KHERSON, Ukraine -- When the Russians first came to Leonid Remiha, chief doctor at the Tropinka hospital in Kherson, they had a simple request: Take down the Ukrainian flag. Remiha refused. He waited a day, then another. The Russian officer who ordered the flag taken down never came back.
The Russians weren't done with him, though. After months of small acts of resistance, he said, he learned from a hospital bed that the Russians would arrest him as soon as he got out. He then spent the next month and a half hiding in boats, on tidal islands, and in apartments around town.
They eventually captured him on September 20 by forcing one of his hospital employees to lure him into a meeting. He was then locked away in a building formerly used as a pretrial detention center. Each cell held up to eight people despite being only designed for four. Three of the cells held women.
After learning he was a doctor, his jailers requested he give medical help to the Ukrainians they tortured. "There was torture every day," Remiha said, speaking in the courtyard of his hospital in downtown Kherson. "You could hear their screams."
Sometimes the Russians beat and electrically shocked their victims so badly they needed hospitalization, he said. The Russians refused to move out any prisoners, though, leaving some to die of their injuries.
"They died from torture," said Remiha, who was eventually released after passing a polygraph test.
Over the more than eight-month occupation of Kherson, the Russian authorities cranked up the pressure on hospital administrators in an effort to bend them to their will. Some left Kherson for government-held territory, according to Remiha. Others, like Remiha and Pavlo Palamarchuk, who heads Kherson's main psychiatric hospital, stayed and faced the consequences, despite the risks.
"What could they scare me with?" Palamarchuk, 65, said with a hint of humor in his voice while standing in the yard of his sprawling hospital on a cold November day. "I'm a motorcyclist."
The city of Kherson fell soon after Russia launched its invasion of Ukraine on February 24. Russian forces, pouring north from occupied Crimea, overwhelmed the city's defenses quickly and controlled it by March 2, making it the first and only regional capital they seized following the invasion.
Russian forces then swept on toward the city of Mykolayiv, to the northwest, taking most of the over 28,000 square kilometers that make up the agricultural Kherson region. Ukrainian forces repelled the assault on Mykolayiv, but the front remained relatively static for months, until Ukraine capped a counteroffensive by recapturing the city as Russian troops retreated in November.
Over those long months, the Russian occupiers set about remaking the city of Kherson in their image. Among their first moves was to set up an occupation government. They appointed Volodymyr Saldo, a former mayor of Kherson, as the regional head. Kirill Stremousov, a marginal figure known as an anti-vaccine activist and who would die in a car crash in Crimea in November, was appointed Saldo's deputy.
Beginning in September, the occupation authorities forced a Russian curriculum on teachers and students and sought to replace the Ukrainian currency with Russian rubles but later backtracked on that plan.
In late September, Moscow baselessly claimed that the Kherson region and three other Ukrainian regions were now parts of Russia.
Remiha's first act of resistance came almost immediately after the invasion. Members of Kherson's territorial defense force, a lightly trained military reserve, made a doomed stand against Russian forces and were crushed. Five wounded members were brought to the Tropinka Hospital, where he said he told staff to register them as civilians to hide them from the Russian authorities.
Soon enough, Russian soldiers came to say they were going to turn a section of the hospital into a ward for their wounded. Remiha thwarted the demand, he said, by playing up the hospital's involvement in treating COVID. Staff posted flyers warning of the presence of coronavirus patients and dressed in disinfection suits. The Russians backed down. "They were really afraid" of the virus, Remiha said.
The Russians gradually cranked up the demands, though, to the point where Remiha's resistance became more and more overt, he told RFE/RL. Russian authorities requested that he film a statement praising Russia's changes to the health-care system. He refused and was questioned by the feared Russian Federal Security Service (FSB).
They would return again for another round of questioning in which they screamed at him over the continued presence of Ukrainian flags in the building, he said.
Worse was to come. While recuperating at the hospital from a minor stroke, he was told by hospital staff that the Russians would nab him as soon as he got out of the hospital. He beat them to the punch, he said, leaving the hospital on August 1.
Remiha, spry but slowing down at the age of 67, spent the next month and half hiding from the Russians. He moved from safe house to safe house, at times even staying on boats on the Dnieper River and on riverine islands reachable only by watercraft.
In the meantime, the Russians appointed a former doctor at his hospital, Iryna Svyrydova, to take his place. Svyrydova had worked at the hospital until 2014, when she was fired after being found drinking on the job three times.
Remiha could have left by using connections across Ukraine to smuggle himself out through Russian lines, he said, but his affection for Kherson kept him there, and he told those who offered to help him get out that he would "remain with my team."
"I'm an old man," he said. "My parents' grave is here, my brothers, my sister."
Other hospital directors made similarly tough choices, Remiha said. Iryna Sokur, head of the Kherson Regional Oncological Dispensary, left for Ukrainian-held territory, as did Viktor Korolenko of the Kherson Regional Clinical Hospital. Inna Kholodnyak, director of the children's hospital, went into hiding in Kherson.
Remiha kept up contact with his staff despite being on the run. In order to avoid FSB surveillance, he established a set of codewords that told his staff where the meeting place would be. "Fish," for instance, meant the market.
This system would be his downfall. One day, Remiha received a call to meet and didn't even have time to slow his car before he was boxed in by the FSB. He doesn't blame the co-worker who set up the false meeting; he believes the call was made under the barrel of a gun. Nor was the arrest entirely unexpected.
"I wasn't afraid," he said. "I felt that sooner or later they would arrest me."
He was then taken to a prison, where cells for four now housed as many as eight. They tortured him with electric shocks several times, he said, but he described his punishment as far lighter than that doled out to other prisoners.
Jailers would force captives to sing the Russian national anthem and shout "Glory to Putin" and "Glory to [Sergei] Shoigu," Russia's defense minister.
Some of those imprisoned had passed information about Russian military movements to the Ukrainian Army. Others were simply the victims of a system repression run amok, Remiha said, such as an imprisoned man who was accused of being a "NATO soldier" for no obvious reason.
WATCH: After Russia launched its full-scale invasion of Ukraine, underground resistance movements found ways to fight back. Some locals sent information about Russian troop movements to the Ukrainian military.
Once his jailers realized he was a doctor, they put him to work treating the other inmates after they were tortured. Using the basic medications and instruments the Russians allowed, such as bandages, he attempted to treat the victims. Not all survived.
On the eighth day of imprisonment, he was removed from the jail and put under house arrest. He was then hauled back in to take a polygraph on October 3. The questions were inane. "Do you have a code name with the SBU?" they asked, referring to Ukraine's intelligence agency, the Security Service of Ukraine.
They told him he hadn't passed. "Good," he said he answered. "I'll get to see the guys again."
Remiha was let go but told he couldn't work at the hospital again.
Soon after the Russian forces retreated and Ukraine recaptured Kherson, Remiha was back at work, overseeing patients wounded by shellfire while dealing with a lack of supplies after the Russians drove off with hospital equipment and ambulances. Svyrydova left with the Russian military.
Not everyone experienced such brutality in response to their resistance. Pavlo Palamarchuk, the psychiatric hospital director, described his experience of the Russian occupation in radically different terms.
The first time the Russians military came to Palamarchuk, they demanded he sign documents saying clinical trials at the facility were part of a U.S.-funded bioweapons program -- one of the baseless narratives that Putin's government has used to justify the invasion.
Palamarchuk, despite being held for 12 hours, refused to sign the paperwork. "I was afraid," he said, but not scared enough to back down. The Russians didn't press the point.
Palamarchuk would stand up to the Russians at least two more times. Once, a hospital employee was imprisoned for his pro-Ukrainian tattoos. Palamarchuk said he went to a Russian block post and won the employee's release.
WATCH: Serhiy Mak says he spent 25 days locked in the cellar of an office building in Kherson, southern Ukraine, where he was tortured by a Russian man nicknamed "The Specialist."
The third time came in October, when the Russians demanded he evacuate all 400 of his psychiatric patients to Russia amid Ukrainian battlefield gains. Palamarchuk refused to comply twice, and, for some unknown reason, the Russians didn't press the point.
Soon after the Russians made the request, they escaped themselves, ending the sense of "absurdity" that Palamarchuk said they brought with him.
Palamarchuk himself believes the Russians didn't bother him more because medical protocols between the Russian and Ukrainian psychiatric systems were broadly the same. However, cast against the experience of Remiha, such a straightforward explanation seems unlikely.
Despite his return to work, Remiha is not yet back in his office.
"I won't sit there because the collaborator sat there," he said, adding that a priest would soon be coming to cleanse the space. "The priest will bless it, and then I'll go in," he said.
