Over the course of the campaign in Red Dead Redemption 2, players are introduced to the lazy, free-loading gang member Uncle. As he is one of the longest-standing members of Dutch van der Linde's gang, the other gang members seem to have learned to merely endure Uncle's presence as a necessary nuisance. One of Uncle's favorite conversation topics is that of his chronic, terminal lumbago. Uncle cites his lumbago as the reason for his inability to help with various chores around the camp and his aversion to going out on missions.
Lumbago is a common condition, simply defined as lower back pain. According to the Cleveland Clinic, four out of five people experience some sort of lumbago in their lifetime. Lumbago can be treated with stretching, physical activity, and proper posture, and it often goes away within two to four weeks. Contrary to Uncle's claims, lumbago is not terminal.
He's a Major Pain in the Back
The term lumbago has largely been done away with in modern medical contexts in favor of more specific clinical terms. It is possible that Uncle made a self-diagnosis of the pain he was experiencing, or that at the end of the nineteenth century, lumbago was used as a catch-all term for back pain of any kind. If Uncle really did suffer from lumbago, he likely would have had very little opportunity or knowledge to receive treatment for it as an outlaw in 1899 (the year Red Dead Redemption 2 takes place).
In Red Dead Redemption 2, Arthur calls Uncle a compulsive liar in response to Uncle using his lumbago as an excuse for getting out of work, implying that Arthur thinks Uncle is faking his condition. While the game never makes it clear whether Uncle really does have debilitating back pain, Uncle does appear in Red Dead Redemption, which takes place in 1911, and he never mentions his lumbago.
Uncle is shown to be quite intelligent and worldly throughout both Red Dead Redemption 2 and Red Dead Redemption. Based on the manner in which Uncle describes his struggle with lumbago to the rest of the gang (namely John and Arthur), it appears that Uncle takes advantage of his higher level of academic knowledge compared to the rest of the gang. In Red Dead Redemption 2's epilogue, Uncle tells John, "I'm real sick, John. Lumbago. It's a slow and painful death, my brother." This is obviously not true, as lumbago cannot kill people on its own, but Uncle knows that John doesn't know enough about medicine to refute his claim, so he gets away with his lie.
As seen in the epilogue of Red Dead Redemption 2 and the main game of Red Dead Redemption, John treats Uncle with a much firmer hand than Arthur ever did, often yelling at Uncle to make himself useful. While Arthur constantly berates Uncle and complains about Uncle's very existence, John persistently encourages Uncle — albeit in a demeaning way — to help around the ranch. Seeing as how Uncle begins pulling his weight much more while living with John, it is clear that regardless of whether Uncle truly suffers from chronic lower back pain, his true ailment is chronic laziness.
Uncle's insistence about his struggles with lumbago is yet another way that Rockstar fleshes out the world of Red Dead Redemption 2. The writers at Rockstar seem to have been especially interested in the idea of how people of the time dealt with illnesses and medicine. This is made clear by the fact that lumbago is not the only disease featured in Red Dead Redemption 2 — the disease of tuberculosis also plays a key role in the game's plot. Regardless of whether Uncle is telling the truth about his lumbago, the fact remains that he is a colorful character that brought some much-needed levity to the van der Linde camp.
Red Dead Redemption 2 is available now on PC, PS4, Stadia, and Xbox One.