I graduated from cardiac rehab today, Nurse Patty Ryan gave me a certificate signed by the other patients in the group and sat down with me to discuss how I had done with my goals. She told me my echocardiagram had shown that I now had a stronger heartbeat than more than 65 per cent of all Americans. I said in August that I wanted to get through a day without crashing in exhaustion, I wanted to improve my stamina,  to be focused and energetic, to live without significant pain, to walk several miles each day, to mange my medications well and confidently.

I had, she said, achieved all of my goals. My stamina has improved by more than 60 per cent she said, I am doing twice the minimum work in rehab asked of people considered healthy and in full recovery.  My cholesterol is low, excellent.

This, I understand, does not mean that I do not have heart disease, it means I have made more than a full recovery from open heart surgery and am a a level of conditioning that I probably have not known for decades, if at all. I no longer life a life only of the mind, but a more integrated life of body and mind. I love the exercise I am doing, especially the walks and the aerobic work. I feel clearer, more focused and creative than I can recall. The pain from my scars and incisions is almost totally gone.

It will take enormous focus and discipline to keep and even improve upon these good results, it is so easy to slip back, I sometimes fear myself.

I have important issues to work on. My diabetes remains in flux, as happens with heart surgery, I am meeting with a specialist next week to continue my work to get it under control. Some of the medications I am taking cause pain and stiffness in my muscles and joints, I am considering alternatives, have found a chiropractor who is helping me work through the structural issues.

And I need to maintain this exercise and conditioning, for my heart and for my overall health and well-being. A very big and positive change for me, one that I would never have undertaken without the shock and challenge of open heart surgery.

Rehab was a triumph for me, an important and valuable thing to do. Patty Ryan, the nurse in charge of my rehab, was extraordinary, loving, caring, always available, helpful and understanding Her presence was something I badly needed and could not have gotten from doctors, overwhelmed with busy schedules and insurance, tests and procedures.

Today, Patty congratulated me on the good work and urged me to consider Phase 3, the next chapter, where I can drop by the rehab facility two or three times a week if I wish and work on my own schedule, without being tied to monitors, free to choose my own machines. I will consider it, I’ll try it next week, I think I would like it better than a gym, but I do want to continue my own regimen at home. She hugged and kissed me, and cried at the idea of my graduating. So did I.

Rehab and recovery are both stories of triumph and loss. Today, my friend Irene struggled to breath, had to go home, her heartbeat was irregular, she looked tired and pale. The nurses urged her to go to the emergency room, she refused to leave her 17 cats alone in the house. We worried about Irene, she should have gone to the emergency room.

Hugh, working on the treadmill, nearly fell and had to get off, he couldn’t understand what had happened to him. Roger, suffering from crippling rheumatic arthritis,  has disappeared, not been seen in two weeks, Arthur stopped coming after he hit his dog on the head during a dogfight and broke three knuckles. The dog is fine. Dot is recovering from another round of surgery and will, she said, be in rehab a long time. She looked tired and sad today.

Penny, Irene and Carol are all in Phase 3 and want me (and Red) to join them there.

My surgery and recovery showed me the other side of a therapy dog – suddenly, this summer,  I was the one who needed one. Red has done an amazing job for me, he transformed the experience of rehab for me and for many others, he brought light to shadows, smiles to many faces, warmth to the cold.

The rehab nurses are sponsoring a celebration holiday dinner this week and we are all going, a reunion of sorts and a celebration. We are here. For me, open heart surgery curiously turned out to be something I needed, a slap in the face perhaps, an experience powerful enough to turn me inside out and once again, alter the trajectory and nature of my life. That seems to happen to me often. I barely graduated from high school, never graduated from college.

Rehab was hard work, every day, every time. When I began, I was soaked in sweat and grimacing in pain, short of breath and disoriented. None of those things are true now.

This is the most successful class I have ever taken, the first one where I exceeded everyone’s expectations, including my own. Perhaps it was Patty. Perhaps it was Red. Perhaps it was Maria, or the friends I made in rehab. I have crossed to the other side, at least for now, filled with gratitude, pride and hope for the future. Crisis and mystery – the next chapter of my life – is just around the corner.