On the face of it, after all those years of trying homicides, this shouldn't have been the case that almost did Richard Sax in.

The defendant, Alexander Flores, is a recognizable man -- 500 pounds with 12 fingers and 12 toes. And unlike in many Philadelphia murder cases, there were willing witnesses.

But this was not the most unusual thing about the case. The most unusual thing of any case involving Richard Sax is often, well, Richard Sax.

After nearly 40 years as a prosecutor – and three decades in the homicide unit – it's hard to find anyone who fights as much for victims and grieving families. But it's equally hard to find a prosecutor who drives judges and defense attorneys as batty. If the courtroom is a stage, Sax puts on a performance. He suffers no fools. He huffs, he puffs, and occasionally leaves in cuffs.

Over the years, Sax's courtroom dramatics have gotten him held in contempt enough times that the joke is that in the bowels of the Criminal Justice Center there's a cell with his name on it.

Seriously, he's lost count.

"I wear my heart on my sleeve," Sax told me.

There was that time in 1983, just three years into the job, when a judge slapped him with contempt during an argument over sentencing for a teenager who assaulted a cop.

"He insisted on being cuffed, I don't know why," Judge Jerome O'Neill told Daily News columnist Pete Dexter. "It's nothing personal about Mr. Sax, but I'm afraid he is just a little disturbed."

Sax says he prefers "zealous."

And last year, Sax and Judge Karen Simmons battled during a trial when a murder witness went south on the stand.

"Carry through your threat," Sax dared Simmons when she threatened him with contempt. For that, he nearly spent the weekend on State Road. His bosses fetched him after an hour on ice.

With Sax, it's not an act.

"He is one of the greatest voices of the voiceless that I have ever shared a courtroom with," said Brian McMonagle, a former homicide prosecutor and now one of the city's top defense attorneys. "He is not afraid to make himself bloodied in the fights for these victims."

That August 2016 case of the 12-fingered and -toed defendant was going fine. The evidence was lining up against the 31-year-old from Kensington who was accused of ordering the killing of a rival drug dealer. And Sax hadn't even gotten himself thrown in the clink.

During opening arguments, he had felt pain in his chest but dismissed it as heartburn. The night before closing arguments, Sax had jolted awake in the Chestnut Hill home he shares with his wife, former prosecutor Leslie Gomez, and their two teenage children. The pain was piercing.

"Like a blade into my chest and out of my back," he said.

At Penn Presbyterian Medical Center, his heart stopped. He was dead for two minutes. A clogged artery.

Despite the courtroom stress, Sax had always lived healthy – he's a member of the ski patrol at Elk Mountain and one of the top fund-raisers for the annual Tour de Shore bike ride that raises money for children of fallen first responders.

After half a year of recuperating, Sax will be back in a courtroom this week for his first homicide: the shooting death of a Germantown bar manager. On Thursday he handled a routine violation hearing. But Sax quickly fell into a fight with the defense attorneys.

"I love you, Rich," defense attorney Robert Gamburg told him afterward, shaking his hand, and asking about his health. "But don't get so excited."

Friday the Center City Crime Victim Services group announced Sax as the winner of its Philadelphia Victim Supporters Award. That honors someone who goes "above and beyond" for victims, said the group's executive director, Sherry Hunter. Prosecutors and family members of murder victims nominated him.

The nomination letter read: "Someone who never gives up."