May 18, 2026: While the Russian Ministry of Defense has dependably documented Russian casualty removal and medical care catastrophes since the first weeks of the Ukraine War in 2022, it is apparent that the Russian military medical system has dissolved. Russian losses were regularly reported to be 37 percent dead and 63 percent wounded. Given the decrepit performance of Russian combat medical care, many of those wounded eventually died from lack of care. The Russians regularly abandoned wounded soldiers, leaving them to die alone. Russia used to send the bodies of dead soldiers back to their families for burial. But now all that is returned are the heads. It has reached the point where not even heads were returned, and the dead soldiers were simply reported as missing. This included those taken prisoner or, as is more frequently happening, deserting.

The Russian Ministry of Defense has been ignoring prisoner and desertion losses. Russia’s losses for 2024 were 430,000, which were larger than 2022 and 2023. Worse the dead to wounded ratio was 11 dead for every 15 wounded. The 2025 Kursk offensive when Ukrainian forces invaded Russia’s Kursk Province saw 38,000 Russian casualties with 40 percent killed. Overall, Russia has suffered over 800,000 casualties so far with 268,000 killed plus 53 thousand wounded who eventually died plus many missing or deserting for a total about 360,000 dead. That means that Russia lost nearly half, 45 percent, to death, missing or desertion. The desertions have been increasing, even though Russian officers have long been allowed to shoot dead soldiers who refused to advance or defend. A growing number of soldiers fired back and killed the officers who were trying to prevent desertion or forcing soldiers to advance. Western analysts have had a hard time accepting this reality, because American soldiers are regularly evacuated quickly, which won’t be possible when we eventually fight a drone-equipped enemy in ground combat.

All this is nothing new because two decades ago the fighting in Iraq and Afghanistan brought about a major change in how the American military dealt with combat casualties. The result was that over 90 percent of the troops wounded survived their wounds. That's the highest rate in history. There are several reasons for this. The main one is that medics, and the troops themselves, were trained to deliver more complex and effective first aid more quickly. Military doctors expressed the importance of the Platinum Ten Minutes, meaning that if you could keep the wounded soldier, especially the ones who are seriously wounded, alive for ten minutes, their chances of survival increased. Military medics were equipped and trained to perform procedures previously done only by physicians, while troops were trained to do some procedures previously handled only by medics. This skill upgrade was made possible by a number of factors.

First, over the previous decades, there has been continuous development in methods and equipment for emergency medicine similar to that received by ambulance crews and medical personnel in emergency rooms. This sort of thing was slowly migrating to the military, but since the fighting in Iraq, most of it has been adopted by military medical personnel.

Second, there's the high intelligence and skill levels of the volunteer military. High enlistment standards were largely unnoticed by most people, but within the military, it meant that combat troops, who are much brighter than at any time in the past, could handle more complex equipment and techniques. Getting the combat troops to learn these techniques was no problem, because for them, it could be a matter of life and death.

Third, medical teams capable of performing complex surgery were closer to combat. These teams, like the medics and troops, possessed powerful tools and techniques. This included items like telemedicine, where there was a video conference with more expert doctors back in America to help save a patient.

The Platinum Ten Minutes was part of a century old trend. During World War II, the Golden Hour standard of getting wounded troops to an operating table, was developed. Antibiotics were also developed at about the same time, along with the helicopter, whose first combat mission, in 1945 Burma, was to recover injured soldiers. Therefore, these new developments were not particularly exotic. Finally, the military medical community had a track record of success that the troops knew about. So, everyone realized that if they pitched in, chances of survival were good, and they still are.