I grab the laryngoscope. I click the light on.
"Open wide, buddy," I mutter.
I pry the driver’s jaw open. It’s a mess of blood and broken teeth. I can't see the vocal cords.
"I can't visualize," I say, sweat freezing on my forehead. "It’s a difficult airway. Grade 4 view."
"Don't force it,"Max says."If you stimulate the gag reflex, he’ll vomit. He’ll aspirate."
"I’m doing a digital intubation," I decide. "I’m going in by feel."
"Jax, that is ancient medicine."
"I’m an ancient kind of guy."
I stick my fingers into the man’s throat. I feel the epiglottis. I feel the opening of the trachea. I guide the tube over myfingers.
" advancing the tube," I narrate. "Through the cords... now."
I push. The tube slides in. I inflate the cuff. I attach the bag-valve mask and squeeze.
The chest rises.
"I’m in," I say, leaning back against the shattered windshield. "Good color return. He’s stable."
Suddenly, the bus lurches.
It’s not a small shift this time. It’s a drop. The front end—where I am—slides three feet down the slope.
"Jax!"Max screams over the radio.
"I’m okay!" I yell, bracing my legs against the dashboard. "Miller! Get a rope down here! We need to haul the driver out!"
"We can't!" Miller yells from outside. "The wind is pushing it over! Doc, you have to get out! Now!"
I look at the driver. He’s unconscious, breathing through the tube I just placed. If I leave him, he falls with the bus.
I grab my knife. I slash the driver’s seatbelt.
He drops. I catch him. He’s heavy, dead weight.
"I’ve got him!" I yell. "Pull us up!"
I drag the driver toward the window. The floor is tilting steeper. It’s sixty degrees now. The metal is screaming.
I shove the driver toward Miller’s outstretched hands.
"Take him!"
Miller grabs the driver’s belt. They haul him out the window.
I scramble to follow.
My hand touches the window frame.
And then the world falls away.
The bus groans, a deep, structural failure. The ground beneath us gives way.
