It was the slightest of twinges, a brief pain in his back.
It was enough to alarm Dr. Kashyap Patel of Rock Hill. To be safe, he visited a friend who was a cardiologist. He examined Patel and told him not to worry. But on the road to Charlotte, a voice told Patel to return to Piedmont Medical Center.
He immediately turned the car around.
After arriving at Piedmont Medical Center, his colleagues took him to the heart catheterization lab to run tests, expecting not to find anything. But Patel had suffered a mild heart attack, there were blockages and immediate treatment was required.
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"God," Patel says in retrospect four years later.
But at the time, Patel's spirituality was an eclectic mix of religions and experiences. His beliefs were shaped by the Hindu, Buddhist, Muslim and Christian faiths and the teaching of Mohandas Gandhi.
The heart attack, and other crises in his family, made Patel ponder the frailty of life and mortality. How do people survive, Patel asked. His thoughts immediately turned to a former patient, Anne Sanford.
Sanford, who was active in several Rock Hill community organizations and at Westminster Presbyterian Church, had been referred to Patel, an oncologist, complaining of aches, pains, a low-grade fever and red spots along her legs. The symptoms were the usual signs of a flu, but could also be clues to something worse.
When Patel examined her blood, he found "large, immature and angry-looking cells." Sanford not only had leukemia, but a very aggressive form of the disease, called ALM, or acute myeloid leukemia.
He paused before telling her, not knowing how she would react.
After hearing the news, Sanford began praying.
"Oh Lord, I thank you today for giving me this opportunity to serve you through my own suffering. I am thankful to you, Lord, once again for choosing me over someone who may not have as strong a faith and family as I do. I am truly indebted to you, my Lord, and from now on, I will be at your service always."
"I was transfixed," Patel said of that moment in 2005. "I was shocked at the power of her faith, her saving strength. It was an a-ha moment for me. I didn't understand the power of faith."
It was the beginning of a journey that Patel tells in his book, "From Raindrops to an Ocean."
The story, told through Sanford's journals, conversations with her family and Patel's perspective, is not a solo journey. It is as much Patel's journey as it is Sanford's.
"She cared deeply for Kashyap," said the Rev. Shelton Sanford, Anne's husband. "She prayed for him, prayed for him to know Christ. It was her desire that he really come to embrace Christ as the Lord."
It was not quite the love story that Patel tells in the book. The author took a few literary liberties, said Shelton Sanford. But the love between Anne Burns and Shelton Sanford that blossomed in their hometown of Macon, Ga., endured for 37 years of marriage.
Early on, Shelton Sanford said, his wife "clearly heard the Gospel and embraced Christ. She was a servant, she served people."
Her children never knew their mother without faith.
"If we passed an ambulance, she would pray for the person in it," said Connie McIntyre, one of the Sanfords' three children. "If we had a crisis, came to her tearful and upset, her first reaction was prayer."
Her friends saw it too. She volunteered at Piedmont Medical Center. She was a Come-See-Me festival team leader, served as treasurer of the Catawba Chapter of the Daughters of the American Revolution and was a member of the Amelia Pride Book Club. She was involved in numerous Bible studies and other activities at Westminster Presbyterian Church, where Shelton has served for decades.
"This was her life, there was never any difference," McIntyre said.
After the leukemia diagnosis, the Sanfords separately prayed and then consulted each other. Shelton told her he had claimed Isaiah chapter 43, verses one through 10.
Anne, replied, "so have I, which is your favorite verse?"
Shelton said verse two: "When you pass through the waters, I will be with you; and when you pass through the rivers, they will not sweep over you. When you walk through the fire, you will not be burned; the flames will not set you ablaze."
He knew that battling leukemia would be "the biggest challenge of our lives. I asked God to be with us through the water and the fire. You've got to take us through."
Anne claimed verse 10: "You are my witness, declared the Lord, and my servant whom you have chosen."
Shelton Sanford said there were family times of denial, of holding out for hope. "An experience like this drives you to your knees," he said. "You say, 'Lord, this is out of control. I give it all up to you.'"
But Anne was steadfast. "She never questioned God, the depth of her belief in Jesus Christ was so clear," he said.
"Anne was God's pure creation," Patel said. "She was a spotless expression of dignity in human form."
Shelton Sanford, however, is quick to point out that "Anne knew she had failed God. She knew of the sins of her life. Christ paid the price for that."
As she had done for years, she turned to her journals to record her inner-most thoughts. Patel uses many of the journal passages in the book.
"They were very personal," Shelton Sanford said. "She wrote to God as a friend. He was her father. He loved her."
Her entry of March 3, 2005 - three weeks after the diagnosis - is typical of her thoughts and prayers.
"This is going to be a harder disease to beat than I had thought," she wrote. "I know that with your help, I can get over it and again do the things I enjoy doing. I want to be able to give spoken testimony of your love and grace in my life so that others might come to know your joy, peace, patience, gentleness, love, kindness, self-control, goodness and faithfulness."
Chemotherapy beat the leukemia cells into remission. But the cells - which Patel describes as immortal - mutated and returned, immune from the poisons used to kill them. On March 3, 2006, in the bedroom of her Rock Hill home filled with family, Anne Sanford died. It was the beginning of a journey, not the end.
"I felt a total peace in the room," Connie McIntyre said. "I knew clearly that she saw the Lord."
Words and actions
Years later Patel, struggling with his own health, the nervous breakdown of his son, Masharshi, and the death of his mother-in-law, remembered Anne Stanford's struggles and spiritual strength.
He directed his thoughts into words, not the easiest of tasks considering English is his second language. The result was the book - and his own spiritual growth.
The experience led Patel to adopt a more holistic approach to medicine. Faith and prayers are an important part of his practice. Before he talks with a patient, he closes his eyes, prays "and lets divinity take over. That connection has not failed me"
His demeanor has also changed.
"I'm a lot quieter now," he said. "I listen for faith absolutely. I pray with them."
To facilitate prayer, a non-denominational chapel was built in the front of his practice, the Carolina Blood and Cancer Care Associates office off Constitution Boulevard in Rock Hill.
He has become more aware that death is not an end, but a beginning.
Many doctors, he said, see death as a failure and have a difficult time talking with patients, he said.
"Anne helped me with that. Medicine needs faith," Patel said.
Patel has put more emphasis on helping families understand death.
"The biggest fear in a patient's eyes is what will happen to me when I die," Patel said. "How will the family know I'm dying. I'm there to put things at ease. Death is a healing process."
He is working on a book about dying with peace and dignity. The book is about 12 different families who he has treated.
During Anne Sanford's fight against leukemia, her goal was, "if one person can be led to the Lord than this is worth it," said Connie McIntrye, her daughter.
In the five years since her mother's death, McIntrye said she has grown closer to the Lord. Her father said he has also grown spiritually. "It was the comfort, control that God gives you," he said. "My heart aches and God comforts me."
He said the experience has given him a deeper understanding of how families are affected and he tries to put that understanding into his sermons.
Patel and his wife visited Israel last year, going to the Church of Holy Sepulchre, the reputed site of Jesus' crucifixion and burial, and the Cenacle or Upper Room on Mount Zion where Jesus held the Last Supper and returned there after his resurrection. Patel said it was important he see these sites.
As for his future, Patel said, "I'm leaving it in God's hands to take me where he wants me to go."