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One body at a time, a Kyiv coroner documents Ukraine’s death toll

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April 20, 2022 at 2:00 a.m. EDT
A body bag near the site of a suspected missile strike in a residential area of Kyiv, Ukraine, on March 15. (Heidi Levine for The Washington Post)
10 min

KYIV, Ukraine — One body has been haunting the coroner. She was shot through the face with a high-caliber bullet through a car windshield. Then a Russian armored vehicle ran over the car, crushing her rib cage like a soda can and tearing off what was left of her head.

Volunteers peeled her body out, zipped her into a black plastic bag and laid her in the trailer of a refrigerated 18-wheeler. She rode an hour through capital-city suburbs before being removed carefully from the bag and laid on coroner Vlad Perovskyi’s metal autopsy table.

The gunshot that killed her disturbs him less than the way her body was treated later.

“I’m used to seeing horrible things done to bodies,” Perovskyi says. “But I was very shocked to see such horrible treatment of the deceased by the Russians. How can someone shoot a person and then run over the body? Or throw them into ditches. How can someone put a bullet into a dead man’s head?”

Citizens of this country of 44 million being invaded by its neighbor are fond of saying each Ukrainian has their own front line. This is Perovskyi’s. In a 20-by-20-foot room in a building on the campus of Kyiv Regional Clinical Hospital, Perovskyi and a team of five men have processed more than 200 dead civilians and Ukrainian soldiers in the past seven weeks. With prolonged power outages in many suburbs, Kyiv’s morgues have become a bottleneck for the dead.

“Compared to guys in the army that are at the front lines, this is the least I can do,” Perovskyi says.

In a room with multiple windows, the death investigators dare crack only one in an effort to alleviate the oppressive stench of decomposing human flesh. Any more open windows and the flies swarming outside would have free rein. As it is, dozens of them are stuck to a twisted band of sticky flypaper hanging from the ceiling. Below that, more than 15 bodies filled the room in varying stages of autopsy.

There are bodies filled with bullet fragments and bodies with pea-size entry wounds and golf-ball-size exit wounds, civilian clothes stained in blood and pocked with glass and wood shards; bodies with twisted metal lodged in throats and torsos; bodies with chest cavities and skulls delicately carved open by the coroner, slowly dripping blood on metal tables; bodies that have been lying for weeks in spring rains, or buried a few feet deep in mass graves of damp silt, making them impossible to clean, for fear their rotting flesh will fall apart. To combat the smell, Perovskyi burns church incense.

“People think you get used to that smell,” he says. “We never do.”

With alarming frequency, the bodies are headless. Sometimes bodies arrive with bruising about the face and stomach consistent with punches and kicks, or bruising around the wrists, where hands were tied behind backs. Unexamined bodies are piled four-high against the walls in plastic bags, waiting their turn to be examined, counted and recorded.

Hospital policy prohibits photography in the examination room.

Investigators exhumed 21 of at least 67 bodies suspected to be lying in a mass grave in Bucha, Ukraine, April 8. (Video: Joyce Koh/The Washington Post)

The latest updates from the Ukraine war

Perovskyi, 27, works in the forensic department at Kyiv Regional Clinical Hospital — for more than a month during the invasion, he was its acting head. In 2019, the year he began a career as a forensic examiner, the province had 87 murders, according to government data. Perovskyi investigates a portion of those crimes in conjunction with two other area morgues. He attended medical school with the goal of treating living patients but fell in love with death investigations after a summer internship at the morgue.

“I am actually a very sensitive and emotional person, despite my profession,” Perovskyi says. “If I watch a movie and there is an emotional moment, that can bring me to tears.”

When Russia launched its full-scale invasion, some of its forces quickly carved a narrow path to Kyiv in the country’s center. They hoped to destabilize Ukrainian leadership while additional forces fought for border villages, towns, bridges and roadways in the north and east. That capital assault stalled in the suburbs, and in towns such as Irpin and Bucha, Russian forces apparently took out their frustrations on civilians.

The United Nations says 2,104 civilians and 71 children had been killed by Russians as of Tuesday, and the government discovers new victims in homes and graves daily. Perovskyi is one of more than 50,000 people investigating potential Russian war crimes against civilians, according to the Office of the Prosecutor General.

Perovskyi’s morgue began receiving the first war dead in late February — Ukrainian soldiers killed in action at the front. Then in mid-March, the first civilians turned up in vans and ambulances. Most hospital employees were still trapped in their homes or had fled the region. So Perovskyi, who lives a few minutes away in his parents’ apartment, handled the first bodies on his own, cleaning them, examining them and sewing them up by himself in an empty morgue.

By late March, as Ukrainian forces took back occupied towns around Kyiv, bodies started arriving in the back of refrigerated tractor-trailers faster than morgues could process them. Perovskyi’s younger brother, a medical school student, started assisting him.

Perovskyi’s task: Identify the cause of death, quickly.

Before the invasion, a death investigation might take six hours. Perovskyi would carefully examine every injury on the body, make a Y-incision through the bellybutton, up the sternum and across the collarbones, and saw open the skull.

Now he’s performing as many as 10 autopsies a day, cutting open a body only if the cause of death is unclear after examining superficial wounds. Even at that pace, refrigerated trailers sit in the parking lot overnight with bodies stacked three-high in two rows against the walls.

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“These morgues were not designed to handle this amount of bodies,” Perovskyi says.

Neither were the people who work there, Perovskyi fears. So far, colleagues have remained steely in the face of the onslaught.

“What is the choice?” asks Perovskyi’s colleague Pavlo Snisarevskij, head of the hospital’s anatomical pathology department. “When 56 bodies are brought in, the next day 20 bodies, 27 bodies — well, it lingers in memory. As you examine the body, you do not perceive it as a dead person. It is the object of study. But later, it catches up.”

Perovskyi has asked friends to recommend possible therapists or psychologists to speak with. He has one in mind but has not reached out yet. He’s not sure he can afford to dive deeply into his emotions about the war and his role while it’s still happening.

Before the invasion, when most people on his tables had died of natural causes and only a handful had died at the hands of another person, he spoke to the dead. At the beginning of each autopsy he washed his hands with soap and water, put on blue latex gloves and, on most days, asked the most obvious question.

“How did this happen to you?”

Then he’d spend the next six hours searching for the answer. “Every single body I treat with respect,” he says. “You have to do it.”

Now, the answers only raise more questions. Perovskyi has cut down his news and social media consumption to try to separate his work from the larger war narrative in his mind.

“The news put the bodies that I worked with into context, and that is what can mess me up,” he says.

His attempts to compartmentalize are further complicated by interactions with grieving families. When bodies come in with no identification, families are asked to identify their loved one. Perovskyi realized early in his career there was nothing he could say to mitigate the devastation in those moments.

“Words are going to be useless for them,” he says. “You just have to be with them. If they need that hug, hug them, or just give them time to cry.”

In addition to searching for identifying documents on the remains, Ukrainian police have been cataloguing details such as tattoos, clothing and hair and eye color to help families narrow their search. Less could be done for the woman in the crushed car; only her lower jaw remained after the Russian vehicle destroyed her body. Perovskyi still doesn’t know her name.

Much of the time, crime scene images accompany a body’s arrival, but there were no pictures available in the woman’s case, leaving many questions.

“All I know is that she came from Irpin,” Perovskyi says. “She was trying to evacuate.”

He doesn’t have much time to search for answers.

He ends most days around 5 p.m., heading home to his parents’ two-bedroom apartment. On this day, he rolls up his sleeves and cooks an omelet with ham and red peppers, revealing the face of a lion tattooed on the inside of his right forearm. Seven years ago he Googled “calm lion” in Ukrainian and liked the first image result enough to get it tattooed in black and white.

“I’m a Leo,” he says. “And every single tattoo artist tries to draw the lion roaring or having a crown. But I am not an aggressive Leo. I wanted a calm lion.”

After dinner Perovskyi hugs his mother and father goodbye, puts on a jacket with a green tape armband signifying military affiliation and walks to his overnight job as a volunteer military medic in Kyiv. His mother, Yulia, works for a Ukrainian news outlet aimed at countering Russian propaganda outlets in Ukraine’s eastern provinces.

“I’m proud of both of my sons,” says Yulia, 49. “Everybody has their front line. Someone’s fighting the war with firearms, and my sons are doing this important work.”

Yulia, who has friends and relatives living under Russian occupation in eastern Ukraine, says she hasn’t spoken with an uncle who lives in Crimea since the beginning of the war. That’s when, in a phone conversation, he expressed solidarity with Russian President Vladimir Putin and his justification for invasion, including the false accusation that Ukraine is governed by far-right extremists and neo-Nazis.

The notion that he has family members who believe the war is justified — who believe people should die this way — is too much for Perovskyi to handle right now.

At 6 a.m., he wakes up on an army cot and heads to the morgue. He focuses on the endless line of lifeless victims in front of him. He still whispers some version of a question that once seemed very simple.

“Why did you die?”