of historical continuity. The brigade, named for Ivan Sirko, fights in eastern and southern Ukraine — the same locales where Sirko himself fought against Ottoman and Tatar forces. The soldiers of the 92nd are, in a literal geographic sense, defending the same land their namesake defended 350 years ago, against a different empire but with the same essential purpose: the preservation of Ukrainian independence and self-governance.
Cultural Echoes
Cossack culture permeates modern Ukrainian wartime expression:
- Songs: Traditional Cossack songs and modern adaptations are widely shared among soldiers and civilians. The musical tradition of the kobzar (Cossack bard) has been revived in contemporary folk and rock music that references the current fight.
- Snake Island: The famous response of Ukrainian border guards on Snake Island to the Russian warship — “Russian warship, go f**k yourself” — was immediately recognized as a moment of pure Cossack attitude. The defiant profanity, the refusal to surrender, the willingness to die rather than submit — this is the spirit of the Reply to the Sultan, reborn in the 21st century. The phrase became one of the defining utterances of the war, printed on stamps, painted on missiles, and tattooed on soldiers.
- Humor as resistance: The dark, profane humor that Ukrainians have displayed throughout the war — the memes, the gallows jokes, the cheerful defiance — is a direct cultural descendant of the Cossack tradition exemplified by the Reply to the Sultan.