It is 2:37 am in Crescent City, a city of 8,000 souls on the Redwood Coast of northern California. A fast moving cold front driven by a strong Pacific low-pressure area off the coast of Oregon is causing the usual heavy rains and strong gusting winds one expects here near the ocean. The familiar beeping of my pager snaps me awake. Somewhere out there, in the stormy darkness, a man is having a massive heart attack and needs to be flown to the heart center in Medford, Oregon for surgery. The man's condition is critical and his need is immediate. He will not survive a two and a half hour ground ambulance ride through the rugged coastal mountain range. The man is now our patient and I can have him on the ground in Medford in 25 minutes.

I contact the flight coordinator, and receive all pertinent patient information. I obtain a weather briefing and file a flight plan. It's nasty up there, with winds exceeding 40 knots at the surface, and known ice above 2,000 feet. It is snowing in Medford with reduced visibilities in fog. At times like this, I am grateful for my hundreds of hours of training and thousands of hours of experience. In the back of my mind is the knowledge that this man will suffer irreparable heart damage if not transported quickly; however, safety is never compromised. I will not be doing the patient any good if we don't arrive at our destination.

I meet the ground crew in the hangar and prep for the flight. The Cessna 421C is fully equipped for flight in known icing and its pressurization allows me to assist the patient by keeping a sea level pressure in the cabin during our ballistic-arc flight to Medford. I am flight-ready in 15 minutes. The ambulance arrives with the patient who is already under the care of my medical flight crew - two critical care ICU flight nurses. The patient is quickly loaded onto the aircraft while still inside the hangar and then we are tugged onto the ramp. My medical flight crew is fully trained to FAA standards and work with me in the operation of aircraft doors, hatches and emergency equipment. After four years and over 575 missions together, the challenge and response between the nurses and I for engine start and their readiness for taxi proceeds with the finesse of a ballet.

Engine start, taxi, and run-ups are completed. I obtain departure clearance and we launch into the storm. I lose ground contact climbing through 700 feet and all is pitch black outside. As forecast, I start picking up light rime ice climbing through 2,500 feet all the way up to cruise at 9,000 feet. The rest of the flight is a trade-off between GOOD and BAD.

The ice is now moderate mixed and I am constantly cycling the boots to stay ahead of it . . . BAD. I have a stiff tailwind, and am doing 265 knots over the ground . . . GOOD. I am in cruise for only six minutes before it is time to start down . . . GOOD. It has stopped snowing in Medford and there is less than an inch of snow on the runway . . . VERY GOOD. Medford is now reporting a 100-foot overcast with 1/2 mile visibility in freezing fog . . . VERY BAD!

I must have had the heat set too high in the aircraft as I found myself damp with sweat on touchdown. The patient has thanked me for the 'great flight' as he was loaded into the waiting ambulance. I return his thanks with a very professional 'Thanks, just routine sir.'

Oddly enough, the flight was routine. Storms, wind, fog, forest fires, and wildlife on the runway are but a few of the challenges in the coastal area. It is not unusual to fly off of a 2,800 foot mountain strip in the morning and find myself on the ramp at San Francisco International in the afternoon. When asked why I fly twins in such a challenging area of the country, I can only answer that I get a certain satisfaction out of the challenge and helping people in need. There is no doubt that I could be making more money driving around in the biz-jet but I am not excited by that type of flying. I began flying in 1976 in the aviation program at Tempe High School in Tempe, Arizona. My first flight instructor instilled in me a desire to make my flying count for something, and I always strive to fulfill that vision.

All such thoughts now must be set aside and my concentration returns to the mission at hand. My medical flight crew is arriving back at the aircraft. The nurses report that the patient is in surgery and doing well. It is now time to get ready for the return trip and once again launch into the black sky.

Steve Clary is a senior pilot with Cal-Ore Life Flight, based in Crescent City, California. Cal-Ore Life Flight is an award winning leader in medical transportation, providing prompt, caring and dependable ground and air transportation for people in medical emergencies. Cal-Ore Life Flight airlifts more patients from the Del Norte, California and Curry, Oregon counties than all other services combined. Cal-Ore's aircraft transport patients to destinations throughout California, Oregon and Washington and other states as authorized by the sending physician.