Ballistic missiles overhead at 2 a.m. Surgeons back in the OR at sunrise. A city buying groceries and sending kids to school while medevacs arrive around the clock. That contrast is the setting for our conversation with Dr. Roman Hayda, Chief of Orthopaedic Trauma at Rhode Island Hospital and a retired US Army colonel who has traveled to Ukraine repeatedly to support frontline trauma hospitals.
We trace how his Ukrainian roots and military surgical career shaped a calling for war surgery, then zoom in on what makes the current conflict medically different. With contested airspace and relentless drone surveillance, traditional evacuation assumptions collapse. When you can’t fly a helicopter and you can’t safely drive into the kill zone, the “golden hour” becomes a moving target and the downstream impact shows up in limb salvage decisions, prolonged tourniquet times, infection risk, and a growing need for amputation care and complex reconstruction.
We also dig into leadership lessons for any orthopaedic surgeon considering humanitarian work: arrive with humility, listen first, adapt to limited resources, and treat teaching as a two-way exchange. Finally, we talk practical ways to help even if you never get on a plane, from donating external fixation resources to supporting reputable NGOs and advocating for sustained support.
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