A Brain Wider Than the Sky: A Migraine Diary

by Andrew Levy

there is no line between the migraine and worrying about the migraine

the anticipation of some future pain is so intense that sleep is now impossible. And, of course, sleeplessness such as this is an invitation to the headache. This cycle cannot be stopped. It is almost, I hate to say, interesting.

because your eyes took in too much light all of a sudden, because of a tall cup of coffee (caffeine stops some migraines but makes others), menstruation, a chocolate bar (maybe), a glass of red wine or a glass of white, cigarette smoke, air travel, that storm front coming down from Denver, the leaves falling off the big oak in your front yard, that extra hour of sleep you got last night, the hour of sleep you lost, too much heat, too little water, too much stress or too little, that other headache, the painkiller you took to stop the last migraine, the last migraine itself, your Eastern European grandmother’s errant genes, nothing at all.

a migraine constitutes a metaphysical crisis. At first, it is simply impossible to believe that this headache is coming from within your head,

The Egyptians, similarly, recognized what every modern migraineur who has ever clamped pillow to temple, or icepack to forehead, also recognizes: that applying pressure to the tender point seems to help, whether or not a clay crocodile is the means.

A headache comes in the seventh hour of a transatlantic journey and stays for three days, on the right side, at a jaunty angle, almost, like something affected I brought back from Europe, like a beret.

I can make guesses, can align my symptoms and its timing to any number of diagnoses, but the thing about a migraine is that you can always do that.

migraines go on for hours and hours, if not days and days, and there is no easy way to paint, film, photograph, or write about monotonous pain.

within two hours it resolves itself into a thick, throbbing pain like a band across my forehead, a little between the eyes, a little alongside the left eye socket, a little on the left temple, just a grace note there.

I have to tell myself that this will end at some point.

Then there is a long nothingness. Bu-duh, bu-duh, bu-duh. What else can I say? There’s no vocabulary for monotonous pain. By ten or eleven, the migraine lifts, it rises like leavened bread and grows light and airy, and then floats away.

The Bible, in fact, is a long history of humankind being punched in the face by God and being invited to think about what it means.

As helpless as a newborn left alone in a room, I realized that toughing it out was really a form of self-immolation, the desire to beat the headache only making the headache worse, a long, slow road down.

As a headache, however, “migraine” was the most compelling example of a “primary headache,” a headache with no other source but itself.

the “convergence hypothesis” argues that most primary headaches are essentially migrainous, “different points along the same physiological process,” “escalating” in the direction of migraine if not stopped.

there is no clear gestation period that turns trigger into throb,

Not sure whether they are migraining, patients “wait and see,” when all evidence suggests that nothing beats a quick triptan before whatever you might be having escalates.

a low pain lies over my right eye like a thin cumulus cloud at sunset, tilted slightly. Not too bad, but a sad inevitability.

It’s not that the migraineur looks blind, stares vacantly, for instance, or is unable to focus, but that the eyes seem to be engaged in some other activity not visible to the nonmigraineurs in the room. The migraineur is staring at something not visible, or looking around something that is not visible, or wincing at light which, to everyone else, seems normal, or even subdued.

when you consider that most of the people with their heads down, their eyes averted (or sunglassed), are women, that many men still see head pain as something one might defeat with a dose of the stoic, one can easily see how the intersection of migraine and gender is a flashpoint.

amid the layers of triggers and treatments and genetic explanations, there is no one single key to tell you if migraine is something you make or something you can’t help.

when this headache visits, I’m no more human than the feral cat that waits out its injury underneath a bush.