I know, because it happened to me. In January 2000, while I was traveling through Laos on a Southeast Asia photo assignment, the bus I was riding in was sheared in half by a logging truck. My seat was at the point of impact. The force of the crash instantly broke my back, pelvis, coccyx, and ribs; my left arm plunged through a window, shredding it to the bone; my spleen was sliced in half; my diaphragm and lungs were punctured; my heart, stomach, and intestines tore loose and lodged in—yes, it's possible—my shoulder. I would have bled to death if it hadn't been for passersby, including a British aid worker, Alan, who drove me seven hours, bouncing and jarring over potholed roads, to a hospital in Thailand. Three weeks later came the return home to Kaiser Permanente Medical Center, in San Francisco, and a rehab battle that doctors told me was hopeless. “You'll never walk properly again,” they said.

Their negativity seemed outlandish. I had already survived, hadn't I? I'd kept myself alive and conscious for 14 hours without medical help, following my meditation practice by focusing on my breath, believing each one to be my last. I'd been taken from the crash site to a “health clinic” that turned out to be a filthy, dirt-floored shed where there were no doctors. I'd handled the most excruciating agony I'd ever experienced, when a T-shirt-clad Laotian kid, who looked no older than a teenager, poured alcohol on my mangled arm and stitched it to stop the bleeding—with no painkillers. Several times I'd closed my eyes and prepared to die, yet somehow it didn't happen. How could anyone tell me I was doomed?

“You're going to have to face reality,” the doctors said.

Obviously, they didn't know me.

AS A DOCUMENTARY photographer and adventure traveler for more than 20 years, I had often been forced to test my limits. Years ago, I covered a brutal revolution in Nepal, when the army opened fire on demonstrators. Dozens of people were shot and killed, and tear gas was flying. I threw my shirt over my face and raced into the crowd. “If you're not living on the edge, you're taking up too much room,” I used to laugh to my friends. Now I had to live up to my words. There was no harsher edge than lying eviscerated on the roadside in Laos.

At Aek Udon Hospital, in Udon Thani, Thailand, I underwent numerous surgeries to repair my heart, lungs, and internal organs. My surgeon, Dr. Bunsom Santithamanoth, resutured my arm with more than 100 stitches, trying his best to clean out the innumerable shards of glass and bits of debris that the Laotian kid had left in.

Finally, I was medevacked to Kaiser, and my chart was translated from Thai.

“You realize you should be dead,” my doctor there told me.

“Yeah, I've heard.”

“No, I'm serious,” he scolded. “You have to be aware of the extent of your injuries—the sutures inside, the scars outside, the broken bones to heal.”

I could go home to my apartment, he went on, but I'd have to find someone to drive me to the hospital almost daily for doctors' appointments. “You will have to rely completely on friends for at least the next three months and do absolutely nothing but convalesce.”

That's how my new life was. For the first 12 weeks I lay in bed at home in a morphine-induced haze as my bones slowly knitted. I was so doped up I thought I had brain damage, and no matter how I lay, it was impossible to get comfortable—there was no reprieve. Within a month I was able to hobble around with a cane or crutches, but I still had a limp. The scarring on my left arm was so severe that I had to wear an elastic burn sleeve for more than a year to help repair it. For months the nerve damage from my spinal injury made my skin prickle as if I had an extreme sunburn, and I could barely tolerate even the feel of bedsheets against my body; at other times, I had no feeling in my arms at all.

Every few months, Jann Johnson, my plastic surgeon, removed debris from what she called the “garbage dump” in my arm. Scars were removed, the skin was resutured, and then the healing process began all over again. Occasionally, bits of glass would work their way out on their own, and I would tape them into my journal. On bad days the pieces would get stuck in my skin and I'd end up in the hospital with blood poisoning.

I had traveled the world through my every ocean, journeyed 2,000 miles down the Amazon in a decrepit fishing boat to photograph shamans, and produced two books, including one on Tibet and the Dalai Lama. But now I was forced to completely depend on others. I despised being weak and needy.

The day I scrubbed the blood off my camera bag was the first time I really cried. It had been three months since the accident, and life seemed intolerable. Insomnia was killing me. When I did sleep, I was tortured by violent dreams filled with lacerated bodies, screeching metal, and, for some reason, drownings. Finally, I decided that though my body might not be functioning, I could at least clear my fogged mind. I ceremoniously flushed my painkillers down the toilet.

Over the next few weeks, I bought every book I could find on alternative healing and studied medical texts in between. I found supportive doctors and incorporated acupuncture, meditation, homeopathic medicine, hypnosis, yoga, Pilates, and massage into my rehabilitation. I tried magnets for my back pain, and even cupping, an ancient Chinese practice used to stimulate blood circulation.

But whenever I made some progress, I'd have another operation—I underwent 20 in all—and be laid up for weeks. Every step forward felt like ten steps back, and that's probably what pushed me to make my rash pronouncement.

“You certainly won't be able to continue traveling and working as a photographer,” one of my specialists told me. “You need to accept that this is who you are now.”

“I'm not only going to travel again,” I replied. “I'm going to climb Mount Kilimanjaro for my 40th birthday!”

It was an idea blurted out in total defiance, but I immediately latched on to it. My birthday was a year away, so I figured I'd have time to prepare. Kilimanjaro isn't a technical climb, but—at 19,340 feet—it's about 1,000 feet higher than a climb I'd once made to Everest Base Camp, so it would set a personal record. It would also prove to myself and the world that my heart, lungs, and body were back in working order.

That is, if I made it.

“I'M SENDING YOU to a psychiatrist!” a doctor who'd been treating me announced when he heard about my grand plan. “You're in denial!” Kilimanjaro, after all, is the highest point in Africa—an ice-capped dormant volcano that sends about two-thirds of the people who attempt it back down with altitude sickness. Summiting requires a five- or six-day trek, and on the last day you ascend a breathtaking 4,000 feet.

But I wasn't in denial. Climbing Kili gave me the focus I needed, a new challenge to overcome. I felt euphoric. The taste of death became a touchstone, reminding me of what was important: my friends and family, and giving back to the world through my photography.

When I wasn't thinking about my own providence, other people were.

“I don't know if you were a spiritual person before, but I hope you are now,” said one of my lung specialists, as he peered at my X rays. “I have never seen anyone survive the extent of your injuries. From a medical standpoint, you should absolutely not be here.” The doctor looked me squarely in the eye. “I want you to think about that every day for the rest of your life.”

His words haunted me. So did survivor guilt. Why did I make it out of that bus alive, when others didn't? At least two people had died in the collision, including one of the drivers. I had been en route to a meditation retreat in India when the accident occurred. I have no doubt that what I'd learned as a practicing Buddhist and meditator—how to focus on my breath—is what saved me. I'd also started to understand that you never really live until you almost die.

“Tell me what I can do, not what I can't do,” I pleaded with Susan Hobbel, my new physical therapist at Kaiser, as I stumbled through her door on crutches, nearly seven months after the accident. “My goal is to climb Mount Kilimanjaro next year,” I added. I waited for her to refer me to a shrink.

“We'll get you back out there doing the things you love,” she told me instead, “but you have to be patient with the healing process.” I had finally found an ally.

I met with Susan at least twice a week, and during each session she worked me to the point of tears. She also crafted a regimen for me at a local gym—the same place where I'd once been an aerobics fanatic. In the past, I'd thrived on jogging, kayaking, hiking, skiing, scuba diving, and yoga. Now, lifting a two-pound weight was a challenge. But I refused to give up. When one doctor told me I'd never have abdominal muscles again, due to all the surgeries, I started doing as many sit-ups as I could. Over the next year, I worked up to more than 1,000 per day.

In the fall of 2001, I managed to jog three miles on the beach in San Francisco. I was so happy, I hugged a startled Vietnamese fisherman.

Next stop, Kilimanjaro.

IT WAS DECEMBER 2001—almost two years after the accident and a week before my 40th birthday—when I traveled to Arusha, Tanzania, and found a guide (whose name was also Arusha) to lead me up Kilimanjaro's Machame Route, through rainforests, over valleys and craggy plateaus, to Uhuru Peak, the mountain's highest point.

I was wired with anticipation. By this time, I'd gone six months without using a cane, and my legs felt strong and fit. We hiked for five hours the first day, taking a gentle path through a green cathedral of ferns, moss, and creepers.

On the second day, another relatively easy tramp to 12,000 feet, the campsite was filled with dozens of travelers. I wound up playing Hacky Sack that night with five climbers from Colorado who had read my first story in ºÚÁϳԹÏÍø, which detailed the Laos bus crash. News spread of my summit bid, and soon people were stopping me all the way up the mountain to high-five me.

But on day three, the cakewalk was over. The terrain changed to sparse black-rock moonscape. My head pounded from the altitude, my hips ached, and pain shot through my lower back. “I paid money for this?” I joked to Arusha. I knew the trek was only going to get tougher: The next two days were steep climbs into what would surely feel like the stratosphere.

On day four, all I could do was plod, one agonizing step at a time. We made camp at 15,180 feet; I could hardly tear myself away from the sight of the gorgeous snow-covered mountain glistening in the moonlight. But I also felt deep pangs of doubt. In a few hours, I'd find out the truth about myself. Did I really have the stamina to make it?

We began climbing at midnight, following the tangerine moon, in order to reach the top by sunrise. I was nauseated. My brain felt like it was cooking. The icy air pierced my lungs, and breathing hurt like hell. In desperation, I sucked glucose tablets, hoping they'd give me an energy boost. “Polepole,” Arusha encouraged me in Swahili. “Slowly, slowly.” I shot him a glance: What—did he think I was going to sprint? Up until now, I had carried all 30 pounds of my photo equipment, but the cold magnified the pain in my back and I started handing it over, lens by lens, for Arusha to carry.

The path became a wall of gravel, illuminated by my headlamp. I focused on my labored breath and thought back to my struggle to breathe in Laos, which reminded me of why I was doing this. I wasn't going to come this far and let the mountain beat me. Arusha motioned for me to stop and rest, but I shook my head. If I stopped now, I'd never start again.

And then, suddenly, Uhuru was in front of me. The sun began to rise, turning the glaciers a pink-and-blue hue just as I reached the summit. Wind and emotion made my eyes tear. Juha, a Finnish man I'd met on the trail, ran up and presented me with a hand-carved wooden cup as a trophy. “Congratulations!” he cried. “Happy birthday!”

I dialed my friend Lynn's number in San Francisco on my cell phone. “Hey, it's Ali,” I yelled to her. “I'm on top of Kilimanjaro!” Her Christmas party was in full swing, and my friends thousands of miles away toasted me with champagne as the snow whipped my face. I had been at the same party last year, leaning on crutches and vowing to everyone, “Next year, I'll be on top of the mountain.”

Fog swirled below, and I felt risen to the heavens. I stood on the precipice gulping air, awestruck. It was the dawning of a new day, a new decade for me—and, I realized, a new life.

THERE IS NO END to getting your life back—eventually, you have to come down the mountain. A few months after my climb, I realized that the physical healing had demanded so much energy, the emotional repair work had taken a backseat. My sleep was still plagued by nightmares. I often dreamed that I was with friends in Laos, and they all got on the bus. At the last minute I would become too paralyzed with fear to board, and I'd be left behind.

Exactly three years after the crash, on January 2, 2003, I was back in Thailand on a magazine assignment and got the chance to rewrite the past. I traveled north to the hospital in Udon Thani where I'd spent three weeks and waited patiently in the hallway. At first, Dr. Santithamanoth walked right past me. I stood to get his attention. When I told him who I was, his face lit up.

“You are so short,” he exclaimed at my five-foot-two stature. “I had no idea!” He had never seen me standing before. I tearfully hugged him and thanked him for saving my life. I showed him pictures of my nieces, and my latest photography book, Faces of Hope, documenting the lives of children around the world. I told him about the new books I was working on and about windsurfing in Hawaii, scuba diving in Micronesia, snorkeling with beluga whales in the Arctic, and, of course, the Kili climb—slices of my life that nearly never came to be. We said goodbye with difficulty, and then I tracked down a phone number in Laos for Alan, the British aid worker who had driven me all the way to Thailand.

“It's the anniversary of your rebirth day!” Alan greeted me when I called. We filled each other in on the events of our lives. Then he became somber. “My son was killed three months after your accident, on that very road—mowed down from behind by a drunk on a motorcycle,” he told me.

Why not me? I could only wonder again.

When I returned to the clinic where I was taken after the accident, I was shocked to see it was as awful as I remembered: a ramshackle shed in a cow pasture. Curious locals gathered around and, unable to communicate with them in any other way, I brought out photos of my zipper-stitched arm. A young man next to me suddenly broke into a grin, which I immediately recognized. “Oh, my God, you're the one who sewed up my arm!” I exclaimed. Much to his embarrassment, I embraced him. “Kap chai lai lai! Thank you so much for saving my life!” I said. His name was Chanthamougkhong Khamthat, he told me; he was a 25-year-old lab worker with no medical training.

Then it was time for the hardest journey, the one that fueled my nightmares. The bus to Luang Prabang stopped for me, but unlike in my dreams, I got on. Inside, it had the same rickety wooden interior as the bus that had wrecked, with plastic chairs lined down the middle. I rode it for hours, a curving death threat over endless precipices. And then suddenly—unbelievably—a huge bus whipped around a hairpin turn and hurtled straight for us. People screamed. Not again, I thought. The bus clipped us and was gone. In a second, fate can send a bus crashing into you—or not. There was no reason to feel fear anymore, I told myself; fear was just a thought.

When I disembarked in Luang Prabang, I visited a monastery and made food and monetary offerings to the monks, a symbol of thanks to all the gracious people who helped save my life. Maybe I'd come back to experience just this small precious moment in time. Maybe it was just that simple.

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