I noticed an unkempt man on the train this morning. He stood out because I've started to be able to recognize all the regular riders. He was wearing a dirty sweatshirt with the hood up. He looked back at me with bloodshot eyes as I walked past him to my usual seat. He looked troubled. A few stops later, he staggered past me to exit the train, and I briefly wondered where he might be going.

I turned my attention back to the book I was studying, but as the train pulled away, I heard and felt a loud thump, kind of like the noise the wheels of a plane make when they're pulled back into the plane's body after takeoff. "New train noise," I thought.

I didn't think more of it, but a man in front of me pivoted in his seat to look and see what was going on. "Hey!", he said. I turned around and saw the man crumpled motionless on the floor of the train, about a foot behind my seat. He looked dead. He wasn't. He was clutching his skinny left arm and contorted in pain. He hadn't been drunk when he staggered by me before, he had been having a heart attack.

I whipped out my cell phone to call 911. It wasn't on. By the time it had booted up, the train attendant had made his way to us and was radioing dispatch to have the paramedics meet us at the next stop, which wasn't for about 10 minutes because we were in the middle of nowhere, not even near a road. It felt like eternity. He was clearly getting worse. His lips were turning blue. I thought about yelling across the train to see if anyone had an aspirin to give him, but I didn't want to make it worse if he wasn't having a heart attack or was already taking something else.

I led him in some cognitive-behavioral pain reduction breathing exercises instead. His lips lost the blue tinge, but that might have been a coincidence. When we finally reached the next station the paramedics were gruff as they examined him, helped him to his feet, and made their way out of the train. I couldn't see any more as the train pulled away.

The other passengers resumed their usual morning conversations about TV and the weather and what they'd had for breakfast, and the train schedule. I tried to go back to my book. I could only stare at the pages.