I first saw “Mary” as I entered the exam room. She was lying on the table in tears, complaining of a three-year history of excruciating back pain. She had seen two neurosurgeons and an orthopedist (my specialty), had had an MRI and, despite great hesitancy on the part of the neurosurgeon, had had a (failed) back surgery: her pain had been relieved for three days before it recurred exactly as it had been before. Following a second MRI, she had been referred to me because the neurosurgeon thought I was a “pain specialist,” whereas really I was interested in mind-body medicine as it related to the orthopedic patient — how emotional and psychological stress lead to pain.
After a four-day bout of intense, immobilizing, lumbar back pain, associated with a fever of 103.4, my wife and I decided that going to the ER was indicated. Within a very few hours, I was in the ICU with a presumptive diagnosis of Staph septicemia (infection) and pneumonia. Faced with my falling oxygen saturation, the intensivist recommended intubation and thus, for the next five days, I was in an induced coma while he and the infectious disease physician battled to save my life.