Captain Picard has an artificial heart. This is because as a young cadet, he was man enough to fight for what he believed in and ended up knifed in the heart for his trouble. When Q offered Picard a chance to make a different choice to avoid the health complications he was facing with his artificial heart, Picard went for it.
Instead of fighting like a man, this time Cadet Picard ran away like a Big Loser coward. Unfortunately, this set a bad precedent, as Cadet Picard never learned to fight for what he believed in, always playing it safe in life and never causing trouble because he feared trouble like a Big Loser coward. So in the new timeline, Cadet Picard didn't become Captain Picard, but Science Officer Picard.
Shocked at this, Science Officer Picard asked Captain Riker about Picard's opportunities at earning his own command. Captain Riker tells Science Officer Picard that Picard has nothing exemplary in his service record, no commendations for bravery or valor. Picard was average and thoroughly unremarkable and will never be captain, and never be involved with military intelligence.
Realizing what he has done, Picard demanded that Q send him back so Picard can put everything back the way it was, artificial heart be damned. So Cadet Picard stood up for what he believed in and fought like a man against overwhelming odds before getting knifed in the heart. Picard laughs at this, because who gives a ****? Picard learned what it means to be a MAN.
Picard learned that it is better to go out fighting like a man than to live like a Big Loser coward, or a Chicken-**** Koward, or a Kowardly ****, or a Corrupt Cop coward who fears a man so much he that he wants this man to put away his box cutters and knives when seeing the man because the Corrupt Cop coward fears what could happen to himself like a coward.
Sometimes a man's gotta do what a man's gotta do, consequences be damned. People don't get credit for something they never did, they only get credit for what they actually do. If Picard had a history of running away like a Big Loser coward who fights with his head instead of his balls due to having no balls, is he really a man? It is actions that make the man. Picard had 2 options: play it safe in life and never cause trouble, fearing trouble like a Big Loser coward... or fight for what he believed in and become legend. Picard opted for the latter and was man enough to fight for what he believed in like a MAN. Being a man isn't about fighting with your head, it's about fighting with your balls. Picard had it right the first time. The lesson that Q taught Picard resonated with me.