On June 12, 2025, Air India flight crashed minutes after takeoff from Ahmedabad in India. Among the many 242 folks on board, just one survived: a person seated in 11A.
That picture has stayed with me—not simply due to the miraculous survival, however due to what it reveals about programs. Seat 11A was positioned close to the airplane’s wing field, the structurally strongest a part of the plane, and beside an emergency exit. Specialists say this uncommon mixture gave him an opportunity. Everybody else perished.
In that story, I noticed not simply an aviation tragedy, however a brutal metaphor for the well being care system I dwell and work in every single day.
As a result of typically, it appears like drugs can also be mid-crash—and we’re all nonetheless inside.
We belief complicated programs to hold folks from hazard to security. Whether or not it’s an airplane or a hospital, we depend on construction, design, and coordination. However when these programs falter, when one half fails or stress overwhelms capability, the crash isn’t simply potential—it’s inevitable.
In drugs, system crashes don’t make headlines. They occur quietly, in examination rooms, in emergency departments, in insurance coverage denials, in missed diagnoses. They occur when a affected person’s ache is dismissed, when care is delayed as a result of somebody lives too far or earns too little, or when a supplier is simply too burned out to pay attention carefully sufficient.
And like within the flight, just a few get out.
Seat 11A has change into a haunting image for me. It represents the one that survives not simply due to resilience or willpower, however as a result of they occurred to be seated close to the exit, within the structurally strongest place. In well being care, who will get that seat? It’s typically the affected person with one of the best insurance coverage, the one who lives close to an educational medical middle, or the one who is aware of find out how to navigate the system. It’s not luck—but it surely’s not equity both.
Others, simply as worthy, sit within the metaphorical again of the airplane. They’re those who don’t get seen till it’s too late. Those with limitations that by no means present up on the chart. And much too typically, they don’t survive—not as a result of we failed as particular person suppliers, however as a result of the system failed them lengthy earlier than we ever met them.
Even we as clinicians are passengers on this plane. We think about ourselves as pilots, in management, however more often than not, we’re simply strapped into the identical construction, making an attempt to maintain others secure whereas turbulence shakes us from the within. We’re educated to soak up struggling, to perform with out relaxation, to care by way of exhaustion. However the reality is: A few of us are barely holding on. And nonetheless, we inform others it’s going to be OK.
I’ve written earlier than about private loss {and professional} burnout—in regards to the weight of witnessing ache that by no means ends and about moments of which means that hardly maintain us collectively. The flight introduced these recollections again. As a result of it made me surprise: Why are we nonetheless counting on miracles? Why ought to survival—whether or not from illness or despair—rely upon being in the proper seat?
We have to construct a special sort of airplane. One the place each seat is bolstered. One the place nobody has to depend on being close to the exit. One the place the system is designed not only for outcomes, however for fairness, for dignity, and for humanity.
The person in 11A survived. However the query that drugs should ask itself is that this: Why didn’t everybody?
And what’s going to it take to verify subsequent time, they do?
Vivek Podder is a doctor in Bangladesh.
