You are correct that I am a physician- however, there has been a lot of emotion and little in the way of facts being presented here. For example, although there has been a lot of discussion about a spine fracture, needing help for disc replacements or four wheelers, none of this has been indicated. Sometimes, just for the sake of clarity, it takes some pretty plain speaking for someone to understand. The recommendations for surgery need to be based upon objective facts, not unrealistic expecations or unclear understanding. If someone is being faced with open heart surgery, it seems that this might be a priority over how strong your coffee was in the morning. He is not my patient, but I would be concerned about lack of comprehension (which could also be poor communication from his providers). If a person did not understand the risks of surgery, this alone might be a contraindication, which I suspect has been the case here with some of his back surgeons. As a surgeon, it is critical to know that the patients have a clear understanding of the risks and benefits of the procedure, yet I get the sense that Tony does not comprehend these risks. This is not personal, but simply an assessment. If so, that alone would make any provider concerned about doing surgery- the results and outcomes would never be good. Sometimes, no matter how hard we try, or how many ways we try to explain, people don't seem to understand- this is very frustrating as a provider. However, the decision to recommend surgery or not has to be based upon the individual's understanding- unrealistic expectations are never met with good results. This decision cannot be made emotionally, but based upon facts, medical literature, and experience. You are correct in that I am not Tony's provider, and neither is anyone else on this board. As a provider, when I see his posts it is frustrating to see how little he comprehends his medical conditions. I see this every day with my own patients, who sometimes see themselves as victims and yet are not able to help themselves. They ignore sound advice and choose to make their own priorities. However, he needs to work this out on his own, and only his physicians can help him. I more than anyone would like to see him as well as all of my own patients do well, but sometimes, as frustrating as it is, we simply cannot help everyone or meet their expectations.