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Authors: Cynthia Kaplan

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I
started having headaches in fifth grade. It may well have been a result of the experimental classroom situation I was in. Twenty ten-year-olds spent the entire day in an enormous room with just each other and two teachers, one of whom looked like Susan Saint James. Or it might have been the New Math. Or perhaps it was our progressive curriculum's constant demand for self-determination in the form of Special Projects. Around the time the headaches began I was working on an idea for a project to write a murder mystery with farm animals as the main characters, and the plan was to actually make life-size stuffed animals who would stand around me while I read the story to the class. A person's mother would have to use a lot of brown felt to make even a
smallish horse. When the big day arrived, not one of the animals, not even the duck, could stand on its spindly, polyfill legs. The headaches continued.

My mother took me to Norwalk Hospital to have an electroencephalogram, commonly known as an EEG. They—when you are ten years old all medical personnel may be justifiably referred to as They—stick fifty or sixty pointy electrodes just beneath the surface of your scalp and measure your brain activity. Your brain waves. The ebb and flow. High tide, low tide. If there is a disruption, something that upsets the regular poom-poom of the surf upon the sand, a sloop wrecked upon a coral reef or a storm a-brewing, or,
say,
the presence of a large unidentified mass, the EEG will detect it. Of course, an EEG is only prescribed when indicated by,
say,
the sudden onset of blurry vision followed by the horrifically painful sensation that your head is about to cave in.

There I lay, whimpering, sprouting wires, Medusa-like, while they recorded what I presumed were my ten-year-old thoughts. Would they learn that I was mortally afraid of Heidi Holbrook, who was known to pin fellow classmates to the blacktop and pull up their dresses, looking for what? Or that I often threw my American cheese sandwiches in the trash, once provoking a teacher to give the entire cafeteria a lecture on starving children in China? I had no idea what could be wrong with me; I didn't read
Death Be Not Proud
until seventh or eighth grade.

 

Here's what a migraine headache feels like. First, it feels like you think you have a brain tumor. It doesn't matter how long you've been getting them, that morbid notion is always loitering there in the back of your mind. So that's first, the Ridiculous Fear. Then there's the Justifiable Dread, humming harassingly in your ear as you prepare for every major event of your life. Will you get a migraine on the class trip to Mystic Seaport? In the middle of performing the spring musical,
Damn Yankees
? Will you get one while you're taking your SATs, during your twenty-first-birthday party, at your college graduation? Will you have to lay down on the floor in the hallway outside your wedding reception? Will you forget to take your migraine medicine with you and have to canvass friends and strangers until you have accumulated at least eight Tylenol or Advil? Then comes the Moment of Truth. Do you really have the blurries? Or is it just a head rush, or snow blindness or photosensitivity or a floaty in your eye?

About 15 percent of migraine sufferers experience what is referred to in the medical world as an “aura” before they feel any pain. This is not the Dionne Warwick kind of aura. My aura, what I call the blurries, is actually, in migraine-speak, a “visual disturbance” during which mini-bolts of lightning appear, slowly at first, and then with increasing intensity, until everything in view looks like a TV after the national anthem has been played. It's pretty disturbing. In the first
moments of their appearance the blurries are accompanied by an intestinal groan, a sort of lamenting in the bowels, which may itself be either a feature of the headache or the physiological manifestation of Utter Dismay. Of course, things could be worse. Other migraine aura options are temporary paralysis of one side of the body and slurred speech.

When the blurries start, it's as though everything is closing down and closing in; the migraine is the dark shadow in a Scooby-Doo cartoon and you are the cringing Gang. The blurries usually last about twenty minutes, then, as the flashing recedes to the periphery of my vision, the pain begins. It is almost immediately intolerable. It defies description, but let's give it a shot, anyway. It is at once sharp and plodding, exact and diffuse. It is so large that it is difficult to place exactly where it is worst. It throbs behind the eyes and at the temples; it grinds at the base of the skull. Sometimes you are doubled over with terrible, bubbling nausea. It is as if a bear has chomped on your head and is trying to dislodge it from the rest of your body, and you are simultaneously sickened by the thought of your decapitated self.

In those first years my mother would pick me up from school and put me to bed with the lights out and the blinds pulled down. I would lie in the dark, keening, praying for sleep. Later, when my brother and father came home, there would be a lot of shushing and creaky-staired tiptoeing. By high school, if my mother couldn't be reached, my friend Mary Beth was permitted to leave class and drive me home in
the car I shared with my brother. She would spend the rest of the day watching TV at my house. By tenth grade I was taking Cafergot, a mixture of ergotamine and caffeine intended to constrict what were then believed to be excessively dilated blood vessels. The trick with Cafergot was to take it before the headache kicked in and then to get to sleep before the caffeine kicked in. The main trouble with Cafergot was that first, it was not a painkiller, and second, it was not a painkiller. My next prescription, Ergostat, consisted of a tiny pink pill, to be placed under the tongue where it would slowly, chalkily melt. It had a vague peppermint flavor and was notorious for inducing extreme nausea. To this day certain mints still inspire horror, and the words
under
and
tongue
uttered in close proximity have the same Pavlovian effect on me that
nest
and
egg
had on Albert Brooks in the movie
Lost in America.

Another unfortunate side effect of migraines is that they make you kind of a bummer to be with. If you are out with friends at night or on a trip or somewhere very inconvenient like on a ski slope, everyone or at least someone has to stop what they are doing and wait for you to recover enough to continue. Everyone has to be solicitous and concerned and not act annoyed that the works have come to a screeching halt. So you get to trying to hide your headaches. You say, “You guys go ahead, I'm going to skip this run and take a breather/admire the view/examine my bindings for a while.” And you hope that someone sidles up to you and
says, “Yokay?” so you can whisper, “Migraine,” and then at least one person knows you're in potentially desperate straits.

No place is sacrosanct. I often get them in the middle of the night and the Me that I am in my dreams will get the blurries, too, interrupting the dream-event at hand to go looking for painkillers, usually aspirin, not anything stronger or more current, in that same way that every time I dream of home I dream of the house I grew up in. Then the headache will begin and I will wake up and fumble in a muddle of déjà vu for my Tylenol 3. I will stumble to the kitchen for an ice pack and a dish towel and I will affix the former to my forehead with the latter. It is possible I will groan as I await relief. When my husband wakes in the morning he will find the remnants of my dead-of-night soiree: a defrosted rectangle of blue liquid in a plastic puddle beside my head and the towel over my face—defense against the dawn. Sometimes I will wake David and let him/make him take care of me, a luxury after so many years alone. Maybe that is one of the best things about being married.

There is an idea, I think, propagated by
Masterpiece Theater,
that people who have migraines are whiners or shirkers or both, or else they are dangerously, unbearably fragile. Women on
Masterpiece Theater
are always claiming “The Megrim” in order to be excused from some unappealing activity, often one involving sex with their husbands. Conversely, a megrim was also an excellent reason to stay home from, say, the hunt, and tryst with one's lover. Unfortunately,
some seemingly authentic sufferers, it would turn out, were actually the victims of undiagnosed brain tumors. Anyway, back to the point, or at least, the point I am making here, as opposed to the larger point, which
is
about brain tumors: migraines rarely occur in the midst of even extraordinary pressure. I used to have a boss who, at the height of the day's tensions, would exclaim, “This is giving me a migraine!” The poseur; it drove me crazy. Migraines are
post
-tension headaches. They happen when the buildup is over, when you finally relax. They like to strike when you least expect them. While this reasoning seems paradoxical, it is not. Most of the worry, most of the tension associated with an important event occurs as the groundwork for that event is laid. What's a good example? I know one: childbirth. You would think the months and weeks and days leading up to the big event would be chockablock with headache-inducing stress. Picking the pediatrician, buying some diapers for the thing you hope doesn't turn out to have two heads and one foot—that can be very worrisome. Yet, not a megrim in sight. But activity is the antidote to anxiety. Once the ball starts rolling there is a necessary letting go, a release. My water broke at ten o'clock in the evening. We went to the hospital, and no sooner had they given me Demerol to help me sleep through the night than I got a migraine. On Demerol.

Of course this is just one theory. But it is, among others, roundly accepted in migraine circles. Other theories have to do with food triggers, such as red wine, chocolate, aged
cheese; hormonal changes, particularly in conjunction with menstrual cycles; and my favorite: weather. I am a human barometer. Sometimes my migraines begin precisely as a storm is moving in or out, as a dry front blows away a wet front or vice versa, or a heat wave is broken by a high-pressure blast from the Gulf Stream, whatever the hell that really is. Mention El Niño and most migraineurs will blanch and shudder.

 

I recently ran into a woman I know on the street and she told me that six weeks earlier she'd had a benign brain tumor removed. In February she'd woken up deaf in her left ear and after a lot of testing by an Ear Man she was sent for an MRI. A tumor in the center of her skull was depressing an aural nerve. But they got it out and now she's fine. The kind of tumor she had was a one-in-a-million thing. “Well,” I said, “after something like that you're pretty much in the clear.” “You'd think so,” she said, “but actually when I was five I had brain cancer, and that was a one-in-a-million thing, too, and the two are totally unrelated, so go figure.”

I'm figuring. I'm figuring that maybe she had both
her
one-in-a-million thing and
my
one-in-a-million thing and now
I'm
in the clear. On the other hand, it makes you think that you're never in the clear. And the truth is, bad things befall the same people over and over again all the time. The same way that disasters often happen in clusters. But, still, brain cancer and a brain tumor? What's the deal with that?

I thought about this woman when I woke up one morning and my left eye was tearing. Why was my left eye tearing? Because I had a brain tumor and it was pressing down on my tear duct, that's why. What else could it be? All right, maybe I had a little cold in my eye. Or maybe part of me was just trying to enjoy the good life while the other part of me was heartsick over apartheid. Or maybe the right side of my brain was sad that I've never been good at math. My eye cried for over a week. I felt like the clown with the single tear. Although, why is he dressed like that if he's feeling so bad? Anyway, I was concerned about the condition's primordial source, if you know what I mean, so I went to the eye doctor. She checked my lens prescription and sent me on my way. Undeterred, I made an appointment with a playwright I know who also happens to be a neurologist.

Actually, I was going to see him anyway. Besides the fact that I knew Jeff would be particularly sensitive to the enormous dramatic potential of a cold in the eye—it's good to have a friend who is both a healer
and
an artist—I'd recently had a very bad run of migraines. Whenever there is an escalation in the frequency of my headaches I go on the lookout for a good opportunity to check on the status of my brain tumor. It is probably still too small to show up on a CAT scan or an MRI, so it was my plan to have Jeff perform what I refer to as the Lindsay Wagner Inert Arm Test. There was a TV movie many, many years ago starring Lindsay Wagner as a woman with a brain tumor. She had been getting headaches
and having dizzy spells and when she went to the doctor he asked her to close her eyes and hold her arms out straight in front of her, perpendicular to her body. Lindsay closed her eyes. One arm rose and one did not. The doctor asked her if she was still holding both her arms out and she answered confidently that she was. The next time we saw Lindsay her head was encased in a helmet of white surgical gauze and her memory was kaput. Could her husband still love her? Could she love him? I'm not sure but I think I remember that the new Lindsay and the doctor fell in love. Hmm.

Or maybe it was Elizabeth Montgomery.

Jeff performed a variety of other coordination tests. With my eyes closed I raised my arms (both of them) and I touched my index fingers to each other and to my nose. I followed Jeff 's finger with my eyes to various points around my head. Then he felt my skull for telltale lumps, and assured me that the one I thought was a brain tumor was actually the tip of my cranium. He also examined my thyroid and popped my knees and elbows with a small hammer. I was ever so slightly self-conscious, being that he was also a friend and colleague whom I have known since before my marriage, and I blushed embarrassingly when he patted the examining table because I assumed he meant for me to lie down, which he didn't. I don't know why this should have been embarrassing, but it was. Maybe I was overzealous for an examination of some sort.

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