Hell on earth

When a kidney stone taught me the meaning of agony, I also learned the limits of my own weak self.

By Albert DiBartolomeo
Published April 27, 2000 4:00PM (EDT)

I've often wondered how I would
withstand great pain. I mean the pain
the body, that which registers on the
nerves, not that of loss or deprivation
that ravishes our emotional life.

When the pain came, would I behave with
some amount of stoicism and even
grim humor, like the protagonists in
Hemingway novels whom I so admired? Or
would I moan and howl in sounds far
beyond intelligible human speech?

Last year I found out when a kidney
stone made
its slow passage through my right
ureter. You may not know what ureters are --
certainly you wouldn't be too aware that you
possessed them until a bit of solid
matter larger than the ureter's diameter
left your kidney for the journey to
the outside world.

This journey can begin suddenly, with
paralyzing force. "Like being hit
with a two-by-four," one friend told me.
"Like being shot with an arrow,"
said another. But no simile can
adequately describe pain, or pleasure
that matter; it must be experienced. We
can know the concrete causes of pain,
like pressure, too much heat, the
splitting of the flesh, but the
pain is an abstraction, and like all
abstractions it lies beyond the precise
grasp of language. We simply don't have
the words. We can have trouble, then,
describing our own pain and another's
pain, even when it manifests itself in
grimacing, say, or writhing. Ultimately
it remains metaphysical -- something to

My kidney stone "attack" tugged me from
an uneasy sleep at 3:07 a.m. The pain
was then only a few degrees beyond
uncomfortable, and I
thought for some hopeful minutes that I
might have a strange muscle cramp or
that my innards were protesting against
the odd-tasting tofu burger I had
risked for
dinner. I tried to ignore it. I tried to
force my thoughts elsewhere. But
the pain was insistent. I massaged my
side and twisted this way and that, but
no amount of repositioning or rubbing
relieved the hot spike tunneling through
my abdomen.

The pain ascended through the long hours
of the early morning toward a
level that dwarfed all the other pains
I had known before, including an
abscessed tooth and torn ankle
ligaments. It nearly equaled the
sensation of bringing a hammer down upon
my thumb, but that was brief in
comparison, a few minutes of localized
agony that then settled into a
bearable throbbing. The pain in my side
was not just severe but unrelenting,
a continuous deep gnawing coupled with
cold sweats, nausea and other blades of
pain that radiated throughout the
confused coils of my digestion, causing
mischief there.

I paced the length of the house, took a
hot bath, tried some yoga and
breathing exercises taken from a dusty
New Age book I had once purchased as a
cure for all my ills. I pulled my hair,
pressed my temples, bit my fist.
Before all emotions left me, I cursed
with a flamboyance that, were I loud
enough, would surely have caused the
houseplants to wilt. At one point, I
curled up on the floor like the
insensate fetus I wished then to be.
But no
measure I took lessened the pain.

When the sun fully rose, I was still in
pain, and still grinding my teeth
against it some hours later in the
emergency room of a local hospital. A
nurse inserted a shunt into the back of
my hand and hooked me up to an I.V.
meant to flush the stone from my
plumbing. It would be an additional hour of
before I received a mainline of blessed
Toradol. In 20 minutes, the pain
began to retreat. In half an hour, I was
smiling, joking with the nurse and
listening to the prosaic conversations
of the staff, even as other emergency
cases groaned and yelped in the
curtained spaces about me. But I smiled
joked because of relief, not elation.
In fact, while I was still in the E.R., a
peculiar despair began to creep over me.

I was still despondent when I underwent
a CT scan two days later because
the "calculus" was taking its time to
leave my body. I had to wait an hour
before the procedure, and I spent the
time shivering in the thin hospital
robe, my socks and loafers, looking as
far from chic as a person can get.
Another man waited with me. He kept his
face in one battered magazine after
the other. We did not speak. He seemed
to want to be invisible, and so did
I. There was a subtext to this business
and it was a dark one.

While waiting, I thought back to the
attack and how my desire for the pain
to end quickly became a need exclusive
of all other considerations. Family,
job, achievements, passions and the like
all lost their significance. The
pain became more than a steel box that
separated me from anything but itself,
more than a wedge that drove itself
between my mind and body, making me more
fully, if not totally, the latter. What
great pain does, I learned that long
night, is obliterate memory, in fact,
"all psychological content, painful,
pleasurable and neutral," as philosopher
Elaine Scarry writes in "The Body in
When that occurs, we are no more than
flesh, bone and blood. We lose our
character, who we are. This is the true
nature of the joy we feel at pain's
cessation -- the recovery of our

Eventually, I was put into the
interesting machine and it did its work.
Later, still in my airy gown, I was
encouraged to see the images assembled
a white screen in a darkened room. It
appeared as though I had been sliced
repeatedly like a large bolt of
prosciutto, and I was reminded of an

After fracturing my jaw in my early 20s
while playing football, I acquired
the X-ray prints of my skull from the
oral surgeon. After my mouth had been
wired shut and I began to dine on
various puries, I'd place the X-rays
the windowpane. With equal measures of
revulsion and fascination, I'd gaze
upon the pencil-line break in my jawbone, my teeth with their bits of metal,
the shadow of my brain.

I felt as though
I were looking at my own corpse, my
flesh sloughed away by time. This is
what would be in my coffin some years
later, I thought. The processes that
went through my mind at
the moment -- That's me? -- were managed
by the very thing I was looking at, a
picture of my gray skull's contents set
starkly against a blue sky. This
was unsettling, but I did not fully
realize why until the internist showed
the CT scan images of my torso many
years later, when I was much closer to
end of my average life span.

"There are your kidneys," he said,
pointing at an image with a pen. "The
right one's a little backed up from the
stone, which you can see here." He
pointed to a white dot near my bladder
where the ureter emptied. "It's hung
up. If it doesn't move within a few
days, we'll have to do something

I only nodded. I was not thinking of
the "something mechanical," nor of the
pain to come should the stone dislodge
itself and travel. The pain had been
only one component of the despair that
followed my kidney-stone attack. The
other, and perhaps more disturbing,
revealed itself in that darkened room
where I was made to confront the notion
that we're all just a bunch of parts
and slippery workings that are prone to
failure like any other mechanism, and
with pain usually added. I was also
thinking of my own father's kidneys, which
were destroyed by 20 years of diabetes
and so killed him.

I was thinking, too, of my stepfather,
who had died of cancer several
years ago after a kidney stone sent him
to the hospital -- where the routine
X-ray, which I saw too, revealed the
"well-defined mass" hovering in his
ghostly lung. I had been with him in
the emergency room while the kidney
stone did its work and, over the next
four months, while pain and his terminal
illness and ultimately the morphine
emptied him of himself. Even love,
or received, could not slice through the
narcotic haze of pain or the
staggering awareness of our own
hopelessly mechanistic mortality. This
will crush even the most positive of
temperaments, the fiercest of wills.

Diagnostic images of my organs glowed on
the walls. I got out of the viewing room
and the hospital as fast as I could.

Three days later, the stone moved. I had
been waiting for it. I had told
myself that that tiny rock would not do
to me what it had done earlier, that I
would keep
the upper hand and, in so doing, keep my
conscience from seeping away. But
before the pain medication kicked in,
the pain
scattered my mind, and all things but
the pain became mere suggestions of
themselves. The pain reduced me to a
single inflamed nerve and little
more. After it was gone, my self
returned but an eerie feeling stayed
with me. Our psychology, our
spirituality, the value systems by which
we live are only possible in the absence
of ill health or pain. Our essence
disappears into great pain, revealing
all that we hold dear to be the most
fragile of luxuries.

Albert DiBartolomeo

Albert DiBartolomeo lives and writes in Philadelphia and teaches at Drexel University.

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