The next evening you return. Look, it’s me, you tell the doctor, a normal me, a pain-free person, someone who can walk and talk and laugh like anyone else, not a creeping shameful crippled bundle of agony, not a drug addict trying to con you. And here’s my dog again, his name is Douggie, by the way, did I tell you that? As if the owner of a dog called Douggie could be suspect in any possible way.
The young doctor is glad you have come back, to show him you are bona fide. I’d like you to see a neurologist, he says, if you’ve been getting these migraines for so long . . . Sure, doctor, I’ll go. He trusts you, doesn’t he, it’s the least you can do and, besides, you do want a cure, you want not to have another migraine ever again. If the new neurologist or anyone comes up to you and says, Look, a million dollars or no migraines for the rest of your life, take your pick, it’s not a competition, is it? It just doesn’t take any thinking. You’d laugh and push the money away and take the gift and go off laughing, the rest of your life. A gift. What a holiday that’d be.
Migraine and Madness
There is no stranger offering you a lucky choice, no cures, no doctors who can give you a speck of hope. This neurologist, you go to her, it takes ages, she’s way across the other side of the city. Yes, she knows how you feel, she gets a migraine herself, every Friday; it’s tension, fatigue, the strain of the working week, a let-down effect, she can tell you all about it, can’t she. But she can’t tell you about your migraines and when you try to tell her yours aren’t like that, neat Friday-night migraines, she doesn’t listen. And to be fair you don’t listen either, you never do, because all you want is to know how to stop them. Perhaps, then, she says, you could consider going to a psychiatrist?
Perhaps you could. You’d never thought you might be going nutty, though you feel that way sometimes with the pain. Never thought you might even be imagining all these migraines, or bringing them on unconsciously, willing them on yourself, your wilful sneaky little mind creating them and forcing them on you, and for what? Some kind of punishment? So that’s what happens, is it?
You’ve paid this neurologist how much this time – only eighty-something dollars: cheap, really – to be told you should toddle off to another doctor, who will say, Tell me about your dreams, or whatever they say, laying you back on the couch there. Or maybe he could hypnotise you out of them, like making you give up smoking or chewing your nails or something. Now you feel a little drowsy and when you wake up you’ll never have a migraine again, you’ll feel relaxed and refreshed and alert . . .
Good one, Doctor I Have Migraines Too. Now you’ve forked out money to have a near miscarriage, money to be told you’re mad, what else can you fork out for? What else can they get you on? You’ve been told before that you need to loosen up, relax, that there’s too much tension in you, that you’re stressed out. This is by the new agers, you’ve forked out money there too. Herbalists, naturopaths, acupuncturists, iridologists, go on, name it, you’ve seen them, you’ve heard them all. Too stressed out, too much tension.
Of course you’re stressed out, of course you’re tense. You’re like a coiled spring trying to be watchful for those migraines which are so cunning, so sneaky. They wait until you’re not looking then they move, leaping out from behind corners, closed doors, grabbing you and holding your head in thrall for two, three, four days. Of course you’re under stress. It’s a very stressful business, waiting and wondering when the next one is going to leap on you like that. Wouldn’t you be stressed not knowing when the next one was coming, you say, knowing how much it’s going to hurt, how much time you’re going to waste lying on the bed in your darkened room grinding your teeth and thrashing about and moaning and thinking how many more days, how many more hours. All the wasted, wasted days and weeks of your life. All the books you could have written in that wasted time, all the jumpers you could have knitted, the floors you could have polished, the artworks you could have painted, the gardens you could have weeded, the toilets you could have cleaned: anything, anything, to be doing anything at all, anything but this lying down, a foetal ball of pain and frustration and anger moaning hating and hating yourself most of all.
Stress. Tension. Madness. What a laugh. That’s not what I mean, says one of these practitioners. But you don’t want to hear what she means, let her have one of these migraines, just once in her life, just for a couple of minutes even, just to let her know what it’s like and see if she talks about being stressed out and having to come to terms with unresolved tension and all that bullshit.
Migraines and Real Headaches
It is commonly thought by those who do not suffer the condition that it is like having a headache. When you are in your late twenties you have one of these, for the first time in your life. You find the pain quite amazing, worthy of analysis and reflection, which it is possible to do given the very mild level of pain you are experiencing. During one of these headaches you discover you can still walk around and watch the television and even read. You can say hello to people coming into the room, and make a cup of tea and drink it with them. You take two Panadols and the headache goes. It goes! This is after two hours, with a couple of little Panadols. Then you understand that this is what people mean when they say, Oh dear, I have a headache, I might leave work early today, or, No, I won’t join you for a beer, I might have a little sherry instead, my head’s aching a bit.
This is vastly different to what you have until this point known. This does not involve having to crawl off, to slink away like an animal and hole up in your cave of a room. There is no need to take every drug you can lay your hands on just to take the edge off the pain, just to make it faintly bearable, just so you can whisper to people, Don’t worry about me, there’s nothing you can do, thanks.
This headache makes you realise that this is what people think, then, when you whisper that you have a migraine, a headache. All these years when you have been feeling like this, they have been feeling like that, with their headaches. Theirs are these sweet little headaches which perch neatly on the front of their heads ready to fly off soon after being given just a cup of tea and an Aspro.
They think you feel like that, so they have no sympathy. They think you have felt like that all these years, these long decades, and so it is not surprising that they have also been saying to you all along, Why don’t you go and lie down, I’ll bring you a Panadol? Or, Can I get you a bit of soup or something? Meanwhile inside they have been thinking, Why don’t you snap out of it, you whinger? Why are you malingering like this, it’s only a headache, for god’s sake, only a headache.
Oh, please, you’d take one of those sorts of headaches any day. You’d take two. No worries, you would be laughing. Oh, you would say, only a headache, don’t worry about me. I shall take my cup of tea and have that lie-down and be right as rain in half an hour, you’ll see, right as rain. Oh, give me one of those headaches, give me one, give me, give me, please please please.
Migraine and Medicine
You go to the university for an interview. The old university, the one on the hill. You meet five old men; they fit with the university. They’re in a huge room with sunlight pointing down from high thin windows, the furniture is dark, the five old men have enough glasses and beards and pipes between them to convince you they are important. You are a special case they must consider.
Now, just why do you want to study medicine, can you tell us? You certainly can tell them. You intend, you say in a clear voice, to find a cure for migraines. That’s why you must first study medicine. They don’t laugh, but the beards twitch a little. Well, young lady, what makes you think you can do what doctors in research have been trying to do for at least a century? Young lady. Why don’t they just come out with it and say, girlie or kiddie, like they really mean. You’re twenty-four or twenty-eight – you can’t remember but twenty-something – and they want you to stick to what you’re best at, what you got honours for, not try to change to medicine at this stage. Wha
t was that gentlemen, professors? What am I good at, what should I stick to? Playdough modelling? Lego construction? Scones and ribbon sandwiches? Leave the important things like breakthrough cures to the beards and the pipes?
Besides, they’re now saying, this sort of research attracts a low priority in terms of funding, I mean, it’s not like cancer research or heart disease now, is it? Migraine, really just glorified headaches, heh heh chortle chortle, cough in the beards. Assuming you could get through the course, I mean, my dear. Then there’d be years in practice before you could even think about turning your hand to research. Have you any idea of the commitment required, you’d be thirty or thereabouts before you even left the university, then you’re looking at two, three years’ registrar work, say ten years in practice, and you’d be going off to have kiddies at some stage, eh? They look at you over the glasses, meaning, but not quite saying, Nice-looking sheila like you, should find a bloke, settle down, want to bake a few buns in the oven, that sort of thing ha ha ha.
Forget all about it. That’s their advice.
Migraine and Malingering
You take the advice. Because it is, in the end, all too hard. And also, in the end, there is more than a glimmer of hope that something might work. You have, you think, exhausted all the possibilities. By now no painkillers ever work: the pethidine makes it bearable for several hours, and nothing else touches it, while the brief and two-edged miracle of the ergotamine is never repeated. Every migraine is like you have embarked on a speeding train that does not stop at any station you expect it to, but instead must hurtle through a dense and lonely darkness until the line eventually and quite mysteriously ends. You, of course, are the only passenger, and there does not seem to be a driver.
By now you are no longer pregnant, and your babies were born perfectly healthy and unharmed by the tsunamis of pain that have regularly crashed through your system in the first trimesters. The few doses of pethidine you’ve been given during these months are viewed with the greatest horror by all except the most wise health professionals, and you are easily the worst mother-to-be, exposing her foetuses to such powerful drugs. All the chambers of your heart and all the fibres of your instinct and all the vast rooms of your soul that protect the babies you nurture with a raw fury that surprises you with its force – all this cannot stop your submission to the offer of pethidine, even though the warm kiss of its effect lingers for no more than a few hours, muffling the pain.
Thus you are: a liar, a malingerer, a drug abuser, a hysteric. A gross exaggerator of pain and suffering. An attention-seeker. An avoider of the realities of life. You want to get a day or two off work, escape your domestic duties, hide from the demands of your children, convince the world you are somehow special due to the exquisite torturous nature of your suffering.
Migraine and Memory
One of the reasons each migraine is so spectacular in its pain is the simple fact that every migraine is so spectacularly painful that when it is over you lapse into a state of forgetting. More than repressed, more like a quite conscious decision of your mind to eliminate all cellular memory of the pain associated with this condition. Every time you recover you not only never want to think about that pain again, you simply cannot contemplate the prospect of it ever happening again. This deliberate denial via memory no doubt means that some prophylactic remedies are unavailable to you, or that you try them but discontinue them, or that you can never imagine that you would need to take them.
Even when Imigran becomes available and you discover it works – you still call it the magic pill – and when it becomes cheap enough to have at least a packet on hand – two precious pills, in one tiny box – you do not carry it with you wherever you go or keep a stock in the medicine cabinet.
So profound is this denial that you find yourself in extreme circumstances again and again: for example, away visiting a friend interstate when a migraine strikes, and she drives you to a local doctor whose waiting room is so full you could have died right there. Kindly, he promotes you to the top of the queue, and kindly he gives you an injection of tramadol, and even though deep down inside you know this will not work, and know you need Imigran, somehow you forget to ask him for a prescription. You go home and the migraine becomes bearable for the rest of the day. You have already been denied a flight home due to this migraine: when your friend had run into the airport the day before, explaining that you were late for your flight and just making your way from the car now, due to a migraine, the desk clerk insisted you were not permitted to travel and instructed you instead get a doctor’s certificate before she would reschedule your flight. Fury and frustration made the pain more intense, but in between bouts of vomiting into a polystyrene cup and holding on to your friend, you could imagine what the airline thought might happen. Perhaps your head would explode mid-flight. Perhaps you would die from the added pressure.
The next morning you lie to your friend and tell her you are well enough to fly. The hour’s flight home is one of the more painful ordeals of your life. When you land you ring your daughter to ask her to run up to the chemist for the blessed drug, and tell her that you will be home in a taxi within the half-hour. And an hour after falling into your own bed you begin to feel that unique and distinct sensation that every migraine sufferer knows: that hard welcome empty space in your head that might be nothing at all but is the very palpable absence of pain.
When people phone you saying they can’t do this or that, or email you, which means they are sitting at their computers, you are astonished that they can claim they have a migraine and perform these simple tasks. The prospect of making a phone call while in the grip of such pain, the possibility of climbing out of bed, of getting into a car and driving, of uttering anything more than a groan, is as mysterious to you as quantum physics.
Migraine and Love
This is the time when you are taken to hospital yet again, and no one looks at you sideways or interrogates you about your drug use or demands a whole family history of allergies. This is when this doctor simply walks up to your bed in EU and briskly says, Migraine, right, let’s get you hooked up to the intravenous aspirin. Which actually works, good old aspirin.
Another doctor, a few years later, says, We don’t give pethidine or aspirin any more, we’re using intravenous largactyl. Largactyl? The drug used to control mental health patients back in the day? Absolutely, yes. And it works. And, although it leaves you feeling mind-numbed for a week afterwards, it’s worth it to escape the pain.
These are the doctors you could clasp to your breast and kiss. The ones who don’t think you are neurotic/psychotic/drug-addicted/playing games/just having a stressful time at the moment. The ones who know. Who roll their sleeves up and jump in just as if you’d been in a car crash and needed emergency surgery.
My god, how you love these doctors.
Migraine and Irony
There is no bruising. There are no red marks. And inside the head, in between the skin and the cranial bones, where the dilated blood vessels have recently pulsed until the sufferer felt their head might burst, there is not the faintest sign of injury. While gripped by the pain, the victim has felt that veins and blood vessels have surely exploded with pressure (in fact, they have felt their entire head would explode) but there is not even a trace of discolouration. Nothing is pinker or redder or purpler than it is meant to be. No membrane is inflamed, red or swollen. There is no blood clot, nor any shrivelled and dried-out veins or vessels. To an outsider, even a sympathetic one, it appears that the pain is all in the mind. As indeed, in the most insidious way, it is.
The migraine sufferer has no tumour or growth, no abnormality. When the pain goes, everything vanishes, leaving nothing but the nightmarish feeling of gross, distorted reality, the belief that this horrific experience never really happened, and the desperate hope that it will never happen again.
A migraine victim might regularly vomit, be dizzy or even faint, be unab
le to bear strong light, feel numbness down one side of the body. But for every person who experiences some or even all of these symptoms, there are those who experience none. There is no visible outward sign of their suffering. There is no evidence. It is hard to believe that a pain as overwhelming as that of a migraine is actually not doing the sufferer any damage. The extraordinary intensity of pain, when it recedes, leaves not the faintest trace of its passing. After an attack, any residual effects, such as weakness, dizziness or fatigue, will be the result of the treatment or the drugs taken, not of the migraine itself.
Hence the sense of helplessness. You are suffering, but you are not bleeding, ruptured, torn, bruised, shattered. This is the silent scream of the migraine victim who nurses their pain in complete and total secrecy. A monstrous joke is being perpetrated. Only the most intense pain a body can experience, with not a single sign that the patient is suffering.
Migraine for Beginners
It is stunningly creative: every time it’s the same but different. Thus never able to be anticipated, contained, controlled, cured. In your pain-free moments you admire this migraine, how clever it is, how elusive and how resistant to definition, which none of the many books on the topic you have read manages to capture. Every migraine represents a brand-new challenge, where the old and learned approaches have to be discarded. Where once strong coffee with lots of sugar helped, now it no longer does. Where a combination of paracetamol and aspirin worked, now it won’t. Where pressure-point massage and heat packs provided relief, now they do not. Hot baths, ice-cold showers, or a combination of both, like in a Nordic noir story, now have no effect. Where the bed with cool fresh sheets made up by your mother provided solace, now it is just an irritant. Once dim lights or no lights made a difference, but now you may as well be parked under the interrogatory glare of fluorescence, as indeed you have been many times in the emergency ward.
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