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John (not his real name) was in his mid-60s, a VA patient with chronic back pain. After three surgeries by three different surgeons over about five years, he was no better off; his lumbar spine was littered with arthritis and titanium implants. He had made the rounds again, to physical therapists, chiropractors, and pain providers, and now he was in my office. The last thing he needed was more surgery.
The more gently I explained, the angrier he became. He left looking like a man betrayed by the system. He wanted me to “do something” and to “fix it.” I could do neither.
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