"I had the intention to commit suicide". How psychiatrists treat soldiers from impacts of war
“I have lost hope. What is there left to defend?" says a young black-haired man with a small beard. His eyes are covered by glasses with thick lenses.
"What else is there to do?" I respond.
“Are you asking a person who wanted to commit suicide what to do?”
Ivan (name changed) is a serviceman. He is currently a patient at the Pavlov Kyiv City Psychiatric Hospital. Or "Pavlivka". He was sent here after a suicide attempt. Ivan doesn't sleep well, and this causes all his other problems: headaches and leg cramps.
Today he was allowed to go home for the night because it is difficult for him being in the hospital. We met him at the exit of Pavlivka and started talking. Ivan smoked a cigarette. Men like him, men who had been to war, were smoking nearby. Some of them did not stop at one cigarette and reached for the next one.
"They treat me humanely. I honestly did not expect it"
Before the full-scale war, Pavlivka mostly treated people with severe mental illness. Later, a new cohort of patients was added – the military. In June 2022, a separate ward was opened for them, initially with 40 beds. And last August, it was moved to another building.
Now all 70 beds are occupied. The beds do not have time to cool down: when one soldier is discharged, another is brought in his place. An assembly line. The day we came to the hospital, four new patients were admitted.
Post-traumatic syndrome, panic attacks, anxiety, the consequences of explosive injuries – these are the conditions that soldiers usually come with. Almost all of them return to service.
First, we meet a man in a sailor's shirt. He has a well-cut gray beard and an earring in his ear. The call sign “Sedoy” suits him very well. He explains that it has been with him since his biker days.
He introduces himself as Vadym Kononov, 59 years old. In civilian life, he was a director and actor, playing in Ukrainian and Russian films. He was born in Konotop, but when he was a child, his family moved to Russia. He grew up in Siberia and graduated from the Faculty of Philology in the country. But fate brought him back to Ukraine.
"I have mixed polar blood: one half of my family lives in St. Petersburg, and the other half is from Kolomyia. My native language is Russian, but I learned Ukrainian because you need to know the language of the country where you live. It is respect for this land. You then become one of those who live here," Kononov says.
He joined the army with his son in the first days of the full-scale war. He went through battles in Kyiv, Kharkiv, and Donetsk oblasts. He was a mortar gunner and signalman. This year he became a press officer. In this position, he wants to document the stories of the military.
He ended up at Pavlivka because of his concussions. He lost sleep, his blood pressure spiked, so the chief of medical staff sent him for treatment. At first, Kononov did not trust his psychiatrist as she was quite young. But he quickly realized that she was good at her job. It was the same with the psychologist.
"They treat me humanely. I honestly did not expect this. This communication is important to me, and we are far away from triggers. Imagine, in the first days, I didn't want to go home. The grounds are beautiful here, I walk around and look at these sculptures," he says.
As we speak, he is alone in the ward, although there are four beds. There are rubber slippers and tactical shoes next to each bed, and pixelated backpacks on the chairs and windowsill. Through the wide windows you can see the Kyryliv Hills. The ward has a newly renovated bathroom, with turquoise clay paintings hanging on the walls. Between them is an icon of the Archangel Michael.
"Too Soviet"
Kononov is worried that he will never be able to sleep without medication again. In April, he is going to be "demobilized," he adds: "I'll make it somehow."
"Well, how’d you find it here, nice and cozy, like home?" a large man enters the ward. He greets Kononov. It is the head of the department, Ihor Dubinin.
"It's just like home!" Kononov replies cheerfully. He promises that after his "demobilization" he will come here to make a movie.
According to Dubinin, assembling the current team was not easy. Few people want to work with the military, and not everyone is ready for long working hours. Currently, there are four psychiatrists for 70 patients.
The hospital lacks psychologists. More psychiatrists are also needed because they are currently under a very heavy workload. Whether the department will be expanded is an open question because of funding problems.
Treatment at Pavlivka is comprehensive. It includes medicines, psychological help and correction, various types of rehabilitation, including physiotherapy. At any time, the soldiers can turn to a psychologist and talk about their experiences. They also go to the swimming pool or play soccer. They also have time for leisure.
The head of the department says that the first floor of the unit is being renovated, but the second floor is "too Soviet." He takes us to see it. We go up the stairs, and in the dark corridor there is old linoleum on the floor.
"See how beautiful the floor is, the walls, the doors? It's sick!" the doctor sneers and adds: "I'm tired of begging: give me this, give me that..."
On the first floor, there is an area with a huge aquarium and a TV, where the guys play games. The second floor is much plainer. The doctor does not answer the question about whether the state and the city help. But it is clear that they lack money.
Dubinin leaves us because he has a lot of work to do. We take a picture near the wall with flags from the soldiers who were treated here. Next, the tour is led by occupational therapist Mykhailo Parfyonov. He is a veteran himself, has a medal for the defense of Kyiv, and is also a master of sports in kickboxing.
We proceed with him to the gym, which was just a warehouse before the military unit was established. It was set up by volunteers and people who cared. Now not only patients come there, but also employees, says Parfyonov and shows a video of a doctor from another department doing pull-ups on the bar.
"The guys who were most active with me after the captivity were the ones who did the most. I also remember a man with an amputated arm who came to boxing and tennis every day, but still asked for more training," says the occupational therapist.
"If you don't want to live, give your life for good"
Leaving the hospital, we meet Ivan. He praises the local doctors as they are motivated and try to help the soldiers. There is no such thing as in the Soviet Union, where they would give you a pill and make sure you don't run away.
"Why did I end up here? On the one hand, there is the enemy, on the other hand, I cannot go rest, I have to serve. I had an intention to commit suicide, and after that I got treatment," he says.
Ivan claims that if he had not asked for treatment, he would never have been sent.
"My commanders have the following vision: if you don't want to live, f*ck off and give your life for something good, dig a trench toward the f*ckers to make it easier to storm," Ivan says.
His father died when he was young, and his mother is abroad, so they don't communicate with her. His parents were replaced by his sister and her husband, who recently died at the front.
"I feel that my sister needs my support. Most people do this: they neglect their health when their loved ones need help. I did the same," the soldier says about the reason why he spends the night at home.
He says that he had a "A white ticket is a military ID card of conscripts who are medically unfit for military service and/or who have not served in the armed forces.white ticket" (PDQ -ed.) and could have avoided joining the army, but he volunteered to defend the country. But now he wants to leave the army and build his life further.
We said goodbye to Ivan at the crossroads, shaking hands. From there we went our separate ways. Tomorrow Ivan will return to Pavlivka again. Where people like him smoke cigarette after cigarette on the benches.
This piece was created with the support of the German Federal Foreign Office.