Post-socialist societies are full of uncertainty, fragmentation, and competing discourses on social justice [Steinberg and Wanner 2008; Zigon 2011]. This article focuses on how Ukrainian physicians envision the future, present, and past of the health-care system and make sense of social change in their professional lives and society more broadly. The Ukrainian healthcare system has remained largely untouched by post-socialist reforms, but it is nevertheless undergoing profound changes. These changes are occurring on the level of everyday practice and are shifting responsibility away from the state and onto the individual. The author traces how physicians navigate the persisting structures of the old system, and what hopes they carry for the present and the future. Post-socialist health care is bursting with competing interests, commitments, and notions of how health-care providers should relate to each other, their patients, administrations, and the state in general. This article therefore draws on physicians’ narratives of the disorder in health care through the interpretive prism of ‘ruination … as a process that weighs on the future and shapes the present’ and that represents a ‘vital reconfi guration’ [Stoler 2008: 194] or crafting of ‘hope’ [Lindquist 2006].