I had none of my signature red lipstick on, no hoop earrings or stacks of rings to identify me. I don't even think I bothered to bring my purse in. I looked quite barren, much like a canvas without paint. If not for the redemption of my white blonde pixie cut and blue eyes, a small reminder of my personality and frame for my naked skin, I might have disappeared into the hospital walls completely.

Most of us are willing to make allowances in our lives for small, mundane changes -- a new haircut, a tweak to mom's beloved dinner classic or an acknowledgment that those great jeans don't fit quite like they used to. We can also accept, with time and a little effort, the tonal shifts that make us more malleable, and dare I say better people, whether that means reevaluating a stagnant relationship or picking up and moving away for a promising career.

Change might be the current that carries us, but that doesn't mean its waters are always tepid. Or that it comes on our terms. The italics above came from my own shaky hand, scrawled on a scrap piece of hospital visitor paper. I had bandages and medical tape running the length of my sternum. I was also 24, and five days out from open-heart surgery. This, as you could imagine, was not change that I asked for. Nonetheless, this was the change that I got.

But this is not actually an essay about open heart surgery. Anyone who has spent time as a paper doll replica of a human, with machines contracting out the work of vital organs, knows there is no shortage of material to pool from. And my own roller coaster with my heart health started a few years before I saw the sterile, cold operating room. As heart disease often is, it was a bewildering and wildly exhausting ride.

But change, particularly when it comes in the form of a major operation, is not really about having the rug pulled out from under you. It's about the ensuing headache when you hit the floor.

"Are you breaking up with me?"

I wasn't dating anyone, but on the other line joking with my best friend and roommate, who wanted to come over and "talk." She had just returned home from a 10-day trip to Argentina, and I was three weeks out from surgery and at my parent's home for the foreseeable future, still largely unable to fend for myself in my day-to-day routine, be it driving a car or tackling a flight of stairs. I was also uncharacteristically and comically sunshine-y, thanks no doubt to a cocktail of opiads. My drug-induced optimism, though I hardly realized it at the time, was a potent tool for convincing family and friends that I was in better shape than what my many-month recovery would suggest.

Back to my friend. Her voyage abroad had come as a sort of mid-twenties soul search, a getaway to stretch through some growing pains. She had always been a wanderer, the kind of intensely creative, enigmatic character that needs to build things up just for the discovery that comes from tearing it down. This energy was oftentimes constructive and occasionally destructive. It meant never knowing if she was going to send me on a thoughtful, multi-day scavenger hunt for my birthday -- or hurl a cookie at our living room wall during an argument. I loved her in spite of, and perhaps because of, this.

We had both agreed that it would be best for her to travel immediately following my surgery, as I would likely be bombarded by visitors in the first few weeks and would spend much of my time napping anyway. She would be crucial in the coming months of my recovery, we thought, once the dust had settled and we picked up the pieces of our often inseparable lives that had previously been dominated by my poor health.

I never got to see out this plan, as the reader might have anticipated. We sat on my parent's deck on the edge of a suburban forest preserve, listening to the hum of August and drinking a glass of Cabernet (it's good for the heart). But as she told me about her adventure, politely and visibly nervous, I knew instinctively that there was a gap between us far broader than our folding chairs.

"You know, don't you?" she mouthed quietly, as if she was pleading to not have to say it outright. I didn't, at least not consciously. Though she had been increasingly distant in the months prior to my surgery, I was too sick to think much of it. My own ignorance and embarrassment for having missed some sort of cue was pressing against my face as a stain on my cheeks.

I couldn't quote what she said next directly if I wanted to, because whatever variation of "I'm moving to Argentina" came out of her mouth floated far above both of our heads, into the space where words are not semantic parts to be interpreted by ears, but symbolic messes to be misinterpreted by hearts. She already had a job lined up and was staying with a host family that she had met back in college. She had made new friends on her trip and they were eagerly awaiting her return. I, meanwhile, had a broken sternum and was effectively living in my parent's basement -- a dream come true, really. She sat quietly waiting for a reaction. I was fettered by wanting both to cry and to punch her in the face, but was too dumbfounded to choose either.

We had just entered into a new, and not entirely uncommon territory of adulthood: estrangement. In my mind, there were a few basic rules to friendship. 1) Don't hit on the same guy or girl at the bar; 2) Always order a large popcorn at the movies; 3) Don't move out of the country immediately following a life-changing operation.

We spent the better part of the next two months in a highly-charged silence, strung by the occasional game of telephone among our close-knit friends, who were disappointedly not interested in taking sides. With a timing befitting the dramedy gods, her uncouth exit collided with one of the most unsuspecting physiological side effects of heart surgery: depression. I dove headlong into an utterly terrifying and unexplained anguish, not caused by, though certainly not helped, by the profound void she left behind. There were many days when I could be found congealing alongside a bowl of cereal at the kitchen counter, still in my pjs at three in the afternoon. On others, I cried so hard that I could feel the stitches heave and pull away from my newly-minted incision.

I did what felt natural to dig myself out this menacing hole, which at the time meant turning on an escapist reflex by applying for jobs all over the country. I couldn't stomach the idea of retuning to our neighborhood, to what seemed now to be a shelf of a former life. We actually ended up moving in the same week, just shy of her 25th birthday. Me: to Boston. Her: to Buenos Aires. I was just approaching my three-month post-op mark, and in hindsight, still very green in my recovery.

One of the best parts about being in your twenties is that you don't owe yourself to anyone. One of the worst parts about being in your twenties is that no one owes themselves to you, either. It has taken a full year to begin to sketch the lines of my identity out again, though it's as if the tracing paper has moved. I staved off paralyzing memory loss, aphasia, vision problems and hot flashes. I've left friend's birthday parties early thinking I needed an ambulance, and pulled over on the side of rural Massachusetts roads when met with a firework display in my field of vision. I've called my mother sobbing at least a dozen times when I thought I might never get my brain back to make a career as a writer. I've seen more specialists than our healthcare system allots for.

I have learned only complicated lessons, and cast many judgments. But as best as I can tell, humans are still capable of remarkable generosity and empathy, even if the outpouring doesn't come from whom we ask. That is reason enough to stretch our heart muscles towards forgiveness. That is reason enough to tell this story.