Mark Singel, a Johnstown native and Penn State graduate, won election as Lieutenant Governor in 1986 as Robert Casey's running mate. In 1993, Governor Casey was stricken with Appalachian familial amyloidosis, a rare and usually fatal liver disorder. The governor required a multiple organ transplant, which was still experimental at that time. While the governor was incapacitated and recovering, Mark Singel became the acting Governor of Pennsylvania. This book is Mark Singel's recollection of the events that year.