Migraines have plagued me for years. A new book puts my pain in perspective

|    Sibbie O’Sullivan    |

IT’S estimated that over one billion people today suffer from migraines, two-thirds of them women. I am one of them.

In Migraine, Katherine Foxhall delivers a thorough and illuminating history of migraine that traces our endeavours to understand, treat and eliminate this painful condition we still know little about.

Is migraine a disease? What causes migraine? What are its social costs? These are not the questions I ask when a migraine hits, but I’m glad Foxhall does.

Her intention to write “a history of migraine from below” by examining the experiences of people in pain, many of whom lived centuries ago, puts my own pain in perspective. I and my wincing, throbbing right eye do not suffer alone: Migraine is as old as humanity.

Foxhall’s early chapters are a cornucopia of historical detail and examples of human ingenuity in the service of finding, if not a cure, then a way to live with migraine. Early remedies included bloodletting, an evolving and increasingly sophisticated practice that relied on specific charts and instructions.

Applying to the forehead a plaster of ground-up boiled earthworms encased in linen was another. Then there was trepanning, a process of drilling holes in the skull to dispel bad vapors in the brain.

By the 1700s, pills promising relief were advertised in British newspapers and sent through the mail.

By 1781, the French word migraine entered the English language as the accepted medical term, replacing older words such as ‘megrim’.

Migraine: A History by Katherine Foxhall. – JOHNS HOPKINS

The history of migraine also involves gender and class. Foxhall, a cultural and social historian, relates how migraine came to be seen as a female disorder in the 19th Century, and how the belief in a migraine personality – “sensitive, effeminate and nervous” – infected the medical establishment with gender bias.

By the 1960s, an image of a suffering housewife with her face in her hands appeared in advertisements for migraine medications. Men who suffered migraines were seen differently. An 1888 article in The Lancet, the prestigious medical journal founded in 1823, declared that “the (male) migrainous patient frequently belongs to the most cultivated and intellectual class of society”.

Smart men got migraines from thinking too hard, but men working in factories and on farms were evidently pain free. Women were simply nervous and hysterical. With growing knowledge about the brain and nervous system, the occurrence of such medical cum moralistic declarations declined, though their sexist residue still exists: In 2017, the National Institutes of Health budgeted USD22 million for migraine research compared with USD57 million for smallpox, a disease that was declared “globally eradicated” in 1980.

One way to explain the disparity is that migraine, an ongoing global problem, is still considered a women’s problem and therefore gets less funding.

Foxhall’s erudite and vivid accounts of migraine spoiled me for other books on the subject, but I wanted to see how self-help books approach migraine. The ones I read are focussed on recovery; all their case histories are success stories.

Their titles vibrate with attitude and resolve. There’s a migraine relief ‘plan’; a migraine ‘miracle’; a ‘you-can-take- back-your-life’ promise. These books do provide basic medical information but are over stuffed with bulleted factoids, endless pages of recipes and daily tracking goals.

They are carelessly written, historically shallow, and contain no elegance, no awe, only plans of action and can-do peppiness. Worst of all, they bully the reader. Did I learn anything from them? Yes – to stay away from bananas. Bananas!

Oliver Sacks’ 1985 book, Migraine, does contain elegance and awe. Sacks – the late neurologist best known for his book The Man Who Mistook His Wife for a Hat – eschews self-help but embraces mystery and acceptance of a condition that remains shrouded.

Foxhall’s history of migraine, unlike the self-help books, accommodates human complexity without scanting medicine’s contributions to a condition that affects roughly one in seven people on our planet. A lively, scholarly book about migraine, Foxhall’s history is also a treatise on the human condition. Although relief from pain is wonderful, pain remains the great equaliser. Whether we take Imitrex or dress our foreheads with worms, we shouldn’t forget this.

(O’Sullivan writes frequently about culture and the arts. Her book of essays about John Lennon is forthcoming from Mad Creek Books). The Washington Post