I arrived at the church hall where the cardiac rehabilitation was to take place early. I cannot abide being late – and, besides, I had a laptop problem so I would need to go into the office afterwards.

After about ten minutes I was joined by an older guy who looked just like my uncle. Exactly the same face – could almost have been his twin. Except this fellow was much taller and had a shaved head. My uncle is quite short and has a good head of hair.

This fellow has had a quadruple bypass and merrily showed me the long pink scars on his legs and his chest. It sounded like it had been quite touch and go as to whether he was going to survive until the operation because the surgeon kept opening him up to adjust things.

As more people joined the waiting area, I really began to feel like a fraud. I was the youngest there (at 51), and certainly the healthiest. Some of them looked quite grey and frail.

A nurse opened the door to the hall and we were let in and asked to sit. The newbies were called up for checks first. Being a newbie that was me.

My nurse asked various questions about my medication, when I take it, and any problems. She took pulse and blood pressure readings, both of which were lower than I’d normally have expected before the heart attack, at 55bpm and 108/75mmhg. Then she calculated my target heart rate for exercise, which was much lower than I’d have expected – a maximum of 108bpm!

After the little interview and assessment, I returned to the waiting area and she and the other nurses worked through the rest of the attendees. I was waiting for a while.

Warm up wasn’t challenging to me, but I could see that for some it was really very difficult. One lady, who must have been as old as Yoda, had to sit down. The quadruple bypass guy didn’t seem to be having too much trouble.

I noticed that there were maybe two out of the fourteen patients who appeared to be younger than me – one of them might have been in his early forties. If you met him in the street you’d have thought that he was extremely fit: tall, broad shoulders, and nothing much to note about his waist. He struggled much more than many there.

Looks can be very deceiving.

After the warm up we were gathered into small groups, each with their own nurse, who regularly took pulse readings and checked in with us.

Generally, I was strong and the exercises individually weren’t difficult – but I did get hot and had to switch from jogging bottoms to shorts.

I also got a bit lightheaded and had to slow down.

After the exercise, was a cool down and the lead nurse went around the group asking what our favourite pancake toppings are. I am afraid my favourite is lemon and sugar, but I have had jam, honey, cinnamon and sugar, Nutella, and cheese. I didn’t like cheese.

To finish, a nurse led a discussion on risk factors.

Genetics and age. OK nuffink to be done about those directly. Type I diabetes doesn’t affect me.

I don’t smoke. I don’t drink often.

I like my veg, and some fruit. I do like a colourful plate (although this time of year I feel drawn to a hearty bit of stodge).

I have a sweet-tooth. Sugar and butter are real weaknesses.

There was some talk (and debunking) of BMI, but there was much more discussion about waist size. Women with a waist greater than 81cm (32″) and men with a waist greater than 94cm (37″) are at a much higher risk of heart attack.

The only thing I could connect to was a possible genetic predisposition (but I am scrabbling about to find relatives that have had a heart issue not related to weight), and stress – which is the only one that I feel strongly about as a possible cause.

Stress.

My engineering brain reads the checklist and disregards items that just don’t fit and settles upon the one that fits the known facts.

A silent assassin.

From years of living with somebody suffering from unmanaged bipolar.

From years of calling ambulances and sitting in A&E.

From years of chasing medications for somebody else.

From years of sitting on my own emotions and hiding my deep sense of dysphoria from everybody.

From years of pretending to be normal.

I felt like a fraud at the start because I was the least ill in a room of ill people.

If stress was what did me in, then I need to be damned careful about letting it into my life again – and impostor syndrome is just one such stress source that I don’t need!