Tag Archives: migraine

Oliver Sacks and Migraine’s ‘Strange and Riddling Landscapes’

We learnt earlier in the week of the death of the neurologist and prolific author Oliver Sacks. In February Sacks had announced that nine years after being diagnosed with an ocular melanoma, the tumour had spread, and that he now faced death.

There have been many heartfelt tributes to Sacks, who had a rare gift of writing about neurology in a way that appealed to millions. In studies on music, hallucinations, deafness, sleeping sickness, and migraine he mingled history, personal memoir and medical science to ponder the mysteries and marvels of the human brain.

I have only come to Sacks’ work relatively recently. No-one can spend much time on migraine without reading his seminal account, first published in 1970, and revised a number of times since. For Sacks, migraine was a disorder which struck particularly close to home. In 2008, in a blog for the New York Times Sacks talked of how he had experienced migraines, and particularly migraine auras, for most of his life. After experiencing his first aura at the age of 3 or 4, the young Oliver was reassured by his mother, a doctor, who shared her own experiences with her son. Years later, he went on to work in a migraine clinic, where he discovered more people who saw the same patterns that he did. Sacks mused that  perhaps “the geometrical hallucinations of migraine allow us to experience in ourselves not only a universal of neural functioning, but a universal of nature itself”. Such a comment reflected his fascination with the cultural importance – in art, folklore and religion – of neurological quirks, and the creative potential of ‘defects, disorders and disease’.

Sacks’ writings were united by his empathy for patient selfhood, his eye for a good story, and his ability to take meaning and wonder from the real-world lives of the people he encountered during his practice, lives so often assumed to be marred by loss, deficit and inadequacy.

In the revised version of Migraine Sacks added an epilogue in which he wrote:

“For every patient with migraine there is A Long Road, and a Short Cut. The Short Cut is a diagnosis, a pill, a pat on the head. It takes all of five minutes. There is nothing wrong with this. The only thing is – it doesn’t usually work. Hence the necessity, for many patients, to take the Long Road. The Long Road is the road of understanding – an understanding of the heart no less than the mind.”

Sacks certainly received criticism – from other neurologists and disabled people – for his ‘popular’ approach, and for the way he transformed medicine into literature. But the centrality of Sacks’ patients to his writing (Migraine, alone, contains over 80 case histories), and his appreciation for their journeys, sticks with me. As I continue to make my own way through the history of what Sacks’ called migraine’s ‘strange and riddling landscapes’ it is patient stories that I, too, hope will be at the centre of my work.

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Filed under aura, commemoration, history, legitimacy, patients, people

On Elizabeth Garrett Anderson

In 1870 Elizabeth Garrett Anderson obtained her M.D. with a thesis on the history of migraine.

I’ve noticed Elizabeth Garrett Anderson popping up in my Twitter feed recently. On 29 September the Royal Society of Medicine in London are hosting ‘A celebration of Elizabeth Garrett Anderson and 150 years of medicine’, to commemorate the 150th anniversary of Elizabeth Garrett becoming a Licentiate of the Worshipful Society of Apothecaries. This made her the first woman in Britain to qualify for inclusion in its Medical Register.

In 1872, Elizabeth Garrett Anderson founded the New Hospital for Women, which was also staffed by women. After her death the purpose-built premises in Euston Road were renamed in her honour. Until 1988 it remained facility run by women, for women. The building is still a prominent feature on Euston Road, now part of the UNISON Centre and housing a gallery commemorating her achievements. Continue reading

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When bodies appear.

‘The head suffers from a certain internal pain which the physicians call migraine…It feels as if there is hammering and pounding in the head. Sound or talking is unbearable, as is light or glare’.

                        – thirteenth-century description of migraine from Bartholomaeus Anglicus, De Proprietatibus Rerum (On The Properties of Things) c.1245. Source: Faith Wallis, Medieval Medicine: A Reader (2010), p. 250.

I was reminded last week of one of my favourite books about bodies and illness. In The Absent Body Drew Leder asks a simple question: why, ‘if human experience is so rooted in the bodily, is the body so often absent from experience?’ (p.69-70).

Pain, Leder observes, makes our bodies appear to use, it reminds us of their presence. Pain ‘reorganizes our lived space and time, our relations with others and with ourselves’. Bodies that are normally silent, that we take for granted, seize our awareness at times of disturbance. Chronic pain, in particular, forces people into a constant dialogue (so often described in terms of battle) with their bodies. In the case of migraine this seizure is a deeply private one, invisible to those looking on. Leder’s book was one of the main reasons that I decided to look seriously into migraine’s history, to ask how, in different times and places, people have made sense of this often unfathomably painful intrusion of the body into their lives.

I first came across phenomenology several years ago. I am certainly no philosopher, but this way of thinking appealed because it is concerned above all with individuals’ relationships and interactions with their own surroundings. Phenomenologists recognise that people do not live in the world of rules and reasons conceived of by science, but in a much messier, more unpredictable world – the ‘lifeworld’. In his foundational book Phenomenology of Perception (1945), Maurice Merleau-Ponty described phenomenology as paying attention to “a general setting in which my body can co-exist with the world” (p.250). In another important text, The Poetics of Space (1958), Gaston Bachelard proposed analysing how people take root, day after day, in a “corner of the world” (p.4). The idea of the ‘lifeworld’ was not a new one. In 1934 Jacob von Uexküll had used the concept to explain how an animal’s existence is experienced through “meaning carriers”. These carriers of significance might include a sensitivity towards heat, or sound. Experience can also be affected by orientation, memories, preconceptions, fears and suspicions.

Pre-migraine

Debbie Ayles, ‘Pre-Migraine’. Credit: Debbie Ayles, Wellcome Images.

It is this emphasis on significance that I find most useful for thinking about the history of an illness such as migraine. This is not ‘environmental health’ in the way that we normally consider it, i.e. in terms of pollution and waste, but a much more personal and less tangible kind of relationship – in which noise, smells, light, changes in air-pressure or the phases of the moon are taken seriously.

One example of this that has stayed with me is a response to a Youtube animation of migraine aura (WARNING: this video contains black and white flashing images). In the comments posted below the video one woman described a time when she had experienced an aura while driving:

seeing multiple images such as repetitive road signs, lights from other cars coming at me while I was dizzy and not knowing if they were in my lane or not, and rays of colors shooting towards me all at the same time. Yes, I pulled over ASAP on a long, dark country road, scared to death and crying’.

People with migraine gain an acute awareness of their surroundings, As can be seen from this quote, and the excerpt I began this post with  this kind of environmental awareness has a very long history.

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