On June 12, 2025, an Air India flight unfortunately succumbed to a crash shortly after its departure from Ahmedabad, India. Remarkably, among the 242 passengers aboard, only one individual emerged alive—a man located in seat 11A. This incident not only conveys a narrative of survival but also acts as a metaphorical commentary on the healthcare system.
Seat 11A was situated close to the wing box of the aircraft, recognized as the structurally strongest segment, and near an emergency exit—elements that experts suggest may have played a role in the man’s survival. This unique combination of circumstances provided him with a chance to live, while others faced a different fate.
As a doctor, I have begun to perceive this event as a striking metaphor for healthcare. The systems we depend on for our safety can falter, just as an aircraft may crash when external pressures exceed its structural capacity. In healthcare, these breakdowns manifest subtly within examination rooms, emergency departments, through insurance denials, or perilously missed diagnoses. Individuals endure pain in quiet crashes when their discomfort is disregarded, when socio-economic barriers obstruct access to care, or when healthcare providers are too mentally fatigued to deliver their customary level of care.
In both aviation and healthcare, survival chances are not evenly distributed. While the individual in seat 11A survived due to favorable circumstances, in healthcare, survival frequently depends on variables such as the caliber of insurance, closeness to advanced medical facilities, or knowledge of complicated systems. This is not simply a matter of chance, but rather a representation of embedded systemic inequities.
The metaphorical ‘back seats’ within our healthcare system are filled by those grappling with insurmountable obstacles, whose battles might never be visible on medical records, and who frequently fail to receive timely care. Their lack of survival stems less from personal shortcomings and more from systemic wrongs that hinder them even before they enter a healthcare provider’s office.
Healthcare practitioners often perceive themselves as the pilots of this system, yet in truth, they are fellow passengers, subjected to the same systemic flaws and pressures. Many extend their efforts beyond their limits, absorbing unending anguish, while still reassuring patients of eventual safety.
The survival of the passenger in 11A compels us to reconsider our dependence on such tenuous factors. The future of medicine should not hinge on being symbolically seated in the ‘right’ position. We must build a system where every ‘seat,’ every patient experience, is secure, with equity serving as the cornerstone rather than the exception.
Despite the existence of the solitary survivor, the overarching question remains: why did only he withstand? And what transformative modifications are essential to guarantee more equitable healthcare outcomes? As emphasized by Vivek Podder, a physician from Bangladesh, the urgency for change is unmistakable—we must rethink this framework for resilience, justice, and humanity for everyone, not just a privileged few.