Almost a year ago to the day, Tommy Rivers Puzey, a professional runner who has won or placed in big city marathons and other endurance events, learned to sit up in bed again.

Over the course of a few weeks, he trained his body to slowly swing his legs over the side of the bed. Eventually he was able to walk from one end of the room to the next, despite exhaustion from the effort lasting two to three days.

On Sunday, Puzey, 37, entered the New York City Marathon. He knew he would be far off his best time for such a race but it didn’t matter. Like the majority of participants, it was enough to be there, even better to finish. Unlike most, he almost didn’t make it to the race in the first place because he had nearly died.

In July 2020, Puzey was admitted to a hospital near his home in Flagstaff, Ariz. with what was initially assumed to be Covid-19. Instead, he was diagnosed with a rare and aggressive form of lymphoma. He began chemotherapy and remained in the intensive care unit for two and a half months.

His wife, Steph Catudal, could not be with him because of Covid-19 regulations. So she wrote a short note to him before he went into a medically induced coma. “Stay alive,” the note read, with an expletive added. “Love, Steph.”

It was not easy, nor expected.

“The doctors and everyone acknowledged that his extreme fitness allowed him to endure what he did,” Catudal said days before the race. “Someone that wasn’t training as rigorously as he did would have died.”

Indeed he was training, even in the hospital, up until he could no longer do so. Catudal recalled getting calls from nurses. They told her that her husband “was doing push-ups beside the bed and situps in bed,” she said. “They’d be like ‘dude, you can’t get out of bed and do push-ups in the I.C.U.’”

His muscular frame soon deteriorated during aggressive treatments. He lost 75 pounds, becoming skeletal.

When he woke up from the coma weeks later, he was transferred to a bone-marrow transplant unit, and then a rehab facility. He would have to relearn everything. How to swallow, how to use his hands, how to shift his weight from one side of his body to the other. The idea of using utensils or a pen was beyond his comprehension, he said, and when he was handed a smartphone, he was taken aback by its weight. He did not go home until November 2020.

Both Puzey and Catudal have large social media presences, and followers were hanging on every word posted on Instagram, looking for an update from #TeamRivs.

Puzey is known in the running world as equal parts a fierce competitor and a gentle soul, a man who waxes poetically on the meaning of movement while also blazing through races with an intensity that has landed him on podiums in marathons and ultramarathons.

He placed 16th at the Boston Marathon in 2017 with a time of 2 hours and 18 minutes. He has won a handful of marathons, including the Phoenix Marathon and the Rock ‘n Roll Arizona Marathon which weaves through the Phoenix metropolitan area, and was selected to be a member of the U.S. team for a 50-kilometer road race in, a global ultrarunning competition.

Initially, Catudal said, doctors told Puzey that if he survived, he would probably be on a ventilator the rest of his life. Then they said if he survived he’d be on oxygen. Eventually, they just stopped giving him projections. “Well, it’s Tommy,” they would say.

By April 2021, he was able to walk two miles with a walker, stopping every five minutes to rest.

He has progressed to walking for up to six or seven hours in his high altitude home of Flagstaff. It’s far from the training he was accustomed to, and far from where he was just a few months ago.

It takes time for Puzey to describe his health and his training because his brain doesn’t work as well as it once did, he said.

Indeed, when Puzey has something to say, he slowly figures out the best way to frame it. “If you are moving, you are still alive,” he repeats.

“Everything I’ve done, every movement has been a conversation with death,” he said. He compared those conversations to ones that he imagines having with a driver picking him up from a party. “It’s like being dropped off at a New Years Eve party. You get dropped off at six o’clock and at eight the driver comes back. It’s like ‘no, I don’t wanna leave,’ and ‘you should be grateful you’ve been here for two hours and had a great time,’ which eventually just becomes ‘you can try to take me but I’m not leaving.’”

He decided to attempt the New York City Marathon not as a race, not necessarily as a comeback, or even an inspirational story. He entered the race because it’s a beacon, he said. Something he’s looked at on the horizon for a while now.

“A marathon, like any event, doesn’t matter the distance, it’s a stamp in time and space,” he said over the phone, from his home before the race. “It’s like a horizontal line on the side of a door frame in our childhood home. It’s a mark that says ‘I am here in this exact moment and in this exact space.’”

He arrived in New York City for the first time ever a few days before the race.

“I don’t think that there is anywhere on earth on that particular day that will be beaming with more solidarity and cohesion and cooperation and strength and love and inspiration than New York City on the day of their marathon,” he said days before the start. “It’s magic. If such a thing exists that’s what it looks like that’s what it feels like.”

On Sunday, he said he was pulled along by that magic. By spectators who drew signs for him, with phrases like “Eyes up, Rivs,” and people who jumped in the race to walk with him throughout the day.

He measured his progress not my mile markers, but by what he said was moving “dot to dot to dot between these expressions of love and inspiration.”

The last few miles, with Catudal joining him, he tried to wrap his mind around anything besides being entirely present. It was just too daunting, he said.

“You just close your eyes and keep moving and eventually you get to the end, and when you get there, there’s this sigh of relief,” he said.

He got there, after the sun went down and most spectators had gone home.

His time was 9 hours 19 minutes.