"Lance Berkman swung, smashing the 90 mph fastball up the middle "about as hard as I could hit it."

As Berkman dashed from the batter's box in the first inning of that Houston Astros-Pittsburgh Pirates game April 24, 2010, the baseball hurtled back toward home plate and sailed over the head and glove of the Pirates' leaping catcher.

It didn't make any sense. And yet, eerily, it did.

"It just doesn't register at first. All of the sudden, I saw the ball coming back to me, and my first instinct was to run," said Berkman, now with the St. Louis Cardinals, who come to Baltimore this week. "I remember getting to first and thinking, 'Please tell me that didn't hit him in the head.' In my heart, I knew it had. All you can do at that point is pray."

Several feet from Berkman, right-hander Chris Jakubauskas was sprawled face-first on the mound, his legs kicking furiously and viciously at the dirt. Left then right, left then right, like a toddler having a tantrum.

Jakubauskas, in his first and only start with the Pirates, thought he had dodged the screaming liner and that the searing feeling above his right ear was from his dive to the ground. It took him a moment to comprehend the frightening truth — he was struck so violently in the head that the baseball ricocheted more than 60 feet away in the air.

"It was about 30 seconds of agonizing pain, and then the pain went away," said Jakubauskas, now an Oriole. "Then I was just really foggy and dizzy and nauseous."

At that moment, everyone at a hushed Minute Maid Park in Houston was seemingly sick to their stomachs while fearing the worst. Orioles bench coach John Russell, then the Pirates manager, remembers most clearly the unnerving sound — a nearly simultaneous double crack.

"There wasn't much difference between the ball hitting the bat and the ball hitting [Jakubauskas]. That was the biggest thing," Russell said. "And then, when he went straight down, you knew it was something real serious. At that point, baseball is irrelevant. The game is irrelevant. You just want to make sure he's OK.""