They came close.
Luckily, the deception remained intact. Piliarska and her staff outwitted the Russians and bided their time until the city was liberated.
And because of her efforts, at least five children at the Kherson Regional Children's Hospital were saved from being taken to Russia for adoption — through an apparently deliberate campaign by Moscow to seize Ukrainian children orphaned by the war it started.
CBC News has been on the ground covering Russia's invasion of Ukraine from the start. What do you want to know about their experience there? Send an email to ask@cbc.ca. Our reporters will be taking your questions as the one-year anniversary approaches.
The open adoption of Ukrainian children by Russian families is an emotionally explosive topic in Ukraine.
Piliarska and her staff falsified the children's medical records, giving them fake medical conditions that made it appear they were too ill to be moved from the neonatal ward, let alone hundreds of kilometers east to Russia.
"I was very afraid," Piliarska told CBC News through an interpreter at the bomb-scarred hospital, which has been hit three times recently by Russian shelling.
She said she can only assume the Russians wanted the babies to feed into their adoption system.
"When the Russians were here, they called me to give them the list of kids," she said.
"They said they wanted children who could be evacuated to Russia. I had just five kids like this, in this condition, and I wrote some [reports] that they cannot be transported because of the state of their well-being."
Piliarska's story first emerged last fall in the chaotic aftermath of Kherson's liberation. She sat down this week for an extended interview with CBC News, during which she provided fresh, startling details of a desperate, months-long struggle to keep the children out of the hands of Russian authorities.
Piliarska confirmed for the first time that four of the five children for whom she falsified records were not even orphans — they had parents with whom she spoke regularly.
For privacy reasons, Piliarska would not say whether the parents were in Kherson, living under the occupation. She did indicate some of them were serving in the Ukrainian military.
"We were protecting these kids," she said. "We had kids whose parents were fighting. They were saving us from Russia, and we were trying to save their kids from Russia."
Piliarska described how she and two other doctors arrayed medical equipment and monitor the children to trick Russian authorities into thinking they were sicker than they were. Every time soldiers and occupation administrators came around to check on the kids, she said, the doctors collectively held their breath.
"We had put the ventilators near every child's bed," said Piliarska, who has been practicing at the children's hospital for 22 years.
"If [on] occasion they had been checked by the doctors, they would have caught us and realized everything was a lie. But thanks to God, the inspectors weren't medical people."
What made the exercise even more precarious was the fact the administration of the hospital was pro-Russian, Piliarska said.
As Ukrainian forces battled their way into the city last November, the hospital administration fled with the evacuating Russians.
Dr. Olena Tishaninova, another physician who falsified medical records to protect the children, said it was a surreal time for everyone.
"We didn't understand what was going on at all," Tishaninova said. "We didn't know what would happen next, but we just couldn't do it another way.
"This is our home. Our kids."
The head of the regional Ukrainian military administration in Kherson said hundreds of children, mostly orphans, were taken from several shelters in the city.
"The orphanages are all empty," said Oleksandr Tolokonnikov. "There is an investigation going on about how it happened and why it happened."
He said the investigation by prosecutors is complicated and distinguishing people who openly collaborated with the Russians to deport children from those who "had a gun pointed to their head" has been difficult.
"We cannot judge people until we have all the facts," said Tolokonnikov.
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