Like many people, Dr Yussef has a ritual when he begins his working week. He parks his car, and leaves the keys with the parking attendant.
He then reminds the attendant of the phone number of the friend he must ring if he doesn’t come back. It would be a shame for his family if his car went uncollected.
Dr Yussef has more reasons to fear the worst than most. He is a doctor in Syria - more specifically rebel-held Syria, the most bombed patch of territory in the world, and one where hospitals and doctors’ clinics are not only not immune from the horror, but apparently are specifically targeted.
“I have lost five doctors from among my close friends, and three nurses, and two technicians,” he says. He enumerates how they died with a doctor’s habit of proper classification.
“Three doctors were killed by shooting. Two were killed by bombs from the regime. One of the technicians was killed by a Russian bomb, and one by a regime barrel bomb.
“Of the three nurses, one was killed by Russia and two by the regime.”
Dr Yussef and hundreds of doctors and other staff like him have seen not only their lives transformed in the last five years - like those of all Syrians - but also the way they work.
He was once an ordinary ear, nose and throat surgeon in a Syrian state-run hospital. Now he is a wanted man by both the regime - for treating people in rebel-held areas - and Islamic State of Iraq and the Levant, for refusing to join and work directly for them.
The latter threat came when when Isil had a heavy presence in one of the towns in Aleppo and Idlib province where the three hospitals he now oversees operate. Since then, Isil has been driven out of a swathe of northern Syria by non-Isil rebels, and into its heartland around the town of Raqqa.
The threat to his life, though, has only got worse. The regime of President Bashar al-Assad has always regarded the threat from non-Isil rebels, who control most of Aleppo and Idlib provinces, as more immediate than Isil. They have targeted these areas for punishment bombings, including using the ubiquitous barrel bomb - oil canisters stuffed with shrapnel and TNT.
Since Russia joined the war three months ago, the bombs have been bigger, better and more precisely targeted, the doctors say. That is not a good thing, either.
According to claims by the group Physicians for Human Rights, published by Amnesty International this week/last week (Subs: Dec 23) Russian air strikes hit 10 medical facilities in October alone.
Separately, Medecins Sans Frontieres recorded 12 hospitals hit during the month, including six facilities the group runs or supports.
Increasingly, clinics are being forced underground. One of Dr Yussef’s colleagues, Dr Samir, who works in a hospital in Idlib, now spends most of his life in basements - those where he works, and those where he lives with his wife and two young children.
Both young daughters were born after the start of the civil war, a sign perhaps of undimmed optimism.
“It’s extremely difficult, and extremely dangerous,” he said from Syria, speaking over Skype. “In truth, there’s absolutely no form of security, no security forces, no basic amenities. Somehow life is still carrying on though.”
Every day, he says, his clinic sees around 200 patients, civilians hit by the bombing and shelling, or fighters brought in from the front lines 20 miles away, while trying to keep space free for regular treatments and surgery.
The day before, his team had treated a three-year-old boy whose arm was fractured in one air raid, and a woman whose leg had been broken in another. That is a regular day.
Like all doctors in Syria, though, he has particular memories.
“The case I remember is from an aerial bombardment,” he says. “There was a family of 10, all of them IDPs [internal refugees], staying in a school.
“Two of the family had been killed. One came in with a massive abdominal injury, one had to have a leg amputated. It was total chaos - the whole family was in panic, screaming to work out where they all were, asking who was alive and who wasn’t.
“They were all traumatised - while at the same time, we ourselves were all afraid from the bombing.”
Some things have improved a little for Syrian hospitals in the last three years. In 2012, in rebel-held Aleppo, a doctor showed a team from The Telegraph round the pitifully empty medicine cupboard of the Dar al-Shifa Hospital. He thrust into our hands a scrap of paper with requests, shocking for its list of basics like anaesthetics and antibiotics, to pass on when we got out, “to anyone who can help”.
The hospital was destroyed in a regime air strike a few weeks later, but since then some of the major aid agencies have moved in to help, ferrying supplies in from the Turkish border.
Dr Yussef’s three hospitals are among six supported by Care International, one of The Telegraph’s chosen Christmas charities this year.
Even the supply routes are at risk now, with Russia choosing to target border crossings and roads precisely because they are rebel lifelines.
However, for the time being, staff like Drs Yussef and Samir - not their real names, for fear of further victimisation of them or their facilities - are able to continue operating on the scores of victims of war being brought in.
It is remarkable that they stay. Hundreds of their colleagues have tried to stick it out, but have eventually given into the possibility of escape, many taking the unknown path to Europe and hoped-for safety.
Dr Samir confesses his wife asks too whether they should be leaving. “Every day,” he says.
They have suffered their own tragedy. His wife, also a doctor, lost a baby she was carrying when a bomb struck just outside the hospital, a nightmarish event that stunned the staff even as it overwhelmed them with patients.
Dr Yussef has travelled abroad - to New York, to Geneva, addressing the United Nations to argue for commitments to spare health facilities from attack - but to no avail, and now says he is going to stay put.
He visits his own family, in exile in Turkey, every weekend. Then he takes what may be his last drive back in, leaving his car and keys with the attendant at the border crossing car park.
“I can’t expect anything now,” he says. “But I can tell you, and tell everyone, we have to stay in Syria. We have to face everything.”
This article originally appears on The Telegraph’s website: http://www.telegraph.co.uk/news/worldnews/middleeast/syria/12062735/Syrias-brave-doctors-keep-working-as-Russian-and-regime-bombs-fall.html