It was a battle. Looking back I don’t think we ever had a chance, but you don’t just give up on a young man in the prime of his life. We had to try. He was my patient.

He was a foreigner, on a gap year in Africa where he was going to learn all sorts of things about conservation and African wildlife. Up until the accident, all had apparently gone well. The group of teenagers on the course had so far enjoyed every moment of their time together and some close friendships had even begun to develop. As it always is with these sorts of things, when they all climbed into the bus that day, no one expected what rippling ramifications there would be.

From what was later told to me, it sounded like the accident happened in slow motion. The bus was driving along a fairly narrow mountain pass when, while negotiating one of the sharper turns, one of the back wheels went off the road into a ditch. As the bus drove on, the wheel was dragged along trying to remount the edge of the tar before a steep precipice that was looming up.

It was unsuccessful. When the side of the road dropped away beneath the wheel, the undercarriage of the bus smashed into the edge of the road and slowly started getting dragged down. Still the bus drove on. I suppose the driver either didn’t realize the dire nature of his dilemma or he felt he still had a chance of pulling the bus back up onto the safety of the road. Whatever his reasoning, it didn’t work.

Slowly the back of the bus slipped further and further off the road. Once the other back wheel also went off the edge, the bus teetered for a moment and then went crashing and rolling down towards the river below. In those moments between the realization of impending doom and the moment of the first impact of bodies colliding with the walls and roof and floor in a continuous spinning cycle, I often wonder what he thought. Was he aware of the gravity of the situation or, like most people that age, did he trust in the indestructibility of his body? Did he cease to look forward to the promise of a long and happy life and instead, look back to see if what had gone before would constitute a worthwhile existence? Was there an awareness that the sheer abandonment of youth was over forever? Or were his thoughts limited only to the constant tumbling of the bus and the melee of the bodies of his friend being thrown together and around?

For what had happened most of the people got off fairly lightly. Sure, as the noise of the tumbling bus settled together with the dust it would have been replaced with screaming and sounds of pain and despair, but there were surprisingly few serious injuries, except of course my patient. There will always be chaos after such an event. Somehow I think my patient didn’t make too much noise. It would have been painful to breathe let alone scream. I imagine him lying quietly in blood soaked gravel, almost hidden from view of the rest of the disaster trying to make sense of all the new sounds and smells and sensations, trying to come to terms with what had happened and that it had happened.

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