The actor Robert Duvall was seventy-nine when he was asked if a body double replaced him in more active scenes. Not Bob. He was way too tough and manly for that. “I do my own dancing, my own horseback riding, my own singing, and my own chopping of wood in all my movies.”

You only get to be such a caricature of manly independence if you’ve never had back surgery. Even if it occurred a long time ago, the memory remains. Probably increased vulnerability, too.

After serious surgery, being a patient requires being helped. That’s often hard to accept. You want it, but you don’t want it. The caregiver/spouse is similarly conflicted: empathy and kindness are never far from fatigue-engendered impatience.

Last week, I had back surgery (my fifth – I’m a recidivist), so this is much on my mind. My nephew Mark is about halfway through eight weeks of being tortured by a neck brace following fusion of four cervical vertebrae. He, too, is thinking about what being a patient involves. So is my friend Vic who was severely handicapped in use of his dominant arm by an accident and surgery several months ago. My friend John is struggling with an unsatisfactory outcome to a laminectomy. I’ve been talking with each of them about our lot as patients. Not whining – mostly just trying to come to terms with feelings we’re not supposed to have, and we tactfully keep to ourselves.

I’m not talking about big issues, just stuff like, “The white isn’t done enough on these eggs.” The other day, Mark howled to me, “I want to make my own sandwich sometimes.” The caregiver is not a restaurant server. Asking her to make an improvement in some offering she felt pretty good about is a dicey move. You might get away with it once, but more than that would probably provoke a response something like the Russians are getting in Ukraine.

And then there is the hot issue of caring-that-crosses-a-line-into-fussing-and-over-direction. Try to sneak a shower without supervision and a supporting hand, and the caregiver will explain forcibly (and reasonably) that the risk is not just to the patient but also to the caregiver, who has to call 911 and pick up the pieces.

To my friends and me, it seems like only yesterday we could dress and feed ourselves easily. Even do a little cooking. That’s the natural order of things, isn’t it? So how’s a guy supposed to be grateful for help – no matter how generous – when it shouts that we who were strong – functional, at least – are now weak and needy?

I’m sure our caregiver wives have mixed feelings, too. Being unable to help when waves of pain have their way with us surely calls up unqualified sympathy. But when a longsuffering caregiver is wakened in the night to help the old guy use the toilet just as she’s gotten back to sleep after cleaning up the mess he made by knocking his water glass off the bedtable – well, kindness and empathy may go missing for a while.

Underlying the particulars of receiving and giving help is fear. It’s probably especially strong following spinal surgery. Am I ever going to be myself again – note, not young, just not handicapped? And the caregiver’s never-to-be-spoken vision of the patient being decrepit and failing ever after must surely be a pain in itself.

Beyond all this, there is having to acknowledge dependence. I resist that. I’m guessing my hobbled brothers do, too. But it’s a dumb way to look at things. Of course we are dependent. We have been ever since we married. So have our wives. None of us would be whole alone. The traditional marriage ceremony has it right: we promise to love each other in sickness and in health, and in the Judeo-Christian view, we become “one flesh.” The frictions that are part of day-to-day care receiving and caregiving just don’t count much. In the end, the whole thing is about more than helping the patient do things he can’t do for himself, it’s about being a benevolent, loving presence. And we patients owe the same thing to our caregivers. That was the deal we made.

Anyway, there is nothing wrong with patients being grateful and annoyed at the same time or with caregivers being empathetic and impatient at the same time. At least, I hope there’s not. It’s unavoidable when serious surgery makes a house call.