I’ve just learned that a brother-in law has been afflicted with his first kidney stone. I am a serial grower of kidney stones, enough times over enough years that I’ve lost count. I’ve had three (or is it four?) lithotripsies, one cystoscopy, and passed a half dozen or so without clinically mediated trauma (note I didn’t use the term “naturally”; there ain’t nothing natural about it).
That legacy has made me an accidental and unwilling connoisseur of pain. Kidney stone pain1 is a multidimensional experience; each time is a creative variation on a soul-crushingly familiar theme. Some are just a few days of that distinctive, unforgettable, omnipresent abdominal pain that instantly disappears when the offending stone finds its own way to freedom. The epicenter of the pain isn’t necessarily right where you’d think the stone itself is, and when the pain is bad you hurt everywhere, from your toenails to your scalp. My very first stone went undiagnosed for many months, until my urine looked like iced tea, because I didn’t recognize the symptoms and describe the location accurately (now I recognize the sensation, instantly). Some stones find me whimpering and babbling on an emergency room cot, curled in a fetal position, begging for another injection of morphine. But every stone announces its presence the same way, leaving me to wonder what journey of discovery this one will lead me to. On the worst of those journeys the world contracts to a tiny little point that contains only you and the pain, and everything else fades to insignificance.
It’s not all bad, there are some compensating advantages. Once freed of the stone and the pain, by whatever means, your world suddenly expands. The mere absence of pain is an exquisite pleasure. The sky is brighter and bluer, the air is sweeter, your loved ones are lovelier, life is good! Little discomforts like bee stings and broken bones no longer bother you as much. You can also save a few bucks on dental work by skipping the anesthesia — I’ve had four crowns and some fillings installed without any.
As a spiritual journey such acquaintance with pain is both uplifting and humbling. On the one hand you can look down on the lesser mortals around you as they snivel and whine about their petty little aches and discomforts. On the other, any fantasies you may secretly have nurtured about the inner steel you would show in the torture chamber, steadfastly refusing to betray your dignity or your comrades, are gone forever. Before my cystoscopy, if the docs had come to me and said “We’re sorry, but to stop the pain we’ll have to castrate you and tattoo an obscenity on your forehead” I would have replied “fine, fine, whatever, just get on with it already”.
The term “painkiller” is a misnomer because those drugs don’t kill the pain … and I mean the most effective ones, the “Schedule II” ones that are tightly controlled and that physicians are reluctant to prescribe. They just take the edge off, even intravenous morphine (been there, done that). What’s worse, thanks to the insanely stupid War on Drugs, you’re afraid to actually use what drugs you do have. Kidney stones (mine anyway) usually do their worst in the wee hours on a weekend, and you never know how bad this one is going to be, and the memories of the times you didn’t have the painkillers and would have taken them are so very clear and vivid. So, you conserve your stash as one of your most precious possessions (note to blog-reading home-invading drug fiends: you aren’t going to find my stash easily). With each new stone I fill the prescription and then add it to the stash. I get a surprising amount of comfort at the low point of an episode just by caressing those little bottles, like a miser with his gold or Gollum with his ring of power. It’s there if I really, really need it … my preciousssss…
Speaking of wretched social policy … we euthanized a pet a few weeks ago. At sixteen years of age this cat was beyond effective medical intervention, at any price, and beginning to suffer. We paid (dearly) for the vet to come to the house because we wanted the animal to spend its last moments in comfortable and familiar surroundings. It’s a pity that we can treat our pets more humanely than we can our fellow humans. When my father was dying of cancer, in a hospice arrangement at home, we were permitted to keep on hand one small bottle of painkiller to be used “at the end” to relieve pain. I’ve forgotten what it was (time has dulled my memory of details, and these are not memories one wants to keep), but it was a liquid applied as drops on his tongue. It was effective, acting almost instantly, as we could tell from the relaxation of the furrows of pain in his face. Towards the very end his pain level was much higher (obviously so even though he could not speak). It was the middle of the night and a quick calculation showed that at the new rate of application we would run out at 3 a.m. I called the designated duty nurse for a refill. She was unwilling to “disturb the doctor” and told us to wait until morning.
I have never been as angry, as thoroughly, totally, consequences-be-damned angry, as I was at that moment, and hope I never am again. I knew the name of the doctor and the general neighborhood where he lived, but didn’t have his phone number. I told the nurse: “The doctor IS going to be disturbed one way or another. Either you call him now, or I go to where I know he lives and start pounding on doors until I find his house”. Fortunately for me and my still clean arrest record I did get the prescription, and Dad died in the mid-morning of the coming day.
Such is the gloriously civilized society we have created, where we have the means to at least partially vanquish much pain and suffering, and yet sometimes fail miserably to do so. Thanks to draconian drug laws we are the prison nation, leading the world in the number of our citizens behind bars (both per capita and in absolute numbers), yet illegal drugs are no less a scourge than they ever were. Shame on us all.
1. I’ve read that kidney stones and childbirth are two uniquely painful experiences. Only women can make that comparison directly. I’m glad I’m a guy↩