My little brother has been suffering from debilitating pain and had an MRI appointment tonight. My schedule was free and I could take him. He wound up not going due to his pain. This isn't the first time that he's missed/ no-showed for important appointments. The following text conversation ensued since talking to him seriously in person is next to impossible.

Him: I'm not walking

Me: I can assist in any way you need me to. The MRI would help give you answers to your pain

Him: Don't you dare guilt trip me with promises of answers. "it's ok if you're in too much pain and can't go" that's what you should say

Me: I worry about when it becomes a common answer for when there are important appointments

Him: Kelly... I'm this close to exploding over text don't push me. Why are you guilt tripping me!!! This family doesn't deserve texting. That discourages me from going even more I hate how that guilt trip felt. I hope your reply is gonna help not hurt.

Me: Everyone has things that they need help with and to be called out on. What matters is how we learn from what we need to improve on.

Him: Goodbye. Called out on my pain? Learn and improve on pain? What the fuck are you talking about

Me: Improving your conduct. I don’t mean your pain

Him: Conduct....

Me: Yes

Him: What does that mean

Me: It’s a synonym for behavior

Him: Oh jeez Kelly goodbye. You're upsetting me and when I react you say I have behavior issues? You're gaslighting and guilt tripping me. You must learn from mom. I think you have the behavior issues

Me: I’ll print out this text convo so you can see for yourself when you’re in a better body and mind space

Which I did. Several hours later after I took time to myself for a drive and came back. He still thinks he isn't in the wrong and said he needed a clonazepam to combat suicidal thoughts and that mom and I can be nicer. Granted, mom and I have done NOTHING but he as accommodating to him as possible, more than any government or disability system could ever be. Our mom is the reason he has social security income and home health physical therapy, and I'm the reason he still has a roof over his head and didn't go mad from loneliness from being indoors all day long.

He had a traumatic brain injury when he was 12-13 years old. I understand his judgment can be impacted, especially if the TBI has anything to do with his unbearable pain now. It's been 15 years now. I feel like he's running away from taking accountability for his health and situation then gets mad at us about it and says hurtful shit. Am I wrong?

Edit: He has gone to an MRI before and he has two herniated discs, one near his neck and one in his lower back. This new MRI would scan the rest of his back because doctors couldn't get the full MRI done last time from his pain. Listening to him shriek and moan in pain almost every night and knowing he doesn't want anyone near him or to do anything about it is extremely agonizing. All three of us live together.