I went to my cardiologist’s office in Vermont to take a stress test to see if it was all right for me to go on Cardiac Rehab Phase II. I was told that I am completing Cardiac Rehab Phase I, which is recovery, building enough strength and vitality to go onto Phase II. There is a Phase III, but I’m not sure yet what that is. Maybe it is the rest of my life.

Almost every one of the doctors I’ve seen says a different thing about Cardiac Rehab, most say I don’t really need it, I am motivated, smart enough to figure out how to be healthy if I want to be, and healthy enough. The cardiologists say I do need it, without question. According to them cardiac rehab programs can reduce a heart patient’s risk of premature death by 20 to 25 per cent. How much longer is that?, I ask. Nobody has that statistic.

Talking to people and doing some reading, it also appears that one reason cardiac rehab patients live longer than other patients is that they are motivated and disciplined enough to go to rehab. This stands to reason, but does not generate much income.

This stress test was easy, it was only to make sure I didn’t drop dead on the treadmill. It was  three minutes, not a strain for me after weeks of walking, I walked five miles today. The staff was nervous about it, I had wires attached to much of my body and a nurse on either arm, one taking blood pressure measurements every minute the other watching my EKF readings like they were photos of life on Mars.

The next step is to be called into an orientation session, then, if I choose to go forward, to begin a thrice-weekly three- month rehabilitation program that offers progressive aerobic exercise, education and counseling. The idea, they tell me, is to get as fit and healthy as I can, and to help me better understand the best way to manage my heart condition. “You’ll learn about heart health food,” a nurse said. “I think I know about it,” I said, “it is pretty close to diabetes healthy food: fruit, vegetables, nuts and fish.” The nurse was skeptical. “I think heart healthy food might be a little different.” Perhaps, I wondered, she might give me a pamphlet.

Lots of people think cardiac rehab is a good idea, the many medical experts on  my Facebook page sure like it. I am not yet persuaded. I don’t really grasp why I can’t learn these things myself, they are not especially complicated, and I am already well along when it comes to diet and exercise. I am motivated and paying attention.I am not going to be doing much in the way of aerobic exercise, I think that will soon be clear to them.

The system rarely pays much attention to what I want, or even what I am like. No one has yet talked to me much about me, aside from my heart.  I imagine a class of heart patients is efficient and lucrative over three months, insurance seems eager to pay for it, perhaps because they think it will keep me alive and healthy longer.

I am an easy patient, I respect my nurses and doctors, I don’t trawl the Internet much for the true story, but I am learning that decisions about my health are personal, individual and up to me. The medical community is far from united when it comes to treatment of chronic diseases like heart trouble and diabetes, there are different ideas about almost everything.  Ultimately, I have to make the best decisions for myself, there is no one magical wizard to help me. Each doctor has a specialty,  different piece of the pie. Nobody but me is really responsible for the pie.

I am also ironically aware that I am not right in the middle of that particular cohort that is wreaking havoc with the nation’s health care system and with the economy. I am an older male with two chronic conditions, and that means a lot of doctors, visits, medications, insurance forms,  tests and procedures. And perhaps cardiac rehab. This is not a club I wished to join, but I will surely make the best of it.

I want to sit down with my doctor at some point, if it is ever possible, and tell him that I am individual, not a subset or a statistic. I am not like most other people, for better or worse. I do not wish to live forever, I do not mean to stay alive much past the point where it is natural and feasible and requiring vast expenditures of money and equipment and pills. Is he trying to get me to 90 or 100? I don’t really want to go there, and I want to know how I can be healthy and still retain control over the rest of my life and the end of my life. I’m not sure he knows.

My time in the stress room did not reassure me.  I appreciate the wall print of a soothing forest, but it is not nearly as pretty as the forest we walk in behind the farmhouse. It was awfully yellow and green. Tthe nurses kept urging me to look at the print rather than at the treadmill, it would keep me calm and lower my blood pressure and keep me from keeling over.

If this is the idea behind cardiac rehab, I will not last very long. Maybe I should start with the counseling.