A Brain Wider than the Sky: A Migraine Diary

Because my headaches began when I was only three, I am reliant on my mother for the crafting of my migraine narrative. The first of what would become weekly or twice weekly attacks, she tells me, hit while I was watching television: I turned pale, complained of terrible pain over my right eye, and soon thereafter threw up. Psychosomatic, the neurologist told my mother after years of searching for a cause. Triggered by stress and repression. Sensitive, artistic kids are prone to them, he said. He told me they were a sign of high intelligence and, though he stopped just short of using the word "neurosis."

Thus began my lifelong equation of pain and merit, pain and talent, pain and psychological self-abuse (and interestingly enough, a lifelong aversion to recreational drug taking). My childhood migraines singled me out, providing what I saw as concrete medical confirmation that I was smart and worthy, even as they stole weeks and months from my life. Now Andrew Levy -- in his fascinating new book, A Brain Wider than the Sky -- examines the effect migraine headaches, through the personal suffering of writers, artists, and religious and political figures, have had on broader cultural history. What emerges is a migrainous personality at work in the world, a divided self that carries around a brain both victim and attacker, the dissonance of which undoes some and stirs others to genius. The blurring between what is internal and external gives rise to hallucination and religious visions, wild flights of creativity, radical thinking, and madness.

Levy himself suffered periodic migraines all through adolescence, but in his early 40s, with a book under contract and a young son at home, he experienced a four-month spell of headaches so debilitating it nearly cost him his marriage and his sanity. During this period he kept a diary, seeking, he freely admits, comprehension more than cure. He researched the history of migraine, recognized and described as far back as Hippocrates. To relieve the pain, Galen recommended that a live string ray be placed on the temple of a suffering man. Maimonides, a little more rational and conservative, suggested toast in undiluted wine. Trepanning (cutting a small hole in the skull) was practiced before Christ and after Darwin. But despite millennia of such speculative cures, the cause of the malady itself remains inexplicable. Is it a vascular disorder? The nerve storm of a "hyper-excitable brain"? Or as researchers felt by midcentury, merely an "inappropriate protective or adaptive reaction to tension, hostility, frustration or fatigue"? Migraine can be triggered by nearly everything -- low-pressure systems, high-pressure systems, perfume, stress, boredom, too much caffeine or too little. Sometimes, as all migraine sufferers know, nothing touches them off. They just are.

Migraine's ineffable and contradictory nature is what fascinates Levy most, and where his book lives. Wincing in the dark, he took notes on the many permutations of his pain and "aura" (the term used to denote sensory alterations that for many precede the onset of the headache itself), though like trying to describe music or dance, he found it nearly impossible to convey headache's intensity or artistry. Whether Levy's pain "stabs" or "balloons," he layers metaphor upon metaphor, painting a portrait not only of the headache but of the sufferer compelled to describe the pain both to himself and to his family and friends, those whom it most adversely effects. Levy's attempt joins in a long tradition of other inspired migraine sufferers -- Hildegard von Bingen and Emily Dickinson and Lewis Carroll -- but perhaps Kipling comes closest: "One half of my head, in a mathematical line from the top of my skull to the cleft of my jaw, throbs and hammers and sizzles and bangs and swears while the other half -- calm and collected -- takes notes on the agonies next door."

For Levy, this simultaneous passion and detachment, two selves in a single skull, defines the migrainous personality. Comfort eludes. Civilization, with its myriad everyday triggers of smell, light, even the touch of a loved one, hurts, and relief can only be found in the absence or negation of the very world that sustains us. Those with chronic migraines develop a de facto "politics of isolation," alternately retreating from and pushing beyond that which they feel mentally oppresses them. Nietzsche was tortured by headaches, as was Thomas Jefferson just before penning the Declaration of Independence, a document "migrainy for what it asks: Leave me alone." During a period of intense migraines, (and with the help of a little cocaine therapy), Freud developed his theory of ego, superego, and id, those warring fiefdoms within the mind and the psychic territories they control. The perpetual internal struggle, Levy writes, forces one to contemplate "the boundary between free will and fate, between the things we choose to do and the things we're made to do....The great migraineurs understood intuitively that a creative act sometimes looks and feels like something you didn't want to do."

As with any chronic sufferer of any disease, Levy has a slight tendency to romanticize and overidentify with his own pain. Reading along, I found myself bothered by the term he favored for a person who suffered from migraines: "migraineur," with its connotations of "connoisseur," as someone who appreciates and cultivates the art of migraine. It bothered me that I was bothered, until I realized that the labeling of a person by his pain connoted for me a merging of the disease with self, as opposed to the self undergoing a series of episodes, albeit lifelong. While I could never deny that my personality and creative vision have been profoundly shaped by my history of migraine headaches, I have stopped short at granting them that extra "power" over me, choosing to put myself at the center as a "person who suffers migraines," rather than emphasizing the disease by adopting the identity implicit in a term like migraineur. Waging this private argument with Mr. Levy and myself drove home how absolutely accurate his analysis of the migrainous personality was. I am still locked in an internecine cranial battle for a "self" that should somehow separate from the punishing brain. My headaches are still out there somewhere, not a part of me. We're still not sure who is in charge of the asylum.

April 24: "[The HST] lifted a curtain from our view of the universe, changing it so profoundly that no human can look at the stars in the same way..."

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