Panel 1: John gets up and screams in pain.
Panel 2: When Elly asks him what's wrong, the back he didn't take proper care of last time is hurting again.
Panel 3: This baffles her because all he's been doing is paying the bills. This harkens back to her doing exactly the wrong thing the last time and also advising exactly the wrong thing.
Panel 4: When she asks what heavy thing he was carrying, he makes a stupid comment about their overdraft.
Summary: This is why I don't feel bad that he goes to see a quack about his back. He deserves to be misdiagnosed.