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."

When he arrived at first base, Berkman briefly crouched and put his head in his hands. He then called timeout and ran to the mound, where he remained while the medical staff attended to Jakubauskas. Eventually, as Jakubauskas was being led unsteadily to a cart, Berkman placed his left hand on the pitcher's right shoulder, patted it and said he was sorry.

Later, Berkman visited Jakubauskas in the hospital and the two big leaguers watched as the moment that would forever link them was broadcast on TV.

"It was kind of funny, they were showing replays of games and we ended up watching the replay together," Jakubauskas said. "So it was a little bit of an interesting twist of fate there."

Berkman and Jakubauskas haven't been together since. That will change this week, when the Cardinals make the first visit to Camden Yards in franchise history. Jakubauskas is scheduled to pitch Wednesday, and, therefore, likely will face Berkman again.

"I am not going to tell you it is not going to run through my head," Jakubauskas said. "I know it is Berkman, but he is just another hitter. I have to get after him like I have to get after the other eight guys that are in their lineup. … It's not a personal thing, it's more of a 'Hey, let's see if we can actually relive this in a different way and get him out.'"

Berkman, a five-time All-Star outfielder-first baseman who is having a resurgent season in St. Louis, said he knew nothing about Jakubauskas' improbable baseball journey before that fateful day.

"Since the incident, I have sort of monitored him from afar, and, when I saw that he was up with the Orioles, that was great. I am just really glad he is back in the big leagues," Berkman said. "It will be good to see him. And not see him in the hospital."

Berkman was highly impressed with Jakubauskas when they met. Not only was the pitcher not feeling sorry for himself, but he actually comforted Berkman, stressing that there was no reason to apologize or feel badly.

"It probably did me more good than him to go there," Berkman said of the hospital visit. "He was lucid, he was fine and he said: 'Hey, it's part of the game. Don't worry about it.' He seemed to really have a great attitude all the way around."

Dealing with adversity is nothing new for Jakubauskas. He was a left-handed power hitter who wasn't drafted out of high school and attended four colleges. He eventually became a right-handed pitcher and played parts of five seasons in independent leagues before the Seattle Mariners' organization signed him in 2007.