This book was originally written in 1970 with subsequent revisions in '85 and '92. Given that it's slightly outdated I wasn't sure how relevant it would be, especially considering all the different migraine medications they have now. I couldn't have been more wrong!
The wonderful thing about Dr. Sacks is that he's not all about standardized, generalized drug-treatment and he has a full respect for nature. He considers each case and patient as an individual human being with all the uniqueness that implies.
In addition, I was fascinated to read historical perspectives on migraine and realize that some of the insights from hundreds, if not thousands, of years ago are relevant and spot-on today.
As someone who grew up with a neurologist father and watched my mother suffer terrible migraines only to develop them myself at age 12, I obviously had a selfish, personal interest in this book. When in my mid-30s I developed a migraine that wouldn't go away (Sacks writes "migraine gathers identity from stage to stage, for it starts as a reflex, but can become a creation") and spent the next two years going to the top migraine neurologists (one of whom Dr. Sacks quotes) and taking countless drugs.
Eventually, realizing that the drugs were making me feel worse than the migraine, I stopped it all and have been developing ways to manage it on my own.
In reading Dr. Sacks' book, I now realize that it was not the drugs alone that were exacerbating my situation...it was the doctors! "The physician must not dominate or be dogmatic to the patient, must not play the expert, insist "I know best"; he must listen to the patient; listen beneath words; listen to what his illness, the migraine, is "saying".
My biggest frustration was that these "experts" that I sought help from did dominate and did insist that they knew best, to the point of literally telling me that some of the symptoms I described were not possible! If I could have Dr. Sacks as my doc, I might actually consider seeking medical advice again.
Of further interest, Sacks provides numerous case histories and artistic renderings of what migraine aura look like as experienced by the migraineur. What a validation this was! I now have an actual picture I can point to and say "that's what it's like" when people ask me to describe my auras.
Lastly, he provides a brief appendix discussing the "visions of Hildegard" and how there's "no room for doubt concerning their nature: they were indisputably migrainous". The excerpts from Hildegard's writings provided, once again, great validation and a beautiful new way in which to envision my migraine auras/visions.
In the end, an excellent book for somone with migraines, but more importantly, for those who treat people with migraines to read. Sacks is a physician, so at times the book can be a bit heavy on the medical jargon, but not so much as to overwhelm. In addition to being a thoughtful, empathetic, and extremely knowlegeable physician, Dr. Sacks is also an excellent writer who uses language beautifully.