To wait (burning out) or to operate in chronic pancreatitis (CP) has become a top matter of debate between internists and surgeons. The often cited editorial: “patients, patience and the impatient surgeon” characterizes the issue (1). Is the controversy as real as it is often stated? Is the statement in the surgical literature: “some internists advocate that no surgery is necessary for pain relief in CP” and that “pain relief will come spontaneously if you wait long enough?” 2–4 not an oversimplification? Confusion regarding the management of pain in CP exists for many reasons. Three aspects shall be considered here.