Nietzsche and Kanye Don’t Know Shit About My Migraine Pain

“Migraine is deceptive pain. It lies when it begins, and it lies about what it signifies. It signifies nothing.”

N-now th-that that don’t kill me 
Can only make me stronger 
I need you to hurry up now 
’Cause I can’t wait much longer 
Kanye West, “Stronger”

For several mornings, I used stealth to approach the entrance to my kitchen. I wanted to catch sight of the mouse who came out at night so I might see where she was scurrying into the wall when I turned on the light. I had seen her a few times, a furry black blur that shot across the tile floor. But despite a search, I found no signs of mouse droppings or evidence that a mouse had been chewing at the edges of boxes of pasta or packets of crackers.

I lose faith in the sensory information being fed to me by my eyes; I watch as flower-explosions of light pop across my field of vision, drifting like dandelion fluff. I struggle to hold together the breaking up of the atmosphere into infinite pixels. I need the picture to remain complete.

When I was a kid, I used to think that I could see molecules because, when I lay on my back in the grass and looked up toward the sky, it appeared to me that the light had broken into millions of tiny pieces floating in the air. But I never told anyone that my eyes did not see solid color, just as I had learned not to tell people that root beer tasted pink.

My childhood synesthesia has disappeared from daily life, except when I have migraines. My ability to smell the pain of an approaching migraine, or see outlines of objects in my visual field now, is read by my body as a change in my horizon. It reacts with nausea, as if the natural reaction to body parts conveying the wrong information to my brain is to feel sick, off-balance.

These symptoms, known as prodrome, also include a constant struggle to filter input from my left eye. The eyeball hurts, and it feels as if it is wrapped in crinkly, hard plastic that blocks what I see. I feel myself trying to favor information coming from my right.

*

After Joan Didion wrote the essay about her migraines, “In Bed,” in 1968, few writers have ventured into the same territory. Thirty-seven million Americans suffer from migraines, and of those, two to three million are estimated to share with me the condition of “chronic migraine,” having more than fifteen migraines per month.

Seventy-five percent of migraineurs are women, although, because the mechanism that causes migraine is not understood, the reason that migraine affects more women than men does not have a simple causal explanation in female hormones. While hormones may play a role, so too may a host of other triggers—foodstuffs, bright light, certain smells—that are not sex-specific.

Megrim came into English parlance in the late sixteenth century, but the existence of what we now call migraines exists in medical literature going back to the fourth century BCE, when Hippocrates described “violent pain” and “vomiting” that followed when a patient reported, “he seemed to see something shining before him like a light, usually in part of the right eye.” Celsus, who wrote in the first century of the common era, reported that the pain seemed to correspond with “drinking wine, or crudity, or cold, or heat of a fire, or the sun,” a list of migraine “triggers” that migraine patients are today asked by their neurologists to track. But triggers vary from person to person. Some people have told me that caffeine is a definite trigger for my migraines, although drinking a strong cup of coffee during an attack offers me some relief. And over-the-counter migraine pills contain caffeine.

Aretaeus, who was born sometime around 81 CE, writes of headaches that I recognize as my own. He distinguished between cephalagia, which is a headache that lasts a few days, and cephalea, headaches that last days or weeks without remission. When I still lived up north, I had frequent contact with a man who worked at the local wineries. Each time we saw each other, we would ask about the other’s migraine, both of us talking about the phenomenon of headaches that we woke up with and went to bed with, day after day. Both of us could attest to unbroken headaches that lasted for months and how it had become necessary to continue working with pain that other people took sick days for. “There aren’t enough sick days in a lifetime,” he said to me one day, after telling me he was on day ninety-one of his current headache. “Can you imagine going to bed for this?”

*

Migraine breaks thought into the shards of light at the end of a kaleidoscope. If the prodrome for my headaches produces a range of colors and lights, smells, sometimes even thinking that I am in the presence of an animal that isn’t there, then it confronts me with an epistemological problem.

As a feminist, and for most of my adult life, I have tried to close the gap between mind and body, to reject religious theology and other philosophical arguments that emphasize the superiority of the mind over the body. In these formulations, the human form itself becomes gendered, so that the mind, the spirit, is the exalted part of each of us. The spirit is the part capable of higher thought, perceiving God; the body is the vessel that performs tasks to keep the spirit capable of functioning at its highest level. Thus the body must deal with the quotidian indignities of life, the sleeping, eating, shitting, and expulsion of fluids. Even reproduction is seen as part of this earthly insult to the mind’s desire for purity.

Many who have wanted to pursue some magical life of the “mind” have denigrated the body to the point that they not only reject sex, but they reject all possible pleasures of the flesh and subsist on a bare minimum of nutrition to sustain life. In its most extreme form, those seeking mystical communion have bricked themselves up behind walls, becoming anchorites, or they have taken themselves to the desert wilderness to become hermits.

Again and again in these formulations, woman is the creature of the body, the lesser of the two sexes because of her connection to its physical state. French feminists, especially Julia Kristeva, showed us the “abject” female body. Apertures that allowed the body to be penetrated, and the fluid that oozed, frightened men who perceived of their own bodies as closed, impenetrable systems, whose only desire for penetration was through spiritual union with their god. What to make then of the open-closed-open state of the female form?

I see no rift between body and mind, seeing it as a whole system that is not divided. Doing so has allowed me to accept that the depressive episodes that I first began experiencing as a little girl were not so much “mental illness” but a breakdown of the whole system. We think of depression as a mood disorder, but many of its effects are physical. The feeling of heaviness in my limbs, the unwillingness to work when the work before me is something I love, the inability to organize my thoughts so that I can organize a series of disparate objects into a rational whole, the changes in sleep and appetite—all these symptoms reflect a malaise of the whole. And physical illness brings with it emotional lability and weariness of thought, the whole instrument of my body under attack by a virus or bacterium when I am sick.

The prodrome of migraine disrupts the relationship between mind and body. It manufactures sensory data that is taken in by eyes or ear or nose, which my body sends back to my brain for interpretation. But the false data produced by my brain re-cleaves me. It forces me to question what I see. In order to function, I must disregard the information it supplies. I cannot rely on my eyes to see what is before me. I cannot waste my time trying to track down odors only to discover that the ammonia I smell is coffee brewing, or that there isn’t a hedge of honeysuckle at bloom in my bedroom. After years of re-teaching myself to trust my female body, I must disregard its signals.

*

The only story that I can find in religious mythology about headache comes to us from the Greeks.

Hesiod tells us that Metis was a Titan. Zeus would not leave Metis alone. She shape-shifted in her attempts to avoid his touch. But, the stories tell us, Zeus raped women who said “no” to him, regardless of their attempts to get away. Despite Metis’ attempts to escape from him, she became his first wife, and after they had sex, she became pregnant. She possessed the knowledge that the child she carried would be stronger than his father, but Zeus became aware of her secret. She turned herself into a fly so that she might escape, but Zeus devoured her, thus eating his supposed love and the child she carried.

Inside of Zeus, Metis armed the child—who turned out to be a daughter—with a suit of armor and an aegis. When the screaming pain of his headache felt to Zeus as if it might destroy him, Hephaestus struck him with an axe and split his skull in two.

Thus was born Athena. She arrived into the world as a full-grown adult, the goddess of wisdom. From her mother Metis, who was also a goddess of wisdom, cunning, planning, and good counsel, she received the brain that would make her the wisest of the dwellers of Olympus.

The headache, we are to understand, were labor pains. Zeus birthed Athena in pain, but her birth imbued the headache with meaning and justification. Perhaps this is the beginning of the idea that “that which does not kill me makes me stronger”, written by Nietzsche in Twilight of the Idols, and popularized by Kanye West. But the valorization of suffering as the path to improvement is to slap a moral value onto a physical process. It isn’t much of a leap to start making moral judgments about other physical processes, and that hasn’t worked out well for women over the last several millennia.

A slogan on Nike shirts declares that “pain is fear leaving the body,” which makes me uncomfortable with its evocation of Fascist ideology which emphasized that creating the soldier’s body required pushing through weakness. His (and it was always “his”) soldier’s body needed to exceed physical limits—including pain—so that it could become whole, unlike undesirables—women, Communists, Jews—who were fragmented and weak.^[1]

*

Nietzsche, Kanye, and Nike don’t know shit about the pain of a cluster headache. Cluster headaches are nicknamed “suicide headaches” because of the body’s inclination toward self-annihilation while in the midst of one. They are similar to migraines with the added bonus of facial symptoms that include, for me, a numb nose that drips with snot, a teary eye that sometimes swells half-shut, and a desire to punch myself in the face. It turns out that the desire for intense counter-pressure against the pain is one of the hallmark symptoms. Counter-pressure provides some relief, as I discovered one night while I tried to drive my head into a wall to push back against the hurt.

Staying up all night with a cluster headache that won’t break, or struggling to concentrate on work while my eyeball throbs, causes me to question my strength, and making my own moral demands of the body. Perhaps, I think, I’m not really in pain, but this is some plot by my inner sloth to quit working, to stop interacting with a world. I question my moral being, as if on the days when I’m overwhelmed by pain, I have really admitted that I’m not a good person. I worry that depression has found a new way to incapacitate me, although the passage of time has shown me that even after I have left depression behind, through a combination of drugs and talk therapy, the headaches have stayed.

Our desire to make meaning out of pain doesn’t ameliorate the pain. When people claim a high pain threshold, like it’s some kind of Boy Scout merit badge. I have learned not to respond with all my past experiences where doctors commented on my ability to handle pain. We want to treat it like a contest, but that kind of thinking is, I think, part of why women can’t get doctors to take their pain seriously. The same issue affects people of color when doctors deny them powerful pain medication. If a white adult male claims to be in pain, doctors assume that he’s suffering “real” pain. The rest of us are weak and, therefore, undeserving.

Perhaps we’re still stuck in the same mental universe as when people could prove their innocence in court by withstanding a physical ordeal. If it were possible to win a court case by immersing your hand into a pot of boiling water, what have I won for myself in twelve years of near-continuous headaches? And the idea that pain happens for a reason—be it karma or because I’m being tested by the divine—is the perpetuation of the cruelest of hoaxes, another example of layering wishful thinking onto a biological process.

*

When I purchased Joan Didion’s The White Album many years ago, I remember the impact that “In Bed” had on me. I remember thinking that migraines sounded horrendous, and I hoped that I would never have to experience a pain like that. The worst headache I had at that point was after a night of heavy drinking in college, a self-inflicted wound I was determined never to repeat. But reading the essay now is to see all of the ways that she blames herself for her own pain. Didion writes, “That in fact I spent one or two days a week almost unconscious with pain seemed a shameful secret, evidence not merely of some chemical inferiority but of all of my bad attitudes, unpleasant tempers, wrongthink.”

She misses the connection between the everyday sexism she encountered as a writer and journalist, and how she has internalized that misogyny to explain her violent headaches. As I read through the essay, I wanted to assure her that her pain is real and it is her doctors who have covered their inability to cure her pain with explanations invoking anxious “migraine personalities,” described by Didion as “ambitious, inward, intolerant of error, rather rigidly organized, perfectionist.”

Even in her description of the after-effects of a migraine, that time when the agony has gone and the simple euphoria of not being in pain has replaced it, Didion insists that the migraine has some meaning. “Right there is the usefulness of migraine,” she writes. “ . . . there in that imposed yoga, the concentration on the pain. For when the pain recedes, ten or twelve hours later, everything goes with it, all the hidden resentments, all the vain anxieties. The migraine has acted as a circuit breaker, and the fuses have emerged intact.”

I read Didion’s essay now and I feel sad. Migraines are presented to her as the natural brakes that keep her from exceeding her role as a woman. The pain keeps her from working for one or two days a week, and that is apparently a good thing. The message is that when Didion is thinking too much, migraine is there to slap her down and keep her in her place. She accepts it as the price she pays for pursuing the life of the mind.

Migraine is appetite that feels like need but not want, a pain that serves no purpose—no warning that a ligament or tendon has stretched beyond its tension point, no ache in a pelvis that signals the inflammation of an appendix or the twist of a bowel. It does not signify stroke or cancer. It is just pain that feels like irritation, like anger, like cicadas filling my orbital socket and spilling out across my temple into my hairline. I pull my hair to create counter-pressure, press the boney ends of my fingers against the architecture of my face, seeking the hidden spring that would open the door to relief.

Migraine is deceptive pain. It lies when it begins, and it lies about what it signifies. It signifies nothing. It does not bring me wisdom. But its effect is to separate me from wholeness, to make me distrust myself. I could attempt to assert my will over the pain, insist that my weak body and its flawed sensory data be disciplined to obey. But that counter-pressure would be as ineffective as pulling my hair, and even imagining it provokes the echo of jackboots in my head. And so, rather than grasping hold of a false narrative that my suffering has been imposed in order that I might torment myself in search of that moral understanding, I have found peace in accepting that physical pain is proof of life. It’s not the boulder I would have chosen to push up the hill, but, like Sisyphus, I can still find joy in the struggle. Pain defies narrative. It also defies meaning. But I doubt that I can convince Nike to put that on a t-shirt.