One morning after finishing surgery, my nurse pulled me aside. “You need to get into Exam Room One,” she said. “He’s in bad shape.”
Curled up on the floor was an active-duty Navy SEAL. His girlfriend knelt beside him, rubbing his back as he rocked back and forth in pain. A military backpack leaned against the wall. When he looked up at me, tears streamed down his face.
“Doc,” he said between breaths, “I swear I’m a tough guy, but this really hurts.”
“I believe you,” I responded.
The enemy wasn’t a gunshot wound. It wasn’t a battlefield injury. It was a 2-millimeter kidney stone.
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Over the past two decades, I’ve treated thousands of patients with kidney stones. CEOs, construction workers, teachers, surgeons, marathon runners, accountants, grandparents, and college students have all passed through my office. Kidney stones have taught me something medicine rarely says out loud.
Pain has no respect for résumés. It doesn’t care how much money you make, how physically fit you are, how many degrees hang on your wall, or whether you’ve survived Navy SEAL training. When a ureter begins spasming around a tiny obstructing stone, everyone becomes simply, and profoundly, human.
I’ve had women tell me they’d rather experience childbirth again than pass another kidney stone. I’ve seen grown men cry without embarrassment. I’ve watched patients pace emergency department hallways because sitting still was impossible.
And eventually, almost every one of them asks the same question: “Why me?”
It’s one of the oldest questions in medicine. Patients aren’t asking why calcium crystallized or why urine became concentrated. They aren’t looking for a lecture on oxalate metabolism. They’re asking why human beings suffer.
Medicine is remarkably good at explaining mechanisms. I can explain exactly why a stone hurts. I can describe the anatomy, the obstruction, the inflammation, the spasms, and the pressure building inside the kidney. I can show patients their CT scan and point to the tiny white speck causing all the misery.
But physiology isn’t the answer they’re looking for. The real question isn’t what caused my pain. It’s what do I do with it now?
That question has occupied philosophers for thousands of years. The Stoics argued that while we cannot control what happens to us, we can control our response. Buddhism teaches that pain is inevitable but much of suffering comes from our relationship to it. Viktor Frankl wrote that even in the worst circumstances, people retain the freedom to choose their attitude.
Patients rarely quote Marcus Aurelius or Frankl in the emergency department. But they’re searching for the same thing. They’re searching for meaning.
Early in my career, I thought my job was to remove stones. Now I think my job begins much earlier. It begins when I pull up a chair.
Over time, I’ve realized that one of the most powerful treatments I offer isn’t a laser, a medication, or an operation. It’s understanding. Fear magnifies suffering. Knowledge diminishes it.
When patients understand why they’re hurting, why they’re nauseated, why they should sip rather than chug water, why a stone may pass on its own, or why it won’t, their fear begins to loosen its grip. The pain is still there. But the suffering changes. Knowledge gives people something pain often steals: a sense of control.
Patients rarely remember the diameter of their stone. They don’t remember which laser fiber I used. They usually can’t recall the name of the medication I prescribed. They remember something else. They remember whether I sat down, whether I listened, whether I explained, whether I treated them like a frightened human being instead of another CT scan with a pulse.
One patient changed the way I think about resilience. She sat calmly in my office while I reviewed her scan. She had a severely obstructing stone and a badly swollen kidney. She looked remarkably composed.
“You don’t seem to be in much pain,” I said.
She smiled. “Oh, Doctor,” she replied quietly, “I’m absolutely miserable. I’ve just developed a very high tolerance for pain.”
She’d lived with debilitating migraine headaches for nearly twenty years. Years of invisible suffering had taught her how to endure. It reminded me that every patient carries a story we cannot see. Some have spent years learning resilience through chronic illness. Others are experiencing serious pain for the very first time. If we’re not careful, medicine reduces both to the same diagnosis code.
The longer I practice, the more convinced I become that physicians are witnesses as much as healers. We celebrate cures, procedures, and technical excellence, and we should. Modern medicine performs miracles every day. But there are moments when our greatest contribution isn’t eliminating suffering. It’s refusing to let patients face it alone.
Those moments rarely appear in clinical trials. They’re found in ordinary conversations. A chair pulled beside an exam table. A few extra minutes spent answering questions. Three simple words: “I believe you.”
My Navy SEAL recovered. The stone passed. The pain eventually became another story to tell. But the lesson stayed with me. Strength isn’t the absence of suffering. It’s the willingness to endure it without losing hope.
After thousands of kidney stone patients, I’ve come to believe that medicine isn’t simply the science of curing disease. It’s also the privilege of walking beside people on some of the worst days of their lives. Sometimes we remove the stone. Sometimes we can’t immediately remove the suffering. But we can always remind our patients that they don’t have to carry it alone.
Carmin Kalorin is a urologist.
