The bombings at night are the worst. There is no electricity in the rebel-held portion of eastern Aleppo, and the warplanes flying overhead target any light piercing the blackness beneath.
So families huddle together in the dark, gathered in one room so that they don't die alone, listening to the roar of the jets and waiting for the bombs to fall.
After they do, rescue workers venture out, navigating the rubble and craters left by earlier bombings, to dig out victims without headlights or lamps. They haul them to hospitals swamped with patients being treated on the floor by doctors who barely sleep, and must choose which lives to save and which to let go.
In the small hours, it was the turn of two hospitals, the biggest in eastern Aleppo, to be hit and put out of use for the victims of more bombings.
Such is the tenor of life in rebel-held Aleppo, which had become accustomed to regular airstrikes since rebels seized control of the eastern portion of the city - but nothing like the intensity of the past week.
At least 1700 bombs struck eastern Aleppo in the first week after the ceasefire's collapse, according to the White Helmets civil defence group, a volunteer force funded by the United States and Europe that helps people buried by buildings collapsed by bombs.
The challenge of staying alive has been heightened by the complete siege imposed by government troops earlier this month, shortly before the ceasefire was announced. Hundreds of thousands of people had already fled Aleppo to refugee camps further north, to Turkey and on boats to Europe. But 250,000 remain surrounded, many of them the poorest of the poor.
Food is scarce. Doctors have already detected signs of malnutrition in some children, said Caroline Anning of Save the Children, which estimates that 35 to 40 per cent of those trapped in Aleppo are children.