Retired tulip farmer Klaas Buijsman sits between his wife and the Utah doctor who saved his life, flipping through photos. He particularly likes the one of his granddaughter, Ella, born back home in Holland "when I was dying here."

An American vacation in 2006 is not one Buijsman or his wife, Ineke, are likely to forget. They saw Las Vegas and, purely by happenstance, traveled toward Utah, stopping to admire Canyonlands before heading to mountain country. That's when he got sick, ending up in the Panguitch hospital, where "everyone was nice to me, but they knew they were in over their heads."

An ambulance took him to Dixie Medical Center in St. George, where a scary diagnosis was made: He had an infected, ruptured thoracic aortic aneurysm.

Its nickname is Death.

He remembers only snapshots of the early hospitalizations, telling his story, his wife jokes, with "hearsay." He arrived, by air ambulance, at LDS Hospital, where Dr. Douglas Wirthlin, a vascular surgeon, told him he had less than a 50 percent chance of surviving surgery but that it was his only hope.

"I've kissed my wife," Wirthlin remembers his quiet patient saying. "I've said goodbye to her. Let's go do surgery."

Over the next several hours, Wirthlin, general surgery resident Dr. Brian Reuben and others would try to change the tulip farmer's future.

"It's a rare, extremely complicated problem," said Wirthlin, who remembers not meeting his patient until just before surgery because he was plotting the intricacies of the operation as he looked at the disaster depicted in the medical images. Thoracic aortic aneurysms are rare, afflicting one or two out of 100,000. One ruptured by infection was catastrophic. Wirthlin had to figure out how to cut out the damage, remove all the infection and replace that artery with a cloth tube in such a way that it would not itself become infected.

They opened his chest at 3 a.m. and worked for several hours. When they were done — and it all looked good — Wirthlin said a long journey was still ahead. Healing would require weeks of hospitalization, and because Buijsman lived continents away, he'd have to be triply safe to travel. And Wirthlin needed reassurance there would be adequate care close back home. It took a week or so of the monthlong hospitalization to make the arrangements.

Not many people survive the condition, Wirthlin says. And after the operation, he and Buijsman became pen pals, checking in by e-mail periodically.