Sometimes a person is awakened from a dream by the very thing he is dreaming about. For some veterans I know, the deafening chop-chop of helicopter blades takes them back to Viet Nam. For us, the din of the blades and the intensity of lights so bright they bathe the island in daylight means someone is in trouble. No matter how many times it happens, the process is the same. It takes a minute or two to clear the head after the abrupt awakening, and acute consciousness quickly follows. A glance out the window reveals six vehicles parked in a circle marking a landing zone on Bayview Drive. The pulsing of the Gay Head Light, ordinarily a comfort, is suddenly ominous, accentuating the seriousness of the situation. An evacuation is under way, and at three in the morning it means someone is very sick. Standing at the window, the first question that comes to mind is “who?” followed by “do not disturb.” We can only wait and hope. At these moments there are no feuds and no ill will, there is only us and one of us is in trouble.

This time I had been an islander for almost 30 years but because we were now spending the school year on the Vineyard we had become summer people in the eyes of the core residents. It hit us hard; we were no longer on the inside of the story that keeps the community surviving these tests of will. In earlier times there would have been a knock at the door, a hasty muted conversation, quickly dressed and out the door we would gather to take on the situation together. Can do, no question. At one time it would have been our door first, but now we are just watching from the outside as visitors.

There have been quite a few evacuations over the years, not all by helicopter. If there is too much fog or wind, the chopper can’t fly; in that event the person is securely strapped to a gurney and tied to the engine box of a boat with six people holding on for a two-hour ride through the hell created by gale-force winds battling a horsing tide. One such trip began with 300-pound Ria McNiff being carried from her third floor bedroom, suffering the complications of late-stage MS, and transported to a waiting ambulance in New Bedford. We got a message back a few days later that she was going to be okay, thanking the island for treating her more gently and with more kindness than any of the rest of her experience.

We had to hang Manny Sarmento, who’d had a stroke, down over the railing head first strapped to a gurney and lower him to the first floor and out to a pickup and then the helicopter in the middle of the night, because the stairs were too steep and narrow to navigate. “It’s okay, it’s okay,” he said. He never came back. He’d known for awhile that something was wrong, but like a lot of the older people was afraid to say so for fear of being taken away. The irony was that if he had said something he might have come back. Manny and his wife Mary had been the lone, childless caretakers of Nashawena island for 40 years without ever seeing a doctor. Mary lived to be 101 on the mainland with extended family. The islanders were the last to know or refused to believe that she couldn’t take care of herself any more. She was gone before we knew she was leaving. Another island trait, no goodbyes, ever.

I once sat on the floor holding the hand of an eighty-year-old heart attack victim I’d never met and never saw again, listening to a life story while waiting two hours for a helicopter. “Thank you,” was all the note said.

And why does a child choose a stormy winter night to push a chair up to the bathroom sink to reach the medicine cabinet so she can consume a whole bottle of cherry-flavored Tylenol? I don’t know and it was my own my four-year-old daughter. It was the worst crossing of my life, not being able to see the height of the next wave in the dark and the fog or where it was coming from and navigating with only a compass and a depth sounder while fearing for her life. Old school, dangerous school. Won’t do that again.

People are always asking how we can live our lives without worrying about the fact that we have no medical resource other than a postmistress who thinks she was a nurse in 1956, and a Coast Guard helicopter over two hours away with limits. The answer is that we just don’t think about the what-if’s, because if we did we would drive ourselves crazy with worry and move off island, something we can’t allow as an option. We can only think about the what-is and do the best we can, believing that everything is going to work out as part of the same preordained story of survival that brought us to this place of refuge.

So here my wife and I stand now at the window; it’s three in the morning and we are watching from the outside that which was once part of our very heart and soul. That which set us apart from the rest of the world and probably now apart from the need that brought us here in the first place.

Will Monast and his wife Leslei live in West Tisbury. They washed ashore after spending 25 years on Cuttyhunk raising four children, but that’s another story.