A most memorable message awaited me on my desk one morning: a brief note from Mrs. G asking, “Why did my husband take his own life today?”

Startled, I reflected on Mr. G’s history as I had been treating him in my urology clinic for the past few months. It had recently come to my attention that his complaints were related to painful recurrent renal colic.

Anticipating a distressing phone call, I recalled my interactions with Mr. G. I remembered his Italian accent and his difficulty in expressing himself, which went beyond a language barrier. He seemed burdened by obsessions, repeatedly questioning his case. Over several months, his history seemed disjointed, and only shortly before his tragic death did I grasp that he suffered from intermittent flank pain caused by kidney stones, a condition known as renal colic. I was relieved; although future episodes of pain might occur, I understood the problem and how to treat it.

However, his suicide, a gunshot wound to the head, made me realize that he did not possess the same understanding of his condition or its treatment. I firmly believe that those who take their own lives, without exception, endure severe pain, comparable to renal colic or childbirth. They perceive only unendurable suffering with no solutions, foreseeing a future plagued by intolerable pain.

I failed to grasp the emotional anguish that these excruciating episodes inflicted on Mr. G. I overlooked the emotional insecurity stemming from the severe and unpredictable nature of passing kidney stones. I realize now that I neglected to explain the origins, commonality, and treatability of his condition to him.

The insecurity accompanying relentless emotional pain is a familiar backdrop to suicide. I failed to recognize this at the time. My own life was different then; I had yet to reach the desolate depths of despair and defeat. In the years that followed, I would attempt suicide multiple times. With that personal history, encountering someone like Mr. G today, I might have sensed his pain, and perhaps made a difference.

“Blessed is the man who perseveres under trial because, having stood the test, that person will receive the crown of life …” – James 1:12 (NIV)

This scripture holds the answer for those contemplating suicide. Many years later, I am still haunted by this man and wonder if I could have made a meaningful impact.

William Lynes is a urologist.