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Of Mothers and Migraines; or, How I Learned to Stop Worrying and Read Oliver Sacks

My mother gives me a headache.  It would appear, also, that she gave me headaches.  When I spoke with a neurologist last winter about the increasingly frequent migraines I was having, I told him about my mother’s medical history.  He smiled sardonically, one adult survivor of Jewish parents to another, and said, “Well, the good news is that this is probably your mother’s fault!”

Twenty-eight years ago, when my mother was the exact age I am now, she began to have migraines.  These manifested as powerful and debilitating headaches, which, along with major pain relieving drugs administered by ER doctors and later by her neurologist, would knock her out for days.  Days have a way of adding up.  Enough knock outs and you stop getting up so fast.  As I recall it, anyway, my mother slept on the couch in the daytime for about four years.  I have memories of coming home after school and just sitting on the floor watching her sleep.  I think I felt abandoned.

My mother’s neurologist was a world-famous specialist who, Google informs me, wrote what is still considered the textbook on headaches.  He recommended Oliver Sacks’s book, Migraine, and when Sacks later came to our local metropolis on a book tour, my otherwise homebodyish parents went.  My mother loved being taken care of, understood little science, and was in awe of doctors.  Oliver Sacks blazed on her horizon like a bright star.  Yet, when he signed her book, she gave him my name.  Sacks inscribed my mother’s copy of Migraine “To Jordan, who taught me everything I know.”  I was eleven or twelve, at home, alone.

Even in those childhood days, my mother’s headaches were already marked as my inheritance.  Because she suffered from migraines, there was a 40% chance I would too.  But because there was some migrainous history on my father’s side, the chance jumped up to 80%. My mother repeated these numbers, and I grew up repeating them too: her words in my mouth, her pain in my head.  Perhaps we each wanted to believe that having this connection was the same as her giving me what I needed.

If I was being ignored as a consequence of my mother’s illness, I was being roped into it as well, made complicit with things I didn’t do and certainly didn’t understand.  I coped in the ways I could: meaning, I waited out the better part of three decades, and then told this story to my therapist last week.  Afterward, I walked into the independent bookstore down the block from his office and bought myself a copy of Migraine.

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My first migraine headache came at sixteen.  It was fierce pain that blossomed rapidly and lasted overnight.  My parents were out of town.  I don’t recall much else, including how I treated it.  I much more vividly recall my second one, ten years later, which arrived in the midst of grad school, much like doom.  There was a blinding pain behind my eyes and in my temples.  It was late afternoon, and the day was cloudy, but any light was too much.  I put a cold washcloth on my forehead and lay in my mercifully dark bedroom and cried.  It was an exquisite pain that I never would have guessed a body could feel.  

And then, after three hours, it was gone.  Just gone.  I was lying in the dark crying and suddenly I was without any reason to cry.  There was no gradual diminution–I just felt fine.  It’s hard to really comprehend what “disorientation” means until your body turns on you like this.  My perceptions felt so warped that I wasn’t sure I hadn’t made it all up.  Something about relief’s suddenness seemed to leave my experience without the possibility of validation.  I think I felt abandoned.

Days later I called my mother and, forcing in a word edgewise, I told her I’d had this migraine.  “Oh,” she said, uninterested. I didn’t know how to prompt her, and she changed the subject.

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Psychologists tell us that proximity is the great liability of caregiving.  When you’re responsible for another human who can’t be responsible for itself — a child, say, who can’t clearly know or tell you what it needs — it becomes just as easy to get too close as not close enough.  Plenty of caregivers (mothers, parents, others) balance this distance fine, though no one ever gets it perfect.  Care involves a lot of give and take, and it’s not surprising that the well-adjusted learn to appreciate the best their mothers were able to do.  But, for the same reasons, neither is it any wonder that everybody who’s ever had a mother worries at some point that they’re turning into her.  

My experience and my mother’s experience were usually too close, even before the headaches.  But her migraines threatened me with a particular kind of closeness: that 80% chance I too would inherit her suffering.  I didn’t want them, but also, how could I not at least want the affinity to my mother that my future headaches stood for?  In a period of years when my mother was supremely sick and so mostly unavailable, her appointing me heir to her headaches was one of the few forms of proximity to her that I came to rely on.  Freud tells us that all love is narcissistic, but being a mensch he demurs from stating the corollary: not all narcissism is love.  That one you have to figure out along the way.  

No one in my childhood spoke of Freud, and it was Oliver Sacks from whom I always assumed my mother had learned her terrifying statistics about my future pain.  I think I was quietly afraid of what other horrors Sacks might have in store for me.  Studiously, deliberately, I undertook the not-inconsiderable feat of wandering through a liberal arts education in the 1990s and avoiding all of his writings.  It was a balancing act.  I didn’t want to get too close.

When the migraines came for me last December, I thought: it’s finally happening, I am turning into my mother.  I took a quick look at the life I was living, compared it to the ones she lived both before and after the headaches took their toll, and said to myself, no. No, I won’t turn into her.  The only model I had for dealing with the unreal pain of migraines was not one I was going to follow.  So I took drugs and played with dosages and submitted my brain for scans.  When the side-effects of one preventative medication nearly hospitalized me, and my doctor, (the one who had said it was my mother’s fault,) this time declared “It’s not science!” I found another doctor.  I cried in front of my therapist, my boyfriend, and my dog.  And then, finally, out of ideas and out of the blue, I decided to read Oliver Sacks.

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Considering how large the book, Migraine, looms in my childhood imagination, I am surprised at how nearly impossible it seems to me now that my mother would have actually read this book.  Though my parents were educated people, ours was not a bookish family, and Sacks’s otherwise readable prose alternates rapidly between descriptive case studies and abstract generalizations, each dense with medical terms.  Even with a PhD and a sizeable vocabulary, I have had to pause in order to appreciate the distinctions in a sentence like “The same considerations apply to pulse-rate: an initial tachycardia is likely to be followed by a protracted bradycardia, the latter sometimes associated with significant hypotension and postural faintness or syncope.”  

It’s also difficult to imagine that my mother would have appreciated one of my more unexpected pleasures in reading Migraine: observing Sacks’s thinking.  Despite the technical density of the account, its organization is masterful, as it attempts both to classify a full catalog of migraine symptoms and also to offer a sustained critique of the rigidity of much nosological literature.  What matters to Sacks is not just that diagnostics be accurate, but that they be user-friendly.  It’s that same gentleness of manner that leads him, in the preface to the book’s 1992 reissue, to call migraine a “recurrent yet essentially benign” condition.  But this, too, was amazingly far from my mother’s take on the subject.

“Essentially benign” is a borderline dishonest way of describing a phenomenon that took up so much space outside my mother’s head, in the world we were supposed to share.  Her headaches left her broken down in tantrums, screaming and crying; made her irritable, unhappy, on edge; provoked a volatile cocktail of hallucinations, lethargy, and sometimes violence.  Her migraines were the reason that my obediently handing her something she’d ask for would end with her slapping my face.  They were the reason she’d get doped up beyond consciousness and sleep for days, or take three Percocet and then drive on the freeway.  They were the reason that at twelve years old I knew something about the dosage of Percocet.  To say the least, I was not disposed to imagine that migraines were “essentially benign.”

Whose side was Oliver Sacks on?  Whose position was getting too close to whose?

But the more I read, the more Migraine continued to be full of things that my mother — that my childhood — had gotten wrong.  I now know that there is no agreed-upon cause for migraines. But what has long eluded medical science was something that my mother declared solved from the beginning.  She was very satisfied to think that she’d inherited her headaches from her parents (neither of whom had suffered from recurrent migraines, but, like me in my teens and twenties, had experienced isolated ones in youth).  She clung to heredity as both explanation and prediction.  But astonishingly, my likelihood of having inherited migraines from my mother turned out not to be 80%.  Sacks puts it just on this side of a coin-toss, closer to 60%.  But he insists on the ambiguity of this figure.  “The fact of familial incidence is indisputable,” he writes, but “the interpretation of this fact is far from clear.”

I nearly dropped the book.

Perhaps it seems foolish that it would take me months of having headaches, treating headaches, and reading about headaches to learn that, in fact, these were my headaches.  But I’d had so many reasons to believe — at some level, to want to believe — that they were my mother’s.  In retrospect, I suppose the reason that no one explained to me whose headaches I was having is because that detail must have seemed rather obvious to anyone for whom this acute pain was not a long-anticipated bequest.  Presented with the very thing I had been waiting for, it took a while to figure out that, no, I had always misunderstood what would come to pass.  It turns out I had been waiting a very long time for something that would never — that could never and should never — happen.  And while that’s a classic recipe for regret, that’s not how I feel.  Instead, I only wish that while I was waiting I’d had the foresight to bring a book.

–Jordan Alexander Stein: educates the future leaders of tomorrow at Fordham University and tweets @steinjordan

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2 COMMENTS

  1. “Freud tells us that all love is narcissistic, but being a mensch he demurs from stating the corollary: not all narcissism is love. That one you have to figure out along the way.” Accurate, and timely. What perhaps all writing should be.

  2. As someone whose parents both got migraines, who suffered from migraines in high school and college. As someone who married a man who had debilitating migraines in high school. And as someone who has two daughters who get migraines. . . and as someone who enjoys Oliver Sacks, I enjoyed reading this.

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