When Ann Marie Howard first opened her eyes after the accident, her grandmother thought that was the end of their worries. But a coma only works like that on television. In real life, where there are no closing credits, life comes back so hesitantly that sometimes all you can go on is faith.

Ann Marie had been in a deep coma for about four weeks before she opened her eyes. After that she slowly began to notice her surroundings, but even after a couple of weeks you still had to get your face a few inches from hers before she would respond at all. And even then, unless you were her grandmother or her sister, she would not acknowledge you.She was sitting in a wheelchair outside her room at Holy Cross Hospital, staring into space, the day Grace Means brought her puppy in for the first time. Means, a recreational therapist at the hospital, placed the puppy on Ann Marie's lap.

What happened then surprised the nurses who were standing nearby. "Did you see that?" they asked each other. Ann Marie had begun petting the tiny dog and was moving her lips.

After that encounter, says Means, Ann Marie began to really improve.

A live animal, one that is warm and will look you right in the eye, seems to do a couple of things for patients in a hospital or a nursing home setting, says Eila Cagle, occupational therapy manager at Holy Cross. For stroke patients, the petting movement itself provides exercise in a spontaneous, natural way.

For patients coming out of a coma, the animal provides a stimulus, one that responds back. And for any patient, adds Means, "it takes a person's mind off his own troubles." When a patient pets an animal he suddenly becomes not just a receiver of care but a care giver.

IT HAS BEEN 10 weeks since Ann Marie Howard was hit by a car as she crossed Fort Union Boulevard. It was five days before Christmas and she and her brother were walking from the bus stop to a restaurant across the street, where Ann Marie was going to treat her brother to dinner.

It was snowing lightly, so Ann Marie pulled her coat in front of her face. She didn't see the car as it approached, and the driver - looking in her rear view mirror as she crossed three lanes of traffic - didn't see Ann Marie.

It has been a hard 10 weeks since then. But Ann Marie continues to improve. She can now talk, and even jokes with the staff. Recreational therapist Grace Means thinks the visits from the puppy have speeded up her recovery.

The puppy, a dachshund-Chihuahua mix named Gideon, visits the rehab unit once a week. Because Ann Marie's short-term memory was affected by the brain injury, she doesn't remember Gideon after he leaves the room.

But dogs don't stand on ceremony. What matters is the here and now, and a hand that will pet you. What matters is that a connection is made.