I thought is was the beginning of another lazy Sunday duty, the only highlight of which would be installing the newer printer to the older computer in the panoramic x-ray room (which also serves as the resident's makeshift office/quarters), when we got the call:

A busload of mostly Iranian nationals headed towards Balamban had fallen off a ravine.



I braced myself for the busiest duty of my residency so far while the non-duty senior clerks, PGI's and residents were being called back to the hospital. The minor OR was opened for the patients to be accommodated. I also heard that they opened the hospital boardroom for the use of the Iranian ambassador.

The junior resident on duty with me chose to stay in general radiography, while I took on the task of generally giving preliminary readings at the CT-scan. (Our MRI is closed on Sundays, and the attending physicians decided to do CT's in the meantime because of the time element).

There were several fractures, a few suspected spine traumas, but no major brain injuries.

There was the toddler who was with a senior clerk the whole time as the mother had died, the father was still being transported and nobody could tell us the little girl's birthday (the techs decided to just estimate the age since they could not log the patient).

The surgical service thought a now unresponsive young woman had a brain injury, but with an unremarkable CT-scan of the brain as well as the visible abdomen, the diagnosis was changed to hyperventilation/hysteria vs. an electrolyte imbalance.

We heard the story of how one ophthalmology resident in another hospital had the presence of mind to remove himself from the vehicle and climb up the ravine by grabbing on to a few shrubs to finally reach the highway. He was the first patient airlifted and transported to the hospital.

We had to call the radiology resident on duty at another hospital to clarify findings on the CT-scan of a just-transferred patient (their institution and our institution now print on thermal paper which is insufficient for diagnostic purposes) as well as exchange news about the cases here and the badly injured radiology resident who was still at their institution.

The thing that struck me the most was that not a few of the people injured or dead and the relatives and friends around them were those I see from time to time in the hospital as they were also in the medical field.

Total death toll (as relayed by the surgical residents): 22 (mostly those seated at the front of the bus), including 1 who just finished residency in orthopedics at the local government hospital, 1 doing residency in nuclear medicine at our hospital, 1 doing residency in pathology at our hospital and 2 doing residency in radiology at our hospital and other sister institutions.

One of the radiology residents who died was rotating with me in the ultrasound section for this month.

As one of the orthopedic surgeons said, "It becomes an entirely different story when those involved in an accident, injured or dead are people you have work with or know." The week before, he had been assisted in the OR by one of the fatalities who had just finished his training in orthopedics at the government hospital. A few consultants were at the hospital looking for the whereabouts of their Iranian residents.

The department received the last patient for imaging at around 1am. By early morning though, we still had to endorse some clarifications regarding imaging for one patient to the incoming radiology resident on duty. There is a plan to transfer all of the injured patients to our institution and have them occupy a single wing of the hospital.

In the end, I never did get to install the newer printer to the older computer... I will have to do that during my next weekend duty.

Life does have unexpected twists. We just have to be ready for any eventualities that come our way, including the end of the road at the next turn.

* In memory of the deceased, and in solidarity with those injured or in mourning.