Denis Johnson's short story "Car Crash While Hitchhiking" is a narrator's first-person account of a car accident, replete with vivid imagery and figurative language. The story describes the narrator's unique view of the landscapes and emotions surrounding crash and the aftermath. As the story spans only a few pages, characters are merely outlined, and the reader is left to fill in much of the backstory.

The narrator describes three people: a salesman, a bourbon-filled Cherokee, and a college student who was driving a car filled with marijuana. These are the diverse individuals who have given the narrator rides up to this point. The car involved in the wreck belongs to a family from Marshalltown, and the other was driven by a man driving west from Bethany, Missouri.

The narrator is clearly nomadic and eccentric, but there are indications that he can see the future (even if these vision are, in fact, drug-induced hallucinations). The narrator claims that he know that an Oldsmobile would pick him up and that, when he heard their sweet voices, he knew there would be an accident.

After admitting this foreknowledge, the narrator flashes back to his afternoon spent in the luxury car of the salesman mentioned before. While driving him to Kansas City, the man explains that he loves a girl who runs a furniture store, but that he also loves his wife and children.

The college student next picks up the narrator and lets him off at the outskirts of the city. The narrator lies in the grass by the exit ramp during the rain. The narrator then is picked up by the predicted Oldsmobile and falls asleep in the car, before waking up to the crash. The driver remains alive long enough to tell the narrator that there has been an accident, and the narrator exits the car with the nine-month-old baby in the back seat. He sees that the other driver seems to be still sleeping, though he is covered in blood. The narrator approaches a truck driver who comes by the scene at about three o'clock in the morning, but the driver refuses to take the baby.

Soon, ambulances and police cars drive, and the narrator, too, is taken to the hospital because he was a passenger. The narrator refuses the offer to get x-rays and admits that he takes a certain pride in lying to doctors. The narrator hears the woman from his vehicle scream when she is told that her husband is dead.

The narrator uses the setting of the hospital to flash forward to another hospital in Seattle, Washington where he entered a detox program. Here, he imagines a beautiful nurse injecting him with vitamins amid a landscape with giant ferns and a river.

The last line rather suddenly addresses the reader: "And you, ridiculous people, you expect me to help you." There is little to cement a meaning within these lines. The people could be the readers, who ought not to expect that the drug-addicted narrator use his clairvoyance for good. The addressees could also be the hospital staff. The meaning of these lines, like much of the backstory to the short piece of fiction, is left open to interpretation.