Memoir — From the May 2013 issue

An Uncommon Pain

Living with the mystery of headache

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“I’m very brave generally,” he went on in a low voice: “only today I happen to have a headache.”

 — Tweedledum

My headache began on a Monday afternoon around three o’clock. The pain centered on my left temple and eye, constant, gnawing, broken only by sudden waves of sharper pain. My doctor was on vacation, but after several days I decided I couldn’t wait and took the next available appointment. By the time I made it to her office I could hardly walk across the room in a straight line.

The physician’s assistant was attentive, working down the neurological checklist: reflexes, balance, gait, grip strength, and cranial-nerve function, which affects swallowing, eye movement, sensation, facial expression, and more. Everything was normal, except for the pain. Finally, with a grunt of satisfaction, she decided that I must be dehydrated. I knew that I was dehydrated because I couldn’t eat, and that I couldn’t eat because I had a headache that would not stop. By then the headache had so eroded my ability to think that I didn’t even comment; I just waited in a darkened room while she wrote a prescription for Vicodin.

When my doctor returned a week later, she was also attentive, and took her time: reflexes, balance, gait, grip strength, cranial-nerve function. The Vicodin had given me no relief. I was tremulous, ill defined. The feeling was hard to describe; my words failed, trailing off.

“I’m sure it’s not migraine,” she told me. Migraines rarely last more than a few days. “But I’m not sure what it is.” Although severe headaches are only rarely a sign of something dire, like a ruptured aneurysm or a brain tumor, she recommended an MRI to be sure.

“There is a medication that sometimes works for headaches like these,” she said, and suggested I try indomethacin, an anti-inflammatory drug in the same class as ibuprofen. Usually reserved for arthritis, it’s a nasty medication, known for causing stomach ulcers and gastrointestinal bleeding, cardiac arrhythmia and heart failure. I started taking twenty-five milligrams twice a day — started as soon as the pharmacist handed me the bottle — along with a daily dose of omeprazole, an acid-reducing drug, to protect my gut. The pain retreated but didn’t disappear. I complained in private but mostly I kept my headache to myself, shivering my way through conversations. I had work and a class to teach and my son was getting married in a month.

Headaches are nothing special. They grant one only brief and local respite. That this one endured, that it buffeted my every step, was hard to explain. I wasn’t sure anyone would believe me; after all, I hadn’t really believed in such a thing, either. Another person’s pain, writes Elaine Scarry, is “vaguely alarming yet unreal,” and the inability to truly sympathize with another’s suffering is a sign of “pain’s triumph.” She adds, “Whatever pain achieves, it achieves in part through its unsharability.”

The MRI rooms were spacious and cool. I exchanged my shirt for a cotton gown that smelled of sunshine. A young woman called my name, introduced me to a bearded man seated in front of a set of screens, and led me to the machine. She deftly inserted an IV needle into my arm and slid me in. Many people feel claustrophobic in the sleek white tube of the MRI machine; I was relieved simply to lie down and be left alone for a while. The rhythmic clangs, knocks, and thuds of the magnets were not unlike the ambient music I enjoy; the clatter was soothing, and I dozed.

After a time, the frame slid out and she injected the contrast.

“If there is any pathology, this will light it up,” she said, and slid me back inside.

My doctor called a few days later. The MRI was clean. No tumor, no bleeding, no stroke. Over the next few weeks, I saw a dentist, a chiropractor, a massage therapist, and a nutritionist. No one had an answer. I got confused if I tried to do more than one thing at a time, even when the pain had receded. I would sometimes find myself hunched in a chair, covering my left eye with my hand, doing nothing. I began to feel like an invalid. I was not “having headaches.” I had a headache, one single unrelenting headache, drowning everything else out.

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’s last article for Harper’s Magazine, “The One in Front of You,” appeared in the July 2012 issue.

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