A Stone On The Camino
By Mark Farenbaugh
The Camino de Santiago, or the Way of Saint James, is one of Europe's oldest and most celebrated Christian pilgrimages. Its origins date back to the ninth century, when, according to tradition, the remains of Saint James the Apostle were discovered in what is now Santiago de Compostela in northwestern Spain.
For more than 1,200 years, pilgrims have walked hundreds of miles along routes crossing Spain, France, Portugal, and other parts of Europe to reach the magnificent Cathedral of Santiago de Compostela, in northwestern Spain, where the apostle is believed to be buried. For most pilgrims, the cathedral marks the end of the journey.
Historically, pilgrims undertook the journey as an expression of faith, repentance, or spiritual devotion. I met some who needed a reset from a tough life experience. Today, I believe the traditional pilgrim, carrying everything in a backpack, experiences the 300- to 500-mile journey in three stages. The first third is filled with awe and adventure. The second becomes dull and repetitive, when one wonders why in the world one decided to do this. The final third, I suspect, becomes more spiritual. Yet the Caminos continue to grow in popularity. When I set out to walk the 500-mile Camino Francés, beginning in France just north of the Pyrenees, I was motivated by something considerably less spiritual. I wanted to do something marathon-like, challenge myself physically, and record the experience along the way. I did not need a religious reason or some profound personal revelation. I was bored and wanted an adventure. I enjoyed physical challenges and believed I was in good enough condition to endure the journey. Completing such a remarkable pilgrimage, I thought, would be its own reward, since less than 15 percent complete the full Camino.
In my case, however, the transformation would prove considerably more physical than spiritual. I was about to discover that a seven-millimeter kidney stone could bring a grown man to his knees faster than any divine revelation.
The Start
I arrived in Paris, France, early on the morning of September 6, 2025, and boarded a high-speed train to Bayonne, where I spent the night. The following morning, I caught a smaller regional train to Saint-Jean-Pied-de-Port, the traditional starting point of the Camino Francés. Almost immediately upon arrival, I joined the line to register for my pilgrimage to Santiago de Compostela. Five hundred miles lay ahead.
The next morning, I began the first leg of my journey. It was a torturous climb through the Pyrenees, following what I would generously describe as goat trails. Having chosen the secondary route around one of the larger mountains, I found myself almost completely alone. Not necessarily bad, but not particularly safe, either. I proceeded cautiously, periodically sending my brother WhatsApp messages containing my map location. Should an accident or medical emergency befall me, at least someone would know where to start looking for the body.
The next five days were exciting. I met people from all over the world, each walking the Camino for reasons of their own. I had read that approximately 25,000 pilgrims walk the Camino Francés during September and October alone.
By the end of my sixth day, I could feel myself getting stronger. I had covered approximately 70 miles and, apart from that brutal first day, found the daily distances relatively easy. No problems. Life was good.
A Rude Awakening
At precisely 0200 hours the next day, my body staged a rebellion.
I awoke to an intense, penetrating pain in my side. This was not the familiar discomfort of sleeping in an unfamiliar bed, nor the muscular complaint of having walked too many miles. This was something altogether different.
The pain was excruciating, accompanied by violent waves of nausea and vomiting.
I attempted to take pain medication, but my stomach had apparently declared independence from the rest of my body. Anything I swallowed was immediately rejected.
I needed advice.
Fortunately, my brother, who had previously suffered from kidney stones, was available by telephone. I described my symptoms, and he suggested that I was probably experiencing one myself. His advice was surprisingly simple: apply hot water to the affected area.
I did.
Within seconds, the pain subsided.
Miraculous!
Then I removed the hot water.
The pain returned just as he said it would.
I replaced the heat.
The pain diminished.
I repeated this little experiment several times, eventually concluding that perhaps I could swallow one of the pain pills I had brought along while keeping the hot water pressed against my side. Nope.
Not exactly the sort of spiritual enlightenment I had envisioned when planning the Camino.
To Walk or Retreat
By morning, the pain had subsided considerably. I entertained the optimistic possibility that the stone had moved from my kidney into the ureter, the narrow tube connecting the kidney to the bladder, or might even be in the bladder.
Perhaps the worst was over.
I decided to rest for a couple more hours. There was little sense in setting out along another remote Spanish trail only to find myself doubled over in pain miles from a town.
It was a sensible decision.
Unfortunately, the stone had apparently not received the message to move on.
The pain returned within an hour. Just as hard.
Now I faced a considerably more serious decision. Should I continue waiting, hoping nature would resolve the problem, or abandon my long-awaited Camino and retreat toward Madrid for medical attention?
After another unpleasant hour with pain and nausea, the choice became obvious.
Madrid it was. I checked out and took a taxi to the nearest major railway station offering high-speed train connections. The hour-long drive was miserable, with every bump in the road reminding me of the small geological formation attempting to excavate its way through my urinary system. I purchased a ticket and waited for the first direct train to Madrid. Two hours later, I was moving. Somehow, the nausea subsided. Perhaps it was my posture in the seat. Not particularly good science, but I was not about to question a successful experiment. I barely moved for the next four hours.
Upon arriving in Madrid, I was met by my wife’s niece, who immediately suggested that we go to the emergency room. Genius logic. I agreed. We entered the ER at approximately 5 p.m.
An Unexpected Pilgrimage Through Spain’s Emergency Rooms
My first encounter with a Spanish emergency room was an experience I would not soon forget.
I arrived expecting questions, an examination, pain relief, a diagnosis, and, with any luck, effective treatment. Perhaps they could patch me up, send me on my way, and I could resume my Camino. Wrong.
Instead, the hospital seemed primarily interested in pumping water into my veins. The staff refused to give me anything to drink until they determined the size of the stone and whether surgery might be necessary.
An intravenous line was established, and fluids began flowing. Very slowly. I understood the importance of hydration, particularly since I couldn't keep liquids down, but I was rather hoping someone would address the small asteroid attempting to work its way through my urinary tract.
Five hours passed before I received a CT scan.
Five hours! Socialized medicine at work.
I had spent considerable time waiting around military installations, aircraft hangars, government offices, and foreign bureaucracies. I thought I understood the meaning of institutional inefficiency.
Spain was providing me with an advanced course.
The scan confirmed a seven-millimeter kidney stone.
Now, seven millimeters may not sound particularly impressive. Placed on a table, such a stone would hardly attract attention. But lodged within the narrow confines of the human urinary system, it assumes the dimensions and destructive capabilities of a small asteroid. At seven millimeters, whether the stone would pass naturally or require medical intervention became a serious question.
With the diagnosis finally established, I assumed the next step would be straightforward: prescribe medication to control the pain and help the stone pass, or operate.
I preferred the former.
Another two hours passed. It was nearly midnight.
By now, I was beginning to wonder whether the hospital's strategy was simply to outlast the patient.
Finally, at approximately one in the morning, I was discharged with two prescriptions: acetaminophen for pain and tamsulosin to relax the ureter and help the stone pass.
There was, however, one conspicuous omission.
Nothing for nausea and vomiting.
Apparently, the medical staff believed that once my pain was managed, my stomach would simply forget about the entire affair.
It did not.
A Return Engagement
The following day was miserable. Fortunately, I managed to find occasional breaks between the pain and nausea long enough to swallow the prescribed medications. But despite taking the tamsulosin, the stone showed no apparent inclination to move toward my bladder. Worse, I could barely drink enough water to remain hydrated without vomiting. Not good.
Adding to my misery was the culinary situation in the apartment where I was staying. My wife’s niece, who had graciously provided accommodations, was also the primary cook. Unfortunately, she was quite possibly the worst cook in all of Madrid. Every meal seemed laden with salt, and the mere thought of eating was enough to stir another wave of nausea. If a dish was not heavily salted, it was invariably fried in cheap cooking oil. Either way, my stomach was destined to rebel. I continued getting weaker.
Eventually, I had no reasonable alternative but to return to the same hospital.
Back to the Torture Chamber
The second visit to the public hospital was remarkably similar to the first, although the accommodations had deteriorated.
Once again, I arrived in the late afternoon. Once again, I received intravenous fluids. Once again, there seemed to be considerable uncertainty about what, if anything, should be done about the seven-millimeter stone. “¿Está seguro de que tomaste la tamsulosina?” a nurse asked. Are you sure you took the tamsulosin? Yes. I was quite sure.
The medical staff instructed me not to eat because they had not yet determined whether surgery might be necessary. I promised not to eat.
I understood the medical logic.
But at the same time, I was sure the medical staff was getting overwhelmed. Two ladies entered at about the same time as I did, screaming in pain. I’ll bet they had the same issues. Either way, the two ladies got the beds.
Instead, I was assigned an uncomfortable chair.
And there I remained.
Hour after hour.
In pain, exhausted, and developing an increasingly intimate relationship with a chair that appeared to have been designed by someone with a profound dislike of the human spine.
Midnight came and went. No decision. I was about ready to walk out.
At approximately 5 a.m., a young medical intern finally arrived to discharge me.
She handed me a prescription.
I studied it.
It was essentially the same collection of medications I had received during my previous visit.
I pointed out that there was still nothing to control the vomiting.
The young woman assured me that such medication was unnecessary. In fact, she explained, vomiting was beneficial because it allowed the body to expel unwanted substances from the stomach.
I stared at her in disbelief.
I explained, as patiently as a sleep-deprived and thoroughly miserable man could, that I was not suffering from food poisoning.
I had a kidney stone.
A seven-millimeter kidney stone.
In my kidney!
My stomach was merely an innocent bystander caught in the crossfire.
I pleaded with her to reconsider.
She did not.
And so, at approximately five in the morning, I was once again discharged into the streets of Madrid, equipped with essentially the same medications, the same nausea, and the same unresolved problem.
I was beginning to suspect that the Camino’s famous emphasis on suffering and perseverance had been taken considerably too far. Cowboy the hell up! I kept repeating to myself.
A Moment of Inspiration
By now, I had lost considerable confidence in the hospital that had twice attempted to treat me without adequately addressing one of my most debilitating symptoms. I could almost hear the medical staff thinking: “Why operate? He’s a gringo. Let’s save money. Let him wait.”
Then a thought occurred to me. The United States Embassy maintains information about medical facilities available to Americans traveling abroad. Brilliant.
Why hadn't I thought of it two days earlier?
I had traveled extensively throughout the world, spent years working overseas, and dealt with more foreign institutions than I cared to remember. Yet somehow, while wrestling with a kidney stone, I had overlooked one of the most obvious sources of assistance available to an American abroad.
I consulted the embassy's website and located a hospital on its published list of medical providers.
Off I went to a Private Hospital.
The difference was remarkable. The staff promptly evaluated my condition, administered intravenous fluids, performed another CT scan, and finally addressed the symptoms that had made the previous several days so thoroughly unpleasant.
Most importantly, I received the medication I had repeatedly requested to control the nausea and vomiting. They also prescribed longer-lasting pain medication to help me endure the nine-hour flight back to Miami.
Within approximately two hours, I was discharged with an appropriate prescription.
Two hours!
After two miserable hospital visits stretching through the nights, the experience seemed almost luxurious.
Victory!
For the first time in several days, I began to feel that civilization had returned.
The stone remained a concern, but at least I now had a fighting chance of eating, drinking, and functioning like a normal human being.
Which brought me to the next challenge - food.
Out of the Frying Pan and Into the Kitchen
Returning to our niece’s apartment with the right medication and a banana I found in an open market, I was starting to feel some hope. Even if I made a banana sandwich, I would be screaming with hope.
I was genuinely grateful to have a place to stay while dealing with my medical problems. There was, however, one unfortunate and remaining complication: I was still in her apartment. And her cooking methods had not changed. Consider the irony. Spain is a country celebrated for its cuisine. It has given the world paella, tortilla Española, gazpacho, jamón Ibérico, empanadas, tapas, and countless other culinary masterpieces.
Somehow, none of these remarkable achievements had found their way into her kitchen. I had survived the Pyrenees, hiking in drenching rain, drinking with the Irish, drinking with the Australians, a seven-millimeter kidney stone, and two encounters with Spanish public healthcare. But I was beginning to wonder whether I would survive lunch.
When we got back, I took a quick shower as she prepared one scrambled egg that I said I could possibly eat. And there it was on my plate, alongside my precious once-fresh banana that was now oil-soaked and fried. Despair. I couldn’t eat the banana, but I toughed it out by consuming half the over-salted egg.
Escape Plan
Fortunately, I found a direct flight from Madrid to Miami, departing at 7 a.m. the next morning. All I had to do was endure one more night. This time, however, I had the medication to do it.
I took the stone with me.
Follow-Up.
Upon visiting the ER in Miami, the doctor confirmed that the 7 mm asteroid had made its way out of the kidney along with two other smaller stones. I was so relieved that I asked, “Am I cleared to return to the Camino?”