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There are two things that terrify me: airplanes and hospitals. I have been known to require pharmaceutical intervention to get me near a boarding gate, and I haven’t set foot in a hospital ER since giving birth to my son at Kapiolani 44 years ago.

So when the chest pains became overwhelming on Oct. 23, radiating from the center of my chest out both arms down to the elbows and up into my jaw, I knew I was about to face both my fears in short order.

Living on Lanai has its advantages, but living on an island without medical specialists is not one of them. We used to joke back in the ’70s that you can’t be born on Lanai and you can’t die here.

Fast forward almost 50 years and things haven’t changed all that much. We have two clinics with (super) all-purpose docs, but even a routine CAT scan or mammogram requires complicated travel arrangements and complex appointments off island.

For over two hours I tried to walk (will?) the pain away, but at about 11 a.m. I finally gave up: “I think you better take me to the ER,” I told my husband. I grabbed my ID, health insurance and vax cards, a jacket and shoes and 2 minutes later we were there.

Outside in the otherwise deserted parking lot was Patty, the only phlebotomist on the planet who can find problem veins in one try; I took that as a good sign. With her was a bear of a man in dark blue scrubs who took one look at me and asked, “Chest pains?” as he gently took my elbow and steered me inside.

The next hour was a blur as the ER nurse, Dennis Patrick Stewart (who we snagged a year ago from a much busier ER in Flagstaff, Arizona), calmly hooked me up to a heart monitor, ordered a chest X-ray, drew blood, attached an IV and gave me a squirt of nitro under the tongue for the pain. (He later told me in an interview that being calm “is fundamental to emergency care”).

Within minutes, he’d found an elevated level of troponin, an enzyme indicating something was wrong with my heart and told me I’d have to be flown out. Maui Memorial Medical Center was the choice, since it’s easier to find an accepting physician than on Oahu. By now it was noon, and a whole new series of events kicked in.

An ambulance with an EMT and medic was summoned to take me to the Lanai airport, , an air ambulance service, was called to meet me there, and a second AMR ambulance took me to MMMC from the airport in Kahului.

Meanwhile, since he would not be allowed to fly with me, my husband of 53 years (who would be a saint if he wasn’t Jewish) frantically lined up a car from a friend, closed down the house, got himself on the Expeditions ferry to Lahaina and found a hotel room near the hospital. I wouldn’t see him again until 8 p.m. that night.

The ER at MMMC was a whir of noise and machines, with people everywhere, both patients and medical personnel. Nonetheless, within an hour I’d been assessed by no less than four doctors; one of the ER docs kindly hauled in a laptop with a heart schematic and explained what might be happening. “My money is on your right side, which would be great! Easier access!” (Turns out he was spot on.) I was told I would probably have to have an early the next morning. I had only the vaguest idea what that was.

My good luck continued when I was handed over to RN Doreen Randall, who’s probably forgotten more about cardiology than most doctors will ever know in a lifetime. Funny and spirited and everywhere at once, Doreen was a rock: there wasn’t a question she couldn’t answer and no fear she couldn’t quell.

Forty-eight hours later, I walked out of MMMC with a , prescriptions for a gazillion pills I can’t pronounce, and a vastly improved appreciation for the level of cardiac care available both here on Lanai and at MMMC.

So what have I learned?

I learned that AMR, an arm of , responded to 20,000 calls to assist tourists and residents in Maui county between September 2021 and September 2022. It has two full-time employees on island 24/7, working 48 hour shifts under a contract with the state to provide services to all islands. During the same period, AMR answered 300 calls on Lanai alone, 80% of which involved transport from a residence to the ER or the ER to the airport.

I learned that Hawaii Life Flight, also an arm of GMR and (absolutely the first bill we pay each year), has been around for 14 years and safely flies an average of eight patients a month from Lanai to Oahu or Maui. Most are trauma or stroke victims.

While I’m sure they were closely monitoring my heart vitals, my crew understood the real problem would be addressing my fear of flying — and they did (“It’s going to be bumpy here” and “We do this ALL the time, we’re going to be fine!”).

I learned that my cardiologist , was enticed away from Tripler Army Medical Center with support from a federal program that supports new medical practices in underserved areas. She and her partner Ryan Smith have a unique arrangement with other cardiologists like , who performed my procedure, to cooperate in providing a full range of services to MMMC patients.

I learned that I ignored my family medical history to my peril: I paid no attention to the fact that my biological father, whom I never met, died at 53 of a massive heart attack, not his first. I learned that I should have thrown away those cigarettes way earlier and I should have noticed my cholesterol (the bad kind, LDL) creeping up. After all, heart disease is the .

I knew that Maui Memorial had been in the news leading up to Kaiser Permanente taking control of hospitals on Lanai and Maui back in 2017 – and again more recently — but I didn’t know the facility has for years for superb cardiac and stroke care, while struggling, as are hospitals everywhere, to retain staff.

Finally, I learned that there’s no going back, that foreign object, that stent, will be lodged in my artery forever. Bones will mend, even cancer can be treated and removed, but my family history and will never go away – I can only stabilize it and try to keep it from causing more damage.

I’m a little less terrified of flying now, and I’m not afraid of hospitals anymore — as long as the hospital is Maui Memorial.