From thousands of feet above the blue-green waters of Nantucket Sound, reality seems to wait below.

Inside the cabin of the 1977 single-engine plane, Mike is the tough-talking washashore, piloting his Skylane 182 from the Vineyard to Hyannis. Joe, the co-pilot, is an Islander through and through, with a war story for every patch of water below. And for the moment, Bruce, who peers from the plane's window looking for his Lambert's Cove home, forgets about his battle with cancer.

The wind blows hard in bright sunny weather and the plane bucks repeatedly in gusty breezes. It's not a day for a joyride, but spirits remain high during the 11-minute trip to the airport and the drive beyond to Cape Cod Hospital where Bruce will begin a 10-day cycle of radiation treatment.

The passengers - meaning Bruce - clap when the plane's wheels touch the runway. "Oh, good, I can open my eyes now," Mike jokes. Joe cranes his neck to see if a five-inch stuffed aviator bear remains stuck to the rear window. His standards for a safe landing are simple: if the bear remains stuck to the glass, it's been a good flight.

After coming to a complete stop, Bruce Scott, cane in hand, works his way to the hospital shuttle, which waits for him at the gate. The pilots, Mike Shabazian and Joe Costa, saunter over to the private terminal to let airport officials know the Angel Flight has arrived.

This journey is more a mission of mercy than a field trip. It's the third such trip that Mike and Joe have made this week. And it is but one of 4,800 trips that a group of pilots throughout New England have flown at no cost to patients in need of some kind of medical treatment since Angel Flight began operations in the Northeast in 1996.

"It's a flight of fancy. Out there for half an hour, you keep your mind off the problem," Mike says.

Like 4,000 other pilots across the country, Mike sacrifices time, wear and tear on his plane and fuel costs for the Angel Flight missions.

"Every organization shares as they can," Mike says, rattling off airports that waive landing fees for Angel Flights and fuel providers who offer discounts to the volunteer pilots. "And the pilots pull the money out of their pockets to make this absolutely free for the patients."

Patients and their families must only demonstrate a need for treatment and a financial hardship that would otherwise prevent them from receiving critical care at distant medical facilities. Angel Flight patients suffer from a broad range of illnesses and injuries: from cancer to burns, from organ failures to severe handicaps. After a bit of paperwork and a doctor's certification, patients of all ages are allowed entry into the Angel Flight New England computer-based scheduling system.

Traveling back and forth from the Island to mainland facilities for treatment with medical specialists is difficult by ferry and long car trips, particularly when treatment is required daily or weekly. Ordinary travel becomes an obstacle and disrupts the normal, everyday lives of Vineyard patients.

"The remoteness - you live on the Island for that reason - but when it comes to something like this, that's when it gets tough," Bruce says during the flight to the Cape. Bruce will be back within two hours today. That's four hours less than a round-trip ferry ride and car trip to the hospital.

"We help them get back part of their life. Getting back and forth is so difficult - both physically and emotionally," says Mike, who has been an Angel Flight pilot since 1998.

While Angel Flight - a program now spread across the United States - has been offering free service to patients in the Northeast for six years, only in January did the Island get its own Vineyard-based crew. Mike, who lived in New Hampshire when he joined the volunteer team, used to fly into the Vineyard and transport the lone Island patient relying on Angel Flight for transportation to an off-Island hospital. When Mike finally convinced his wife, Elaine, to spend a weekend on the Vineyard, the two agreed to set up permanent camp. Last July, Elaine moved the family and a team of Friesian horses to a farm off Barnes Road in Oak Bluffs. Mike, who hasn't completely retired from his career in business, mainly fills his days behind the controls of his plane or crafting grandfather clocks in his woodworking shop.

The former military flight instructor wasted no time finding his "people" on the Island.

"You're a pilot first - not from the Vineyard, not from New York. You are a pilot," Mike says emphatically.

That's when Joe Costa, who swapped mechanical expertise for flying lessons at Trade Winds Airport 50 years ago, signed on to the Angel Flight mission. Joe brought both the wit to counter Mike's one-liners and several more Island patients in need of rides to the mainland.

"Joe's got a big mouth and, of course, he knows everyone," Mike says playfully. Since January, the number of Vineyard patients relying on Angel Flight has jumped from one to nine.

"Of course, you become some sort of missionary," Joe admits.

Jen Sayre and Kevin Hearn - both waging battles against cancer - quickly became part of the Vineyard-based "crew" when Joe told them about Angel Flight.

"I was absolutely exhausted. The treatment knocked the crap out of me. My work here is a 6 a.m. to 7 p.m. deal," remembers Kevin, who owns and manages Heather Gardens with his wife in West Tisbury.

Kevin, who recently finished six weeks of radiation treatment, leans over his calendar and counts the blue and black ink marks spread across the month of March.

"Only five times out of the 32 did I have to take the boat," Kevin says, looking up from the calendar. Poor weather prevented pilots from safe landings on the Vineyard.

"Beth from Connecticut had the Cherokee, Keith the Comanche," Kevin continues, rattling off the list of pilots and planes that delivered him and Jen to Hyannis for treatment.

And Kevin recalls a story for nearly every trip, from the day that "Beth from Connecticut" made first-class goodie bags for them to the hospital receptionist who complimented them on their good spirits.

"They make you feel like kings and queens. The pilots don't ask what's going on with you; they just make you feel so special," Jen says.

Undoubtedly, Kevin's best story involves getting another Vineyarder hooked up with Angel Flight.

"We were in the waiting room in Hyannis when they announced that the [radiation] machine went down. I grumbled that I had a plane to catch, and this guy beside me, who must have thought I was some rich little guy, says, ‘Yeah, well, my horse and buggy are outside,' " Kevin remembers, laughing.

Kevin missed his flight that day and crossed paths with the "horseman" on the ferry ride home. That same week, Wally Crossland joined the Vineyard-based crew.

"I could never afford to fly. It would have been $200 a week [with a commercial airline], even with a discount," Wally says.

As the three sit around Kevin's kitchen table swapping progress reports and hearing about Wally's upcoming surgery, the conversation drifts to the competition Mike set up for his crew.

Through Mike's Vineyard Flyer Award Program, the patients earn points for frequent trips and supportive comments to pilots. Tardiness and harassing the pilots are cause for demerits.

Wally attributes his clear win to sympathizing with bad landings. "I didn't criticize. And the chocolate cigar. Mike loves chocolate," Wally says.

The first-place finish earned Wally and a guest a free round-trip ride anywhere in New England - compliments of Mike and his Skylane.

Kevin finished in the negative and actually owes the crew a free lunch.

"I was busting him on his mag checks," Kevin says, shaking his head. "I'm going to keep this forever," he says, eyes fixed on the tally sheet.

As fond as the pilots and patients become of one another, they realize that painful illness is what binds them together.

As Bruce climbs out of the plane's backseat once they've returned to the Vineyard, he shakes Mike's hand, thanking him for the ride.

Mike answers: "We'll be rejoicing the last day we take you over."