Ronald Kmiec of Carlisle once said it would probably take a coma to prevent him from going out for his daily run.
Last Thanksgiving, it almost came true.
Kmiec had joined about 2,500 other runners at the Feaster Five Road Race in Andover. For Kmiec, a 5-mile course should have been a piece of cake; he typically ran 30 to 40 miles a week, and a month earlier had completed the Bay State Marathon in Lowell in a time of 4 hours and 3 minutes, which qualified him to run the Boston Marathon for the 35th time.
He hadn't missed a day of running in almost 32 years. The 65-year-old is a "streak runner" as defined by the US Running Streak Association, whose members are committed to covering at least one nonstop mile every day of the year.
Kmiec's streak began on Nov. 28, 1975. According to the official Streak Association registry, that makes him the streak-running record holder in Massachusetts, several years behind the nation's top streak runner, a California schoolteacher who will hit 40 years of daily running in July.
"As soon as the race started, I felt a pain in the center of my chest," Kmiec recalled about Thanksgiving Day. "It just stayed there."
After a visit with his mother and Thanksgiving dinner with his wife and son, he rested, and went out the next day for a mile. But the pain didn't subside - not that day nor when he ran the next two days.
On the Monday after Thanksgiving, he went to see a doctor, who recommended that he be transported by ambulance to the nearest hospital. He refused and went home for his daily run.
Then he packed a hospital bag - including his running shoes - and drove to Emerson Hospital. Tests confirmed that he had suffered a heart attack due to an arterial blockage, and he was transferred to Lahey Clinic in Burlington to have a stent inserted.
Awaiting the surgery the next day, Kmiec could not stop thinking about his running streak. It wasn't like there hadn't been challenges in keeping it alive. He had run with broken ribs and stitches, through hurricanes, lightning storms, and the Blizzard of '78, and on the days both his sons were born.
"I kept asking the nurses, wasn't there a treadmill somewhere in the hospital I could use?" he said. Normally, Kmiec eschews treadmills but, technically, a treadmill mile would have counted toward his streak.
"Your bed is alarmed," the cardiac nurse declared. "If you try to get up, the alarm will go off."
Sure it is, Kmiec thought to himself. When the nurse left the room, he got out of bed. The alarm went off. The nurse returned, laughing.
Kmiec had a stent put in, and for the first time in 32 years, almost to the day, he missed his run.
But Kmiec, a concert pianist and piano teacher by profession who comfortably refers to himself as "somewhat obsessive-compulsive," came to see it as a wake-up call.
He followed his doctor's orders over the next few weeks with rest, medication, and dietary modifications. He started a walking program. He enrolled in Emerson's Cardiac Rehabilitation Program. And with his doctor's permission, he started running again - on Dec. 28, his 33d wedding anniversary.
Having broken his daily streak, Kmiec set his sights on a record he was determined to maintain - his Boston Marathon streak. He has completed every Boston Marathon since 1974. Only eight other competitors have finished more consecutive Boston Marathons.
"Right away," he said, "I decided I was going to get back into training for the Marathon."
Ginny Dow, manager of Emerson Hospital's Cardiac Rehabilitation Program, said she found it fascinating to work with a patient as fit as Kmiec.
"Some of our program participants had very sedentary lifestyles before their heart attack," she said, but even trained athletes like Kmiec can be at risk.
"People ask how someone at a high fitness level can have a heart attack," she said. "But diet is just as important as a cause of heart disease. Stress and genetics play a role as well. Athletes sometimes have a false sense of security."
Kmiec acknowledged that he paid little attention to nutrition, for exactly the reason Dow indicated: Being trim and fit made him feel inherently healthy. "I thought I could eat anything, so I did, much of it sweet and fat-filled."
Dow, who discussed Kmiec's situation with his permission, said he isn't her first cardiac patient who has run a marathon or achieved similarly impressive athletic feats.
"Working with us gives people who want to resume their exercising a greater level of security," she said. "When people feel symptoms but don't know whether to be concerned or not, we can check their cardiac monitors."
Kmiec's ongoing rehabilitation, like that of almost everyone at the cardiac rehab center, combines group support, nutrition counseling, calisthenics, strength training, and cardiovascular work.
Dow laughed as she described what happens when Kmiec gets on the treadmill. "Men are competitive with each other," she said. "The other guys in the program see what he's doing, and I can practically feel the adrenaline level going up around the room.
"I have to go around slowing the rest of them down, saying, 'He's running a seven-minute mile because that's what he was able to run before. Please don't try to keep up with him.' "
So, on Monday, Kmiec will join more than 20,000 others at the starting line in Hopkinton. In earlier days, he ran the Marathon in nearly 3 hours. "My average time is now 3:22 for Boston, and, of course, it goes up every year," he said ruefully. "I never expected I'd be running this slow."
Kmiec is hoping for a sunny, 60-degree day and a finish time no worse than last year's 4:26, when he was running with torn cartilage in his kneee in a cold, heavy rain.
He'll be wearing his heart monitor. And his cardiac rehab team has promised to be out there cheering for him along the route.
"I always envisioned that a day would come when I was in my 80s or 90s and would drop dead just after crossing the finish line of the Boston Marathon," he mused.
"Given what I now know to be the general condition of my heart and coronary arteries, I realize that if I were not a runner, what happened on Thanksgiving could have been a fatal occurrence. But now, all signs are good, and it looks like I can go on a few more decades."
Correction: Because of editing errors, an article Thursday about Ronald Kmiec gave the wrong time for his running of the Bay State Marathon in Lowell last fall. Kmiec ran the race in 4 hours and 3 minutes. In the same article, a photo caption had the wrong day for the Boston Marathon. It will be held tomorrow.