When Joan Didion writes about her migraines in her essay, In Bed, she reveals that doctors believe there is a ‘migraine personality’, which includes being inwardly-focused, ambitious, rigidly organised and a perfectionist.
You pause to reread this list, noting that you probably tick all of these boxes. You have suffered with migraines for as long as you can remember, your mother claiming that your incessant crying as a baby suggests they started when you were in nappies. When you were older you were prescribed tablets that she crushed with the back of a spoon, mixing the grainy powder with a spoonful of jam to make them more palatable. But nothing could stop the inevitable. The migraine was a runaway train with you as the only passenger.
In the first thirty years of your life you were given fair notice of an attack, with the ‘aura’ beginning as a spot of absence in your vision, expanding to become a thread of fairy lights strung through your left eye, blinking and flashing as though they were floating on the rippling surface of a lake. The headache would come a swift half hour after the lights faded away, as punctual as you are perfectionist.
You haven’t experienced the aura for many years now, and you feel almost nostalgic for its flag-waving here-I-am bravado. Now an attack begins with a quietly persistent tiredness, an ache that may begin in your right eye, or ear, or temple, expanding slowly slowly slowly to fill the right side of your face, your jaw, your cheekbone, your neck, by which time you know what it is but it’s almost too late to take the medication. Almost, but not quite. Now you have medication that works, quickly if you have an empty stomach, much slower if you’ve eaten, the stomach gradually ceasing to function. This is why migraine often comes with nausea, sometimes vomiting. There are also other symptoms, such as intolerance of sensory stimulus, confusion, hallucinations, sweating, stomach pain.
Occasionally you don’t take the medication in time. Or you take the medication and continue to drink red wine, so what comes next is entirely your responsibility. You go to bed, curtains closed, press the right side of your head to the pillow. The pain escalates until you find yourself rocking to comfort yourself, and when you stop you feel a moment of deep tranquility in the stillness, until the pain pushes you to begin rocking again.
At the highest, most relentless period of pain, you always ask yourself if you’ve got it wrong this time, if you really should be going to A&E because this time, this is surely a brain haemorrhage and you are dying.
If you are lucky, the fog of fatigue and temporal distortion will lead you to sleep, drooling onto your pillow with abandon.
Didion makes note of the hereditary nature of the illness, hers acquired from both grandmothers and both parents. She also has ‘bad attitudes, unpleasant tempers and wrongthink’, all of which she considers to be potential triggers.
Your own familial link is tenuous in comparison, your grandmother the guilty party, whose triggers were cheese and chocolate. Your own are stress, fatigue, an array of alcohols and once, the smell of White Musk Cleanser. And of course there’s always your rigidly organised and perfectionist personality traits. Did they begin when you were in nappies, you wonder? If you’d allowed the tower of bricks to tumble across the carpet in any haphazard fashion, would you have grown a more relaxed brain? And would that have changed the course of your body chemistry, your mechanics, your spirit, your thoughts, your intelligence, your life?
Once upon a time you thought you were in control of all these things, but now you know this is a classic case of wrongthink. The only thing you truly have control over is your perception of the truth.
And the truth is that there’s something startlingly beautiful about the migraine.
Didion elegantly describes its aftermath as ‘a pleasant convalescent euphoria’.
I open the windows and feel the air, eat gratefully, sleep well. I notice the particular nature of a flower in a glass on the stair landing. I count my blessings.
In the aftermath, you too feel a powerful sense that your body has pressed the reset button and you can see the world for what it truly is; a vivid, gentle and generous place. You eat with a sense of grace. You are filled with wonder when you go outside. You feel generosity and love for everyone you see, strangers and friends alike.
You feel blessed.
You imagine now how it would be for every person to feel this way. If time could be paused for communities to rock together in a vascular hiatus. The universal button would be reset, sensory feeling would be washed clean, and the perceived goodness of this world and everything in it would shift on its axis.
And after, when the pain has subsided and we return to our bodies and our lives, we’d emerge into this vivid, gentle and generous world as new beings.
We will be reborn.
You think of this and you know that even in the midst of pain the good will always be there, waiting for us.