When air sirens sound over Kyiv, Ukraine, patients undergoing bone marrow transplants at Ohmatdyt National Children’s Hospital don’t have the option of going to the bomb shelter.
They stay in the transplant unit, and they need medical staff to stay with them. It’s a reasonable calculation: exposure to infections in a bomb shelter presents a greater threat to them than Russian bombs.
Thus, at about 10:45 A.M., on Monday, July 8, Oleksandr Istomin, a pediatric hematologist at the Bone Marrow Transplantation and Immunotherapy Department, sat at a computer in the fourth-floor conference room.
I still can’t get this through my head: we visited America just a few weeks ago, we spoke with people about new technologies, about immunotherapy, and then my hospital is hit with a fucking rocket, and I and my colleagues at my department almost die—and two people, indeed, die.
Oleksandr Istomin
As sirens blared, Istomin was looking through patient files when he heard an impact somewhere close.
Glass around him began to crumble suddenly, all at once. Istomin dropped to the floor.
This—and good luck—likely saved his life.
A massive glass pane dropped from the window, falling at the exact spot where Istomin had been sitting. Luckily for Istomin, the thick glass didn’t shatter, and its fall was broken by a pair of red beanbag chairs.
“I still can’t get this through my head: we visited America just a few weeks ago, we spoke with people about new technologies, about immunotherapy, and then my hospital is hit with a fucking rocket, and I and my colleagues at my department almost die—and two people, indeed, die,” said Istomin, who a few weeks earlier visited the U.S. to attend the annual meeting of the American Society of Clinical Oncology. (The visit also included a vodka-lubricated dinner at the house of this reporter in Washington, DC.)
“Had the rocket hit the building across the courtyard, we would not be having this conversation,” Istomin said.
After the rockets hit, Istomin took out his cell phone and started to document the damage around him, first at the transplant unit in what was, until the rocket fell, a sleek four-year-old building at his country’s premier pediatric hospital.
Through the void where three layers of glass had been, he aimed the camera across the courtyard, sweeping the view of a row of shade trees that now stood decapitated, and, though a cloud of dust, looking at the now demolished section of a 120-year-old two-story building that housed Ohmatdyt toxicology, dialysis, and intensive care units.
We have immunosuppressed patients who cannot be moved to bomb shelters. When air raid alarms sound, we tell them to go out into the corridors or stay in your rooms.
Oleksandr Istomin
A physician, 30-year-old Olena Lukyanchyk, and a visitor had died there, Istomin would learn later. The children’s hospital was hit with a Kh-101 long-range cruise missile that was launched from a bomber on Russian territory. That day’s barrage of Ukraine’s capital also demolished a maternity hospital, where seven people were killed.
Had the Russian rocket hit the Ohmatdyt building where Istomin was working, the death toll would have been much higher.
“We have immunosuppressed patients who cannot be moved to bomb shelters,” Istomin said. “When air raid alarms sound, we tell them to go out into the corridors or stay in your rooms.”
In recent months, this wasn’t an urgent problem because air defense systems usually shot down the incoming projectiles.
Getting off the floor, his phone still in hand, Istomin walked inside the building to capture the damage. Shards of glass, including some that could pierce dagger-like through human flesh, were on the ground and sticking out of boxes. Tiles hung down from the suspended ceiling.
There were 20 patients in the unit, all of them understandably traumatized by what had happened, but none were physically hurt.
![A large pane of glass collapsed on top of bean bag chairs and a desk chair in a conference room.](https://cdn.cancerletter.com/media/2024/07/19141710/1-conference-room.png)
![A large pane of glass collapsed on top of bean bag chairs and a desk chair in a conference room.](https://cdn.cancerletter.com/media/2024/07/19141710/1-conference-room.png)
Guiding a reporter through the first moments past the explosion, Istomin showed how close he came to losing his life. “I sat there, at this computer when it happened, and I had the presence of mind to get out of the way before this massive glass pane—weighing about 25 kilograms—crashed down at the exact spot where I was sitting. Somehow, I managed to jump out of the way. Had I been slower, it would have killed me,” Istomin said.
![The sleek glass facade of Ohmatdyt before the missile’s impact.](https://cdn.cancerletter.com/media/2024/07/19141747/2-Ohmatdyt-before.png)
![The sleek glass facade of Ohmatdyt before the missile’s impact.](https://cdn.cancerletter.com/media/2024/07/19141747/2-Ohmatdyt-before.png)
![Ohmatdyt’s facade after the impact, with major damage, broken windows, and missing panels.](https://cdn.cancerletter.com/media/2024/07/19152503/3-Ohmatdyt_after.jpg)
![Ohmatdyt’s facade after the impact, with major damage, broken windows, and missing panels.](https://cdn.cancerletter.com/media/2024/07/19152503/3-Ohmatdyt_after.jpg)
The blast took the façade off the hospital building where Istomin worked. Here is the before and after photo. The windows of the conference room where Istomin was during the blast are circled.
![The view from the conference room where Istomin was working shows a destroyed building across the way.](https://cdn.cancerletter.com/media/2024/07/19141906/4-view.png)
![The view from the conference room where Istomin was working shows a destroyed building across the way.](https://cdn.cancerletter.com/media/2024/07/19141906/4-view.png)
Istomin was fortunate to be sitting behind three layers of glass. The first two layers covered an outside-facing gallery that was constructed to enable visitors to look into the rooms of young immunocompromised patients without introducing infections. The two layers of glass panes that enclosed the gallery and the entire skin of the building were blown away by the explosion, and the third pane, intact, fell onto Istomin’s desk.
Looking over the balcony railings, Istomin could see the dust and smoke rising over the caved-in building housing the toxicology, dialysis, and intensive care units. A section of that building had caved in. Soon, passersby would come from the streets to search for victims.
Istomin left the conference room to survey the damage, recording a video as he went.
With the squeal of alarm systems and rising dust and smoke, patients were crying for help. Istomin located a staff member—an orderly. “She was okay—just scared.” Luckily, the half of patient rooms that looked out onto the outside passageway were protected by three window panes, and patients were protected.
![A storage room covered in broken glass, with a large shard pierced deep into a cardboard box.](https://cdn.cancerletter.com/media/2024/07/19141942/6-storage.png)
![A storage room covered in broken glass, with a large shard pierced deep into a cardboard box.](https://cdn.cancerletter.com/media/2024/07/19141942/6-storage.png)
This is a storage room where various supplies were kept. Said Istomin: “Note the massive glass shard piercing the box. Imagine what would have happened to a person after being hit with this massive shard, for instance.”
![An office with fallen ceiling tiles, broken glass, and a window fallen inward crushing a desk chair.](https://cdn.cancerletter.com/media/2024/07/19141630/7-office.png)
![An office with fallen ceiling tiles, broken glass, and a window fallen inward crushing a desk chair.](https://cdn.cancerletter.com/media/2024/07/19141630/7-office.png)
Damage inside the transplant unit.
![A hospital hallway with a gurney and medical equipment, covered in shattered glass and debris.](https://cdn.cancerletter.com/media/2024/07/19141639/8-hallway.png)
![A hospital hallway with a gurney and medical equipment, covered in shattered glass and debris.](https://cdn.cancerletter.com/media/2024/07/19141639/8-hallway.png)
Damage in the hallway.
![The collapsed building across the courtyard, swarmed by passersby and first responders searching the rubble.](https://cdn.cancerletter.com/media/2024/07/19141648/9-outside.png)
![The collapsed building across the courtyard, swarmed by passersby and first responders searching the rubble.](https://cdn.cancerletter.com/media/2024/07/19141648/9-outside.png)
With dust and smoke still rising over the historic building that housed toxicology and dialysis, people from the street ran over to try to help. Said Istomin: “These are random people, women in heels and flip flops starting to clear the rubble before the emergency crew arrives. All of us were doing this.”
We have doctors on duty 24/7, because that’s what we do. We can’t just send our patients home, because they have already received chemotherapeutic agents in sublethal doses.
Oleksandr Istomin
A video from the same site the next day, July 9. Said Istomin: “Here you see that a quarter of the building is gone. Luckily, the children were evacuated. They were safe because the medical staff followed protocol.”
Within seven hours, the staff managed to evacuate the 20 patients and all that was needed for their care to another hospital, the name of which Istomin is not at liberty to reveal.
“Patient care was not interrupted—not even for a moment,” he said. “We have doctors on duty 24/7, because that’s what we do. We can’t just send our patients home, because they have already received chemotherapeutic agents in sublethal doses.”