John had made an appointment to discuss these episodes when he first started having them, about a month or two after the surgery. The doctor said it would improve. When it didn’t, and when the steroid injections, over-the-counter anti-inflammatories, and weekly physical therapy weren’t doing jack shit either, John brought it up again. Poppy was at that appointment. She was in tears, listening to John describe the pain. She pled with the doctor, “What do we need to do? What the hell is happening? Help us!”

The doctor prescribed a painkiller, recommended weight loss, and authorized an MRI scan. John cut out the dessert and quickly lost ten pounds. The pills helped him sleep at night but made his emotions bizarre and unpredictable. Crying over commercials for Bob Evans. Irritable and morose over nothing at all one moment, overcome by ripples of euphoria and world-conquering notions the next. By and large, he didn’t like how the pills made him feel, so it was odd how often he found himself counting down the hours, then the minutes, until he could take the next one.

When the results of the MRI came in, the doctor identified inflammation and nerve damage, which was not necessarily a result of the surgery, but John’s body wasn’t healing the way a body ought to. The weight loss was promising, but unlikely to correct the underlying problem. He was glad the meds were helping John sleep but wasn’t inclined to increase the dose.

When the doctor recommended a second surgery, Poppy just about lost her mind. John nearly did too. A second surgery would mean at least another four days in the hospital. Their health coverage was abysmal—they were still crawling their way out of debt from the first operation. And the doctor wasn’t even able to guarantee better results; it was just his best recommendation. John had to drag Poppy out of the office that day before she hurt someone. Right before they left, the doctor had slipped John an increased prescription for the painkiller.

Back at home that evening, John and Poppy talked it over. She was still livid over the failure of the first operation but ultimately in favor of doing the second, so that he could get off the medication. John wasn’t so sure. “I came out of the first one worse off than I was before,” he pointed out. “And our debt’s already through the roof, Pop. I go in for another one, we’ll be paying it off for the next twenty years. And with no guarantee? Why don’t I give it a go for a few more weeks with the new dosage, try and do better with the exercises I’m supposed to be doing, then see where we’re at.”

The combination of a higher dosage and renewed diligence with his exercises at home had helped. He continued to watch his diet and was shedding a pound or two a week. John still had episodes, but they were less frequent and passed more quickly. As he gained strength, he was less afraid to be active—to throw a football with his kid, to swing an ax. He was nearly back to full functionality at work.