Action, for a physician with a lifetime of answering the ethical call of that profession, is compelling. For Dr. Tom Rusing his career work has been about helping and acting, not watching. He has followed that call here in Prescott for more than 30 years, becoming familiar to many and respected by other practitioners and the public alike.
Working in medical settings always involves risk to the practitioner, but is manageable day-to-day. Prior to his retirement in 2017 he saw the needs of people outside Prescott facing natural disasters, leading him to volunteer his expertise. Tom expressed to me a strong sense of duty to participate to stay honest with his own professional self, and more importantly a personal, moral calling to do something for others in need, and not sit on the sidelines.
With that calling there are different faces to ever-present personal risks within medical practice. A surgeon’s exposure to infection and bacteria are part of the workplace. When Tom volunteered in Haiti in 2010, earthquake destruction and aftershocks were a concern, as was access to clean water. Farther from home, Nepal held similar risks caused by the big 2015 earthquake, and cultural and language differences complicated efforts to help. In 2020 he and his wife Cathey, a nurse, volunteered at the Gallup Indian Medical Center in Gallup NM, where Covid-19 hit native populations hard and overwhelmed the healthcare system. The situation was complicated by cultural and socioeconomic challenges and evolving recommendations for treatment. Again, despite higher risks to volunteers, he knew he had to help.
In each, though, were organized systems, processes, and procedures; checkboxes and fallbacks to contacts elsewhere, translators in place, leads for access to other supplies and necessary equipment made it all seem doable. These experiences were flexible and adaptable in quick response to often changing conditions.
Then on February 24 came the brutality of Russia’s attack on Ukraine. It became clear that Ukrainians wanted to maintain their sovereignty, and the incursion quickly accelerated to a bloody invasion and destruction of property and people. Again, Tom had to answer himself: “Why aren’t you doing something?” and he answered the call. But his experience in Ukraine, while following the same heart of his calling, differed strongly from his prior experiences. The risk there was on a different scale and became a constant internal conversation for Tom, requiring him to ask and answer that question many times.
Hoping to find a formal relief effort, as he did in Haiti and Nepal, Tom reached several dead ends. It became clear that this was a different ball game. This is a hot war, following no rule books, with irregular communications and continuously changing conditions, nations and languages. Calls for and availability of supplies, food, safe places to stay and travel were difficult, and needs were constantly changing. But to stay true to himself and his lifelong calling he felt he needed to try, whether in medical or other ways, to be of help.
Tom initially thought he would provide care at the Polish-Ukrainian border, but it became clear that he would need to move into Ukraine, initially to Lviv, and then, despite warnings, to Kyiv, at the time surrounded on three sides by Russian troops.
But soon after he arrived the Russian army got more Ukrainian military pushback than anticipated, so it pulled back, creating a bit of a lull in hostilities. “In addition, the Ukrainian military and civilian medical systems are good, and were now focused on war-related needs. So there was less need for my medical skill set during the ‘lull,’” Tom told me. In his travels he also saw many Ukrainians reversing course, having initially fled but then feeling compelled to return and join the fight.
The experiences were life-changing for Tom. War is chaotic. There is no common language, no useful prediction of what was to happen in the next hour, much less tomorrow. Each travel experience was time-consuming, often unpredictable. He explained, “the curfews, air-raid sirens, the scattered destruction in Lviv and Kyiv and extensive destruction in other towns makes it all very real.” During our conversation he recalled an experience in Haiti in which bodies had lain under rubble for an extended time; he remembered that moment in Bucha, where rubble was being pulled off victims, with a similar set of sights and smells and the suffering it implied, not experienced every day. In one sobering instance, in Borodyanka, he saw evidence of war crimes, and their physical effects, being investigated.
Travel was often on the quiet; leads were given in code. Heading to Lviv, high-security messaging told him to look for someone by description, with no name, and a set of map coordinates. On his arrival, given the high level of risk involved, his contact asked, “How did you get here and find us?” While waiting for an assignment, he was able to travel around the city a bit. Air-raid sirens would sound but, as time went on, most people on the streets seemed to ignore them.
While at a small shop in Lviv, a siren blew. The lights went out and he noticed all the staff exiting the room, telling him, “Follow us.” He was led through a “rickety, worn door and through catacombs of a 16th-century church, now a museum.” In there were many people, including a Turkish television crew, which interviewed several of the sheltering people, including Tom.
Later, in Kyiv, Tom became part of an all-volunteer group of medical field personnel, picking up injured soldiers and civilians in the field for stabilization and transfer. Part of his training with a group of others was in use of the tourniquet. He says, “This procedure was developed via our experiences in Iraq: the device was not intended to save another’s life, but rather this tourniquet was required to be carried in one’s own front left pocket, and we’d use the injured person’s tourniquet to stop their bleeding.”
He arrived with the basics, but entering the field required additional gear. “Wearing a vest and helmet when you went into more dangerous areas is sobering. Now the risks are real …. There were many NGOs helping and providing supplies, etc. But the closer to the hostilities one gets, supply needs are greater because the risk of getting the supplies there was greater. There always seems to be the problem of the disparity of where the supplies are, and where the need is, in disaster situations.”
He felt it important to relate that people in Ukraine tried to maintain some sense of normal life, despite the difficulties. “At the small ‘hospital’ where I was for part of the time in Kyiv, they had a gathering one night, and they played guitars and sang, and one night watched a humorous movie and socialized,” he noted. Everyone, though, was affected: “at least one of the people, a paramedic, was suffering from PTSD from his time near the front lines rescuing the wounded and experiencing a continuous 30-minute bombardment … and the trauma is both physical and mental. They need medical and psychological care and support, which isn’t always available.”
Two hours after he left Lviv, and again after leaving Kyiv, missiles were fired into those cities. Always present was the sense of how important it is to “be a part of the solution, not become a part of the problem.” Tom’s specialized skills, at that time and place of the war, were less needed than the practices of primary-care physicians. But his journey exposed him to the personal experiences of war.
“Humans are tough, resourceful, and resilient. What they really want and need is peace. But they are unified in fighting for their country and freedom. My journey was partly to document and give testament to the fact that this is real, and it is happening in our time and to a democratic European nation. It shows how one man, one leader of a nation, can cause so much destruction, death and suffering in another country and with effects that extend throughout the world. It shows the importance of having good leaders who are looking out for the best interests of their citizens and the world, and why we, as a country, should support other such leaders and countries.
“Not everyone can travel to Ukraine, but we can all make a difference here. Slava Ukraini.”