There’s no attempt at narrative here, and I’m not making any sort of point. I’ve had a busy week, without much time to write, so I’ll just describe a typical migraine. They’re different every time, but this will give you a good idea about what they’re like for me.
I could be doing anything, and it could be at any time, but I’m usually reading, and it’s usually in the evening. And I’ll be reading and then I’ll realize in this slow, sub-conscious way that I can’t read what I’m reading. I go back to the beginning of the line, assuming at first that I was tired and just sort of spaced out. And then I realize, as I can feel my heart rate go up pretty quickly and my palms being to sweat, that, no, I didn’t get confused or anything. The entire central part of the page has been replaced by a blurry, gray, zig-zaggy mess. This is the beginning of the aura, the first phase of a migraine. It is the chaotic parade of symptoms which precede the pain.
If I have the opportunity to do so, I rush to the kitchen and make myself a double shot of espresso and swallow two extra-strength Tylenol. I can’t take ibuprofen. These things help tremendously, dulling the edge of the pain that will come in about an hour. If this migraine arrived during the day, these medicines mean I can maybe salvage part of the evening. At night, it means I might be able to get some sleep. If, for whatever reason, I can’t get a hold of caffeine and acetaminophen, the following 8 to 12 hours are completely written off. I am debilitated.
So then I kind of wait around as this blind spot in my vision, which is really scary, really, sort of waves around in a very hallucinatory way. The blind spot contains shapes, sharp and colorful like a kaleidoscope. Then my pinkies go numb, and that entire side of my forearm goes numb. Sometimes my tongue and mouth lose feeling as well. I can feel the sensation’s movement, as that tingly feeling you get after sitting on your foot, drift over the course of minutes. I know that once the sensory buzz, a static, reaches my chest, it will go away. This phase only lasts about fifteen minutes.
Then I start forgetting words. I find that I can’t speak or write without tremendous effort. It makes me aware of the magic with which I normally draw words from the mine of my memory. Whatever motion I normally make, that reach for vocabulary, falters. It returns either nothing, or incorrect information. This is called aphasia, and it’s the strangest symptom. Your highest level of consciousness could be considered to be your continuous inner-monologue. Crippling it, as a migraine does, seriously effects your self-perception, and excises a big chunk of your ego. It leaves an animal fear in the place of coherent thought. I have no mouth, and I must scream.
A shopping list I attempted to write once, defiantly, stated in part: “Hask pound milk. Hentils.”
And then, like maybe forty five minutes to an hour after I get the first symptoms, the pain starts.
The worst I ever got it was in LA last Summer, and I didn’t have any caffeine or Tylenol on hand. I was, without any warning or trigger, visited by a violent and colorful visual aura so clear that I wondered briefly if my roommates had dosed me with some hallucinogen. A few seconds later, thunder sounded, cliché and ominous.
And I went to bed but I didn’t sleep.
Feel your right cheekbone. Feel under it, through your cheek, the way it contains a concavity on its underside, above your jaw and below your eye. Place an index finger there, pointing upwards, towards the top-center of your scalp, about two inches behind your hairline. Visualize a line running from the tip of your finger to that point on your scalp. You can take your hand away now, but keep imagining that line. It’s made of nylon, I think, like a fishing line, and it’s quite tight. It goes directly behind your right eye, you can practically see it, it’s right there piercing the back of your eyeball and making you go blind. And it’s really tight and it just gets tighter and tighter. Someone reaches into your eye socket and hooks a hateful knuckle around that thing and just pulls it and pulls. It feels like your skull will crack and collapse into itself. It is a line of fire, pounding with each heartbeat, bleeding into the rest of your head and body.
That lasts for a few hours. During this time you are neither awake nor asleep, but in a mid-consciousness where the only real thing is pain, that dissonant cord piercing the world.
Meanwhile, everything, everything, everything wants to make you throw up. The pain itself, sure, but light, noise, smells, friends, beds, everything. And they usually succeed.
In maybe six hours, the pain and nausea have subsided enough that you can begin to catch up on all the work you missed on your sick day. You’ll still have a throbbing headache for the next two days, where if you sneeze or cough, you feel a bit like collapsing, but it’s a manageable thing. You made it.