To stave off dread, the Doña tries to keep on locomoting like “The Little Engine That Could”….

Featured image: Peter AI’ed the image from a grumpy photo of me and a meme about The Little Engine That Could

You’d think, past sixty or so, the unconscious
would give you some respite. But here, it says,
is the little engine of dread and sorrow that runs your story

—Robert Hass, “John Muir, A Dream, A Waterfall, A Mountain Ash”

Life has visited a lot of vicissitudes on me but—with lots of support, supplied at first by my parents and after I met him, Peter, and after we had them, our children and their spouses—I have muddled through. Other than Peter’s prostate- and bladder cancer surgeries, pre-school Marissa turning blue and fainting from an asthma attack in the doctor’s waiting room, new-born Newton turning blue and stopping breathing while he and I were still in the hospital—other than that, nothing has thrown me as much as the back-hip pain with which I’ve now lived for just over 3 months. Yes, on Monday, January 12th, 2026, I visited Dr. William Spiker, the back surgeon recommended by Dr Katharine Smolinski (DO). Unfortunately, no orthoscopic- or minimally invasive surgery pour moi. The surgery I need requires the full monty, in 3 Steps:

Step 1: “Whereof one cannot speak, thereof one must be silent.” Ludwig Wittgenstein, Tractatus Logico-Philosophicus.

Step 2 is decompression, a procedure to relieve pressure on the nerves that exit the spinal column at vertebrae L2 on L3  as well as L4 on L5; pressure has squished the opening where the nerve comes out of the spinal cord and into the body; the opening has been reduced to a pinhole window because arthritis had caused bone/tissue to grow around the exits. The decompression procedure removes bone/tissue that block the nerves off vertebrae L2 on L3  as well as L4 on L5.

The lumbar vertebrae involved in my pain are L2 and L3  as well as L4 and L5.  Both pairs show degeneration of discs, joints, and formation of bone spurs. In addition, the L2 on L3 vertebrae have slipped forward (toward the organs inside the body) and L4 on L5 have slipped backwards (towards the right-up-to-the-skin side of the spinal column).

Step 3, lumbar fusion, is a procedure that permanently connects the two pairs of trouble-causing vertebrae mentioned above; it will be performed immediately after decompression. The decompression will have created instability in the spine, which the fusion must now stabilize. Since my L2 on L3 vertebrae have slipped forward and L4 on L5 have slipped backwards, the vertebrae of each pair will be tied to the partner that moved in the same direction. 

The entire surgery needs full anesthesia and will take two hours. Then 2-3 days in the hospital. Recovery at home (with physical therapy) of at least 2 months before I will really feel that it’s better. As Dr Spiker said, “At about 2 months after, you will no longer hate me.”

Surgery is the worst case scenario that Peter and I were hoping to avoid. After seeing Dr Spiker, Peter and I were convinced that I had to have the surgery, since we couldn’t go on like it is now for an indefinite time period. While we know we have to do it, we’re still settling into this plan—lots of paperwork, bone scan, other tests, a visit to my primary care doctor (Erin McAdams) to address aspects of my bloodwork that I failed. As we work through all the pre-surgery tasks, we become more and more convinced that Dr Spiker is the best possible doctor for the job: looks you in the eye and responds to your questions even if it involves a queasy answer. As Peter told Dr. Smolinski, “Dr Spiker does not have the God complex.” Moreover, his team of patient-support staff includes a nurse and surgery co-ordinator who has been making all the pre-surgery appointments and booked us an earlier-than-expected surgery date—January 27th.

If I feel so good about the doctor, why do I dread everything about having surgery?  Is “dread” the right word for the perturbation I’m feeling? Synonyms for dread include fear (intense, overwhelming fright), anxiety (worry or concern), apprehension (a state of fear combined with anxiety), dismay (feelings of distress or shock).  The dread I’m experiencing bounces from one-of-the-versions-defined-above to the next. If pain as I argued in my previous blog post—with the help of Yehuda Amichai’s “The Precision of Pain and the Blurriness of Joy” as well as the work of several sculptors and painters—might incorporate the unexpected component of joy: to “learn… to speak among the pains”—the artists concur—is a positive result of mentally overcoming your pain in order to develop a higher level of self-actualization. In other words, facing pain and learning to deal with it develop inner strength and induce acceptance of reality (flaws and all). If pain, then, is not inseparable from joy, might we find a surprise positive component embedded within “dread”?

So what, if any, positive component could possibly arise from the dread-related negative emotions defined above? All the way from 1862, Emily Dickenson has an answer:

I lived on dread; to those who know
The stimulus there is
In danger, other impetus
Is numb and vital-less.

Note that the bolded phrase in the first line of Dickenson’s poem is in first person: “I lived…”; in the phrase that follows, the poet immediately switches to third person—moreover, the plural pronoun “those” indicates that is talking to the people among her readers who have also “lived on dread.” She believes her fellow-dreaders might—like Dickenson herself—have found that danger/dread intensifies purpose and action; a life totally free of fear would risk stagnation and/or lack grit. To paraphrase Ms Dickenson, “the more definitively I act, the faster I’ll reach the other side of fear. 

Decades ago, I lived through a fear/dread situation that hardly ever befalls the urbanized Homo sapiens—unless, like me, they have been lucky enough to travel to a wildlife sanctuary like the Kruger Park in South Africa. On one family visit, I went with my brother Boshoff, one or two other family members, and about 4 or 5 people we didn’t know, on an armed-ranger-guided walk into elephant country. The lead ranger placed us in a long line, with 2 other armed rangers bringing up the rear, He warned that no matter what, we had to stay stock still. If we ran, the elephants might  attack. He branded his .458 Winchester Magnum: if we ran, he warned, he and the others might have to kill one or more of the majestic animals. We were then led to an area where a breeding herd had recently been spotted, a matriarch teaming up with her next of kin—mothers, sisters, aunts—to protect the calves.

The animals spotted us when we were about 200 yards away. We stood deadly still. Nevertheless, the matriarch charged. Dust billows from her hooves spelled “no ifs or buts.”  She couldn’t have been even have a rugby-field ahead of the herd when everybody in our party except the guards sprinted over rocks and tall grass to get as far as possible from and her right-angled-to-her-body ears. 

Despite the rangers’ caution, the primitive fear engendered by a charging elephant automatically floods the body with adrenaline and prepares it for intense action—we the uninitiated could not NOT FLEE from the specter of a charging pachyderm: our brains’ most primitive structures the sympathetic nervous system’s TOLD US to believe the threat our eyes perceived. Admittedly my upcoming surgery (it was 2026 after all!) was not the same as a charging elephant mama. But my amygdala knows no such thing. However, Emily Dickenson wants to persuade us to allow our rational brain: to override the urging of our reptilian brain. We have to accept  the reality that our bodies break down. And if needs be, we must seek repair. The second law of thermodynamics tells us that increasing disorder is a fact of matter. You have to grit your teeth and do what you have to do. 

Above, “The Little Engine that Could Not Afford to Do Otherwise”

Despite Emily Dickenson’s conviction that dread has some positives—with which I broadly agree—there is still the elephant in the room:  Step 1 of my surgery: Dr Spiker making a 5-6 inches long incision in my back. While I have inches-long scars from pervious surgeries, they did not involve accessing bone. As a farmer’s daughter who observed my father and uncles shooting bovines, pigs, and wild buck,;cutting the throat of sheep; and wringing chickens necks, one would think that a necessary cut into flesh and the spilling of some blood wouldn’t unduly alarm me. And it didn’t before my previous operations. In the case of my back as well, I’m not spooked by Dr Spiker’s initial cutting through the skin of my lumbar area, a layer of fat, a connective tissue sheet that covers the muscles, as well as through various muscles—to the depth of 1-1 1/2 inches. It’s the next phase that fills me with dread: Dr Spiker must “peel back” the muscles to access my spine. I watched videos of the process. Vertebrae are pointy, curvy things. “Peeling” muscle from all those hollows and peeks is gruesome. The image below is a very much “cleaned up” medical illustration of surgery on the vertebrae of the neck. 

Fusion of vertebrae in the neck area

I can take the medical diagram above—its distance from the real is just enough to not gross me out. If you find the medical diagram or the verbal description above disturbing, DO NOT CLICK here. If you do, you’ll SEE A REAL PHOTO. Watching a video of the procedure and looking at an actual photo was a mistake for me: Emily Dickenson’s urging to allow your rational brain to override the urging of your reptilian brain has been and is very hard—but essential—work for me. However, I know it can be done. I’ve done similar over-rulings many times in my life. My secret: I willfully practice repression (subconscious) and if I get far enough, suppression ( conscious). How? I do exactly the opposite of what positive psychologists recommend. I ignore and push away certain negative emotions, such as those evoked by my exposure to the literal  “nuts and bolts” of spinal surgery. I make a habit of doing so with negative emotions that would otherwise take up too much space-time in my mental apparatus. Why? Even if I should spend my entire remaining life-time on processing/fixing those kinds of emotions, I would lose too much of the joys I still have in the remains of my days. Those of you who know certain mechanisms of our inscrutable brain, will see that I’m not telling the whole truth: by telling the story of my dread, bolding key words, hiding behind cartoon humor, and having some good laughs, I have made the elephant in my room several shades more innocuous.

To Robert Hass, I say that I have run my “little engine of dread and sorrow out of coal. To Emily Dickinson, I’m with you: I’m high on the “stimulus there is/ In danger!” To you my readers I say, Can’t wait until my back is screwed.