As Russian forces inch forwards along a meandering front line in the north of the Donbas region, only one road now remains open for Ukrainians seeking access to the besieged hilltop farming town of Lysychansk.
A brown smoke trail from a rocket drifted overhead, and three artillery shells landed perhaps a mile east of the road one recent afternoon, as Major Oleg Kravchenko drove at furious speed towards a forward medical post close to the advancing Russian front lines.
"Every day it's blood, blood, blood, blood," said Maj Kravchenko, a wry, burly figure who heads the army's medical teams in the area.
"Keep your head down and watch out for snipers. The Russians were shelling this area 15 minutes ago," an army nurse said as we followed the major into a derelict building where ambulance teams were waiting for the next call.
The trill of springtime birdsong was interrupted every few seconds by the boom of artillery. Broken glass and debris covered the floor. An unused table-tennis table stood in one corner, near a large hole that had been torn in the concrete wall by an incoming shell. The medics sat nearby around a makeshift table, drinking coffee.